Joint Commission, where are you?

A large part of this program is to be able to spend some time observing you profession in the culture you are placed in. This morning, I had my first opportunity to do so. My host padre, Axel, took me to a local hospital he used to be a department head at. We toured around and I could tell he was popular and well-respected by everyone. We first went to a surgical ICU, known here as an anesthesia ICU, and then we went to a Cardiac ICU. My first observation as we strolled through were that some employees were wearing sandals with their scrubs. I was unable to discern if they were medical professionals or administrative staff as everyone was wearing white scrubs, however, does that really matter? How completely disgusting is that? More importantly, what a terrible fashion statement! The other disgusting thing I noticed was that the windows either were opened or could be opened in every patient room. Some of you may not realize what a big deal this can be, but imagine this: you are a comatose patient and your mouth is propped open because you have a ventilator tube going down your throat - then a fly/spider/caterpillar decides to come in for a visit and establishes itself on your face while you are completely unawares...you get my point. The thought of it is absolutely revolting. Of course I immediately pointed this out and the doctor didn’t seem to thing this as an issue. Hmmm.

But not all my observations were negative. Each doctor I spoke with was incredibly sincere and friendly and willing to answer all of my silly nurse questions. They seemed genuinely excited to discuss such things with me. I found out that in the anesthesia ICU and cardiac ICU, it is the anesthesiologists and cardiologists that run the units respectively. The latter is interesting because I noticed the cardiac ICU was mostly filled with non-cardiac ICU patients. But it was explained to me that the cardiologists are seen as the most knowledgeable of specialists and therefore can handle these complex medical cases. Also, I was enlightened to the fact that the doctors not only run these units, but they are responsible for the ventilators as well as bed assignments! They appear to have quite a bit more responsibility and are more interactive in patient care than the doctors I’ve worked with. Which makes me wonder why American doctors hold the stereotypes we know so well.