Frequent Flyers

I've seen quite a few patients this week that I had seen already at some point in the previous 6 weeks, leading me to realize that quite a few of the individuals are here on and off, sometimes for years! This can be somewhat frustrating for two reasons, 1. if the patient is noncompliant and that is the main reason they are returning, or 2. in assessing the pt or ordering a diet or nutrition support, something from the patient's previous visit was ignored by the MD/RN/RD, so then you have to go back and fix it- doing work you've already done before.
I saw two patients today who have each had >5 admits in 2009. The older lady has had DM ed 4 times this year, but it was still ordered by the MD and since it was ordered, I had to do it. The older gentleman was in the hospital in March with diabetic gastroparesis resulting in a PEG for drainage, and in his new admit H&P there was no mention of diabetes. So, he was receiving a regular diet and regular Ensure supplements with his BG consistently >240.
I had thought that I was being kind of lazy when I was looking up the previous charts and documentation about the patients in our computer system to see if I was assessing the individual appropriately or if there were any major changes, but now I've decided that it's more like double checking than anything else.
OH and I have to share this disgusting and ridiculous and slightly terrifying story! The other intern at GMH was working with this patient who had a planned C-section & hysterectomy last week and had a sepsis-like reaction following the operation, causing her to be put on TPN. This weekend they did an exploratory lap to see if they had perforated her bowels to cause this problem. They didn't find a perf. They found a surgical towel that had been left inside her abdomen...