Gruel

I always loved that word, "gruel", especially the way they say it in the movie "Oliver!" Not the new "Oliver Twist" movie, because I haven't seen it and don't know if and how they say "gruel" in that one. My grandma used to say it but it didn't sound like it does in that movie.

Anyway, today was grueling. Is that the same root usage of that word? Am I even making sense in "English grammar speak?"

I have learned that Emergency Department work is a lot like pizza delivery (which I have VAST experience in.) You never know when it's suddenly going to get busy. Today we had waves of business, if you would call it that in "hospital speak." Several admits from ED to inpatient; several outpatient O/B patients. Poor little old ladies with weakness, and the hordes of people with sore toes and sore throats. And for each of those people, there is an initial amount of paperwork that would fill a small three-ring binder. And then more paperwork is added by the nurse, and then by the doctor, and then by the HUC, etc. Computers don't reduce the paperwork - they add to it. I bet the ED department goes through the equivalent of about 3 boxes of copier paper a day. And that is not an overstatement.

In ED admission, we primarily use a program called MSA, which is an interdepartmental program with many levels of usage. Basically it's a DOS-type program, probably from the mid-80s, and it's horrendous. It's nice and fast, because of course we have much faster computers now than in the days when this program was invented. But when you are used to Windows (or Mac) and you have to learn a whole program based on function keys and dot-file and different shift-key functions, you might as well have started with no computer experience whatsoever.

And insurance in this country is a nightmare. Just absolutely ridiculous. Michigan has about 30 different Medicaid programs, and there are Medicare policies mixed with Blue Cross, and Wisconsin Blue and Wausau this and Humana that. In the healthcare business, you can't just take an insurance card, enter the number, and automatically get what you need. You have to know EXACTLY how each benefit program works (or how you work that program) and everything has to be entered exactly, letter for letter, or else there's a problem. At least, that's what I'm being told.

And medical terminology, which I know quite well since EMT class, is nothing compared to insurance terminology and hospital speak. I still don't know the difference between a "Physician Biller Copy" and a "Physician Copy", or whether the "Medical Records Copy" gets stapled to the "ROI" or to the "Consent to Treat:" form. I was never good with paperwork, because when my eyes look at a paper full of codes and data, they tend to glaze and cross. And I still misfire on the damn automatic stapler.

Working in the ED is fun though, and can be humorous, gross, and educational all at the same time. When you sit down to register a young lady and the nurse hands you their triage form, which says "Possible Foreign Body Embedded In Vagina", you can't laugh, you can't wince, and you can't say "ouch!" You have to just be sincere and pleasant, and act like you're selling a t-shirt or something. And believe me, I have nothing but sympathy for a girl of 19 years old, who comes into the emergency room in pain (or perhaps itchy) because she might have something stuck up her hoo-hah. I just can't react to it. Which isn't hard most of the time. Except I do sometimes have a little devil in my head saying "you're gonna laugh! You're gonna smile! Ha ha ha ha haaaa haaaa........" and I know that devil is going to come out from time to time and taunt me.

People come into the Emergency Department with all sorts of afflictions and complaints, and about half of those are ridiculous. Ridicuolous because if you go to Emergency with a sore throat, your bill is 800 dollars, base, no matter what. If you go to your family doctor, you can probably save about 740 dollars. If you go to Walmart and buy Sucrets and generic Tylenol, you can save an even further 55.

And I know I have run myself to the ED before with a sore throat. So I'm an idiot too. But it feels so important! I have to go to bed. Good night.