Beruflich Dokumente
Kultur Dokumente
tonight. Even with my limited exposure, I could realize that the theme was repeat
customers. I recognized many of the patients from my early rotations – many coming
back for the same issues. Exacerbations of heart failure, hypertension, and diabetes in
conjunction with noncompliance with medications, and dietary indiscretions (one patient
with severe shortness of breath due to heart failure tried to tell us that hot dogs do not
have that much salt in them, only the condiments do!) caused a long backlog in the ER
waiting for admission. This caused the fast track people to have longer than normal wait
times, which in turn made them mad and rowdy. I can see that waiting a few hours to
have a UTI assessed or a child’s cough would be aggravating. The cynical answer is that
the UTI or cough did not start at 2 AM, nor is either a true emergency. Both patients
waited hoping that the waiting time would be lower, and neither one could miss work the
following day. Neither had insurance or a PCP, but both had symptoms for at least 3 days
and hoped they would resolve. The UTI needed an antibiotic prescription and the cough
was a cold that was improving already. Each case took under 10 minutes for discharge.
What a waste.
Summer brings out the emotional in people and enhances their need for
polysubstance abuses. There are between 4 to 6 people in the ER waiting for in patient
placement into psych centers voluntarily and 4 people that are involuntary or 1013. They
have been in the ER 2-5 days waiting. Although they are obviously being medicated and
cared for by the nursing staff, they are not receiving the full treatment that they need.
They act up in frustration and due to exacerbated baseline psych issues. There is a lack of
beds available state wide, per the intake coordinator. According to her, psych admissions
are not easily reimbursable or socially acceptable on this level (no fancy hotels – just a
step up from jail) so financial aid needs to be carefully vetted. Interesting, repeat patients
are not usually re – admitted to the inpatient programs unless they are a documented
harm to themselves or others, not for substance withdrawal. Alcohol and narcotic
pamphlet to small huddles of the healthcare team. Tonight, I want to present it informally
to the medics to hear their assessment and critique, thus allowing me to readdress any
issues they have problems with. I am surprised with how nervous I am when I know my
audience and material very well! They all had positive feedback, endorsed that there were
no changes to be made, and that I taught them something about public health services
regarding the pamphlet I produced that would provide easily accessible information on
the services available to those Henry County citizens in need. They were impressed that:
5. Wanted to educate them in a way that was the least disruptive to patient care.
In hindsight, I wished I had gotten to see the available resources first hand and spoken to
the people who work there as to the issues they see and what their perception was that
limits accessibility, if there were any prejudices, or factors that prevent people from
seeking them out. I can imagine that this aspect of public health is both rewarding and
Overall, the people were wonderful – my preceptor Dr. Susan Dupree, the medics,
nurses, physicians, housekeepers, radiology staff and the associated patients that passed
thru the automatic doors for the 448 hours I have works thus far, soon to be 478 after next