Fun With Suits! · Pains in my Fifth Point of Contact · Sometimes You Get to Think That You Have Accomplished Something!

Hospice Nurse Midnight Shift Call Off

A long, long time ago, in a galaxy not so far from here….

No, wait, that is not quite right. Well, anyway, after I had departed Da City’s EMS, and started working as an RN, my father took ill. Years previously, he and my mother had moved back to The Megalopolis, and resided in The Maternal State, nearly half way across the country from me. My brother the contractor did not seem well suited to the demands of helping care for a sick elderly man, so I volunteered.

As it happened, while I was helping Mom take care of my Dad, I was working 12 hour night shifts in various EDs around The Maternal State, receiving my assignments from this or that temporary staffing agency. The money was OK, and I was able to keep up with my house payment, my car payments, and all that stuff.

Things progressed. My father was dying, and there was no stopping it. I was glad that I could take some of the burden off of my mother, who was nearly overwhelmed in any event by the looming demise of her husband of decades. You do that which you can do, correct? Around this point in the process, my father had been admitted to hospice, and his care needs had escalated to the point where Hospice supplied a nurse to care for my dad around the clock.

So one morning around 0900, I arrived home from work, and went to bed. I was awakened for a phone call around 11 am, to find that the agency was informing me that my shift that night had been canceled. I mumbled affirmation, and stumbled back to bed.

Around 1400, I was again awakened to learn from the Hospice case manager that they were unable to find a nurse to care for my dad overnight that night. “I don’t know what we are going to do!” she apologized.

I wasn’t all that wound up over it. “So, it looks as if you have a nurse, then.”

No, I don’t. I have called, and called, and I cannot find a nurse to care for your father tonight!”

Yeah, you did. Me.”

You cannot care for your father overnight!”

How come? You need a nurse. I’m a nurse. You need somebody who will be reliable. I flatter myself, that I am reliable. You need somebody here. I’m gonna be here, nurse or no nurse. Looks like I know what I’m gonna be doing, instead of watching late night TV!”

Are you going to be able to do this? Can you handle that responsibility?”

Do you have a better idea?”

She admitted that no, she did not.

Well, then, it certainly looks as if I have to do it, and have no alternative to handling it, doesn’t it?”

We agreed, and I returned to bed.

This time, around 1500, I was awakened for another phone call (this appeared to be developing into A Thing!, and I was not liking it!). My agency was calling, and the staffing coordinator perkily informed me that she had found me an assignment for that very night! “Gosh, thanks, but, after you called me to cancel me, I made other plans.”

She was aghast. “What? Are you refusing an assignment?”

Nope. I had an assignment as of 0730 this morning, when I left duty. I was sleeping, in preparation for reporting for that assignment, when you called me, to cancel it. Once you had canceled me, I had no obligations to anyone, and I have made other arrangements since then. Now, you are calling me and asking, at the eleventh hour, may I remind you, if I can take a last minute assignment. No, I cannot. I am busy tonight, with obligations that I cannot ignore. I’m not refusing an assignment, I am simply not able to accommodate your last minute brainstorms.”

We ended the call at that point, and I resigned myself to my (sleep deprived) fate.

Mom and I had supper, I made some calls, and wrote checks for some of my bills. Once 2300 arrived, the afternoon nurse gave me report, and oriented me to the overnight routine.

We changed my father’s bedding, and bathed him. As we turned him to his left, I held him for her part of the cleaning and linen change, and he sighed once, long and loud. I looked into his eyes, and watched them dilate. I felt for a carotid pulse, and found none. “I think he’s gone”, I told the nurse. She and I tidied up the bed, tucked him in, and she went for my mother.

The next couple of hours were not etched in my memory. Eventually, Mom and I were alone in the house. We cried, we hugged, and we went to our beds.

Monday I had an assignment. I showed up, happy, in a sort of left handed way, to be doing SOMETHING that did not involve constant reminders of my dad’s death. The charge nurse for St. Elsewhere greeted me with, “We heard about your dad. We’re sorry to hear it. How are you doing?”

