Things I forgot to mention

I really meant to add some clinical information in my post yesterday - but I forgot.

So here goes:  Alaska is the #1 state for tuberculosis.   That amazes me.  I would have thought perhaps somewhere in the southwest with a large immigrant/alien population.  But I was wrong - it apparently lives out here in the cold.  And the other disease we are #1 for - MRSA infections.  There is also a large amt of STD's here - and the CDC is conducting a study regarding the efficacy of the HPV immunization.  In fact, the RN that had my position previously left to go work for the CDC and assist with the research.

Also - domestic violence is another huge issue.  I forget the way it was worded when told to me, but it is a very common reason for hospitalization.  Or so I understand.  I guess this is one reason why many of the villages are dry villages, to try and stop that so lethal combination of alcohol and boredom.  I was told that in someplaces in the interior a bottle of Jack can cost $400.  Imagine that!

Today at work the owners provided a dessert buffet - complete with chocolate fountain and fruit and other goodies for dipping.  We also got a gift card to a local grocery store, happily, not Safeway with the oh so expensive prices.  There were drawings for prizes.  2- flat screen TV's, a couple of DVD players, some gift cards to Nordstroms and some other things.  Let me tell you, I have not heard one employee say a bad thing about this hospital or it's owners.

So a typical day - after I make the 4 mile drive in the dark on these slick streets - we check to see if any referrals have come in.  At 9 AM the majority of the hospital administration gathers in the ambulance bay.  This includes the charge RN's (there are 2, one for each floor.  they do not have a pt load), RT director, finance folks, medical director, CEO, dietary... I don't know who all... about 20 people.  They discuss current census, discharges, pts going out for procedures, potential admissions (my job!), staffing, availability of vents, bipaps, sick calls... It lasts about 15 minutes and then everyone goes about their day.  Then a follow-up email is sent verifying everything we just spoke about.  An interesting process.  After that - we go out and either see pts that have been referred, work on paperwork for admits, or just go out and make the rounds and visit with case mgrs.  I'm starting to get the flow of paperwork.  And all those things like DRG's that I vaguely knew about before, well, I will become slightly more acquainted with them and things like insurance verification, LOS, blah blah blah.

So that's it in a nutshell.  Currently there is a pt here who reminds me of pts we had in MHOB ICU.  Pt is ready to go, but the family isn't quite ready to make the decision.  The spouse is, but not the kids.  They are trying to gather all the family here and even though the family is all in-state, that really doesn't mean anything.  The last family member is to arrive tomorrow, but with blizzard like conditions predicted around the state, and this pt only able to get here by plane (no roads you know), there is no guarantee that they will arrive tomorrow.  Just  whole different set of logistics here. 

I'll keep you posted.