jueves, 4 de noviembre de 2010

The Space of the Hospital III

There are two entrances to the children's hospital, each from two different streets, the main one and the other on the opposite side where staff park their cars. Paradoxically or not there is no ramp on the main entrance so people have to lift baby's cars or wheel chairs if they want to get inside the hospital, or they may go and ask to the security guards to let them enter through the ambulance’s door, which is always close to control the movement of people within the hospital.
Once inside the hospital families and patients need to understand the space and how to move within it. There's a clear rhythm of excitement and work from very early in the morning until 1 or 2 pm when everything starts to calm down. Usually staff doctors and some technicians work from 6am until 2pm, and often they leave at that time to work somewhere else (private offices, private clinics, other hospitals, etc.). So then after 2 pm the ones that stay are resident doctors, patients, family members, and few staff doctors, technicians, and administrative. Usually by 4 pm the hospital seems very empty, but still there is a lot of work in all the units and other clinical sites.
This is also a place where other hospitals bring their patients to perform specific studies. The network of city hospitals share their resources so for instance CAT scans are performed at this children's hospital and often you see adult patients waiting in radiology for their turn for a CAT.
Certain studies like CAT can be done at any time because the machine is working 24/7, so some times children have a CAT at infrequent times like 4 am.

The emergency room works 24/7 and is always full of people, but it is more crowded in the morning. It is next to the main entrance and is the only way a child can get into any unit and be hospitalized. Many children are treated ambulatory but if they need to be hospitalized they need to go through the emergency room. It is the same emergency room for all the kinds of patients that are treated within the hospital. If children need to be hospitalized they send them to the units that have treated them before according to the specific child's condition or depending the availability of beds at any given time. Some times there's no bed, like in the peak flu season, and they may stay at the emergency room for days. Very often parents and family members of children with oncological and hematological conditions complain a lot about the lack of a specific place for their children. These are a particular kind of patients since they almost always have their immune system compromised, therefore being close to other children with other kinds of diseases is a serious risk.

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