The Brave New Hospitalist

If you've been following the details of my little saga closely, you might remember that immediately prior to Noo's illness I was bracing myself to leave Gimbels. Actually, Noo was hospitalized during my last week there, and the emotional upheaval of leaving Gimbels was overshadowed by the emotional turmoil of worrying about her. This was a mixed blessing at best, because now have the relief of knowing Noo is getting better, I still feel unresolved about leaving Gimbels. I suppose this is how the people who believe they were abducted by aliens feel.

In my case, the tractor beam on the spaceship plucked me up from Gimbels and dropped me into the wards at Macy's this week. Dr. Smurf was willing to take my place for the swing shifts I was scheduled for this week, and I was sorely tempted to take his offer and stay at home for a few days, but ultimately I decided to get the first day at my old nemesis out of the way. After all, I have a mortgage and student loans to pay for, not to mention Noo and the cats to consider. I would like to be a professional idealist, but it turns out I am merely a breadwinner instead.

So I showed up at Macy's, received my new name badge, dictation number and access codes and was off to the races. Macy's staffs three hospitalists during the day but we work independently, with practically no interaction, so I was at the mercy of the nursing staff to point me in the right direction when I was lost. Which floor am I on? Where is the patient? What am I doing here? What happened to my life? Where is that damn spaceship?

That was the first day. The second was much easier, now that I knew where everything was located and had moderate mastery over Macy's EMR. I have to admit, Macy's has some very rational systems in place. For example, if you order a chest x-ray on a patient in the morning, the order is entered in the EMR, processed by the radiology department, who sends a tech to bring the patient down to X-ray, brings the patient back, scans the image into the EMR, and alerts the radiologist on call, who looks at the image and has a report dictated within an hour. Compare this to the same process at poor old cash-strapped Gimbels, where radiographic images are delivered digitally but dictated onto a different system, and requisitions are processed on paper:

ME:  Did 125 get his x-ray this morning?

CHARGE RN:  Who?

ME:  The guy in 125.

CHARGE RN: Did you check the computer?

ME:  The study isn't listed on the computer, which makes me suspect that he didn't get it.

CHARGE RN (calling out to floor RN):  Laura, did 125 go to X-ray?

FLOOR RN:  X-ray?  Was he supposed to get an X-ray today?

ME:  Yup. Ordered yesterday afternoon for this morning.  Did radiology call for him?

FLOOR RN:  Not since I've been here.

CHARGE RN:  What about the end of night shift?

FLOOR RN:  The night nurse didn't mention the x-ray.

ME (wearily, to Charge RN):  Can you find out what's going on?

CHARGE RN:  I'll call down.

(Two hours later.)

ME:  What happened with that x-ray?

CHARGE RN:  Radiology never picked up the requisition yesterday.  I found it in the out basket.

ME:  O-kay.  Do they have it now?

CHARGE RN:  I ran it down to them an hour and a half ago?

ME:  So did he get the x-ray or not?

CHARGE RN:  I've called twice, they say they'll get to him when they can.

ME (with great self-control):  So that means the x-ray which I ordered for first thing this morning is going to get done this afternoon?

CHARGE RN:  It might.

I wish I were exaggerating, but the above scenario happened to me more than once during my four-plus years at Gimbels.

I've had a number of pleasant moments during these first few days at Macy's. The hospital provides a hot lunch entree in the doctor's lounge, and the medical library actually contains bookshelves with books in them (at Gimbels, the featured item in the library/lounge  was a 1984 edition of Current Surgical Diagnosis and Treatment, a real gem of a find on eBay these days). And yet my overall feeling is one of weary detachment, a determination to put my head down and just get the job done, but no excitement, no hopes and dreams for my future there.  Things may change after I've been there for a while, but if I see that spaceship again, I'm going to wave it down for a ride out of there.

Comments

[rlbates]

Take care, Theresa.

[dragonfly]

Ditto