Since a brand new hospital, the Indu and Raj Soin Medical Center, is being built next door to my Family Medicine office in Beavercreek, OH, I have to strongly consider admitting patients again. We gave up admitting about 18 months ago when we had a paucity of admissions to our primary hospital. We noted the 30 minutes to travel to the hospital and the large amount of time required to admit and care for each patient (about 1:30 if we had one patient in the hosp, which seems to be what is happening now- but admitted to our hospitalist friends). The hospital rounds were done before or after office hours, so they extended the day a lot, while not yielding a financial benefit for the added physician time and energy expended.
So, to warm up to the possibility of admitting again, I'm starting to admit a person or two to the "Sister of Soin", Greene Memorial Hospital (GMH) in Xenia, OH. In doing so, I'm reminded of the numbers and types of persons needed to run a hospital as soon as I enter the Emergency Department of GMH. They are energized and focused on their multiple tasks, and I'm also reminded about how well these persons function as a caring community. Chaos hits from time to time and they bubble up for the intense responses needed. It's much more meaningful to me than the big ED's featured on various TV programs.
On the patient care floor of GMH, nurses and aids are engaging each other via the tasks at hand, which they masterfully and continuously reframe to patient focus. The size of their caring hearts resonnates toward patients and patients and patients. They have their clinical issues, but they never stop caring. New forms jump up from the patient chart with regularity, challenging the caring hearts to get distracted with mechanistic mandates from the healthcare gods and goddesses who initiate "quality" initiatives with regularity so outsiders can have "quality" ratings available when they have a dysfunctional part to shop around for repair. I admire the nurses for still caring. They appear to me to be the glue that enables the hospitals to survive.
The unsung warriors in hospitals who work at the leverage point for all issues about patients in hospitals is the ultimate performer of tasks per unit of time- The UNIT SECRETARY. These folks have always amazed me with their speed and smoothness. They watch the heart monitors (24 or so in the unit where I'm writing this), answer the phones from outside, (patient families, doctors, etc.), answer the switchboard inquiries of patients and their roommates about every sort of patient issue (including excrement of scheduled or unscheduled types), etc.
They also know the human aspects of the staff and patient lives around them. They know how and when to provide a caring comment to a stressed nurse, med student or physician. They may help the staff to get lunch from a local carryout or enable everyone to know about who had a new baby or a dying parent. I've marveled over the finesse, sensitivity, boldness and humanity of these folks for over thirty years (plus medical school where they could save the fanny of floundering med students). Likewise in residency, they knew the 5 WH (who, what, why, when and where) of everything needed in their bustling community at the interface of the entire world and all its people with their unit, its patients and its staff. They are doing what looks to me like the hardest job in healthcare hospitaldom. Their actions save lives, minds and careers every day.
A few of the best I've ever seen are at Greene Memorial Hospital. OK, I've forgotten some wonderful ones at Kettering Medical Center in Kettering, OH, The Ohio State University Hospital, Licking Memorial Hospital in Newark, OH and the MS Hershey Med Center of Penn State University in Hershey, PA. Thanks to the Unit Secretaries: You make it happen!
UNIT SECRETARIES: YOU ROCK!!