As with most blogs, after a while folks stop reading, but I am also using this as a diary of my thoughts whilst here, so if you happen to read this post it may be a little disconnected a la free form thinking but it helps me remember what happened here in the land of the Navajo.
Today I came home to the curtains I hung to keep otis from destroying more Venetian blinds on the floor. An umbrella was ripped up in the living room. He tried to scratch thru the door to my bedroom. And he pulled the cable for the tv clean out of the wall. So we made our weekly trip to home depot to get the fix ins for cable repair and I jerry rigged something that will get us thru the final 3 wks here and it seems to be working! Today's Otis antics were brought to me by the handymen that were working next door on a flooded apt. They think it's cute to say hi to him thru the closed window, not realizing that it drives him nuts.
Earlier this week, after a particularly interesting day where I was referred to as a Godsend (now that's a first), more on that later, I was driving home and saw a cute Golden running down the road. I said to myself, gee that dog looks a lot like Otis, which is good, because it was Otis. As I drove past the apartment complex to pick him I saw my curtains blowing out the window, and a mangled screen laying in the bushes. And Otis running down the street. I think it was the thunder that day that sent him on his journey. So I have learned to repair screens and cable tv this week.
Work. Ah work. My last post was rather depressing. But unfortunately it was also realistic. It turns out that Tohatchi Health Clinic has had a great deal of difficulty recruiting and keeping docs. I can see why. While I enjoy so many aspects of caring for the Navajo, there is so much I don't understand. Like, why do they expect me to understand their idea of time, but they don't understand that I can't see 10 patients all at once? And how do a few women with a chip on their shoulders gain so much power in the organization? Okay, I know the answer to that. It's the government. When someone fails at one job, promote them to get them out of there.
Let me cite some examples to illustrate why this is a hard place to work. Reader beware, this is clinical.
We are supposed to see anyone and everyone who walks in the door. Graeat in theory. But a lot of folks walk thru the door w/complaints that most of us would not even think of going to the doctor for, thereby utilizing time that could be spent on the other folks who stay at home until they can't breathe before coming in. Case in point: I was recently busily trying to convince a nice Navajo woman that a stuffy nose for 12 hours probably doesn't warrant antibiotics whilst another patient was sitting in the waiting room with a trimalleolar ankle fracture (3 breaks in 1 ankle). And then, whilst trying to fashion a splint out of available material for said ankle fracture, I was being harassed by the receptionist of sorts to get up off the floor covered with plaster dust I had created during the creation of a wonderful if i do say so myself splint. Why? not to protect my clothes from plaster, you silly. She wanted to go home (it was 4:30 after all), but I needed to stop taking care of the patient, go to a computer and complete my note before she could leave. So can you just take care of the important stuff doc???
On the day before I left to come home for a week, which was wonderful I might add, I was seeing the last patient of the day. She was put in the room at 4;20. Somehow I was supposed to see her and get done and out of there in 10 minutes. How do you do that? Especially when her main concern was that she had slept with someone 3 months ago, without the benefit of a condom, who clearly had syphillis by her description. And they weren't just sleeping. When I examined her she had a problem that I wont describe in detail, but suffice it to say she had number 2 coming out of the wrong place. She had been wondering why it was so hard to stay clean. So you don't just see that and walk out of the room. After a little bit of discussion, I come out of the room, at 4:45, and all the clinic lights are off and everyone is gone. I am still seeing a patient that someone decided needed to be seen, but she is not important enough for anyone to stay until she is adequately cared for. Even the med student shadowing me that day said " really?"
When I returned I was determined to put that behind me and carry on without pissing anyone off (by, ummmmm, taking care of patients???). Foiled again. On day 2 after my return a man in his early 50s came in looking like, as we say in medicine, shit. He was having a heart attack before our very eyes. I called the local er and explained what was going on, whilst resuscitating this poor man, and we both agreed the best course of action would be to fly him directly to albuquerque to the heart hospital. I called the cardiologist there and he agreed. So I asked the paramedics to direct the helicopter to the nearest landing site. They did, the patient flew to ABQ, and he survived. the feedback I got? I broke policy. I didn't waste time by sending him via land ambulance to Gallup, who would then have sent him to ABQ. I am a bad girl.
POLICY. FUCKING GODDAM POLICY. Does no one here care about the patients???????? We are supposed to open the flood gates at 8 am, but if that lazy ass white girl doctor isn't done by 4:30 she has probably been sitting on her ass eating bonbons all day. But now I must rest. More later.
No comments:
Post a Comment