I PULL INTO my driveway, home from work, and am greeted by my "family" of stray, wild cats. They are totally wild, perfectly uncatchable, and yet they know I will feed them.
I plod into the house and am greeted by my three assorted dogs and one domesticated cat. I settle down to read the Sunday paper with a glass of wine. Realizing that the news is almost 24 hours old, I struggle off to bed. w
At 7:10 a.m., I am awakened by "T" for Texas" blaring on the clock radio and proceed to encourage the two younger boys to get up for school. Dennis has already delivered 60 Wahington Posts this morning and has crashed back into bed. At 7:50 a.m., we leave the house; I can now fix scrambled eggs, toast and orange juice in less than five minutes and not have a case of the "working mother guilts."
Monday and Tuesday are my days off from my job as admissions officer at a hospital. I work the evening shift from 3:30 to 11:30 Wednesdays through Sundays. Mondays are reserved for catching up on sleep, carrying out the weekend trash and planning my two days off. I start off this Monday by going back to bed until 11. Quite a luxury. Tuesday
I am confronted with a dirty oven and a 10-year-old with the flu. After administering juice, aspirn, cough syrup and a plumping of pillows, I attack the oven. The flu case appears about 45 minutes later and asks why I don't use that stuff on the TV. I wave the can in front of him and explain that I already have and launch into my "don't believe everything you see on TV" lecture.
Tuesday evenings are saved for attending community functions, when available. This Tuesday finds me at a PTA meeting where we discuss discipline at lunch time. Wednesday
A "work" day for me, actually what I consider my Monday. After cooking a big batch of spaghetti that I hope will last for two dinners, I take the dogs for a run on the flood plain behind my house. The dogs enjoy the free run, leaping across the meandering creek and digging in the sandy soil.
At 2:45 p.m., Dennis and Brian are home from school and I take off down the parkway for the hospital. After several years of commuting, I think the car knows the way and, I have become quite adept at applying mascara while driving.
One non-working woman acquaintance once described my job as "paper shuffling." However, there is more to admitting patients than shuffling paper. I have had to become familiar with types of insurance and what they will and will not pay for; what types of cases should or should not be put in the same room, and what responsibilities I have to other departments, the patients and the doctors. The most fascinating part of my work is in dealing with different personalities among doctors and patients.
Patients with the most unusual attitudes are usually our "walk-in" patients or patients with no private doctor or clinic affiliation. They come in with gynecology complaints usually after all the clinics and doctors' offices are closed. A usual complaint is pelvic pain and, when asked how long the pain has bothered them, the reply can be anywhere from a few hours to several weeks.
Too many people expect a complete diagnostic workup in 15 minutes. Patients have a tendency, it seems, to arrive in batches; after punching in, I arrive at my desk and receive in the next two hours, it seems, every pregnant woman in the Washington metropolitan area.
Each patient, if we are lucky, has sent in a form prior to going into labor, listing her vital statistics, insurance and type of room requested. After signing the patient in, we escort her to the labor area and hand her over to the nursing space. If the patient is to be admited, the labor nurses call and we assign a room and a number to the patient.
In between patients, we take telephone calls from doctors who wish to admit patients, telephone calls from friends and relatives requesting information, telephone calls from other departments looking for patients' room numbers, telephone calls from people who will be patients wanting to give information prior to admissions and telephone calls from people looking for people who are patients in other hospitals. In short, the telephone can drive a person slightly mad.
Tonight has been a telephone night with a few non-emergency admissions. Luckily we have no ambulance patients. As 11:30 approaches, I finish the discharge list, the baby admission list and recheck the day's admission list. Each shift is responsible for managing the bed board and admissions has to know exactly where each patient is located. I brief the night shift on the status of patients who are in the labor area but who have not been admitted, punch the time clock and head back down the parkway. Thursday After the boys are in school, I check the refrigerator for left-over spaghetti; there is none, which means I have to plan another dinner for tonight. I watch Phil Donahue explore the question of unmarried women deliberately choosing to have babies out of wedlock. As far as I can see, the question is rather moot, since a large portion of women I admit are single, have never been married and have more than one child already. Instead of discussing whether the question is right or wrong in some moral vacuum, they should be discussing what is. Maybe I'll drop Donahue a line.
When things are quiet, I am free to call patients who will be coming in for admission to get information for their charts. This can be tricky, particularly if the woman is having a procedure she doesn't want others to know about. If the patient is not home, I leave my number. If the person on the phone asks questions about the patient's admission, I just state that I have her coming in for some tests. I try never to call teenage women for information at their home number.
This evening, a teenager from southern Maryland comes in requesting information about the cost of abortion. I give her the figure and she looks absolutely stricken. I ask her if she has talked to her parents and she replies, "I can't. They would kill me." Feeling helpless, I watch her walk back to the car where her boy friend waits.
A young couple arrives and the woman believes herself to be in labor. They seem a little jumpy, and as I look for her form the husband says he'll go call their parents to come to the hospital. I suggest that they wait a bit to see if this is the real thing, but he is off and running. I take the patient back to labor and eventually both sets of parents arrive. However, the woman is in false labor and everybody goes home.
At 11 p.m., a walk-in patient arrives and states that she has one-sided abdominal pain. Another hospital has told her she has a pelvic infection, but she wants another opinion. By 11:10 p.m., the doctor is checking her and at 11:15 I get a call to hurry up and admit her; she is going directly to the operating room for surgery of a ruptured ectopic pregnancy. I log her in the book, assign a patient number, stamp out a patient plate, stamp her charting papers, complete an armband and type a summary. As I punch out at 11:40, I am reminded that hospital employes do not always keep exact hours. Friday
Afer trudging through Safeway and Memco, unloading bags of groceries and putting the food away, I am hoping it will be a quiet Friday evening. Fridays have a reputation of bringing patients in droves. Tonight proves to be no exception and I have 13 admissions. By 11:30, I am convinced that I have seen every gynecologic problem there is. We are about out of rooms, the nurses have been worked to the exhaustion point and I am glad to see the night shift arrive. Saturday
I have chosen to work every weekend, which some people think odd. However, the stores and places to take the kids are usually too crowded to have any fun, so I really don't mind working weekends. It's a bit hard to drag myself in during mild weather but the cold winter and hot summer find me happily working weekends.
Tonight I have a strange urge to straighten the files and wind up cleaning out the complete Sunday obstetrical files. Along the way I admit two ladies who deliver the proverbial bouncing baby boys.
The D.c. rEceiving Home brings in a pregnant teenager who thinks she is in labor. It turns out that she isn't and may have been using her pregnancy as an attempt to escape.
At 10, I receive a call from a physician that he is sending in a gynecological patient for admision. Her diagnosis is pelvic inflammatory disease. While this can be painful, it is usually not a difficult admission.
I am finishing up my lists at 11:10, when an ambulance pulls in, red lights flashing. I greet the patient, who is on a stretcher, and discover she is my gynecological admission. I ask the drivers if they could take the patient to her room but they state they cannot take patients to the floor. We transfer the patient to a wheelchair and wheel her in the office.
I obtain her vital statistics, make copies of her Medicaid card and proceed with her admission. Halfway through, she begins moaning and clutching her stomach, stating she feels sick. I grab a waste basket and rush it over to her, and she proceeds to vomit copiously. There must be, I conclude, a better way to make a living.