How long are the standard shifts, how many of them a week do most people work, is there any restriction on picking up extra? 

(Merrin used to pick up overtime constantly and work shifts literally twice as long as anyone else; there were some screening tests to make sure her cognitive function hadn’t degraded too much from fatigue, and she got Frowned At even though her scores were sometimes actually better a few hours in once she’d hit her groove.)

Standard is 3 or 4 shifts of 12 hours every 7-day week; you can trade around if you want them spread out or bunched up with long breaks in between or not on a specific day or whatever. Some people take extra shifts and the only rule there is that if multiple people want extra shifts at the same time they have to share.

Okay what the HECKING HECK that is an insane length of shift, even when Merrin went around working double shifts all the time it was, like, eight hours. She has ONE superpower and apparently here it ISN'T. 

Merrin does her best to hide this reaction. Can she work one twelve-hour shift: yes. Can she work four in a week and not kill anyone by accident: prooobably? She had better try to find a place to stay that's nearby because she is not going to want to waste a single additional minute on trekking back and forth - and she'd better figure out how to arrange food for herself in a way that doesn't involve ten minutes of waiting in line for every single meal.

She asks one of the nurses if they have a system for the staff to get food here while they're on shift. 

There's a coffee shop and you can eat in the patient cafeteria.

Huh. That seems a bit weird and inefficient, patients will have pretty different food needs from the medical staff, but at least the food will probably be pretty good? 

(Hospital food in dath ilan is very optimized, for being appealing both visually and taste-wise as well as nutritious, because obviously anyone recovering from serious illness or injuries needs to be incentivized to eat enough.) 

Merrin has quite a lot of notes at this point; they're on paper and so not searchable, but one of Merrin's obscure trainings at one point involved learning how to improvise writing materials while alone in the wilderness, so she's much less frustrated about this than many of her colleagues back home would be. 

- speaking of that, how do they keep track of patient information here? (Without any computing tech, it's presumably going to be a lot less automated than what she's used to, which she expects to be frustrating but hopefully she'll get used to it?) 

Soooooo much paper. Reams of paper. And ballpoint pens. And clipboards.

Well then. 

Merrin is at this point feeling fairly oriented - which in this case means that she subjectively feels like she has no idea what the usual done thing would be if anything even slightly weird happens, which is not a feeling she likes at all, but she's going to have to put some level of trust in her ability to improvise from the base of all the protocols she knows from home, and she at least has a sense of which nurses are the ones she wants to grab in an emergency if she needs help. 

(In dath ilan, someone new to the unit would be buddied with one of the existing staff for weeks, in order to pick up all of the less-legible local context, and that would be after an entire day of orienting to the local context that could be written down. This place clearly has neither the habit of doing that nor the staff to spare for it. She'll cope.) 

Great. Can she start today or does having just arrived from foreign parts mean she needs to wait until tomorrow?

She can start today! Maybe with a half shift first, since they’re presumably not relying on her being there all day, and she can get a better sense of things and then still have time to figure out some personal stuff, like a place to stay longer term. 

(She doesn’t really have anywhere else to be, since Eddie is at his own job right now.)

Then she can get some equipment (primitive by her standards) and join Janice and Emily. Payday is every Friday (today is Thursday) and comes in the form of a piece of paper to be taken to a bank.

That seems like a weirdly convoluted way for a bank to work but sure. All right! Time to go! Who's her first patient?

A man with a broken leg who fell off his roof!

Yikes! 

Merrin is not going to assume that whoever saw him before will have done an assessment up to her standards, or that any other injuries would have been remarked on. (Honestly, even in dath ilan she wouldn't have assumed that.)

Fortunately, while most of her colleagues who just do standard EMT work would be at a bit of a loss given the lack of ANY OF THEIR NORMAL EQUIPMENT, Merrin recently re-certified for the 'no equipment except whatever you can scrounge or make out of odds and ends in a city' training, as preparation for the Annual Overthrow The Government Festival. This is actually a significant improvement over that situation! This hospital even has an X-ray machine!

She examines the man first, quickly but thoroughly, while quizzing him on the exact circumstances of the situation: how far did he fall? did he hit his head? was he carrying anything at the time? what sort of terrain did he land on? (She's also paying a lot of attention to how coherent his answers are and how much pain he appears to be in.) 

"Second story so probably, I don't know, twenty-something feet?" [Pained grunt]

"Nah, I landed on my feet, so much the worse for them."

"Well I had a hammer when I started falling, God knows where it ended up, ow fuck."

"Mud, mainly, but at least I missed the damn rosebush."

If examining him involves touching the leg at all, he grits his teeth and makes small unhappy noises but doesn't try to stop her.

"I'm sorry about that - in a moment I'll ask one of my colleagues about getting you a painkiller, all right? It doesn't look like a displaced fracture from here but I'll need a closer look and probably an X-ray." Which she manages to remember just in time that for STUPID REASONS she isn't allowed to just demand using her own judgement, and is theoretically supposed to ask the doctor on call for the ER right now. She should at least be able to get him something for pain relief, though, that would be stupid to need per-occasion approval for. "Do you have any other medical conditions, or have you had surgery in the past? When did you last eat or drink?" 

"I don't have anything. I did get my appendix out fifteen years ago. I had eggs and ham and coffee this morning, call it three hours ago?"

"Okay. Thank you. You just hang tight for a minute, I'm going to go check with my colleagues about some things." 

Are either Janice or Emily available to be briefly interrupted? 

Janice is; Emily's visibly juggling multiple things already.

Janice is presumably also pretty swamped; Merrin will be very efficient in her questions. She jogs over and catches her attention, then gives a pared-down summary of the patient history. 

"- And I'm giving it 99 to 1 odds that he's not otherwise injured - I'm not sure how risk-averse you play it here, where I'm from we would consider doing a full body scan just in case - anyway he needs a painkiller and then probably an X-ray of the leg, it sounded like I need to get that approved by the doctor?" 

"Yeah, you'll need doctor's orders for both of those, broken leg probably isn't a med-seeker so whatever order is fine." She points out the location of the attending physician.

Merrin has no idea what the local social norms are for behaving around a doctor, and is tempted to stall. "What's a 'med seeker'?" she asks. 

"Someone who's addicted to painkillers and trying to get a prescription for them."

This does not even really parse on a first listen-through. "Someone who's - what? Does that– sorry, nevermind, I want to ask you about that later but I don't think now's the time." 

She notes it down on her list of Additional Questions, though, before heading off to try to politely get the attending doctor's attention. 

The attending doctor is also trying to do too many things at once but does eventually notice and say "Yeah?"

(Merrin isn't sure yet what the time-management norms are around here and whether she should have either interrupted or tried to do something else in the meantime, but she'll clarify that later.) 

"I think I need sign-off from you on a couple of things for my patient? He's the one in bed six, broke his leg falling off his roof - he's alert and oriented, I'm 99:1 confident that's the only significant injury -" she has the relevant history down to a fifteen-second blurb because obviously this poor doctor is swamped, "- but anyway, he needs an X-ray of the fracture and definitely something for pain first. Um, I'm new here and I trained in a foreign country so I'm not sure what meds you would normally give for severe pain but he's hurting a lot."