What I've seen and learned

So we're leaving tomorrow. At least that's the plan, pending a couple of pre-discharge tests that have already begun. We will depart around the same time as we arrived, almost exactly 14 days later to the hour. And we'll head home into a snow storm as a bonus.

I was noticing last night that I've only been on a couple of floors in all the time we've been here. All four of the rooms Ronnie has been in are on the 5th floor and I'm staying on the 9th floor and the cafeteria is on the 2nd floor. And the rest of the world is on 1. So those places and a single stairway in between them (I've all but stopped using the elevator) is pretty much all I've seen in here.

Hospitals seem to work on a few basic levels. There are doctors and their cousins, the surgeons. The doctors figure out what's wrong and it's up to the surgeon to fix it. You never ask a surgeon if you need surgery because they will say "yes," because that's what they do. They're also treated like some kind of deity, as if there was a mythology where there was one god who only gave life and then lots of other gods and demi-gods who take care of all the other stuff. When our surgeon walks through a ward, the waters part.

The doctors report, at least here, to the Dean of Medicine, because this is a teaching hospital. Our doctor is the chief of cardiology and our surgeon is chief of surgery, so I presume they report directly to the dean. My father knows the dean well. This has been useful at times.

Once your condition is no longer acute (and often even when it still is) you see your doctors once or twice a day and you are cared for by a second, more intensive level of skilled staff. That consists of nurses, aides, physician's assistants and nurse practitioners (I need to learn what the difference is, from a patient's point of view they seem to serve the same function) who give a full examination and can prescribe stuff (but not administer it). The nurses do most of the heavy lifting, except when it's literally heavy lifting, in which case they're aided by and aide. They are ubiquitous. There are probably two dozen of them in and around where we are. The nurses within a unit seem to be managed by what's called a charge nurse, who makes the assignments and is a good person to be friendly with.

The nurses do not in any way, shape or form report to the doctors. As long as they do what the doctor has prescribed they are complementary, teammates even, but separate. Nurses vary from the doctor's orders at their peril, but doctors can't fire nurses and their overall performance I presume is evaluated by some head of nursing that I am not familiar with. But the point is that if you have an extended stay in a hospital, 90+% of your contact with the hospital is with nurses. And in the vast majority of cases that's a very good thing.

There is also a huge supporting cast of technicians (we've seen portable x-ray and ultrasound) and phlebotomists,  pharmacists, physical therapists, food service and cleaners. There are also social workers who help you with the transition from here to home, which I presume is a more pleasant job in our circumstance than in others.

I have no idea what the administrative structure of a place like this is. There have been mess-ups here and there but the place is so massive, it's amazing it runs as smoothly as it does.