The Valley

On the other hand, working at the Valley can be frustrating sometimes. Paper orders make me happy because they remind me of the days as a medical student when I'd carry around stacks of blank order sheets and run around finding charts so I could put orders in. But the truth is, it's incredibly inefficient; every morning trying to pre-round I have to locate 3 separate charts for each patient. Handwritten notes are often illegible and less thorough. Records are difficult to retrieve. Notes can be easily misfiled or lost. It's a wonder that the whole medical system used to run on paper charts.

Resources at the county hospital sometimes seem limited. Santa Clara Valley Medical Center actually has pretty much anything you'd want, but I find that beds are often limited. Each morning, we get a routine page - now a joke almost - to transfer and discharge our patients because there's a host more in the ED waiting for inpatient beds.

But I think the thing that bugs most people - and will probably be a separate post - is that county hospitals are a repository for people who have no discharge plan. I have at least two patients who have no medical indication to be in an acute care hospital, but will probably never leave. The social reasons that keep people in the hospital, using up resources, time, money, can be ever so frustrating.