Tuesday, July 12, 2005

Come one, come all. Apparently by ambulance.

Last night, work was ugly. Not only was I tired going in, but we were slammed. Last week Austin-area hospitals ended the long-standing practice of going on diversion, which meant that when they were close to being full, ambulances were diverted to other hospitals. EMS hated it because it made for longer rides, less availability, and patient's directives on where they wanted to be treated were often overruled.

Starting last Tuesday, the hospitals agreed to accept all ambulance traffic unless they have some sort of major internal problem. Practically it means that the hospitals have to quickly treat and discharge those patients who aren't serious, and make room for those who are.

As I've noted before, many people come to the ER for fairly minor problems that should be seen by a primary-care doctor or community clinic. Unfortunately, the medical system in the US is not set up to adequately care for us all, so these people come to the emergency room.

Like many hosptials throughout the country, we have a fast track area where patients are seen quickly, often by a nurse practitioner or physician's assistant rather than a doctor, for minor problems. These are the people for whom the phrase "treat 'em and street 'em" was coined. Last night, in our crush of business, the wait for even the fast-track area was roughly five hours.

In light of the volume of patients, the medical staff were pushing hard. Not only were fast track patients were being shuttled through quickly, but the regular treatment areas were on overdrive, meaning that I and the rest of the registration staff had to step it up as well. Pair being understaffed with more ambulance-delivered patients than I've ever seen, and it made for an exhausting evening.

I could go on about an incident of childish behavior by a manager of my department, but I'll spare you the ugly, yet mundane details. Suffice to say, due to my growing annoyance at occurrences, I may be going part-time sooner than I had planned.

Mondays are always the busiest day of my week and it's likely to improve, so I will endeavor to regain my usual attitude; sunny, yet archly cynical. Maybe I should stop listening to The Sundays right now and switch to Banarama's "Cruel Summer" which is also sunny, yet archly cynical.

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