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Dec 09, 2022 3:05 AM
dath ilan marian alt in atlas shrugged
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And off they go! 

Merrin doesn't make conversation on the way. She's trying to think. 

(She is not especially succeeding at this; her mind keeps trying to bounce away from the earlier confusion, and without paper to lay out her thoughts, it's hard to troubleshoot this.) 

She stops outside the X-ray department to wait. Is there anyone else waiting ahead of her? 

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Two other people, one with a nasty-looking wound in his shoulder and one breathing very carefully in a way that suggests cracked ribs.

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Well, it's hard to complain about them going ahead! 

Merrin pats Sherry's arm and says something apologetic about the wait, and then nudges the gurney up against the wall and locks it with the foot-brake so it won't go anywhere. She leans on the wall and briefly closes her eyes. 

 

 

 

 

....Why is literally everything about this hospital - about this entire country - horribly messed up? On reflection, nope, she still doesn't want to think about it. Not yet. It feels like she won't be able to think properly until she's alone, with paper, and no urgent deadlines ahead. 

She waits. 

She wants to go home also not productive, but much harder to avoid dwelling on. 

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The same tech as last time x-rays Nasty Shoulder Guy's shoulder (he complains the whole time) and Cracked Ribs Girl's ribs (she keeps doing her best statue impression) and then it's Merrin and Sherry's turn.

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Merrin smiles at the X-ray tech and does her best to be focused and in the moment and not visibly preoccupied. This is nontrivial. 

"Hey, I've got another patient for you. Hope you're not too busy this morning!" 

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"It's always busy," he says with a shrug. Align align drape click.

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If it's ALWAYS busy even on a totally normal day then they clearly need to HIRE MORE STAFF and set up an additional X-ray machine to do scans in parallel, but Merrin isn't going to bother this poor overwhelmed X-ray tech with her opinions on how this hospital is bad at doing things. She does her best to help things go smoothly, and then escapes as soon as they're done and speed-walks Sherry back to the emergency department; she's starting to get the hang of maneuvering these stupidly low-tech gurneys, at least. 

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Her son is right where they left him. The nurse who needed the IV tubing says she appreciates it; Sherry's original nurse is nowhere to be seen.

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Merrin brings Sherry back to her cubicle and explains to her son that the X-ray is now done and she should have an update within a couple of hours. 

She goes back to the nursing station, and looks around halfheartedly, and then....sits down. She's starting to feel a bit more sympathetic to the other nurses sitting around or taking long bathroom breaks even when there's work to be done; she's exhausted. Not physically - walking around the unit and visiting the X-ray department is actually a lot less strenuous than many of her trainings and scenarios - but her working memory feels drained, which is a very odd experience. 

Maybe she'll take the next few minutes to mindlessly transfer information over from her sheets of paper to the patients' charts. 

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Nobody bothers her in the next five minutes, though she might not get much longer than that.

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Now what. 

Merrin is kind of reaching the point where it's difficult to complete any of her thoughts, because all the plans she starts mulling on run into one or another of the confusing horrifying things she's noticed about this hospital but hasn't yet had time to wrap her head around fully, let alone figure out workarounds for. She can probably keep going for a while on momentum, though, and just doing the next obvious thing until her half-shift is over. 

...She should probably flag down the doctor and try to get some more clarity on what's planned for bed twelve - is she going to need surgery, if so then will she be admitted to a bed in the hospital or stay here until then, is she allowed to eat or drink - but she is definitely feeling very avoidant about this, and he probably hasn't read the X-ray yet. Instead she goes to ask the charge nurse if anyone needs help or if there are new patients arriving and she should take one of them. 

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There are always people who need help, around here. Merrin can autopilot from one task to the next until she's off the clock.

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In which case she's going to be even more tired and frazzled by the time she's finally done. Someone to her own surprise, her feet and lower back are aching a little. She hasn't even done much heavy lifting; it's just that everything here is incredibly un-ergonomic. 

 

She absolutely needs to tell someone about the various horrifying things she's been noticing. It feels the least scary to unload on Eddie, but he isn't going to have answers to her questions or domain-specific advice, and he certainly won't have an avenue to address any of it. What she should probably do is go find Carson, but she's a little worried about having the conversation diplomatically enough. It would be a lot easier if she hadn't just dealt with six hours of...that. 

She steels herself, though, and asks the charge nurse for directions to his office. 

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It's up some stairs and down the hall on the right, can't miss it, his name's on the door.

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It's in fact pretty easy to find. 