I was surprised. She was a lovely soul, cute, smart, professional, and capable (all things that I admire in a woman). She was friendly, and I was very open to that. However, I hadn’t told anyone about my dad’s demise. I was touched that she would make the effort to offer consolation to me, a relative stranger. I had been hoping that I could immerse myself in ED nursing, and not think about my dad for a while.

I offered my response, thanked her for her concern, and asked what pod was mine for the night.

Fast forward a couple of weeks. I received another call from the agency, and another assignment offer. I had made plans to take my mother out for dinner, and therefore I declined the assignment. (Yeah, THIS one I straight up declined.). The coordinator took me to task. “I’m getting really tired of covering for you all the time!”

What the fuck? My query was edited before being spoken. “Huh?”

I said I’m getting tired of covering for you!”

Uh, what are you talking about? Covering for me? When?”

Remember two weeks ago? That Friday night, when you had made other plans? That’s what I’m talking about!”

I was almost speechless. Fortunately, this was a telephone conversation, not one taken across a desk. That fact alone kept me from big trouble. I put as much ice into my voice as I could, and clarified: “Oh, wait! Do you mean the night my father died? Do you mean to tell me that you are irritated that I could not work on the night my father died, in my arms, and you are really, no shit, taking me to task for not working that night? Did you really, actually, just say that to me, not two weeks after he died? It sure sounds as if you did, and I cannot think, off hand, of any other way to take that. What did your supervisor say when you told her you were inconvenienced by my not working that night? Say, how about I call her, right fucking now, and ask her? Gimme her goddamned phone number, please. I feel the need for a heartfelt chat!”

For some reason, she was, well, “reluctant” probably does not fully capture her lack of enthusiasm for me chatting with the manager of the office on a Saturday night.

I continue to be surprised. By humanity in general. And, in particular, that she was such a jackwagon, and that she did not provide me that number.

Although, not giving me the number might have been a good thing.

Advertisements
Fun With Suits! · School Fun And Games · Sometimes You Get to Think That You Have Accomplished Something!

How Adults Roll

Many years after I was FDASL© in Da City, I was a Dad. (In my opinion, my most important job). I had four children with my wife, She Who Would Become The Plaintiff. Our daughter, referred to herein as Brenda, was a lovely girl, but, unsurprisingly, was a typical pre-adolescent.

One fine day, The Wife received a phone call from the school, relating that Brenda was failing Science class. We interviewed Brenda, attempting to understand what might be preventing this child from comprehending the material in her class that, to be honest, was not all that complicated. I mean, it was fifth grade science, in a podunk little school district.

We learned, after The Wife had detail-searched Brenda’s book-bag, that she, Brenda, had not been turning in her homework assignments. Oh, Hell Naw! That simply would not do! The Wife and I decided that, since I worked midnights, I would be the nominated for the role of Science Class Homework Monitor.

I phoned the school and learned that Mrs. Science Class was in her classroom yet, and would be happy to discuss Brenda’s failing with me. Off Brenda and I went.

I asked Mrs. Science Class if our appraisal was on target.

“Well, yes. Brenda has not been handing in her homework assignments.”

“Do you have these assignments? I mean, in a form that I, her father, could use to have Brenda perform this homework?”

“Well, yes I do. You do realize, Brenda is not going to receive credit for this work, do you not?”

“Yep. I don’t care about credit. Brenda, here, is going to perform these assignments, and I will check them for accuracy, and completeness. Then, I will check her spelling and grammar.”

Mrs. Science Class informed me, gently, “I do not check spelling, or grammar.”

I smiled. “How interesting. I do. Once I have corrected those items, Brenda, here, will do the assignment over again, until she gets all that correct. Then I will grade for neatness.”

Mrs. Science again offered, “I do not grade on neatness.”

Again, I replied. “How nice. I, however, do, and Brenda will repeat the assignment until she meets my standards of neatness. Then, she will do the next assignment, meeting all those standards, until she had completed every one, in it’s entirety, to my thorough satisfaction. Then she will deliver them to you for final grading.”

Mrs. Science Class looked at me, her head sort of half-cocked to one side, as if she were a beagle watching me cook something in the kitchen, and she repeated herself. “You know, Mr. Stretcher Ape, Brenda is not going to receive credit for all this work, don’t you?”

