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Meet the ER doc who thinks like a designer – Philly.com

A heart attack one minute. Mysterious stomach pain the next. A steady stream of fevers, headaches, and shortness of breath. As the safety net of the American health-care system, hospital emergency rooms are expected to be crowded, loud, and chaotic.

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Bon Ku, an emergency physician at Thomas Jefferson University Hospital, thinks there has to be a better way.

For the last two summers, he has deployed teams of students with iPads inside Jeffersons busy emergency department, carefully mapping the movements of doctors, nurses, technicians, and patients. The goal of the project, a collaboration with the KieranTimberlake architecture firm, is to learn how emergency medicine could be improved through good design.

People ask me:Are you just trying to make the E.R. look prettier or polished, with the walls a more soothing color? he said. No. You can design spaces to change the behaviors of people.

Among the early results from the research: colorful heat maps suggesting that physicians spend too much time at computer keyboards at the expense of listening topatients, Ku said.

KieranTimberlake

A heat map shows the locations of five categories of people in the Jefferson emergency department over a 48-hour period: patients (red), doctors (purple), nurses (blue), other staff (green), and family/friends (yellow).

That was no surprise, and certainly not unique to Jefferson, which typically gets at least 65,000 E.R. visits a year. Doctors and nursesnationwide have griped about the amount of time spent entering patient information into electronic medical records. But it has gotten Ku and his colleagues thinking about ways to alleviate the problem. Placing easy-to-use keyboard stations inside patient rooms, perhaps. Or better use of scribes employees who document the care while the physician focuses on providing it.

Ku, who majored in classical studies as a University of Pennsylvania undergraduate and later earned a masters degree in public policy at Princeton, has no formal training in design. But he is determined to get medical students thinking about it.

The E.R.-mapping study is one of 10design projects now underway in the Vault, the basement of a former Federal Reserve building in the 900 block of Chestnut Street that Jefferson owns.The lab is directed by pharmacist Robert Pugliese.

Oneeffort involves using a 3-D printer to make plastic models of patients jawbones, helping surgeons to prepare for difficult reconstructive surgery. In another, student researchers use electronic wristbands to monitor the movements of children in playgrounds, in hopes of determining which structures are most likely to encourage physical activity.

The emergency-department mapping project began when Ku saw a KieranTimberlake presentation of research it had conductedat JFK Plaza: how people use the park, where they sit, and where they stand. Billie Faircloth, a partner and research director at the architecture firm, recalled that Ku approached her afterward.

He said, I need this in my emergency department, she said.

Architects are used to interacting with people who have no formal design training. Listening to clients needs is a core part of the job, after all.But in Ku, Faircloth and her colleagues found someone who was unusually insightful about the potential for good design.

He talked very clearly about what he hoped to achieve, Faircloth said. He is basically looking at design from multiple perspectives.

Jefferson did not hire KieranTimberlaketo renovate the space. The firm offered its services purely for research purposes. Ku and his students are still sorting out what the results mean, and how they might lead to improvements.

The hospitals emergency department treats about 180 patients aday and at least seven every hour, though there is a lot of ebb and flow. Mondays are busiest, with a logjam of untreated ailments that has built up over the weekend. Regardless of the day, volumes tend to be highest from lunchtime until 2 a.m.

The spaceis divided into two wings, and, therefore, could serve as a living laboratory for testing different approaches for providing care. The larger A side has the more traditional E.R. configuration, with one central station for doctors and nurses, surrounded by patient rooms. The smaller B side is decentralized, with nurses separated into pods each surrounded by a cluster of four patient rooms.

Ku likes the B side because it tends to be quieter. But neither side has a good spot for providers to decompress. Kus solution?

I go to the bathroom, he said.

Ultimately, he would like to test which seating arrangements and other design elements might improve patient outcomes.

