I am toute a la fois doctor, doula, bed manager, hospital administrator, blood bank supervisor. It depends on the day's most pressing issues, which means most often I am bed manager and blood bank supervisor. I had expected, when I received my medical degree, to be a pretty flexible generalist, but I don't think I had exactly foreseen this.
Hopital Jude Anne, in first and subsequent impressions, is a noisy place, both inside and out. We're located at the corner of a very busy intersection with lots of cars and pedestrian traffic and sidewalk commerce. Loud, insistent honking, then, and lots of bustle, and the bustle intensifies the closer to the hospital gates you approach.
Inside, I'm afraid, there's a lot of screaming. The courtyard is filled with women--the density varies, but it is almost always full--and many are in various stages of labour. We don't have labouring beds for them, or much analgesia to speak of, and one-to-one nursing care that is the standard at home is a laughable concept. We receive a lot of patients and the daily struggle is to find a way to provide them proper medical care despite the volume.
The noise and busy-ness increases inside the actual building, because it is on the first floor where we have triage beds and delivery beds, about six each. Midwives follow the labour and deliver whoever needs to be delivered. On really busy days, we have deliveries on the floor where clean pads are spread. Thank goodness our cleaners are pretty efficient.
Triage is for assessing women who arrive with particular complaints. Often they wait for hours to be seen, since everyone comes in the morning, unless they arrive with something impressive: convulsion, massive bleeding, baby half (or fully) out. Today, we had about five patients who had seized, that I know about; and I didn't spend much time in triage today at all.