12.27.2004

I'm in charge of the pencils, December 27, 2004

Does your job have a pencil monitor?

You know the person...the most insignificant non-contributor...unionized...low/no skilled laborer in the entire building, who's given a title? And you best believe that they take that little title and run.

For instance, the PA who thinks they can read a head CT better than a board certifed, (5-year residency trained) radiologist. "The radiologist reading says there are hypodensities in the occipital region consistent with mass vs. infection, but I don't agree, it looks normal to me." What? As if it matters what it looks like to you.

Or the tech who (very reluctantly) comes over to the ER to shoot an xray on a kid who was hit by a car. "I don't think you need to be doing all these xrays."

See, that's the problem, "you're thinking," we don't pay you to think, (or wonder). They didn't hire you because you have such great ideas, or extensive problem solving skills. You get the order, you bring your machine, you position the patient, and you shoot the xray...that's it.

Ms. Clerk, you mind handing me a pencil?

"A pencil? Well you have to get clearance from administration in order to get a pencil."

What? Why?

"Because I need to see the blue permission form, or I ain't givin you no pencil."

That's not a policy, you can't do that...just make up rules like that.

"Yes I can, I'm in charge of the pencils."

12.10.2004

Should they close King? December 10, 2004

King is a mirage. You have standing here a building masquerading as a hospital. People come here (rightfully) expecting help, but the "hospital" is unable to provide even the most basic care. Is it better to have no hospital, forcing people to go to USC or Harbor; or is it better to have a pseudohospital, where they come, but cannot receive the care they need?

Radiology. If there is no radiologist, mechanisms are put into place to deal with that issue. Either the ER docs read films, and/or you have teleradiology. You need not get approval from a radiologist if there is none in house. BUT, because *on paper* King has radiologists 24/7, it's policy to get their approval for CT scans and such. So, what this means is...by pretending to have radiologists, no one can ever get CT approval. And if a tech is being humane, and does the study despite this fact...there's no one to read it. The ER doctors aren't allowed to read them...and there is no alternative. But, if they were to just call a duck a duck, and state the obvious...admit that there are no radiologists...care could actually be improved. But they don't want anyone to know...so the outcome is, delay in care, and bad outcomes.

Trauma. There are no surgeons. How can you have a trauma center without surgeons?

Pediatrics. No pediatric surgeons, no pediatric ICU nurses...how can you say you're equipped to handle sick kids?

OB. There's one delivery room.

Pharmacy. There's no way to rapidly get drugs to the ER. The list goes on and on.

You bring your child to the ER for a cough. The lady next to you in the bed has active multi-drug resistant TB...and we all know this. She's not isolated because there are no critical isolation rooms. So, you and your child come in with the flu, and leave with TB.

If a hospital cannot perform basic tasks...all of society is at risk, afterall you work with these sick people (with ER acquired TB) and your children go to school with these people.

Security. If there is no security that can actually restrain violent patients (and thereby protect everyone in the ER), that is a worse situation than not having an ER. Again, innocent people in the ER, just wanting to see a doctor...but end up seeing the man next to their 9 year old daughter jacking off.

Having King is like having a gun that on occasion shoots backwards. How is having an unpredictable weapon better than not having one at all??

Having *no* hospital is better than having an unstable, incompetent hospital. Like the gun that shoots backwards...eventually it will kill you.