OMG. It's supposed to be 80 here tomorrow.

And the low?

In the fifties.

I might just live long enough to go to California with Pens The Lotion Slut and see Beloved Sister.

In the meantime, the Universe reminded me that there's something worse than having a chunk gone out of your head: Joint Commission survey prep.

For those of you who are lucky enough never to have heard of the Joint Commission (the Joint Commission on Accreditation of Healthcare Organizations, aka "TJC," aka "JCAHO," aka "Our Benevolent Overlords"), it's a not-for-profit organization that sends out "Surveyors" every so often to your local hospital to determine whether or not people are charting, washing their hands, sterilizing instruments and changing lightbulbs--all the stuff that goes into running a hospital.

Surveys are usually unannounced. You can be sure that the middle manglement of every hospital in every city across this great land is on speed-dial to every other hospital the minute TJC shows up, to warn everybody that The Beast Is In The House. You don't want to be caught unprepared, without liners in your trashcans or with mops in the corners of the utility closets.

Accreditation is bullshit. When a survey's expected, the management of a hospital decrees that every chart will be audited for errors and omissions. Every bit of equipment that normally languishes in the hallways between uses gets taken away and stored somewhere. Things that are normally unlocked, like syringe drawers and storage room doors, are locked by the housekeeping staff, who usually have the only keys. Nurses are subject to surprise searches to be sure nobody's carrying meds in their pockets. Floors get polished and bathrooms get cleaned.

And then, once TJC has either not come or has come and gone, things go back to their usual comfortable, vaguely disorganized state. About the only thing that Joint Commission accreditation tells you is whether or not the management of a facility can handle having a bag of rabid weasels thrown into their midst unexpectedly, because that's what it looks like.

Prep is horrible. Everybody who shows more intelligence than your average turnip is handed a stack of charts to audit--in other words, you go back from day one of a patient's stay and look at everything everybody has written--and correct. Correction means hunting down the folks who made an error and sitting on them until they fix the error (or omission). Given that we move patients between Sunnydale and Holy Kamole all the time, chart prep means hours and hours of soul-destroying fiddly work, followed by the opportunity to have doctors and nurses from two hospitals and all the associated clinics pissed off at you, the auditor.

My job this week was auditing, along with precepting a new experienced nurse for the unit. Thankfully the nurse was sharp and with-it, or else I would've leapt out the window by nine ack emma. Chart audits are the worst thing I can think of to do at work.

But we're prepared! For the survey! And it'll be great!

Never mind that another hospital in Bigton got surveyed a couple of years ago and won accolades from the JC folks, only to return to having potato chips show up in supposedly-sterilized surgical kits. I'll bet their trash bin liners looked fantastic.