A recentstudy funded by the Robert Wood Johnson Foundation suggests that better design can, indeed, have an impact. Among the findings: Hospitals with shorter distances between delivery rooms were less likely to deliver babies bycesarean section. When rooms were arranged in a compact cluster rather than strung out along a long hallway, providers could work more efficiently, apparently reducing the pressure to move patients through the system more quickly by performing C-sections, the authors wrote.

KieranTimberlake developed the iPad tool that was used to map the Jefferson E.R., and it was customized for a health-care setting with input from Ku and his colleagues.

Ku, the assistant dean for health and design at Jeffersons Sidney Kimmel Medical College, wants to eventually make the tool available to hospitals anywhere. From what he can tell, there is far too little study of hospital spaces once they are built.

The science of how we build new health-care facilities, he said, should be as rigorous as the science of how we develop new drugs or therapy.

JESSICA GRIFFIN

Bon Ku (center) and medical student Allison David (far left) are studying how to improve emergency medicine with better design.

Published: September 7, 2017 3:01 AM EDT

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Ortho RI Express Provides Immediate Orthopedic CareSaving … – Business Wire (press release)

PROVIDENCE, R.I.–(BUSINESS WIRE)–Ortho RI, Rhode Islands largest orthopedic care provider, offers patients with orthopedic injuries a better alternative to care through its Ortho RI Express immediate care centers. With fall sports just starting and winter around the corner, injuries needing immediate attention are bound to happen.

When a patient gets injured, whether in soccer practice or slipping on the ice, often the only care option involves long waits at the emergency room or urgent care center, said Michael Bradley, MD, President and CEO of Ortho RI. But they are not staffed with orthopedists so patients are often referred out for specialized care. The result is more long waits, extra fees and copays and delayed care.

Ortho RI Express offers an alternative: immediate care from orthopedic specialists for acute situations, available after hours and on Saturday. All four locations are staffed with Ortho RI physicians and physician assistants, with an orthopedic surgeon on call at all times. Patients benefit from their better understanding of orthopedic injuries and faster care. An Ortho RI visit is billed as a specialist office visit instead of the higher emergency room or urgent care visit.

Ortho RI Express eliminates unnecessary emergency room visits for sprains, strains and fractures, Bradley said. With fall school sports just beginning, the timing couldnt be better to remind families there is a one-stop, lower-cost, better-care alternative.

There are Ortho RI Express locations in Providence, Pawtucket, Warwick and Wakefield. Hours are 9 a.m. to 5 p.m. daily, with evening hours 5 p.m. to 9 p.m. and Saturday hours 2 p.m. to 7 p.m. at select locations. Patients may call ahead as soon as the injury occurs and be seen within 15 minutes of their appointment time. The number is 401-777-7000.

Learn more at orthopedicsri.com/ortho-ri-express

About Ortho RIOrtho RI advances orthopedic care through patient-centered comprehensive musculoskeletal care with 14 community locations, more than 55 orthopedic specialists and more than 55 therapists and trainers. Their areas of expertise include: hand, joint, pain management, shoulder, spine, sports medicine, joint reconstruction, primary care sports medicine and podiatry. Ortho Rhode Island also offers physical and occupational therapy, athletic training, MRI and ultrasound imaging, and durable medical equipment.

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Report finds many emergency room visits are avoidable – ConsumerAffairs

When an accident or injury occurs, its second nature for consumers to go to the emergency room (ER) for treatment. But a new report finds that some of these visits arent necessary or advisable.

In a recent study, researchers from California deemed that 3.5% of all U.S. emergency roomvisits were avoidable. They say that the top three discharge diagnoses were alcohol abuse, dental disorders, and mood disorders, such as anxiety and depression. While some of these conditions can be serious, the authors note that the ER is not always necessarily the best place to have them treated.

Our most striking finding is that a significant number of avoidable visits are for conditions the ED is not equipped to treat. Emergency physicians are trained to treat life- and limb-threatening emergencies, making it inefficient for patients with mental health, substance abuse, or dental disorders to be treated in this setting, they said.

