Thursday two weeks ago was "horrendous," recalled Lucille Frank. There were three heat attachs patients, two people with gunshot wounds and a couple of alcoholic patients with DTs who were hallucinating.
The stretcher room was jammed and the afternoon's emergencies spilled over into the evening; dayshift nurses automatically relinquished hopes of leaving work on time. That day was not terribly unusual, according to Frank, chief nurse of the emergency room and walk-in clinics at D.C. General Hospital (DCGH), located next to the RFK Stadium in Southeast.
Frank oversees 80 nurses and nursing assistants in the city's busiest emergency room (ER). She directs traffic for 250 emergency room patients a day, 20 percent of whom have a life-threatening problem. In addition, nearly 450 people come for appointment in the outpatient clincs and for minor surgery.
It is common knowledge among city hospital employes that most victims of the local "knife and gun club" show up at DCGH.
"Do I have a hard job?" the portly chief nurse asked several coworkers sitting in her office. They said yes. She shrugged. It's all a matter of attitude, she said. "What other people see as difficult, I find exciting.
"What makes it difficult is that nothing is the same two days in a row. . . . Thank God!" she said. "I'm a masochist," she added, winking one crystal-clear, bluish-gray eye.
The entire staff sits on a volcano, she said. "Anything can happen: a drug overdose, a car accident, a roof collapse."
Occasionally, a woman in advanced labor comes through the ER. "When a baby is born here, it creates an emotional boost like no tomorrow," Frank said. "You see so much life going out that it's an extreme pleasure to see a life coming in."
Frank's days are apt to be long. She comes in at 7:30 in the morning and though she is supposed to leave at 4:30 in the afternoon, emergencies, backlogged paperwork and meetings often keep her into the night. She has been known to show up during the midnight shift, just to check things out.
Although Frank refused to tell her age, she is about 50, sources said, and has been head ER nurse 12 years. She knows many of the patients by their first names because so many, particularly the alcoholics, are regular visitors.
Frank, who has seen the hospital lose and regain its status with the Joint Commission on Accreditation of Hospitals, has tried to battle DCGH's unsavory "public hospital" image.
"Critics are often surprised at what they see and what they don't see when they come here. They are surprised it's not as bad as they've heard," Frank said.
Most patients are poor and have nowhere else to go for medical care. And, according to Frank, these patients wait until the last mimute to seek care, which means they are sicker than patients might be at other hospitals.
This can be frustating, she said, because the staff is "often dealing with a population that is not motivated to take care of themselves." This is because they often don't have the resources to take care of their basic needs, she said.
"We see every disease known to God. . . . There's nothing you won't get," Frank said. She knows her constituency well. "Patients are often angry at their lives, as the system. Sometimes they take it out on the nurses." Guards roaming the halls sometimes are needed to calm irate patients who physically and verbally assault the hospital staff.
"The world doesn't end when you walk into the walls of D.C. General; you bring your frustrations with you," Frank said. "I can't look down on an alcoholic patient; I must understand the underlying problems"
She believes in treating the total patient. To that end, nurses in the ER and clinics often refer patients to social services workers located in the hospital.
Sometimes, Frank said, all she is required to do is listen.
For instance, there is an 84-year-old gentleman who comes to the hospital every morning. He brings a brown lunch bag and "spends his entire day sitting in the corridor watching traffic here. He lives alone and, for him, the hospital is his place for socializing."
Listening occupies much of Frank's time.She and the evening ER head nurse, Jerome Wilford, agree that just getting down the hall to the restroom can take an hour. There are always doctors or nurses who have grievances to air, supplied to request or schedules to change.
Because time is precious, Frank keeps the pocket of her lab coat filled with scraps of paper bearing the phone numbers of people she must continue conversations with when she gets home.
Lucy Frank is a legend at DCGH. Because the staff works so closely, there is a great deal of camaraderie. It is almost like family, said Wilford.
"She's my buddy," said Dr. Donald Thomas, assistant director of the ER. He calls her 'Ma.' "For me, working with her is a pleasure." In addition to being a funny lady, Thomas said, Lucille Frank is more hard working, knowledgeable and emphathetic than any nurse administrator he has known.
She strives to make her patients and her staff feel important. To one nurse who will soon undergo surgery for severe arthritis in her hands, Frank said, "Don't worry darling, I'll come see you. Your hand will be a litte sore, but I'll come hold your feet."
Frank is intensely proud and demanding of her nurses and assistants. "I am totally intolerant of stupidity and lack of caring." She said she wants no part of a nurse who gets accustomed to patients dying. "I want the patients here to get the best there is," she added, emphatically.
According to Wilford, Frank's wit is invaluable in making life in the ER tolerable. A few Saturdays ago, on their day off, several solemn doctors and nurses were working at a health fair on the Mall. Wilford said to liven up the group, Frank grabbed an OK 100 Radio adhesive flyer from a little boy and "plastered it across her chest. She takes things seriously, but not too serious."
Frank is from a large Jewish family in Brooklyn, N.Y. She is the only female of a set of triplets. She credits her warm and comical family for her outgoing personality. She is not married and lives alone in Fort Washington, Md.
While in New York City, Frank worked at several hospitals, both public and private, before moving to the District.
"I found out something very interesting," Frank said. "The amount of money an institution has doesn't mean the quality of patient care is any better."
Because she likes drama and was fed up with private institutions in New York, she said she decided to stick with public hospitals.
"My goal is to cheat death," the veteran nurse said, pressing her fingertips together. She is always looking for the opportunity to roll up her sleeves and lay hands on patients, though her job is chiefly an administrative one.
She is also big on motivation and insists that her staff stay informed. She organizes refresher classes from time to time, and a number of her nurses have been sent to learn advanced emergency techniques at the Shock Trauma Center in Baltimore. Frank also has been seen leaning in the doorway of the emergency room reciting football cheers to spur her nurses on.
To combat job frustration, Frank started a pilot progam last January that allows nurses to work a 10-hour, four-day week if they wish. This arrangement gave them more time to take care of personal chores, to spend time with their families and to go to school. Morale and attendance has improved "100 percent," Frank said.
By her own admission, Frank has the demeanor of Nurse Starch on television's "Trapper John, M.D." She is the consummate politician, continually negotiating with hospital administrators for the programs and equipment she wants. "Lack of funding has never deprived our patients of something that's really essential."
She admits to being confident and pushy. "I usually get what I want," she said with a wry smile. And if she doesn't get her way, "I can make people very unhappy!"
Dr. Mona Harrison, the head physician of Frank's units, agreed. "She won't hold her tongue if she has something to say; she can be treacherous." By the same token, said Harrison, "She'll give her left arm for you."
Running a huge nursing division can be nervewracking but, said Frank optimistically, "frustration doesn't bother me. It can help create change."
Stress comes with a job like Frank's. She said she is given to excesses. Her list includes drinking coffee, smoking, eating too much and occasional bouts with chest pains and insomnia. Once, she said, she was so tired that the nights and days ran together. She arrived at work one morning, took off her raincoat and discovered she only had on a bra and slip. No matter, she just donned a white lab coat and kept moving.
When all else fails, her prescription for her own and everyone else's ailments is a bowl of chicken soup.
She claims to make the best, complete with matzo balls.