Dear Surgeon

When you come on the floor, could you actually talk? Grunting and pointing are things Bubba did when he was three years old. Besides, you're not in the OR with a mask on any more. It scares the patients. They think you never smile. (BTW I win bets when you do.)

And finally, please, please, please, do not poke around on folks who have pressure ulcers near bones.
I do not like finding out a patient is in a pool of blood when I turn him/her for the other provider to see his/her wounds because you were just poking around to see what would happen. (Just ask me--I've seen exsanguination like this before.) Dr. X  can't see anything with all the blood and I have to get our people to get your people, and then you can't take off on time to go eat your lunch on the veranda with your wife.

It is not fun to volume deplete someone here at the Hotel when getting blood products here is a major, hours long ordeal. We don't have an ICU, so if you screw up, we call 911 and pray.

Thanking you in advance (and I promise I won't trip you in the hallway),

Sincerely not,

RehabRN

Yes, it's hot

Here in RehabLand, it's getting to be just like the rest of the country: downright hot. This is not terribly unusual for us in July.

However, why on earth is the crime rate going up?

Here are a few things on the local TV crime blotter this morning:

• Man kills his friend for spilling beer in his car around midnight
• Wife kills husband in upscale gated community with a knife

This is can be great for business (people end up in rehab hospitals if they survive) but terrible for society in general.

Just one more reason I really like fall...

More later.

You the citizen, decide!

Yes, we have a show in RehabLand that has a reporter who goes out and "exposes" local government and administrative hot messes on a regular basis.

It's a good thing he doesn't visit too many hospitals, or the Hotel Rehab's parent hospital (Washington) would be on his show.

One of our patients was getting discharged, but the "approved" transportation method to get him home was denied at the last moment because Mr. X. was not eligible for that type of travel due to his insurance.

Cost to discharge Mr. X as requested:
$500.

Cost to Washington to keep Mr. X until he CAN get "approved" travel:
$2000.

Cost of "approved" travel available tomorrow:
$12 (payable by patient, not hospital).

Difference to keep patient an extra day to get his $12 travel:
Cost of $1500 to the hospital. (And extra food, laundry, and maybe an ER diversion or two...)

Cost of patient going AMA because he's so p*&sed off  over the administrative idiocy of the hospital and wants to get to his wife's birthday party:
PRICELESS

As that reporter says, "You the citizen, decide...was it worth it?"

Some hospital genius needs a good ol' dope slap...

Sometimes you're the windshield...

And sometimes, you're the bug, as the song says. Nevertheless, it's Friday and I survived.

It was a busy week punctuated by technical difficulties, rascally coworkers, and stressed out providers who bark orders at you, then apologize later (after you've got a nice case of indigestion).

That was just my side of the house in the beauty of the old, untouched, 70s era Hotel. The new, renovated part of the Hotel is shiny, and the infection control nurse is worried about me. "If you don't have a sink in there where you see patients, what are you going to do?"

Turns out I do have a sink, since I use a clinic room that has one. Problem averted. He/she makes me nervous since one of the therapists tried putting the popcorn machine used by the volunteer group in my clinic room. "No dice." I told the therapist. "We have to move it or it will be confiscated." Thankfully, we found a couple of legal spots for the machine in the renovated Hotel section down the hall. Yes, we'll have to walk, but it has its own spot ensconced next to the nutrition refrigerator.

There was sadness, too. One of our very sick patients got back home and died the other day. He was a sort I wasn't sure would get out of the Hotel. He was elderly and got sick while he was over for his annual check-up. He just bounced back and forth for a while. I was happy to see he was up and motoring around with his wife, who became a minor celebrity on the unit when she was featured in a newspaper story about our town before he left us. They never did hold that "autograph session" I was always teasing them about in the lobby, since we have a paper box nearby.

Godspeed Mr. V.  You fought the good fight. We'll miss you and your "famous" wife, too.