Merrin spots a water fountain on the way, and stops to gulp a lot of water, which helps. At least a tiny bit. She's probably due to eat something, too, but she doesn't know where the cafeteria is and doesn't actually have any money on her and also her stomach is in knots. 

She stands outside the door for an entire minute, her bit of paper with meta notes on her various grievances with the hospital processes clutched between her hands. And then steels herself for YET ANOTHER SOCIAL CONFLICT, and knocks. 

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"Come in?"

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"I - sorry to bother you, I just -" 

Merrin is suddenly very close to bursting into tears, which kind of makes sense - various parts of her brain are much more overtired than they would ever get during normal events, or honestly even during one of the wilder and more pushing-her-limits trainings or rehearsals she's done, and she's sitting on a lot of frustration and misery that she hasn't at any point had the spare working memory to start processing, and she knows she's not done. 

"- Sorry, I just - think I'm having a lot of culture shock," huh that's actually a really good term, why does English have a three-syllable word-phrase for THAT and not for about a hundred other concepts she's noticed and wanted to use just this morning, "and, um, I was hoping I could talk to you and find out which pieces are definitely things I need to - adjust to and figure out how to work with - versus just having a bad luck morning. Is that all right? I know you're probably really busy." Because this entire hospital and possible entire civilization has never heard of the concept of building in enough slack and redundancy to only be strained in the direst of emergencies. 

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He looks, perhaps, vaguely disappointed, but not too much so. "Go ahead. I want you to be able to do your best work here."

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Merrin nods. Fidgets with her paper. The disappointed look stings a LOT more than it really should. 

"I, um, so the main thing is - there was a patient who I think hadn't been properly assessed, it seems like her nurse was really swamped at the time she came in, and I - kind of just happened to be walking around, and noticed she looked pretty sick, so I did an assessment and flagged it to the nurse. We're pretty sure at this point she had a UTI and had gone untreated long enough at home that she was in early sepsis, but - I don't know, I guess something was missed in the triage process? And we caught it by luck, mostly?" 

And now Merrin is catching herself rambling, which isn't going to help this conversation go better at ALL, but she's tired and maybe, possibly, motivated to delay the part about getting into a stupid fight with the attending doctor. Which she's still pretty sure she should have handled better, though she also still can't think of a specific different strategy that would have worked. 

"- Um, right. Anyway, Cathy was too busy to take it on, so I went to the doctor, and - um - I'm not sure exactly what I was missing but I think this is the part where I'm having trouble adjusting to the local processes? Um. He seemed very busy - everyone seems very busy and distracted all the time, honestly - so I was trying to be as straightforward as possible and tell him what needed doing, except, I...think maybe he was having a bad day? And we ended up having a very confusing interaction where he - snapped at me for 'telling him how to do his job' even though I wasn't doing that. I....did end up getting everything I needed for the patient, and I think she'll be all right, but it seems important to know if I was - accidentally being rude? And how to avoid doing that in future." 

Aaaaaaaaaaah this is agonizingly awkward. Merrin had thought she was mostly over being this degree of neurotic about mild social awkwardness, but apparently that was relying heavily on having come to actually understand the implicit social rules, and now she doesn't and this is the WORST. 

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He blinks like he's not sure why he's the person being told any of this and then picks up the one thing he can think of a response to. "So, the way we do it here is, nurses don't tell doctors what needs doing. Nurses tell doctors what they did and what they observed and then the doctors tell the nurses what needs doing."

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This conversation was the WORST IDEA, she should clearly have sat on it and waited until she could talk to Eddie

"Right. Thank you. I...did kind of gather that was a norm. Um, though, I would like to know the correct way to flag it if I think the doctor is missing something or not prioritizing a patient highly enough, though? - Where I'm from, there would be an incident-reporting process to document what happened with this patient as a near-miss incident, so we can figure out how to amend the hospital protocols to avoid it happening again. Is...there something like that here...?" 

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"We don't have time to do that much paperwork. We have to stay focused on results."

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That is NOT HOW ANYTHING WORKS. 

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....All right. She needs to focus and finish having this conversation, because obviously there's some kind of mistranslation of her actual question going on here. 

"I mean, yes, that's - the point? - It sounds like maybe that's just done, um, verbally and informally here." Which on reflection makes a lot of sense; formal documentation is costlier, when it's all done on paper and needs to be organized and kept track of manually by humans. "I'm obviously lacking a lot of context that you or the management would have, so - um, should I consider that now I've reported the incident and it's in your hands?" 

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"For this instance, yes, but--I'm worried we haven't resolved something important that's going to cause friction between you and the other staff."

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