The study analyzed over 424 million visits made to emergency departments across the U.S. between 2005 and 2011 for patients aged 18 to 64. Avoidable cases were defined as those that did not require diagnostic or screening services, procedures, or medications, and led to patients being discharged home.

Of these visits, the researchers say that 6.8% were related to alcohol abuse or mood disorders, while 3.9% were connected to disorders with patients teeth or jaws. While the majorityof these visits did warrant emergency attention, the results indicated that 16.9% of mood disorder visits, 10.4% of alcohol-related visits, and 4.9% of tooth and jaw-related visits were avoidable.

While visiting the ER might seem like the safest move, the researchers note that extraneous visits can impact the overall cost of health insurance for all consumers. They believe that their results may indicate a need to increase public access to mental health services and dental care.

Our findings serve as a start to addressing gaps in the US healthcare system, rather than penalizing patients for lack of access, and may be a better step to decreasing avoidable ED visits, the researchers concluded.

The full study has been published in the International Journal for Quality in Health Care.

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Machias Hospital Expands and Modernizes Emergency Department – WABI

MACHIAS, Maine (WABI) Built over 50 years ago — the Emergency Department at Down East Community Hospital annually treats nine thousand patients — significantly above the capacity it was designed to handle.

Dennis Welsh, President and CEO of Down East Community Hospital says, “This really offers up a lot of space for our patients. Before we were woefully inadequate with regards to space in the E.D. We often had patients lined up in the hallways. It was very busy. We’ve seen continued growth in E.D. services here and I think this will create a completely improved environment for our patients.”

The new Emergency Department has three times the space…and has grown from six beds to nine.

Welsh says, “Hospitals today, a lot of them were built 30, 40, 50 years ago so, when we look at new construction in the new add on it’s up to current times.”

Modern upgrades for the facility include a behavioral health room.

Welsh says, “We have folks coming in for detox or other substance abuse issues, so we’ve created this behavioral health room and it’s really kind of a lock-down room that’s comfortable and quiet. It’s very safe for the patient.”

They also have a negative pressure room for folks with infectious diseases and a new decontamination area.

He says, “They’re large showers that we can put patients in in case of chemical spills or other emergency disasters.”

As the only hospital in a 60-mile radius of Machias, hospital staff say it’s a much needed upgrade for the community.

Kevin McEwan, Chief Nursing Officer says, “We are a very busy community — so there was a demand here in the community to upgrade these services and not have our community drive and hour and a half or two hours to get these services.”

Welsh says, “We have one final phase left. It should be about 4 weeks. We’ll be 100 percent by the end of October and we’ll actually start seeing patients we think early next week in this space.”

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5 Surprisingly Common Penis Injuries That Can Land You In the ER – Men’s Health

Jesse N. Mills, MD, an associate clinical professor of urology at the David Geffen School of Medicine at UCLA, says the most common penis injury he sees is a penis fracture. “That’s when a man tears the tough outer lining of his penis during sex when he bangs his erect penis into his partner’s pubic bone. It usually happens when the female is on top and thrusting down on the man’s erect penis,” he says.

Dr. Mills says penile fractures usually happens when a partner is drunk. That was the case with one of his recent patients. “They were in the throes of disinhibited, liquor-induced passion at 2 a.m. when she elevated her thrusting pelvis to the very tip of his erect penis and momentarily lost coordination as she slammed her pelvic bone forcefully down on his erect penis. They both heard a loud cracking sound followed by his shriek of pain,” he recalls.

As Dr. Mills recounted it, the patient’s previously erect penis had turned into a large eggplant.” “There are three chambers in a penis the two erectile bodies and the urethra (urinary channel),” he explained. “Most penile fractures are mild with a small tear in one of the chambers that requires a few stitches to close the defect and get the man back to normal in a few weeks. This man tore all chambers and the only thing keeping his penis attached to his body was his skin.” All the blood had rushed from his erection through the tear in his fibrous exterior penile lining into the space underneath his skin. His erect penis, now fully deflated, had quadrupled in size and lost all rigidity.

