Tag Archives: bureaucracy

by the numbers

A part of having a highly variable workload from day to day is that it becomes necessary for me to show my work. I have to keep statistics, in the form of a list of time definers. Checkmarks, quite literally, for exactly what I did as part of saving a life.

I always have a bit of a chuckle as I’m doing my stats. How are these numbers even calculated? How have they figured out that it takes 17 minutes to do a respiratory assessment, 8 minutes to change a cylinder, 18 minutes to insert an arterial line? There are many where I write down actual time spent, and it seems a cold kind of truth to me that at the end of the day, 45 minutes spent counselling a family about the impending death of their loved one gets aggregated with other staff members for my department over the month, and written in a tidy little box. #3740, service recipient support, a nice round number for a bureaucrat to sign off on. The funniest part is that I’ve done stats at other places where this kind of service wasn’t even something they had a time definer for. As far as the bureaucrats could see, emotional support didn’t exist.

It seems funny to me that I can distill a really fraught encounter down to numbers. A code on the floors, intubated, sent to ICU, set-up on the vent and handed off. It rounds up to around 4 hours of work, spread across a multitude of time definers. What isn’t in the stats is the looks I exchanged with the ICU nurse, the frustration at the physician who was content to sit on his hands, using my ass to hold open an elevator door, rearranging a barely-set-up-freshly-clean ICU room, and the heartbreak of prolonging the inevitable indefinitely. It doesn’t include the bone-weariness that comes with five flights of stairs times five or six trips up and down. It doesn’t include an entire team of people content to place their anxiety at not knowing what to do squarely on your shoulders, because now you’re here, and they don’t have to worry. But no pressure.

No pressure. I mean, I don’t stat mistakes as mistakes, they just get lumped in with an actual time definer. (#4420, arrest attendance.) It’s funny to me that things which are truly chaotic, which can truly not be distilled down to a series of single actions are lumped in together. The time definer for arrest attendance may as well be #4420: unmitigated chaos.

How does one stat “agonize over a decision”? How do you stat “sat in boss’s office venting”? It’s a rhetorical question — I could find a way to stat either one — but the point is, I can’t put a numeric representation on how hard I’ve worked when sometimes the hardest things I’ve done aren’t things with statistics attached to them.

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