Rapid City Regional Hospital Credit: Flickr Creative Commons – Emilio
I started a new locums travel doc adventure in Rapid City, South Dakota yesterday. I was to report to the hospital for my “orientation”, a word to those in the know as “soul shattering meaningless tedium”. My schedule was as follows:
0645 – 0701: Lean up against the wall opposite the Medical Staff Office where I was supposed to report at 0700. Watched 3 (count them, 3) employees come up, unlock the office and ignore me totally, despite the fact that I was obviously the new doctor who was getting processed (much like the beaks and assholes that go into luncheon meat) and that I was holding up a wall in the hall out of sheer sleepiness and boredom. I did manage to get a picture of Traveling Guck sitting under the Med Staff Office sign, post it on Facebook, and email it to my daughter.
0701: They actually stick their heads out and open the door for me. Apparently they take the 0700 start time very seriously.
0701 – 0707: Introduction to the 3 dickheads who left me standing in the hall.
0707 – 0720: Taken to get a photo badge processed. When I asked them if they needed ID verifying my identity, they said no. Apparently they don’t mind issuing medical staff badges to random strangers. I was of course lined up against a blue wall without opportunity to inspect my hair, and allowed one deer-in-the-headlights shot with no Mulligan. I was told to go do something else; the badge was processing.
0720 – 0735: Taken to IT to get computer passwords and immediately change them. Since they wouldn’t tell me the criteria for the passwords (I swear, they didn’t know whether I needed capitals, lower case, special characters or numbers), I had several do-overs until I found a password that the freaking computer would accept.
0735 – 0740: Back to pick up ugly badge. Future spoiler: they set it up wrong and it didn’t open any of the doors that I needed it to.
0740 – 0815: The ultimate in mind boggling tedium. This is the same standardized spiel you are given at every single hospital that you work in: it is dictated by OSHA and JCAHO and a few other acronyms. Therefore I have heard this 3 times in the past 3 months. It involves: Hospital Mission – a retch-inducing phrase or two about Service, Teaching, Health Promotion and Other Grandiose Bullshit, Fire Procedures – seriously, who doesn’t know about RACE and PASS?, Infection Control – a list of all the nasty bugs floating around in the hospital and the special antibiotics used to treat them, if you are lucky and they can be treated at all (Flesh-eating bacteria included), HIPAA – letters stand for “you’d better not give anyone any information about any of your patients and it we find out you did, we will fine you, fire you and set fire to you”, Code of Conduct – they now must produce a written list about how not to be an asshole (official name: disruptive physician) because people apparently don’t have the sense not to be assholes and must be given a specific list of asshole things not to do, Peer Review – we will be watching you, new doctor, and auditing your charts because you are probably incompetent, and Software Use and Access – the passwords never work.
0815 – 0830: Ridiculously long-winded talk from the head pharmacist, who has a way overdeveloped sense of importance, and who gave me 8 (yes, 8) business cards of pharmacists who I would probably not encounter were I to work at the hospital for 10 years.
0830 – 0930: Computer training. This seems to follow a basic pattern – taken to a dark room where a pasty antisocial individual is hunkered down, sat in front of a computer and given a mouse to click on various things without explanation. This is all punctuated by, “oh, I don’t know why that’s not working – it usually works”, from the IT person who seems to have no idea about real-life applications of the material they are teaching. An hour of, “Oh, let’s back up, oh, no, no, no, we didn’t want to go there, OK, try clicking on that” where really, I would have done just as well playing with the damn program myself.
0930 – 1000: “Do we have anything else for her to do? I’m not sure, do we? Did she see the pharmacist? Oh, I guess we should try to show you the hospital.” Remember that I must see Medical Records for instructions for record dictation. Meet with sourpuss from Medical Records. Receive incomprehensible instructions and dictation cards.
1000: Phone call from the doctor who is already turning call over to you, explaining that you already have a labor patient to take care of, despite the fact that you haven’t even seen Labor and Delivery yet.
1000 – 1020: Taken at a gallop past the OR, doctor’s lounge, ER, radiology, and finally, Labor and Delivery where you are kindly intercepted by the chief MD of the Ob/Gyn department, who gives you an actually civivlized and useful tour of the area. You are introduced to at least 25 people, none of whose names you will remember.
1020 – 1030: Shown where the locker rooms, scrubs and break rooms are. Both the MD call rooms are occupied, so no place to sit there. Insructed to throw backpack on the floor in the nurse’s lounge.
1030 – 1040: Locate and change your scrubs to their scrubs, because the ones you have on (although perfectly functional) do not belong to this hospital and are thus assumed to harbor awful bacteria.
1040 – 1500: Sit around on Labor and Delivery because the patient in labor is having her third baby and it should come fast. It does not come fast. Chat with nurses (who are too busy to chat) and a Family Practice resident who is waiting to do a delivery and who is hoping you will let him do yours. You don’t want to let him do your delivery, because you don’t like how anyone does deliveries except for the way you do them, but you have to be a good sport, because that was how you learned back in the day, and people have to learn, don’t they?
1500 – 1530; Actual delivery of the baby. You let the resident do it. He does OK except for the suturing part, which is so slow and fumbling and incompetent that you want to kill yourself. You would have finished 20 minutes ago. The nurse is uncertain whether the stitching job is adequate. It is adequate and you politely tell her to bugger off.
1530 – 1600: Attempt to take care of strange paperwork and computer work, none of which functions the way you were shown by the creepy IT person in the basement. Swear under breath. Repeat.
1600 – 1615: Use Google Maps (which totally rocks, by the way, and it’s free) to find your way out to Bumfuck where the Ob/Gyn clinic is located.
1615 – 1700: Meet the doc you are working for and her office manager husband, who regale you with how awful and unfair the politics at the hospital are, and how they hope they will not make you suffer too much. Yippee.
1700-1715: Find way back from Bumfuck to the hotel using Google Maps, which by now has used up the battery on your phone. Pray that you get to the hotel before the phone dies and you are stranded forever.
1715: Collapse on the bed with the stuffed duck and eat an Atkins bar. Plan TV watching. Sulk because tomorrow the patient that delivered wants her tubes tied, a procedure you hate doing and you will have to get up early to do it.