6 Things Every Man Should Know About His Penis:

Dr. Mills says that the patients injury was so severe that he not only fractured his penis, but he also tore his urethra completely, so he was unable to urinate. He had to fully reconstruct all chambers and essentially reattach the torn penis to the base, which was still intact. The patient had to use a urinary catheter for three weeks and was out of commission for about six weeks, but he fully recovered and was able to have sex again.

The moral of the story? “Vigorous sex is fine but don’t mix it with alcohol,” says Dr. Mills. “If you do injure your penis, get to the ER right away, embarrassing as it is.”

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Common causes for emergency room visits – KOLO

RENO, Nev. (KOLO) Many household accidents are more likely to occur during the holidays. This three-day weekend is no exception. But common household items can also increase the chance of you or your child getting hurt.

Unsecured prescription drugs and pools are two items in homes that can lead to overdoses, and near-drowning or drowning.

It’s not an uncommon scenario for physicians who work in emergency rooms. But there are five more items they warn about. One of the most obvious is an unsecured gun in the home.

Most people’s kids are inquisitive. They will find them. They will want to know what they are all about. Potentially play with them. If you are going to own a gun you should have it locked up in a safe only you have access to, says Dr. Bret Frey, an emergency physician at Northern Nevada Medical Center.

Trampolines are a great way for kids to get exercise. But they can also lead to injuries even with experience and supervision.

Your child can’t escape gravity. Gravity always wins, says Dr. Frey.

He says the most common injuries are extremity fractures, but sometimes he sees neck and back injuries as a result of falling off the trampoline.

Hover boards are another item. In 2015, the U.S. Consumer Product Safety Commission investigated and ultimately declared all hover boards on the market unsafe. That’s led many retailers to stop selling them. Broken wrists are the most common injury from hover board falls.

Batteries and magnets are tiny, sometimes shiny, and sometimes small children put them in their mouths and swallow them.

So one battery can be pretty bad. If it stays in one place especially, it can cause erosion, necrosis, dying of the tissues, and then that places the bowel at risk for perforation. Magnets cause a folding of the bowel, sticks together causes the bowel to die, says Dr. Frey.

Finally, extension ladders are pretty handy items in homes. They can reach to roofs or trees. The problem is they may only be used once or twice a year. With little experience, falls sometimes from high places are the result.

I see a ton of falls off ladders, says Dr. Frey.

Understanding the downsides of having these items in your home will probably lead to assessing if they need to be there at all. If the answer is still yes, secure and mitigate those items–understanding that in some cases youll have to accept the risk.

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Clinic serving Aransas Pass area 24-7 – kiiitv.com

As you might imagine, Hurricane Harvey knocked out medical services in the hardest hit areas, and damage at the hospital in Aransas Pass left residents with no emergency room within 30 miles.

Rudy Trevino, KIII 8:04 PM. CDT September 04, 2017

ARANSAS PASS (KIII NEWS) – As you might imagine, Hurricane Harvey knocked out medical services in the hardest hit areas, and damage at the hospital in Aransas Pass left residents with no emergency room within 30 miles.

However, some Dallas doctors have now set up a new clinic where it is needed most, and if patients cant pay, the services are free.

We just opened our doors over here at the beginning of August, said Dr. Carrie de Moor, CEO of Code Three Emergency Partners, a brand new urgent care clinic that has seen a good share of emergencies in just the last week.

50 patients already so far this morning, De Moor said. As people start coming back into town and get hurt. We’re taking care of walking wounded. We’re taking care of anything thats an emergency.

They’ve even got an outdoor walk-up immunization desk for tetanus shots.

