To: All Staff
From: Administration/Groundskeeping
Subject: New Cost Cutting Measures
Date: Today
Effective today, this hospital will no longer provide security. Each Charge nurse will be
issued a .38 caliber revolver and 12 rounds of ammunition. An additional 12 rounds will be stored in the pharmacy. In addition to routine nursing duties, charge nurses will rotate the patrolling of the hospital grounds. A bicycle and helmet will be provided for patrolling the parking areas. In light of the similarity of monitoring equipment, ICU will now take over the security surveillance duties. The unit secretary will be responsible for watching cardiac and security monitors as well as continuing previous secretarial duties.
Food service will be discontinued. Patients wishing to be fed will need to let their families know to bring something, or may make arrangements with subway, dominos, etc. before meal time. Coin operated telephones will be available in the patient rooms for this purpose as well as for other calls the patients may wish to make.
Housekeeping and Physical Therapy are being combined. Mops will be issued to those patients who are ambulatory, thus providing range-of-motion exercises as well as a clean environment. Families and ambulatory patients may also sign up to clean the rooms of non-ambulatory patients for special discounts from their final bill. Time cards will be provided.
As you can see on the "from" line above, administration is assuming groundskeeping duties. If an administrator cannot be reached by calling his/her office, it is suggested that you walk outside and listen for the sound of a lawnmower, weed-whacker, etc.
Engineering is being eliminated. The hospital has subscribed to the Time-Life "How to. . " series of maintenance books. These books can be checked out from administration, and a tool box will be standard equipment on all nursing units. We will be receiving the series at a rate of one volume every other month. We already have the volume of Basic Wiring, but if a non-electrical problem occurs, please try to handle it as best you can until the appropriate volume arrives.
Cutbacks in the phlebotomy staff will be accommodated by only performing blood-related lab tests on patients who are already bleeding.
Physicians will be informed that they may order no more than 2 x-rays per patient per stay. This is due to the turn-around time required by Eckerd’s photo lab. Two prints will be provided for the price of one, and physicians are being advised to clip coupons from the Sunday paper if they want extra sets. Eckerd’s will also honor competitors’ coupons for one-hour processing in emergency situations, so if you come across any coupons, please clip them and send them to the ER. In light of the extremely hot summer temperatures, T.U. Electric has been asked to install individual meters in each patient room, office, etc. so that electrical consumption can be monitored and appropriately billed. Fans will be available for sale or lease in the hospital gift shop.
In addition to the current recycling programs, a bin for the collection of unused fruit and bread will soon be provided on each floor. Families, patients, and the few remaining employees are encouraged to contribute discarded produce. The resulting moldy compost will be utilized by the pharmacy for nosocomial production of antibiotics.
I have almost 20 years of clinical experience as a nurse. Every day I interact with physicians and muse about how I would get out of work on time if it wasn’t for them.
After watching them in action, I’ve discovered most physicians are hard working, dedicated and caring individuals. Yet, there are those few who are aberrant. They exhibit behaviors that are strange, peculiar, and as they say in psychiatry, give you that "uh oh" feeling.
These traits often form patterns that are readily identifiable. Note that the more unusual characteristics a physician has, the greater the likelihood he or she will have a therapeutic misadventure.
DR. "SLICER." This physician likes to cut anybody or anything, whether or not there is a pulse. He would be an excellent choice at a dinner party to help slice the meat. Unfortunately, regardless of the circumstances, his approach is to make incisions first and ask questions later. This surgeon needs to constantly "do something" and would operate on himself without anesthesia just for the thrill.
DR. "DEATH WILL NEVER WIN. NEVER." This physician cannot grasp the concept that all patients, despite medical technology, will eventually die. No matter how grim the prognosis, this physician insists on saving every life, no matter what the physical, emotional or monetary expense. "Hospice" and "DNR" are not in his or her vocabulary. This physician is deaf to pleas of patients, families and nurses. In the face of advanced disease process, crash carts are emptied. Every diagnosis requires controversial, experimental tests and procedures, and ultra-potent medications. This doctor plans to be frozen upon death, expecting to be thawed when a cure is discovered.
