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Sunday, October 28, 2007

The reality of small town hospitals

Shoreline Hospital is a relatively small hospital on the shore of a Great Lake in Michigan. I noticed the first time I walked into this place I was going to like it here. As one of the senior RTs described it to me at the time, "this place has a nice down homey feel to it."

There are the obvious goods and bads of working for a small place as this.

The good: We RTs have time to sit and get to know some of our patients. That's one of my favorite things about this job is learning about an elderly persons entire life in just a few short hours. Sometimes it reminds me of the movie Fried Green Tomatoes. If you haven't seen that movie you should.

When it's slow we talk, play cards or simply hang out. Sometimes, when a good ballgame is on, we turn on a TV and enjoy it, only to leave every ten minutes or so to check on our patients, or, in my case, to run down to ER occasionally. And, on nights like tonight, we have pot-lucks.

When it's really, really, really slow I sit here and do this. Earlier in the summer we wrote protocols for everything imaginable, we did research, we looked for new innovations to improve our hospital. That's what we do here. Or, that's what I do here when it's slow. I can't just sit around twiddling my thumbs or gossiping. I hate gossipping.

If I were busy I highly doubt I'd be making entries here every day. How many jobs can someone get paid to blog all night long? When it's like this, coming to work is like going on a vacation. I tell my kids this is what you get to do at work when you go to college.

The bad: When I first started working here Dave came up to me and said, "Rick, you should go to work in Grand Rapids. If you go there you will be able to use your skills all the time, instead of once in a while. If you stay here, you might lose your skills."

He told me he's been working here so long doing frivolous breathing treatments that he didn't have any real respiratory skills left, and that there was no hope for him ever getting them back.

Needless to say Dave is our complainer. He's a great therapist, but a complainer. You know what they say about complainers, that they say more about themselves than the people they are complaining about. Every hospital has them. I hate complainers. I avoid them to the best of my ability.

I also hate doing breathing treatments on people who don't need them. I hate going into a room at 5:00 in the morning to wake up a patient just because the doctor said. If the patient is not having bronchospasms, if he's sleeping, he doesn't need it. I hate waking these patients up. I feel stupid. I feel like any person out of college could do this part of my job. This is why I'm such an ardent supporter of protocols, to get rid of this junk.

We will get busy again soon, and more than likely it will happen all of a sudden, and involve 20 Q-forever breathing treatments for no reason, and ER will be swamped.

My ideal workload: I want to be busy doing real RT work. I want to be busy with critical patients, COPD patients, asthma patients, real chest pain patients, and the only breathing treatments I do are for bronchospasm.

Reality: We will have a mixture of all the above. I will not move to Grand Rapids or Ann Arbor and definitely not Detroit where I'd actually get to use my skills on a daily basis. I can't because I'm not switching my kids to a new school, and I hate moving as much as I hate complainers and gossipers.

So we make the best of it here at Shoreline Hospital. The complainers will continue complaining, the button pushers will continue pushing buttons, and us hard workers will continue researching, writing protocols, and thinking of new ways to make this the best small hospital respiratory therapy cave, even if it's just to appease ourselves.

But there's only so much of this we can do. So when we're slow as long as we've been it's easy to drift off into la la land. When you don't do work for a long time you get lazy.

And I guess that goes full circle to what Dale said. And, ironically, that was one of my biggest fears when I graduated with my RRT: do I go to the small Shoreline in my hometown and risk getting lazy, or challenging my skills in GR?

Anyway, my point is: Despite the bad, despite my newly formed laziness, despite the high school work, we still have a pretty good team here when it comes to solving real patient problems. I think this is a well respected, well experienced, well educated group of RRTs; and this is a pretty nice place to work. I suppose what it comes down to is: it is what you make of it.


Terry at Counting Sheep said...

I've just discovered your blog, and it is quite enjoyable. We both work at the same end of the bed, and find ourselves dealing with peoples' airways.

I love your style, and I've added you to my blogroll.

Rick Frea said...

I think we're all just trying to do what we love: write, educate, have fun, and yeah.


Unknown said...

I'm with ya bud, I work at a small hospital over in Wisconsin. We also have our slow time like this summer when I would go all night with nothing. I'm the only RT on at night so I bring in my laptop, catch up on TV shows and movies. Wander around talking with nursing, mooching food, drinking coffee. But we are busier now and it becomes a welcome change of pace. Keep up the good work.