Where are we going?

It is a prevailing theme on rounds that many times we have the inability to mobilize our SICU patients and get them transferred to other places. We never get moving. Much of this is related to the fact that we are not the primary team and must consult them with management decisions and their usual course is to try to keep the patient in the SICU as long as possible. Because of this and the lack of patient mobilization, it is difficult to really know what the patient prognoses are. So I was on the phone with infectious disease trying to push the fellow to make a consult and she kept asking questions trying to find a way not to consult. Finally she asked me what the prognosis on a certain patient was. I immediately got my attending on the phone, because we just don't deal in prognoses during our rounding and discussions of the patients.