“Yep, you told me that, and I really do not care.”

“You do not care?”

“Nope. So, Mrs. Science Class, do you assign homework simply for your own entertainment?”

“Oh, no!”

“You have a plan of instruction, and homework is a part of that plan? Homework is part of the process by which children acquire an education, correct?”

She nodded. “Correct.”

I leaned forward, intensity in my speech. “Mrs. Science class, my daughter may or may not get the credit: I really do not care. What I care very much about, and what her mother agrees with me completely on, is the fact that our child is going to get the education. Full stop.”

She leaned back. “You know, I do not have this sort of conversation with parents, very often at all!”

I showed her my wolf grin. “That, Mrs. Science Class, is not Brenda’s problem. If she ever, again, so long as she breathes, fails to turn in her homework, in full, on time, and satisfactorily neat and legible, then every single assignment that she may have, I will correct. For completeness. For accuracy. For correctness. For neatness. For spelling. For grammar and syntax. And, she will do those assignments that I find unsatisfactory, over, and over, and over again, until I am satisfied with them.

Or, she could simply turn in her work, to you, on time and complete, to be graded as you see fit.

You see, I am willing to be Brenda’s problem, for so long as she desires it. She will let me know she desires it, by not doing her damned work.”

For those of you who care, my daughter finished high school, and then worked her way through her baccalaureate degree, working full time, with a child, as a single mother. And worked her way through her MBA degree, working full time, with three children, as a single mother. I take some, small pride in her accomplishments.

But, SHE did all the work. In full. On time. And completely. Because she is an Adult Woman.

Fun With Suits! · Life in Da City! · Pre Planning Your Scene

Alimony

Some back story. When TDWM1 (The Darling Wife Mark 1) and I had met up, she was a single mother of two children, working full time and going to nursing school. And, yes, she was successfully pulling that off. Once it was plain that our relationship was going places, well, I invited her to give up her apartment, move in with me, and let me support everybody. I made as much money in one OT shift, as she made as a nursing aid over an entire week. Or two. I told her, “You can always make a buck. You will not get a second chance to make that grade.”

She accepted my offer, completed Nursing school, got licensed, and we lived happily ever after. Or, at least, several years, happily (or so I thought).

So, fast forward to The Divorce. Let me admit, early in my tale, that she could have been way, way WAY more wretched than she elected to be. For example, had she alleged (falsely, but nonetheless she could have alleged…) that I had threatened her, well, a personal protective order was routine in such events, and until I successfully proved to the judge’s satisfaction that I had NOT threatened anyone, well, all my firearms would have to find new, happy homes. That is one example of wretchedness that she passed by.

On the other hand, getting back to my story, TINS ©, TIWFDASL ©…well, OK. There I was in a courthouse conference room with The Plaintiff (en route to transitioning from TDWM1 to The Wretched EX), her attorney, my attorney and me. Her attorney had just finished describing one of their demands, that I pay The Plaintiff alimony, and I quote, “So that Ms. Stretcher Ape can complete her Bachelor Degree in Nursing, so she can support her children better.”

I looked at my attorney, and he shrugged. With that signal, I dove in.

“Uh, Ma’am? why does your client require alimony in order to complete her BSN?”

“Mr. Stretcher Ape, it seems only fair. After all, she worked to put you through PA school, didn’t she?”

I contemplated this gambit. “You know, you have a point. I think we all agree that we all want fairness. You *do* realize that, while she was earning her associate nursing degree, I paid all of the household expenses for her, the children, and myself, right?”

Everyone at the table nodded, some more warily than others.

“So, since I contributed $1000 every month from my student loans to the family budget, while I was in graduate school, full time, isn’t it reasonable to expect your client to make a similar contribution toward her own education?”

Again nods, some wary.

“And, since I worked night shifts, 12 hours each, every night that I could, during our month long semester breaks, and every holiday shift that I could sneak in, as well isn’t it fair to expect Ms. Stretcher Ape to do likewise?”