Inside, only two exam rooms are up and running. The rest of the building is still being worked on in hopes of opening that section of the building as soon as possible.

We built this facility actually because we knew this was an underserved community to begin with, and now we’re the only ones left standing in this general vicinity and the county to take care of anybody, said Dr. De Moor.

The two-room clinic is staffed with several ER doctors equipped with X-ray, ultrasound and a lab, all up and running thanks to generators and a caring staff.

Code Three doctors will be open 24-7, and regardless of a patients ability to pay, no one will be turned away.

2017 KIII-TV

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Atrovent albuterol wheezing emergency room – Atrovent nebulizer for infants – Twin Cities Arts Reader

Adam Jacobs (Aladdin) and Isabelle McCalla (Jasmine) star in the national touring production of Aladdin. Photo by Deen van Meer.How many people does it take to put on a national tour of a Broadway show? If the show isAladdin, the answer is 75…if you only count the people who show

The Catalyst Quartet rehearsing.It was the first of August. Dr. Deborah Justice was settling in for a month of fiddling around musically speaking when the email arrived. “Im afraid I have some sad news from Caracas,” it began. “Venezuela at this moment is now a war zone.”At that

The late J. Otis Powell.Poet, playwright, and overall multi-talented artist J. Otis Powell died on Monday, August 28. Powell was 61 years’ old, and had been awarded a Sally Ordway Irvine Award for Commitment just five days prior. He had struggled with ill health, and received a kidney transplant several

A bar chart showing historical box office totals for the Minnesota Fringe Festival.The Minnesota Fringe Festival announced the final statistics today for the 2017 Minnesota Fringe Festival. The 11-day festival brought in 46,076 butts-in-seats, spread across 860 performances of 167 shows at 17 venues in Minneapolis.Why Count Butts-in-Seats?Since 2016, the

The Ordway Center for the Performing Arts announced today the recipients of the 25th annual Sally Ordway Irvine Awards. These awards were given in five categories to recipients from across the State of Minnesota. This year’s recipients are all based in the Twin Cities metro area: Hunter Gullickson (Arts Access)

Actors Gary Briggle (left) and Wendy Lehr (right). Photo by Keith Bridges.The playwright A.R. Gurney passed away two months ago. Many of the various eulogies and obituaries cited his 1988 playLove Letters, a tale of charmed correspondence that was nominated for a Pulitzer Prize.Love Letters encapsulated many of the themes

Lady Gaga rocked the Xcel Energy Center with her trademark costume-heavy, immersive performance. Here’s the set list from the concert:Act I “Video Intro” “Diamond Heart” “A-Yo” “Poker Face” “Perfect Illusion”Act II “John Wayne” “Scheie” “Alejandro”Act III “Horns” “Just Dance” “LoveGame” “Telephone”Act IV “Claws” “Applause” “Come to Mama” “The Edge of

A mosaic of different graphs of Fringe Festival sold-out attendance data.It’s been one week since the 2017 Minnesota Fringe Festival closed its doors and the Fringe staff are still tallying and double-checking festival data. While a fuller report on the festival box office is still forthcoming, here are six figures

Women dancing inArabian Nights.Photo by Dan Van Meer.The Orpheum Theatre is getting a magic lamp. Starting September 15, the Orpheum will host the Broadway touring production of Aladdin for three and a half weeks (closing October 8). This touring production stars Adam Jacobs, who originated the title role of Aladdin

Actress-musician-songwriter Claire Wellin. Photo by Tiffany Topol.This Friday, Claire Wellin is bringing her band Youth in a Roman Field to Icehouse in Minneapolis. Youth in a Roman Field’s “ghost folk” sound emphasizes haunting strings, acoustic instruments, and multipart vocal writing. The MSU-Mankato graduate spoke with the Arts Reader’sBasil Considine about

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Emergency room crews learn to spot elder abuse – LA Daily News

Abuse often leads to depression and medical problems in older patients even death within a year of an abusive incident.

