Hookin’ Up at Work (How to Get Fired)

June 20, 2009

office romance

I know I haven’t been updating the site recently, and I’m very sorry for that. I have a growing list of posts in my head, but I have been working too hard to get them down. Usually I don’t like to work this much, but I have had to pull several extra shifts because one of our docs got fired. Docs don’t get fired too much these days due to the whole supply-demand thing, but every now and again, some idiot takes it too far and becomes a statistic. This is his story.

Dr. Dumass, as I would like to call him, had a good thing going. Cush hospital, good position, great co-workers, and even a nice office. But apparently for Dr. Dumass, the nursing staff was a little too nice for him. Dr. Dumass was actually working on marriage #4 (I am not making this up) when he met Nurse S. Not only was this his fourth wife, but he had a litter of kids spread out all over the country from the last three. To quote Brad Pitt from Fight Club, “F$%#@* was setting up franchises“.

Nurse S was cute, pretty and they hit it off as friends from the start. She was having problems in her marriage and enjoyed talking to Dumass about her marital conflicts. He in turn would share with her his own marital problems with wives 1-4. They got closer and closer. 

Finally Dumass made a great suggestion, “Why not get divorced from our current spouses and get married to each other!”  I can only imagine that Nurse S was married to a drug addicted, alcoholic bridge troll with anger management issues, because I am not sure what exactly would be the attraction to a guy who has already blown through 4 wives and 10+ kids? Maybe she thought that she would be “the one“. Silly wabbit.

Things were moving along smoothly for our confused couple and they could hardly stay away from each other while at work. Either our darling little nurse would be in the docs documentation area or Dumass would be out at her nursing station whispering sweet nothings into her stethoscope. Just some advice for any of you readers involved in a similar relationship – you may think that no one notices, but in reality, everybody notices. Even the blind frequent flier behind curtain #2 knows about it because he overhears the gossip.

Before long, Dumass had already filed divorce papers and was waiting for wife #5 to-be to do the same, but that’s when trouble in ER paradise started. Nurse S comes in to work one morning and tells Dumass the hard news – she was having second thoughts. Suddenly, Dumass starts to have chest pain – you know the kind you get when you really want someone to feel sorry for you and give you that big hug you want so much and tell you everything’s going to be alright. But instead of calling in a replacement, Dumass decides to work himself up.

He goes and gets an EKG and Troponin heart enzyme done on himself. “Hmmm, looks like there might be some changes on this here EKG“, he says to himself. So he calls up the trusty cardiologist who tells him that he should get a stat echo. The echo ends up showing some wall abnormalities and is not conclusive (imagine that?). So the cardiologist tells him to high-tail it over to the cath lab. That’s when the proverbial crapola hits the fan.

Dumass tells Nurse S that he needs to get cathed … that indeed this might be their last moments together. The sappy soap opera romance is too much for her and she tells the charge nurse that she needs to clock out and take her dying beloved Dumass to the cath lab. There is no ER doc now and the chief of staff – a pathologist (autopsy doctor) – is called in to cover the ER. Must have been interesting for him to have his patients actually talk back to him.

At the end of it all, Dumass’s heart was perfectly fine – no blockages of any concern whatsoever. But folks over at admin weren’t exactly ready to throw the welcome back party for him. Instead they fired him for his Dumass behavior. He had taken this too far, and he put patient lives at risk. I actually thought he deserved an award for entertaining the hell out of the rest of us in the ER though, but decided I would keep that idea out of the suggestion box for now.

What lesson can we take from this story? I will quote a wonderful colleague of mine who once told me, “A doctor can be totally incompetent, but as long as patients like him, he will remain employed. But the moment he has sex with the wrong person or comes to work drunk or stoned, he’ll be fired in a heart-beat.” I guess Dr. Dumass can testify to this one.

Add to Technorati Favorites


A Review of Showtime’s Nurse Jackie

June 15, 2009
She Does What we Only Wish We Could Do to Some of our Patients

She Does What we Only Wish We Could Do to Some Patients

I recently watched the pilot episode of Showtime’s new show, “Nurse Jackie”, with the night crew. Jackie, played by Edie Falco, snorts crushed vicodin, steals money to give to the poor, forges an organ donor’s card, has sex on the job with the pharmacist who supplies her with the vicodin and flushes an arrogant jerk’s ear down the toilet after some choice words – and that’s just in the first episode.

In many ways – sex and drama aside – Nurse Jackie is the quintessential “take-no-crap” ER nurse that has served as an experienced den mother of sorts to so many young doctors and nurses still finding their way in the medical field. I still work with , and learn from, nurses like that, who continue to enlighten me with their experience, wisdom and knowledge. And no, I didn’t grab their boob or have sex with them in the supply room.   

