Well that job at Miami came and went quick.
My limmitted goal was to help bring some continuity and order to what had been a severly understaffed Ed, if possible help redistribute some of the new excess docs to other locations such as gen hospital and st marks clinic where there is a shortage of staff and finally paticipate in the conversation that was supposed to occur today between the various division cheifs the cmo and the doc who is the ultimate head of this field hospital about the changing mission. I am very cognizant of the fact that I Am basically nobody at this place so it felt awkward to Ask for a plAce at the table for that conversation but with the dramatic turnovers In staff I felt like the old head As far as the reality of the situation. The Miami field hospit leadeship is apparanty struggling w the exit strategy or perhaps better put is how to proceed and define their mission. They want to be soley trauma surgery. No medical cases and no fast track. Imminennt life threat can come in everyobe else gets transferred. I do get it because this is an expensive operation and they can't do everything. It's tougb however turning patients away and shipping the sick ones to places that may be very bad. Anyway got here this afternoon and saw several things 1) matt Frankel is doing An awesome job and is staffed with more er docz than he knows whAt to do with. 2) he's got 2 er docs out in front of the gate treating quicky stuff without a chart 3) decision made turn away everyone but trauma and imminent death
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That's the part I hated the most that broke my heart. One time I had an 18 mo old with fever of 103, generalized body rash. parents claimed the baby had been sick for nearly 2 weeks. Child was lethargic. Carried the child and mother to the field hosp. Initially They were turned away. Had to trek across that dusty field on the UN compound. (you know the deal, Pete). Found this ER doc who happened to be in charge and apparently had a say in who gets to stay or not. Spoke to him, he looked at the child, and told me "go back and tell the ED triage Dr G says it's ok." I did that and they took the child. I was relieved as I wold not have the heart to translate to the mother that I brought her all the way over to the field hosp. only t be turned down.
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