"This woman has to be gotten to a hospital."

There's a subject I've been wanting to tackle for awhile, blogwise, but I've been hesitating (and I can be such a hesitator) and that subject is My Work. That's My Work with a capital "M-W". Not my housework or my schoolwork or my work out...I mean the stuff I get paid to do at my place of employ. One of the reasons there can be such long gaps between posts is the fact that all I want to talk (type) about is work, and I'm not entirely certain I should. There are three reasons for this:


1. I work in Labor & Delivery, and because my hospital does not have a seperate gynecology unit, we see some Womens' Health cases that don't fall into the Labor and Delivery category. Why sugarcoat it? I'm specifically refering to terminations. These cases cause some hot debates, both where I work and pretty much everyplace else these days, and I have very strong beliefs on the subject (and all Womens' Health issues) and I feel like in blogworld I'm sitting on the fence between "I really don't want to offend anyone " and "I really don't give a crap what anyone thinks of me". I can think of no other issue that polarizes people so instantaneously, and that people refuse to budge on. Mostly, I think that's cool: it's an important and serious topic and people should have passionate feelings about it no matter what their opinion is on the matter. But on the other hand, why should I (unintentionally) taunt or goad?


2. Sometimes I get really upset about how things are run at the hospital I'm employed by, and I'm not quite sure how much I can say about it in a public forum without getting fired for it. Sometimes I'm so upset about the place that I couldn't care less whether they fire me or not, but then I realize that it would be better to quit on my own terms and cash out my vacation time. There is a policy whereby you cannot speak to the press about anything that transpires on hospital property, but I don't know that it extends to publicly accessible internet postings. It can take days for us to get necessary nursing supplies in that joint, so I can't imagine that they've been moving swiftly with the times as far as communications are concerned but you never know. We have a PR department, but I don't want to ask them because, well, duh. There's also some confusion about whether this is a hospital policy or if it is in my union contract. That's important because our contract expired years ago--before I was even hired--so I figure if it's a contract issue, and it's expired, then I should be free to say whatever I want, who cares?! Except that I can't, really, because of

3. ...great, big, giant, super-important patient privacy laws. Ever hear of HIPAA? I won't get into it all here, other than to say that it is what keeps all your medical information--from your name to your diagnosis to your medications all the way to the flavor of jello on you AM tray--as private as possible. Perhaps you've been in a hospital recently (although I hope not) and seen the little signs posted asking medical personnel not to discuss their patients in the elevators? That's part of HIPAA, but it's way more far-reaching than that. Sure, I could simply change people's names when I write about them, but I don't think that's really enough. There are a lot of medbloggers out there, and some seem to divulge more than others, but I don't want to cross that line. It's one thing to refer to your second-cousin as "Dink-Ass" on your blog and hope that none of your other relatives see it, but it's another to call a patient "Jane Doe" but then go on to discuss that she's 29, this is her 8th pregnancy, she's had 5 terminations, has every Hepatitis in the alphabet, is high as a kite, and doesn't want you to take her socks off because they're full of stolen methadone. That's a lot of information right there. Anyone computer savvy enough, with a strong enough will and enough free time could figure out exactly who I was talking about. I don't know why someone would, but that's not the point.

I'm hoping I can get around these issues by not naming which hospital I work at, and changing details enough to protect the privacy of the patient. I can't think of how else to approach it; I'm willing to take any and all suggestions, though! Then I could feel free to tell you about the patient who showed up with a gigantic blue suitcase who was furious that no one would help her find her husband, and that she came all the way from Arkansas by bus to find his lyin' cheatin' self, and she knew he was around here someplace, that evil man who beat her up in a motel and got her pregnant. After we calmed her down a bit she said "It's no wonder I can't find him. He's very busy. Perhaps you've heard of him? Bill? Bill Frist? My Billy? And where the hell are my french fries?". After we got over worrying about whether or not she had Mr. Frist stuffed inside that blue suitcase of hers she was gently escorted to our psych emergency department because (aside from the obvious) she wasn't really pregnant and was therefore none of our concern.

One thing I can say about the giant, public, nameless, Level One trauma center where I work, is that it is never boring. That's for damn sure.