The attorney nodded. I continued. “So, if we review my W2 forms, which I am sure our friends at the Friend of the Court have supplied you with, you can see that I contributed around $30,000 every year from my night shift earnings, as well as another $12,000 from my student loans. Isn’t it fair to expect a similar contribution from your client?”

The Plaintiff’s attorney started to bluster, but I held up a hand. “I’m not done yet. Now, you are suggesting all this effort should be directed toward earning her BSN, so that, as you term it, she could provide better for our children, right? This will add up to thousands of hours when your client could be mothering our children, and thousands of dollars in tuition, books, fees, and associated expenses, money that could be spent to the benefit of our children, right? All so that your client can earn a BSN, and earn more money, correct?”

The opposing attorney nodded. “Well, I, myself have a BSN. I am presently employed as an RN, and I can tell you, for a fact, that your client will earn twenty five cents an hour premium, as the holder of a degree in Nursing at the 4 year level! That means that, conservatively, her education investment will have paid for itself in (mumble, mumble, scribble, scribble) somewhere between ten to forty years, depending upon where she takes her classes.”

Opposing counsel leapt to her feet. “I do not believe that the earnings increase that comes with a BSN is so paltry!”

I leaned back, and smiled. “Madam, you have my pay stubs. They reflect that my employer, the largest hospital system in this part of the state, pays twenty five cents an hour. Most hospitals do not pay any sort of premium for that degree.”

Across the table, they leaned into each other, and held a hurried, whispered, conference.

I interjected. “May I make a counter offer? One that you likely will see again, like in court?”

Warily, I received nods of assent.

“Well, since I am a MAN, and a MAN wants what is best for his children I propose that, rather than spend thousands of hours in academics, hours when she could be mothering our children, and rather than spending tens of thousands of dollars, money that could be spent to the advantage of our children, that your client instead spend that time, spend that money, for the betterment of our children. And, since I am a MAN, and, being a MAN, I want to do what is best for our children, for my part, I will offer to pay her, annually, in one lump sum, in addition to whatever other money I am directed to pay, the five hundred dollars annually that she will forgo should she defer her education.”

I sat back.

THAT was the last I heard of alimony!

Fun And Games Off Duty · Fun With Suits! · Pains in my Fifth Point of Contact · Sometimes You Get to Think That You Have Accomplished Something!

Sometimes, You Just Gotta Talk So That They Can Understand You!

After I left Da City, I worked as a ED nurse. Eventually, I took a job up north, at Erewhon Memorial Hospital. (“Both Nowhere, and Backwards!”) In due course at work I met The Woman Who Would Become The Plaintiff, after she had been She Who Must Be Obeyed. (another story, for another time).

This woman, let us call her Annie (because “The Woman Who Would Become The Plaintiff” is simply too complex to type repeatedly!), and I began to see each other, dating and, eventually, moving in together. Annie had two children already, Brenda (age 3) and her older brother Adam (age 7). Unsurprisingly, they accompanied her.

Well. Love bloomed, and Annie and I got married. I worked, she went to school, the kids attended school, and all seemed well.

One night Annie and I were asleep. I awakened to hear wheezing from down the hall, in the direction of Brenda’s room. Being the inquisitive sort, I followed the sounds, arriving in Brenda’s room, where she was sitting upright in bed, wheezing and terrified. Annie had awakened when I left the bed, and soon joined us. I listened to Brenda’s lungs with my stethoscope, hearing wheezes. I noted her rate of respirations (42 breaths per minute. Yes, 30 some years later, I remember it), and her pulse rate (162. Yep, I remember.) I got dressed, and Annie stayed home to watch over Adam. Off we went to the ED where I was employed as an Emergency Department RN.

Once we entered the door, well, I was not alone in my assessment that This Was Not Good. Brenda was whisked into a bed, gowned, x rayed, breathing treatment-ed, had blood drawn, and an IV started, and generally auscultated/poked/prodded/imaged very thoroughly.

A couple of hours later, Brenda’s breathing MUCH improved, we were discharged with antibiotics and an inhaler, and instructions to return IMMEDIATELY if her breathing worsened. It did not.

