It’s 0839 am in Cordova, not a shred of light in the sky yet. Sunrise officially predicted at 0926, but I hope to see a bit of a glow by nine-ish. I can hear sleet pelting my picture window, but the only picture there is the drizzle of drops melting from top to bottom, like a cake that’s been iced while it’s still hot. I’m sitting under a lamp I’ve removed the shade from and situated next to my cheek to capture as much light as I can since sunset will be at 1537 and I’ve not left the hospital until after 1430 yet. My face is warm from getting too close to bulb; I feel like a sunflower, or a moth.
I am loving my stint here so far. Duties include 24 hour ER /hospital call, daily rounding on our inpatients—we have 2 official beds (full), but flex up to more if needed (currently have 3), weekly to monthly assessments of our swing and long term care patients (? 10 or 12 beds – all full), new admissions—already did 3 of those, discharges- couple of those, outpatient clinic (I’m only assigned 2 days of that all month) and follow up of any and all new concerns with any patients. I relish the smallness of it—staff is right there, responsive to whatever I order, available to quiz on patient status, needs, protocols. One case manager devoted to pursuing solutions to social issues confronting our patients. The native american community here also runs an OP clinic which communicates very well with us at the hospital since we accept and manage their inpatients. Staff can be called in, and arrive within minutes, to support operations like Xray, lab and additional nursing. I had lab results back within 15 minutes of when I ordered them. I had already told the patient it would be a couple hours!
In Cordova it’s hard to be more than 10 minutes from the hospital—the town, like many in Alaska, is accessible only by air or ferry, and the road only goes for 36 miles before it’s washed out. Most people live right in town, within about 4 square miles. Practically, when you’re on call you’re required to be at the hospital within 20 minutes –so mostly that means no hiking or boating, so I won’t check out the end of that 36 mile road, from which I might be able to see Child’s glacier and the million dollar bridge, until my day off.
Flexing services up and down as needed is much more nimble in a small community like Cordova, than in even a large town like Springfield where so many of our staff live much farther away. But this is exactly what is needed in all our health care institutions, no matter their size, to make health care as responsive and safe as possible, without costing us even more. No nurse or physician can be saddled with more patients than they can handle without increasing the risk of error. I believe it is possible if we restructure our system to focus on quality, and not insurance and medical device/ pharm profit. There are minute movements in that direction: not nearly enough. More on that later.
For now, it’s 915 and a milky daylight has infused the lake view outside my picture window. The sleet is replaced with a light snow so perhaps I’ll be able to walk to work—who new I needed to bring a raincoat and umbrella instead of my skis? I’ll post a photo of the scene out my window if it ever gets light enough to take a decent picture!