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Specimen · fictional patients

Nine decisions on your desk. Everything else is done.

St. Adeline's Teaching Hospital · 412 bedsCompiled 06:00 · overnight shift

1,847actions taken
9escalations
212claims coded
6discharges drafted

Needs a human

9 OF 1,847
  1. 01:427B-04

    Potassium 6.1 mmol/L, rising

    Three draws trending 4.8 → 5.4 → 6.1. Nephrology paged at 01:44, repeat ECG returned at 02:10, binder therapy drafted and held for sign-off.

    Awaiting signature
  2. 02:04ED-12

    Troponin delta positive

    Second troponin up 40% on the chest-pain admission. Serial ECG ordered, cardiology notified; antiplatelet already charted by the ED team.

    Awaiting signature
  3. 02:315A-11

    New fever, post-op day 2

    38.9 °C with climbing heart rate. Cultures drawn per protocol draft; empiric antibiotics proposed — needs a prescriber's signature.

    Awaiting signature
  4. 03:05ICU-03

    Ventilator weaning window

    Overnight gases meet extubation criteria. Spontaneous-breathing trial queued for the 07:00 round with respiratory therapy copied.

    Awaiting signature
  5. 03:266C-08

    Warfarin–macrolide interaction

    New antibiotic clashes with existing warfarin. INR recheck ordered; dose-hold drafted and routed to pharmacy for confirmation.

    Awaiting signature
  6. 04:114B-02

    Urine output falling

    Below 0.5 mL/kg/hr for four consecutive hours. Fluid challenge drafted; two nephrotoxic agents flagged on the active med list.

    Awaiting signature
  7. 04:487A-06

    Goals-of-care question from family

    Night nurse logged a family request at the bedside. Palliative-care consult drafted with the relevant history attached for your review.

    Awaiting signature
  8. 05:153A-09

    Discharge blocked by pending MRI

    Radiology backlog puts the 10:00 discharge at risk. Slot swap proposed with an inpatient elective; both teams notified pending approval.

    Awaiting signature
  9. 05:52ED-04

    One isolation room, two admissions

    Cohorting options ranked by infection risk with rationale attached. Needs the bed manager's call before the 08:00 surge.

    Awaiting signature

Already done — sign at leisure

  • 6 discharge summaries drafted, evidence linked, awaiting signature
  • 214 routine orders filed and acknowledged
  • 14 overnight prescriptions interaction-checked; one substitution proposed
  • 212 claims coded and queued — zero manual entries, zero retypes
  • Today's OT list re-sequenced around a delayed implant; surgeons notified
  • Ward census reconciled; three ghost beds found and released

This report is a specimen. Yours would be computed, not written.

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