So, several weeks later I received a letter from Erewhon Memorial Hospital, informing me that our insurance company had determined that this was not an emergency, and that therefore the insurance company would not be paying anything on the emergency department visit we recently had.

I called Erewhon’s billing department, and asked them what was up? They informed me that I had to speak to the insurance company, in order to determine what they were thinking.

I did so. It develops that our insurance company hires people who are, in short, stupid. I (finally) spoke to a representative who told me that the claim was not going to be paid, “because that visit was not an emergency.”

I asked her on what basis she had made that determination.

“It simply was not an emergency”.

I observed that, where I came from, answering a question seeking an explanation, was not adequately answered by repeating the previous, unsatisfactory, answer. Then, I asked her, “Ma’am? In which corner of the resuscitation room were you standing? I work there, I know everybody-EVERYBODY!- who works there, and I do not recall you standing there, taking notes on the non emergency nature of my child’s acute respiratory distress.”

“Oh, I wasn’t there!”

“Then, how did you determine that my child, in respiratory distress, was not emergent? The leading etiology of cardiac arrest in the pediatric population is respiratory distress, and my child was in respiratory distress, wheezing, tachypneic, tachycardic. Being just older than a toddler, she does not have much in the way of respiratory reserves, and that which she did have, was being expended rapidly. Please, explain that to me, and show your work!”

After a spell of stuttering, she told me that the charting did not support the insurance company’s criteria for an emergency, and I would have to have further conversations with the hospital.

I did so. I walked my happy ass into the billing department, and asked about my daughter’s bill.

The charming soul I spoke with told me that “It wasn’t an emergency, the insurance company would not pay for it, so the entire bill was my responsibility!”

I told her, “Uh, no. My child was an emergency. She was in respiratory distress, wheezing at a rate of 40 times a minute, and tachycardic at a rate of 160 a minute. The leading etiology of cardiac arrest in the pediatric population is respiratory distress, and my child was in respiratory distress, wheezing, tachypneic, tachycardic. Being just older than a toddler, she does not have much in the way of respiratory reserves, and that which she did have, was being expended rapidly. So, I will pay the co-pay, and the deductible, for which I am liable, but you can collect the rest of the bill from the insurance company, which owes you that money, not me.”

She puffed up. “Well, if you do not pay that bill, we will have to send you to collections!”

She saw all of my teeth, in the grin that was my response. “Ma’am, if you do that, you will libel me, and slander me, and impugn my character and reputation. You will get the opportunity to explain yourself, under oath, at trial, when I sue for damages occasioned by the torts I just enumerated that you will have performed.”

She puffed up, more. “You can’t sue me!”

I chuckled. “Ma’am, I can sue you for damages because you are ugly, and your ugliness causes me harm. Count on it. If you send me to collections, I will sue you, personally, and do everything I can to impoverish you. After I am done with you, I will sue your supervisor, personally, for failing to supervise you, and allowing you to perpetrate these offenses. Once I am done with her, I’ll sue HER supervisor, personally, and so on up the chain of command, until I’ve sued every son of a bitch here, and then I’ll go after the hospital as a corporation, and individual members of the board of directors, for breaching their duty to ensure that the hospital is not run in a fraudulent manner, which your plan is. Fraudulent, that is.”

She huffed, and puffed for a while, and then deliver what she evidently thought was her clincher. “You cannot sue me! You simply cannot!”

More wolf grin on my part. “Oh, really? Is that what your attorney told you?”

“I do not have an attorney!”

I smiled, a smile that in no way reached my eyes. “Really? You know, I will fix that. I’m pretty sure that, once you get served by my attorney, you will find an attorney of your own, right damned quick!”

She gaped at me for a moment. “You know, you are an asshole!”

“Yep! Sure am! For most folks I try very hard to conceal the fact that I am an asshole. For you, and everybody working at this shithole hospital, well, I will make an exception! I’ll be in touch! Have a nice day!”

So time passed, Annie and our children moved a couple of times (she is part Gypsy).

A couple of years later, around the middle of December, I received an Explanation of Benefits from the insurance company. I found this odd, since I hadn’t been insured by this company for a couple of years. It appeared that they had paid a claim for emergency services at Erewhon Memorial Hospital, the very claim that I had shown my ass to the billing department about.

