A little reflection is good for... the mirror

I'm glad there seems to be NCHD uproar at the moment. I just want to make a quick point about the future of medicine in this country. I graduated from the 1st graduate entry class: 50 students--30 from North America, 20 from Ireland, 1 from Oz.

With the exception of ONE North American, the rest have returned to the other side of the pond. Of the 20 Irish, one is permanently in Oz, one is permanently in NZ, one is permanently in Canada, one is soon to leave for the UK (and likely won't return), one was in the UK (is now back and likely to leave again), and one is recently back from NZ. The way I see it, more than two-thirds of the class is gone, more will leave when they have to do research or specialty fellowships to advance their careers (only some of whom will return as more will be poached for positions with better pay, better hours, better training, and better support).

When the consultants are the ones doing the work so NCHDs don't have to do call... where are all these consultants going to come from? Who is going to be providing all this care? Awfully ambitious to think that someone doing a fellowship where they have a work hour cap and fully functional support teams (like IV teams, phlebotomy, ANPs), and is employed to use their medical education to think and act as a doctor is going to come back and spend their Saturday putting in IVCs and recharting kardexs... How is this a good idea? How is this safer for patients? How is this going to keep the health care systems from needing doctors to work in violation of the EWTD?

Nothing like a little flood on a Friday

I'd say that most people are familiar with Murphy's Law. If you're not, I'll give you the wiki summary: Anything that can go wrong, will go wrong. As a universal law of truth and inconvenience, it's exponentially more applicable on a Friday afternoon in an Irish hospital (as you may also be aware, hospitals in Ireland function like banks--open M-F 9-5 and anything outside of that is met with out of hours limited services and staff). And in the spirit of good humour and the fact that I have to laugh or I'll cry, I'd like to recount the last few hours at work on Friday afternoon.
Having finished the post-round ward work, mostly involving poking babies for blood tests (as the phlebotomists that work in regional hospitals rarely are comfortable doing the same), I took a rare but on-time lunch break. This break resurrected a forgotten Friday tradition (Ursula, I miss you!) of getting a giant take away baguette sandwich for lunch with fellow SHOs to celebrate Friday (though, no one found the 'full fat coke' comment as amusing as Ursula). Having celebrated the last Friday together (as 2 of my co-workers are on holiday next week and the following week we will be scattering to new jobs), we trudged back up to the ward to finish all outstanding work before (hopefully) making a swift and on-time departure home.

Afternoon work is mostly cleaning up the stuff left over from the week, the stuff not addressed on the ward round, the results of the bloods from the morning, and reviewing any radiology... I was waiting patiently for one of the babies to return from ultrasound, writing up discharge summaries, signing lab reports, and searching for the name of a patient that had been in hospital months prior... These things haunt my dreams.

Fire alarm sounded... Something that happens ridiculously often, given the propensity for toast to burn at tea time, and is frequently ignored. All the fire doors shut, but the sound of the alarm is more of a warning than an alarm of immediate action and it seems that one of the other wards has set it off... Noted, ignored. The alarm stops mere moments later and we re-open all the safety doors, and get right on back to our jobs. I desperately search for the chart of a patient that has returned from ultrasound, but sans chart. There is important information I must record if I want to leave today! ... Does it feel damp in the building today? I get the relieving call from x-ray that the chart happened to be left down with them on the ground floor, so I'll just wander down there and fetch it (I have nothing better to do... she says sarcastically).

Photo not actually from hospital...

Now, I'm used to things breaking, I'm used to lights being off, I'm used to computers running amok, I'm used to things shutting down, I'm used to seeing weird things around my place of work... However, I was still (somehow) surprised to walk to the center of the paeds ward and find the ceiling tiles bulging with water and a slow but steady rain coming from above... Of note, there is a floor above us in the hospital.

Thankfully, we have a quick thinking nursing staff (yeah... this crap is their job too). The lights had been shut off, the computer had been moved to a safer location, the charts and papers had all been moved from the ward desk (above which the rainstorm seemed to be focused) to various dry higher-ground. Things seemed "under control," so I dashed past this mess to the elevators. I needed that chart!

Photo may be greatly exaggerated...
May be...

I took the larger, older elevators (they seemed to be closer to dry ground) to reach the ground floor. And the doors opened into the main ground-floor meeting area/chapel area/cross-roads... Oh the horror!

Across from the old elevators is a single new elevator that is quite small (but quite fast in comparison) with only enough space for 4 people. It's not terribly practical in a hospital, since you've no hope of fitting a wheel chair, but I like it for its size and stealth. From my little, stealthy elevator poured a flood of water. Nothing like what was seen in Hoboken (yes, that picture is from the floods that followed Sandy), but a nice, steady stream of water. And surrounding the open doors and pool of water was a perplexed looking custodial staff. Not much for me to do there, but I did tell them that the water was coming from the 6th floor, given that it was raining on the 5th.

Again, not actual footage, but the
most accurate photo yet

 

I quickly retrieved my chart from the radiology department, and took the large elevators back up to my 5th floor haven... Flooding haven. It was getting messier. I wrote my notes and fetched my coat... There was no work left for me to do, and the buckets had been placed under the bulk of the leaks, but not before an inch of water had collected on the floors. I should have worn my wellies to work. I waded through the water to take the elevators down to the ground floor... I think I was one of the last to use the elevator that day. They locked them on the ground floor afterwards to keep people from getting stuck... A hospital with only one working elevator (reserved for theatre use)... On a Friday afternoon... Three thoughts crossed my mind: 1) What are they going to do with the elderly patients up on the 6th floor? 2) Who broke the fire sprinkler that set off this floor? 3) Boy, am I glad I'm not working this weekend...