DR "NO SPEAK ENGLISH." It is unclear how this physician, with so little understanding of the most common language spoken in the US, is allowed to practice clinically. Despite his or her intelligence, this physician cannot communicate either by the spoken word or writing. The hospital should furnish this physician with a personal interpreter.
DR. "BRAIN." This physician has an extraordinary, off the scale IQ, yet lacks empathy and the interpersonal skills needed to communicate with patients and peers. He is awkward and uncomfortable in expressing his thoughts to living people. Perhaps his specialty should be pathology.
DR. "GOD." This doctor feels he is simply the best in the world, which coincidentally revolves around him. Anonymous sources claim that he calls out his own name during orgasm. He is on call to both the Notre Dame faculty and the Vatican. We should feel blessed to be around someone so important.
DR "AMBIVALENT." Decisions are not this MD’s strong point. This physician’s specialty is vagueness and uncertainty. Thank goodness backup house physicians and smart nurses can get the job done. Another name for this physician might be Dr. "Analysis Paralysis."
DR. "TERMINATOR." Every patient this physician contacts dies very quickly. It is well documented that the chance of death greatly increases when he walks into a room. Thus, this MD is forbidden to attend cardiac codes and resuscitation efforts. Perhaps his family owns a funeral home.
DR "TODDLER." Rages, ranting and insulting behavior toward others distinguish this physician. Due to his poor attention span and limited self control, he wants things done yesterday. His temper tantrums send people running. His bravado is probably hiding his fear of incompetence.
DR "SHAMBLES." This physician looks like an unmade bed. He wears awful combinations of colors and designs. Lord knows how he picks out his clothing and apparel. He has this problem because the drug companies do not give out free clothing to physicians.
DR "HYPOCRITE." This obese, nicotine-addicted physician can be found hiding in the bowels of the hospital smoking cigarettes or eating to excess in the buffet line. He is a walking advertisement for premature death, yet he prides himself on his scare tactic teaching style.
DR. "LEGAL." Severe fear of lawsuits often paralyzes this physician. He or she ignores coworkers whose first names are "Sue". This physician will order every type of test available for a rule out differential of 100 diseases. Before lancing a small boil, this physician will order a type and crossmatch for six units of blood. Distributes "I will not seek legal advice" contracts to his patients before treatment begins.
DR "PUS." Hospital wide infections can be traced back to this physician. Touches patients’ wounds with his dirty hands and then can’t be bothered to wash them. Has no concept of sterile technique, usually orders the wrong antibiotics, and simply cannot understand why his own patients develop nasty infections.
These physicians are the sources of diagnostic and therapeutic misadventures. They inflict misery on everyone around them. They create everyday stress tests for their patients and coworkers. Proper treatment and healing are delayed. On the positive side, they inflate the medical GNP in added costs, secondary to their ineptness.
The following notice appeared on the bulletin board of a hospital in Little Rock. It looked so authentic the employees are still not sure whether it was genuine or not.
DEATH: YOUR OWN. This will be accepted as an excuse. We would like two weeks notice however, since the hospital feels that it is your duty to orient someone else for your shift.
DEATH: OTHER THAN YOUR OWN. This is no excuse. There is nothing we can do for them and henceforth no time will be allowed for funerals. However, in case of hardship, the hospital has a special scheme in conjunction with the local mortuary for lunch time burials, thus ensuring that no time is lost from work.
LEAVE OF ABSENCE FOR AN OPERATION: Henceforth, no time off will be allowed for any operation. The hospital believes that as long as you are an employee here you will need all of whatever you already have and you should not consider having any of it removed. The hospital has hired you for a particular job with all your parts. To have anything removed would mean that the hospital is getting less than it contracted for.
VISITS TO THE TOILETS: Far too much time is spent on this particular practice. In the future, all personnel will go in alphabetical order. All last names beginning with "A" will go from 9:45 to 10:00, "B" will go from 10:00 to 10:15 and so on. Anyone unable to attend at their appropriate time will have to wait until the following day for their turn to come around.