Today I learned the computer system. Sounds simple enough but the EMR (electronic medical records) at the prison is semi-confusing. To get to point A you must first go to point A1, A2 and then A3 and finally arrive at point A. The computer system is linked to the main computer hub in Galveston at UTMB and incidentally the computer has been known to suck a chart note or set of orders or in my case my intake physical and order sheet from the computer and launch it somewhere into cyberspace never to return. The computer system is also known to crash, a lot which basically requires that all notes be printed, copied multiple times, signed by 6-8 different people, and hand scanned into the computer and filed online. Today I learned the computer system - I also crashed the computer system, single-handedly. The IT people told me not to worry, it happens almost always when a new person logs in and tries to sign their note. Unfortunately due to this malfunction, I only got to do one intake physical today. On the other hand I got to enter the patient in twice since my first note is lost somewhere over the hard drive.Too bad I forgot to re-enter a few key things onto my note. I was feeling a little bit scattered brain when trying to fix my note with the IT guy sighing into the phone while he waited for me to try again. My first intake, minus the computer meltdown, went great. I remembered to ask the few key questions, remembered to have him stand on the X in the middle of the floor and for my own sake remembered to have him turn his head when he coughed during the hernia check. I was actually relieved that he deferred the rectal. I even remembered to give the don't use too much soap lecture that I am all too familiar with now that I have watched 2 weeks of intakes.
Despite waiting for IT to figure out what to do with me, the time I spent waiting was not all lost. The inmates sit in chairs lining the walls of the hallway waiting. There is a big sign that says "NO TALKIN" (the "G" is really missing from the paper) but it is rarely enforced. Today two young guys were waiting in the hall, chatting it up. One was a 23 yr old who just lost his nursing license for whatever it is he did and is now worried about the 3 mouths and wife he left behind in the free world. Next to him was the younger guy who was in for stealing a $13 pizza from a delivery person (I make it appoint not to know what they're in for, it was mentioned in the conversation and hence I repeat it). The first guy was telling the younger that he needed to do something with himself, get his GED, make something of the 10months he would be spending behind bars. The young kid laughed (which did earn as sssshhhhh from the unit secretary) but the older and obviously wiser 1st-timer continued urging the young guy to fill himself with knowledge and gave him word after word of encouragement to rise above this one mistake and not make it a habit. He pointed out the tattoos and said "I have tattoos too, but where have they gotten you? Here, behind bars, but education, that will take you farther." This continued on for quite sometime as the older 20-something told of his story and how he would vow to help anyone else like him out there in the free world that was like him - young, educated and headed down the wrong path. Overhearing this conversation was interesting. Most of the guys I have seen have one of three attitudes. 1. I'm here because this is how the world works, I can't change it, 2. Oh poor me, I'm in jail and now my life is ruined or 3. What's 2-15more years here? So to hear just one youngster really get it, to know that he has the power to make better choices and to use the time wisely was really refreshing. It's hard not to have this counselor mentality when a young guy comes in for the first time, there are so many things that cross your mind that seem like a natural thing to say in a situation like that, but it's really not our place. I have heard my preceptors remind the younger ones and first timers it's not too late, but I'm not ready to make that leap yet even though I believe there's hope for some of them.
Other interesting items from today: pt with large cysts on his head - almost looked like horns, could be HIV related but I doubt it. The biopsy I did last week - Basal Cell Carcinoma. Oh hooray! So tomorrow I will spend 30minutes educating the patient on what that is and what can be done. I had my first polydactyly patient (I will double check the spelling of that and correct nomenclature - it's where multiple fingers are fused together making a pincher-like claw for each hand). Also had my first possible dwarf (with a wicked heart murmur) - not sure why this is interesting, but it was, probably because he came in after our 6'11 pt.
Enough jailhouse news. It's super humid here in TX and the miata heats up like an oven during the day - I think it's from the burnt orange leather seats. Even worse than the humidty though are the mosquitos. Oh how I dont miss those little buggers. I have giant reminders that they are out there lurking, just waiting for me. They are particularly heavy in the morning and night - as soon as the door opens you are swarmed, I even manage to get 4 or 5 in the car with me, which explains the 2 or 3 new bites I get each day on my way to work.
Shawn has picked up some extra shifts to fill his time while I'm away. It worries me he works so hard, but I think it's just awesome to know he is busting his tail so we can travel and get a house when I graduate. I feel like such a deadbeat wife.
Oh and awkward moment for the evening, watching the first part of the movie "knocked up" with your cousin and her mom...
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