On one hand, I fear that people will actually believe that nurses behave this way and treat them with even less respect.  I guess we will just have to leave it to shows like ER and Hawthorne to teach people to respect and admire the amazing efforts that nurses make to brighten, save and enrich so many lives on a daily basis in hospitals and clinics throughout the world. It is a noble profession that is too often the unsung hero. But back to the show …

Although it does present a flawed character portrayal of nurses, it is kinda fun to see someone act out what we all sometimes wish we could do with at least some of our patients. She has a distorted sense of ethics that leads her to do what will in the end be the most benefit to society in her opinion, and other times just gives people what we all know they really deserve. Except maybe her poor husband, but maybe the reasons for that will play out later.

From a doc’s perspective, I thought the whole Heimlich scene was coldly amusing. I get a similar feeling when responding to “Is there a doctor on the plane?”, because you really are never on vacation as a medical professional. It is a blessing, and sometimes it can be a drag, but no doubt it is wonderful to always be able to impact people’s lives – although not always in such dramatic fashion.

The nurses who watched it with me – male and female – enjoyed the show and were looking forward to future episodes. It presents an entertaining contrast to shows like ER and Grey’s where political correctness sets a border around the characters. So many of us in medicine hold back what we really think of some of the pathetic excuses for humanity that we see on such a regular basis from the the drug seekers, the self-righteous and those who feel they have the “right” to put us down, the domestic abusers who beat on their spouses, all the way down to child abusers and those who have children when they have no intention of doing anything remotely resembling parenting or loving, etc. It might just provide an outlet for those of us who bite our tongue and “do the right thing” even when it would feel so good to tell these people what we really think.

What I really want to know though is why the pharmacist has a bedroom in the hospital?

Add to Technorati Favorites


Healthcare Administrator Salaries and the French Fireplace

June 5, 2009

stress salary

A few days ago, I had the great pleasure to visit some good friends from the hospital for lunch. They are good, hard-working people; salt of the earth. It bothered me how hard they work and how they seem to get so little back for their work, and I mentioned that to them. It led us into an interesting conversation about how much the admin people are making at our local community hospital – I think I hurt my jaw when it hit the floor.

I am not naive when it comes to the outrageous salaries that health-care administrators (CEO’s, CFO’s, COO’s and all the other acronyms they make up to take more money for nothing) seek to justify to themselves, but most people tend to think of these overblown salaries as belonging to Wall Street types in big cities; not your run of the mill smaller town.

So, I was quite surprised to learn that the CEO at our hospital pays himself close to a half million dollars per year. All while cutting nursing hours, chastising docs about overtime hours and outright terminating other direct patient care personnel positions for “cost savings”. The CFO also gets a healthy paycheck, closer to a quarter million though. He once told the hospital staff that they always have to go for the best in patient care, kind of like when he couldn’t decide on importing an $80,000 fireplace from France or buying an American one for under 10 grand. He decided that he should go for the “best” and went ahead and imported the French one in the end. He probably should have ordered a mail-order brain and conscience while he was at it.

This prompted me to look into the whole issue of the hospital administrator fleecing of America. I found many intriguing details that just nauseated me in general, but none better then the following concise post written by Dr. Ira Kirschenbaum on his Mad About Medicine blog. I will quote just one paragraph here for your benefit:

… the next time you want to argue with your Primary Care doctor’s front desk about a $5.00 co-pay, remember that he makes an average of $149,000 per year. On the other hand — using United Healthcare as an example — your insurance company paid their CEO — one man — [324 million dollars] over a recent five year period.

He then goes on to list 23 health-care CEO’s salaries – mostly those of insurance companies and drug manufacturers – and their published 2005 salary as well as 5-year combined income. The “poorest” guy in the bunch, James Tobin of Cardinal Health, made “only” $1.1 million in 2005, but he had a good 5-year period over-all, making $33.5 million (or just under $7 million/year). Poor James, what ever will he do to keep up with the Joneses?

Inevitably though, discussions like this lead to some people praising the wonders of capitalism and warning against the evil of “socialism”. At the end of the day though, it is balance and moderation which saves a society.

Our hospital will certainly go down, as it eventually must with these crotch stains at the helm. At that time, I seriously doubt that the hundreds of people out of the job will be giving a damn one way or the other about political ideologies as they join the masses screwed out of their job by corporate greed as they try to figure out how they will put food on the table.

Add to Technorati Favorites