Where the fuck I've been.

There really wasn't anything except work and being tired that kept me from posting. Since I started work with the VA I've been just tired all the time. That is a really hard job. I love the veterans - especially the 300-year old ones that hit on me, ha ha, but it's really hard and I just don't have the energy for anything else once I get off work each day. The weekends I sleep mostly.

So maybe I should say what it is I do, then, since all I said is that it's hard.

I work at the Veteran's Hospital on the 7th floor in an administrative area. I wear my little headset, and I answer the phones for the Team Care line, which handles all of Primary Care. So, if someone wants to talk to his (or her) main doctor then I'm the guy who takes the call and decides how best to send them away to the correct area.

If they need a specialist then I make a progress note in their chart and ask the doctor to give them a consult (podiatry, eye clinic, etc.). If they are having trouble right then and want their doctor to know, then I don't play nurse, I make them stay on the line (usually by guilt cause they're trying to be tough guy) and get them to Triage.

If they had lab tests and want the results, I put a note in their chart and send it to a Nurse Case Manager who will decide if she can give it or the doctor must. No one but a doctor can give HIV results, for example.

Also, I handle all secretarial duties for the Diamond Team, which has 4 doctors, 3 nurse case managers, plus all of Geriatrics which may have up to 6 residents plus the doctors who oversee them, plus their nurses. Patient caseload is about 2,000.

That means I type up releases, fax things, get forms back and forth (for example for disabled plates there's a form the patient will want the doctor to fill out and I handle that process), and basically anything else, up to and including taking requests for narcotics from patients and completing the narcotics renewal process so they get their methadone or oxycodone or whatever on time.

And, if a patient has been hospitalized for any reason, their release, follow-up, scheduling, and labs all go through me. I figure out the puzzle of the discharge facesheet and make everything happen usually by phoning the patient and getting him to come back on a certain day, then I order any lab tests or x-rays he needs. If the doctor was unclear (Wow, surprise there, haha) then I have to track down the doctor and get her (or him) to tell me what she wants. Most of my doctors are women in Geriatrics, one or two are men but I don't usually have to work with them and they aren't as good anyway. ;-)

So! I'm usually worn out and brain dead by the time I hop the bus home. I take roughly 50-60 calls per day and I'm always on the computer. I get yelled at constantly by the veterans, and they really like to get abusive to the secretaries. The wives are just as bad. Mostly I handle things well, and if someone is yelling at me I can tell them that whatever it is they want will have to go through me so they'd better straighten up or I will end the call. That works amazingly well, and I have a really good track record of getting apologies so far.

So that's my job. I'm considered a Program Support Assistant, a Firm Clerk, and a Primary Care Team Secretary. I use every part of my brain, all the time, and everyone with whom I work is smart. I love all my doctors even when they are primadonnas, and I'm very lucky to have gotten this job, especially with our economy.

But, if I'm online less or I forget things, that is why.