It was as if it was our own little Christmas Miracle!

Fun With Suits! · Pains in my Fifth Point of Contact · School Fun And Games · Sometimes You Get to Think That You Have Accomplished Something!

Again, with not fitting the mold!

Remember my fun filled interview for Nursing school? So, nearly 30 years later I applied for PA school. Among the requirements was 500 hours of patient contact experience. So, I had worked as an RN for (shockingly enough) 30 years at that point, and had accrued, with overtime, something on the order of 63,000 hours of patient care.

So, I went to interview for the incoming class, and they asked me if I had 500 hours of patient care experience. I had included my resume detailing my schooling and work experience as part of my application, so I assumed that my work history was not a surprise.

I asked, “Do you mean, in the past 3 months? or overall?”

“How about, overall?”

“Well, something like 60,000 plus hours, I guess.”

The reply? “Well, alright then! Let’s move along!”

I succeeded, and so got to deal with the financial aid office.

I filled out the form, complete with the birthdate revealing that I had been born some 50 + years previously. I ignored the part where they sought my parent’s tax forms.

When I turned in my application, the gosling behind the counter reviewed my papers,  and looked my elderly ass right in the eye, saying, “You don’t have your father’s tax form in here!”

She sure was quick! “No, ma’am, I do not.”

She was, albeit, persistent. “You have to include your father’s tax forms.”

“Ma’am, I am not going to submit my father’s tax forms. For one thing, he has not filed in 13 years. ”

“He hasn’t filed in 13 years? He has to!”

“Ma’am, perhaps you could call him up, and let him know that. But, it’s going to be kind of a long distance call. And, when you reach him, please tell him that I love him, and miss him every day.”

Perhaps, she was not so quick. “Huh?”

“Ma’am, my father died over a dozen years ago. You will not be receiving his tax forms.”

Undeterred, she demanded, “Well, we will need your mother’s tax forms!”

I was over this. “Ma’am, you are not going to receive my mother’s tax forms, either. She is pushing 80 years old, I have lived on my own for 30 years, and the only tax forms you will receive are those belonging to my wife and me. Perhaps I should talk to your supervisor?”

After several minutes, an adult appeared. I reviewed my position. “Ma’am, this young lady insists on my providing my parents’ tax forms. That is not going to happen. I have supported my own family for nearly a dozen years. I am not about to provide my parents’ forms, nor have they supported me for longer than this nice young lady has been alive.”

The adult looked at me for a moment. “And, you are Mr. McFee, correct? And, you are the student? Not one of your children?”

“Ma’am, if you look at the applicant’s birthday on the application, you will see that it matches my apparent age.”

This soul indeed perused the applicant’s birthday, and regarded me. “Uh, sir? I think we have everything we need here. You will not be asked again to provide your mother’s tax forms. Thank you, and have a nice day!”

Fun And Games Off Duty · Fun With Suits! · Pre Planning Your Scene · School Fun And Games

Not Fitting The Mold

So, TINS. I decided after several years as a nursing assistant, that I wanted to be an RN when I grew up. By the time that things lined up, I had already started working for EMS in Da City. So, I set to knocking off the pre-requisite classes I had not already collected, and waited for my Nursing school application to be processed.

Now, at this time, there were very, very, very few men in Nursing. The school I applied to, a community college, had a decidedly  problematic academic tendency among the population from which they drew their students.  So, since I had attended Tremendous State University for a couple of years, it seemed that I was a good candidate to handle collegiate level studies. For these reasons, it developed that I was accepted to this school.

In the course of the intake, I had to interview with an admissions officer. We talked about coursework, and finances. She asked me about what financial aid I had lined up. I admitted that I had none, and planned to pay for school through Da City’s tuition reimbursement program, as well as my earnings.

She did not think much of that idea, for some reason. “Mr. McFee, we do not allow our students to work.”

I was surprised. This was, after all, nearly 1980, and I had thought that liberated women, and various movements to remove barriers had changed things. Simply to be certain that I had heard her correctly, I asked her, “Er, ma’am? you do not ‘allow’ your students to work?”

