Tuesday, July 28, 2009

A Little Relief

Central Texas has been setting new records for the number of days over 100 degrees. Depending exactly on where you happen to be, this is somewhere on the high side of 41 days, and there is no end in sight. Naruna is a couple of days ahead of Austin I think, but it is hard to keep track when the temperature routinely hits anywhere from 101 to 111 every day.

This kind of record is not something to which I aspire. I was never the competitive type, and I would just as soon someone else be leading in this category. Nobody tries to fry eggs on sidewalks here like they do in New York when they have a warm day. Hot, dry weather is not something we like to joke about much. At least until after the floods have come and the drought has been pushed back for awhile.

Today was not the end of our drought by any means. But we were pleasantly surprised this afternoon when it began raining in Naruna. It only lasted about 15 minutes, and the sun never stopped shining. It stopped as suddenly as it started, and then it was hot and steamy rather than hot & dry. The surprise came when the LB went out to check how much we received...instead of the expected tenth or so in the rain gauge, we had 1.7". Not enough, but still very welcome...especially since it was not accompanied by any hail, high wind or tornados.

Saturday, July 25, 2009

"We're here to help you."

Anyone who has spent time in the military knows that when someone utters the phrase, "We're here to help you", it means the IG has come to town to see what's hidden under all the rocks. It is understood they don't really mean what they say...after all, their job is to find things that can be blamed on the local commander and his staff. And they will find something.

In the world of civilian medicine, the counterpart of the IG is The Joint Commission. This is a private organization which has attained near mythic powers over the decades of its existence. Without its blessing and the small wall plaque which comes with successfully completing a survey, hospitals are severely limited in participation in Medicare and other government programs. Every three years, a small group appears without warning and throws the hospital into panic. Every aspect of the care provided to patients is scrutinized and compared against both TJC's constantly changing standards and the hospital's own policies and procedures.

Last week was our turn, with three surveyors appearing one morning at our front door. One was focused strictly on the physical structure and whether it was safe for patients and staff. One dedicated three days to looking at the Home Health and Hospice which are associated with the hospital. And the third was a nursing surveyor who was interested in everything. She wandered from the Emergency Room, through Radiology, to inpatient nursing areas. She talked with staff members, questioning how they took care of their patients. Documentation of that care was reviewed to see if it matched the staff's explanations as well as the hospital's policies and procedures. Patients were interviewed to find out what they knew about their own care and what was being planned for them. Personnel files were pulled to see if staff had documentation that they were competent to take care of the patients assigned to them.

Finally, she arrived at the most important part of the entire survey...the Operating Room! Okay, so maybe I'm slightly biased since it's mine, but it is still one of the core areas which incorporates all aspects of caring for the patient. How do you know your surgical instruments are really sterile? Do medications get labelled as they are placed on the sterile field? How are implants tracked? Are surgical sites always marked preoperatively by the surgeon to verify it is correct? What is the process for identifying your patient and the surgery to be performed? In the Recovery Room, how is pain assessed, and how is it documented? Throughout the surgical experience, is the patient's medical information kept safe and private? All these topics and more were raised, discussed and responses evaluated.

After three days of walking on eggshells, it was finally over. We survived as a hospital, once again making it through with no major problems. Of course, they did find some things, since that is their job. These opportunities for improvement will be studied, plans of correction drawn up and implemented, results evaluated and forwarded to the Joint. After a week or two of relaxing and recuperating, the cycle begins all over again. The job of making sure our patients are safe never ends. Three years isn't very long when you are preparing for your next survey.

Did I mention that we get to pay for the privilege of being examined by The Joint Commission?

On-Line Again

One of the joys of living in a rural paradise is getting away from all the many ills and problems associated with our modern society. Unfortunately, you also are far from all the modern conveniences urban dwellers take for granted.

Almost three weeks ago, my Lovely Bride was trying to connect to the Internet using our usual dial up connection. She was unable to get past a chronically "busy" message, and told me I needed to call and investigate. After quietly checking to make sure I had remembered to pay the bill, I gave the ISP a call. The short version of their tale was that the company they had obtained access to most of the smaller hill country towns through had suddenly, and without any warning, gone out of business and no replacement was available.

A few calls and a check of the local yellow pages revealed few options for Internet service in our neck of the woods. The only way to have any sort of broadband access out where we reside is via satellite. Several neighbors reported having good luck with WildBlue, and so a visit was made to their local installer to review what would be needed to get connected to the rest of the world once again. Equipment was ordered and after a week, a couple of "professional installers" appeared and got us hooked up. If you are interested in how professional these installers were, you need to visit with the L.B.. I'm not sure she was terribly impressed, but everything seems to work okay. Not the fastest connection I've used, but a lot faster than our old dial up.

We managed to keep our old email address, so nobody has to learn anything new or make any changes to address books. It's good to be back.

Saturday, July 4, 2009

Independence Day

Happy Independence Day!

I had a rare weekday off yesterday, and the Lovely Bride & I meandered into Austin and watched the latest Star Trek movie. She is not a Trekkie(or any kind of S-F fan), and even she liked it. It was in the form of a "prequel", revealing events which led up to the original tv series, and did a fair job of illustrating how some of the crew relationships began and developed. After the show, it was off to a little hole-in-the-wall Vietnamese place for some really good noodles and such. I miss not having such things close by, but would still rather live in Naruna.

We have no plans for the actual 4th, but are just trying to not melt down. 105 at mid-afternoon, and I'm just waiting for a little shade to get on the, still new, above ground pool before I go float the afternoon away. Maybe a couple of cold Peroni bieres will help with fluid & electrolyte replacement.

My only semi-productive activity this holiday weekend is reading a new book. To those who know me , that hardly qualifies as startling news, but this is a little different from the usual novels I lose myself in. The book is by Giles Tremlett, "Ghosts of Spain", and is about the Civil War, its aftermath and its effects on current Spanish life and politics. In particular, he looks at the "pacto del olvido" or "pact of the forgetfulness" which existed throughout the reign of Franco and has only begun to crumble thirty years after El Caudillo's death. Not an easy read, but worth it in the long run, I hope.