Knackered, buggered, and jacked-up.

Here's a new one for the Life's Little Ironies column:

A soldier goes to a combat zone for a year. He returns unscathed. Two months later, he's riding his motorcycle to work and clips a car that's been left parked in the middle of an off-ramp with no lights, no blinkers, no nothin'. This is in a city which routinely leaves large areas of the highways unlit in an attempt to save money.

So the poor bastich degloves most of his right arm (don't ask; you really don't want to know) while breaking a bone, breaks a major artery in said arm, breaks two toes, slices his nose open, and generally gets screwed up. Luckily for everybody, his head and its contents are undamaged.

He's been my patient for the last few days. You know you're doing good work when a patient and his family--which includes nurses--ask for you by name.

In other knackered knews, I forgot to write closing notes on not one but all of my patients yesterday. Let's hope none of 'em decide to sue me, eh?

The hospital, speaking of buggered, is being bought by the medical school that supplies our residents and attendings. We (the hospital staff) found out about this via an article in the newspaper last week.

This peeves me. Last year at about this time, the hospital board brought in a consulting group to help us cut costs and streamline operations. The general rule with medical consulting groups is that every decision they make, without fail, is a bad one. All recommendations will be ridiculous, and a good portion of them will be dangerous. This is because consulting groups are not made up of people who have hauled patients, cleaned rooms, or taken care of sick people. They're made up of rich fat white guys with names like Woodall McPherson the Third.

We dealt with it. We dealt with seeing our old friends--support staff who'd worked for the hospital since its opening--fired to make room for newer, cheaper employees. We handled losing most of our transportation staff on the grounds that (according to the consulting group) it made more fiscal sense to have a nurse leave five of her patients to transport a sixth rather than paying somebody else one-third the money to do it for her. We handled increased patient loads, not a small thing when the unit you're working on is more like progressive care than medical-surgical.

We're even continuing to deal, as best we can, with the fact that our supply room--the place that stockpiles urinals, catheters, toothbrushes, and other necessities of life--has moved two miles away into a different facility.

*Now* we find out, along with everybody else who reads the paper, that we're being bought and consolidated with another hospital. In a few years we'll be losing our building and moving elsewhere. In the meantime, God only knows what changes will be on tap. State institutions are notorious for funding research (good) and not funding basic needs (very very bad). They're good about benefits and holidays and crappy about paying market wages. We're probably going to get even more layers of bureaucracy and bullshit. Given that the management currently is made up of very nice people who turn into bellicose tin tyrants the minute they punch in, I am not hopeful.

This hospital is probably the best place to work in the area. I love my job. I don't plan to leave unless they call security to escort me out the door. I've seen things here that you don't even read about in textbooks. I've taken care of patients who'll have research papers written about them because they're the first person, ever, to have X happen to 'em.

But I dread what's coming. Maybe it'll all work out. More likely, though, it'll be another year of layoffs, cutbacks, increased loads, lowered supply pars, and general jacked-up-ness.

*sigh*