Yet, those subjected to emotional, physical or financial abuse too often remain silent. Identifying victims and intervening poses challenges for doctors and nurses.

Because visits to the emergency room may be the only time an older adult leaves the house, staff in the ER can be a first line of defense, said Tony Rosen, founder and lead investigator of the Vulnerable Elder Protection Team (VEPT), a program launched in April at the New York-Presbyterian Hospital/Weill Cornell Medical Center ER.

The most common kinds of elder abuse are emotional and financial, Rosen said, and usually when one form of abuse exists, so do others. According to a New York study, as few as 1 in 24 cases of abuse against residents age 60 and older were reported to authorities.

The VEPT program initially funded by a small grant from The John A. Hartford Foundation (a Kaiser Health News funder) and now fully funded by the Fan Fox and Leslie R. Samuels Foundation includes Presbyterian Hospital emergency physicians Tony Rosen, Mary Mulcare and Michael Stern. These three doctors and two social workers take turns being on call to respond to signs of elder abuse. Also available when needed are psychiatrists, legal and ethical advisers, radiologists, geriatricians and security and patient-services personnel.

We work at making awareness of elder abuse part of the culture in our emergency room by training the entire staff in how to recognize it, said Rosen. Its easy for the ER staff to alert the VEPT team and begin an investigation, he said.

A doctor interviews the patient and conducts a head-to-toe physical exam looking for bruises, lacerations, abrasions, areas of pain and tenderness. Additional testing is ordered if the doctor suspects abuse.

Unlike with child abuse victims, where there is a standard protocol in place for screening, there is no equivalent for the elderly, but we have designed and are evaluating one, said Rosen.

The team looks for specific injuries. For example, radiographic images show old and new fractures, which suggest a pattern of multiple traumatic events. Specific types of fractures may indicate abuse, such as midshaft fractures in the ulna, a forearm bone that can break when an older adult holds his arm in front of his face to protect himself.

When signs of abuse are found but the elder is not interested in cooperating with finding a safe place or getting help, a psychiatrist is asked to determine if that elder has decision-making capacity. The team offers resources but can do little more if the patient isnt interested. They would have to allow the patient to return to the potentially unsafe situation.

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Patients who are in immediate danger and want help or are found not to have capacity may be admitted to the hospital and placed in the care of a geriatrician until a solution can be found. Unlike with children and Child Protective Services, Adult Protective Services wont become involved until a patient has been discharged, so hospitalization can play an important role in keeping older adults safe.

During the first three months of the program, more than 35 elders showed signs of abuse, and a large percentage of them were later confirmed to be victims. Changes in housing or living situations were made for several of them.

Its difficult to identify and measure appropriate outcomes for elder abuse victims, because each patient may have different care goals, said Rosen, but we are working on making a case that detection of elder abuse and intervention in the ER will improve the patients lives. We also hope to show that it will save money, because when an elder is in a safe place, expensive, frequent trips to the ER may no longer be needed.

The teams ultimate goal is to optimize acute care for these vulnerable victims and ensure their safety. They plan to work at continually tweaking VEPT to improve the program and to connect to emergency medical, law enforcement and criminal justice services. Eventually, they hope to help other emergency departments set up similar programs.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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In A Houston Emergency Room, It Was A Week Like No Other – NPR

Dr. Winston Watkins, an internist at St. Joseph Medical Center in Houston, volunteered to do a shift in the ER to give his colleagues a break. Rachel Osier Lindley/KERA hide caption

Dr. Winston Watkins, an internist at St. Joseph Medical Center in Houston, volunteered to do a shift in the ER to give his colleagues a break.

St. Joseph Medical Center is downtown Houston’s only hospital, located just down the street from the convention center where thousands of evacuees have been staying since Harvey hit.

As of Friday, some doctors and nurses have been on the clock for almost a full week.