“That’s right, Mr McFee. We do not allow our students to work.”

“Uh, ma’am, you do realize that I am working full time, have a house, and am my own only source of support, right?”

“Mr. McFee, you need to plan for that. We do not allow our students to work while they are in school.”

“Uh, OK. Uh, ma’am, so, where do you live?”

“Why do you ask me that?”

“Well, I support myself and you are telling me that I cannot work. I suppose that means that I’m moving in with you.”

THAT got her attention! “Mr. McFee! You are NOT moving in with me!”

“Hmm. So, how about you document that you have told me that your experience is that students who work while in school do not perform as well as those who do not. You could note that I have acknowledged that warning, and the school’s extensive experience behind that warning. You could write down that I will elect to work while in school, and therefore, any failure on my part will be in spite of your vehement admonitions. Do you think that will work for you? It is a chance that I am willing to take.”

“Uh, Mr. McFee, please sign here, next to my notes to that effect. Thank you. Welcome to Un-Named Community College School of Nursing. You have selected a challenging course of action, both academically as well as because you have chosen to work. Good luck!”

Fun With Suits! · Pains in my Fifth Point of Contact

“But, what do I do?”

So, TINS, TIWFDASL as a nursing supervisor at The Little Un-Named Hospital In Da City (TLUNHIDC). One night, I received a call from our ICU. The nurse on the other endtold me that she had an order to transfer a patient, from our hospital to The House Of God. She asked me what I wanted her to do.

(Again), I thought, “This! This is why I get the Big Bucks!”. I told her, “In that case, I think you ought to transfer your patient to The House Of God!”

She responded, “But, I don’t know if they have a receiving physician at The House Of God.”

My rejoinder, “Well, then, call the House Of God, talk to the nurse in their ICU, and verify that there is a receiving physician.”

(Henceforth, I’ll dispense with the “He said, She said” business. From now on, any dialog beginning with “But…”, is her. Any other dialog, is me.)

“But, what if their physician hasn’t received report from our physician?”

“Note that fact in your nursing notes of that conversation, call our doctor, and invite him/her to call House Of God’s receiving physician, and remedy that oversight.”

“But, I don’t know if report has been called!”

“You might elect to look in the chart, for a note documenting that report has been called. Or, when you talk to their ICU, ASK!”

“But, what if report has not been called?”

“Well, while you have them on the phone, give them report. And chart that fact.”

“But, I don’t know what ambulance service to call, to transport that patient!”

“Ask the switchboard who is next on the rotation, and call that service.”

“But, I don’t know if the family has been notified.”

“So, the required phone number is in the chart, correct? Once all the other pieces are in place, phone the contact person, bring them up to speed, and document same in your notes.”

“But, what do I do about his property?”

“I suppose that bagging it up, and sending it with him, might be reasonable.”

“But, what about the chart? How am I going to send the chart with him?”

“Most nurses photocopy it, and send the photocopy with the patient. I recommend you do likewise.”

“But, how am I going to get it photocopied?”

“Most charge nurses, have the ward clerk servicing their floor do the photocopying.”

“But, we cannot spare her for that long!”

“You have an eight bed unit, have three vacant beds, haven’t had an admission in 6 hours. If you cannot spare her, right now would be a good time to fill your supervisor in on what catastrophe is unfolding in your unit!”

(her: “stutter…stutter…er…um…uh…”)

(Me) “I’m waiting?”

(Her) “But…But…What do you want me to do?”

“Get a pen and paper.”

(her) “What?”

“Get a pen and paper.”

(her) “Why do you want me to get a pen and paper?”

“Simply do it. Now.”

(her) “I have a pen and paper.”

“Good. Write this down. Call The House Of God, verify that our doctor has reported to their doctor.

If not, call our doctor, and invite him to do so. You give report, and chart same. Call the ambulance service that the switchboard tells you is next up on the call list. Call his family, bag his property. Have your clerk copy the chart, and send that copy with him. Have you written all that down?”

(Her) “Uh, yeah.”

“Do you understand all that?”

(Her) “Uh, yeah.”

“Ok, now Do IT!”

End of call.