Trent Tankersley, director of emergency services at St. Joseph Medical Center in downtown Houston, had a very long work week, as did many of his colleagues. Rachel Osier Lindley/KERA hide caption

Trent Tankersley, director of emergency services at St. Joseph Medical Center in downtown Houston, had a very long work week, as did many of his colleagues.

When you’re working in an ER during a major natural disaster, nothing is routine. Trent Tankersley, director of emergency services at St. Joseph Medical Center, describes one tense situation after another in the hospital this week.

“We had a lady who the only vehicle heavy enough and strong enough to get to her through the floodwaters was a dump truck. She was pregnant. She was in labor. She was brought to the hospital in the dump bed of a dump truck, soaking wet.

“As we were getting her over to the women’s building to get taken care of, we had a trauma come in. Shortly after that, we had a young man [who] came in that was having a stroke.”

Tankersley showed up to work Saturday, and hasn’t had what you’d consider “a break” since.

“Finally got to go home last night for a couple hours and do some laundry and then came right back. So it’s been an interesting five or six days.”

Some staff haven’t been home since before Harvey struck

Kristen Benjamin, an associate chief nursing officer, has been right beside Tankersley.

“I think we’re all working on adrenaline right now. We’re working shift by shift. Some people are doing 15-, 16-hour shifts. We let them go off and sleep. They come back in.”

Kristen Benjamin, associate chief nursing officer at St. Joseph Medical Center, says many employees hadn’t been home to see if their houses were flooded. Rachel Osier Lindley/KERA hide caption

Kristen Benjamin, associate chief nursing officer at St. Joseph Medical Center, says many employees hadn’t been home to see if their houses were flooded.

They’ve seen more than 600 patients in the first five days. At times, they saw more patients in a few hours than they usually would in a whole day.

Many staffers have been stuck at the hospital, with no clear path to their homes. As floodwaters recede, their coworkers can finally come back.

“We’re going to start transitioning staff out to get home so that they can check on their homes,” Benjamin says. “Because some of them don’t even know what’s happening at their house right now because they haven’t been home since Friday. So I don’t even really have an idea if their house has been flooded or not.”

His first day working in the ER

Among those staffing the ER are doctors from other departments pitching in, and even medical students, like Diana Johnson. She and her classmates are using a Google spreadsheet to organize shifts to help.

She’s in her third year at Houston’s McGovern Medical school. She’s assisting Dr. Winston Watkins, an internist on his first day in the ER.

“One of the first patients that came in happened to be one of my own patients from my practice, and he came in with his foot hurting,” he says.”So Diana evaluated him and it turns out he has gangrene of his right fourth toe. And so we’re going to admit him to the hospital.”

“Some of them don’t even know what’s happening at their house right now because they haven’t been home since Friday.”

His house is underwater

Nurse Aaron Padron says he’s never seen such a wide range of emotions in the ER.

“A lot of laughter crying yelling, tears,” he says. “People that you work with you think that wouldn’t crack just put their head in their hands and take a second to cry to themselves, or not to themselves, and wipe away the tears and get back to work.”

He’s been working here for most of the last week, except Saturday night.

Aaron Padron, an emergency room nurse, says hospital employees were much more emotional, reflecting the stresses on everyone in the city. Rachel Osier Lindley/KERA hide caption

Aaron Padron, an emergency room nurse, says hospital employees were much more emotional, reflecting the stresses on everyone in the city.

“I went home on Saturday to sort of rescue my family before the floods got too high for me to get in or out,” he says. “And then I came back Sunday and I’ve been working and sleeping here ever since.”

Neighbors say his house is underwater. He says several others working in the ER saw their homes flooded. In a way, he says, it’s all been a transformational experience.

“I think times of crisis, in times of emergency, in times of stress really have a way to bring people together and create a lot of camaraderie and really can push people to excel at what they do,” he says.

Once reinforcements come in, he’ll be able to rotate off his shift and find out just how much his family lost.

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