Heat

[Celexa]

---

Members don't see this ad.

It is unseasonably warm.

Our hospital building is old. I don't know what witchery controls the HVAC system, but it does not switch gears easily.... And so for the last two days large parts of the hospital, including many patient units, have been sweltering.

It has felt like the hospital is literally and metaphorically boiling over. Patients acting up. Staff with short tempers. To the point it feels like a genuine safety issue.

I'm not looking forward to this becoming a repeated pattern...

 

[Sushirolls]

I once worked at a Big Box shop, where the heat stopped in winter. We could see our breath. Same place in summer, windows were open, fans were blowing in halls, temp was upper 90's inside building. I canceled a few geriatric wheel chair bound patients. And elevators would be non-functional. Rats in toilets.

[CAUTION: Below is sarcasm]

Comrade @Celexa you should be ashamed you even heat, which undoubtedly comes from oil. Your floor isn't experiencing thermal intolerance, but Climate Anxiety, Acute, with Psychosis, heating oil induced [F35.67]
The only way to treat this is to march down to the C-suite office and demand all fuel based furnaces, contracts, suppliers, etc be canceled and removed. As you walk out, use red paint [derived from oil] to slosh all over the hallways "end oil." You can only used fair trade, ethically sourced alpaca garments, woven by the indigenous peoples of Peru, and only if above 10,000ft elevation, and these garments must have the hospitals logo on it. [Which, as you recall, logo development cost 10x what it would have been to fix the furnace in the first place.]

But good news. You'll be better able to fight the Climate Anxiety scourge, because you just learned that the new Big Box Shop DEI officer determined that Physicians violate the policy, with their years of discriminatory education and especially those entrance exams, licensing exams, board exams that clearly have no merit when compared to the quality of ARNPs. We also saw on your Facebook post from 30 years ago you declared, "I'm so grateful, I passed!" This is clearly hate speech to the disenfranchised populations who didn't pass. And recognizing that your degree credentials are a symbol of colonizing oppressors as MD and DO existed at the time of the civil war, not in alignment with hospital policy we must inform you this is a 'for cause' termination and you must leave the building immediately.

 

[hamstergang]

I really did like the hospital that I worked for but they did something wrong when renovating a building they took over for a bunch of outpatient services. My side of the building got direct sunlight through most of the day, and so it heated up much more than the other side of the building. They'd put the air on, but then the other side would get very cold. Since I had my door closed for back-to-back 30 minute follow ups, the heat would build up. I'd regularly get into the 80s.

It seemed like a simple solution would be getting some sort of blinds that actually blocked the sun, but this never happened (we only had see through shades). I asked patients to complain to management when they were sweating in my office, but I don't think any actually followed through. I kinda wished someone would have passed out just to force the issue.

 

[Bartelby]

I would escalate it to hospital leadership noting that many psychiatric medications decrease heat tolerance and that if a related bad outcome were to occur (in, say, an 85-degree room in the middle of winter) that would likely fall below the facility standard of care. I would probably talk directly to them rather than emailing it though, an email showing everyone knew about the risk and didn't address it would be bad news if discovery starts. Most importantly, keep an eye on patients and make sure no one is becoming hyperthermic.

 

[Celexa]

I would escalate it to hospital leadership noting that many psychiatric medications decrease heat tolerance and that if a related bad outcome were to occur (in, say, an 85-degree room in the middle of winter) that would likely fall below the facility standard of care. I would probably talk directly to them rather than emailing it though, an email showing everyone knew about the risk and didn't address it would be bad news if discovery starts. Most importantly, keep an eye on patients and make sure no one is becoming hyperthermic.

I actually did file a safety report. I'm CL so these were medical units. It wasn't so hot I would say people were in danger of hyperthermia, but it was absolutely hot enough to be affecting pt behavior and staff patience/morale/etc.

 

[Sushirolls]

I would escalate it to hospital leadership noting that many psychiatric medications decrease heat tolerance and that if a related bad outcome were to occur (in, say, an 85-degree room in the middle of winter) that would likely fall below the facility standard of care. I would probably talk directly to them rather than emailing it though, an email showing everyone knew about the risk and didn't address it would be bad news if discovery starts. Most importantly, keep an eye on patients and make sure no one is becoming hyperthermic.

Forget that.
Email.
Get the paper trail. It's their job, to address it, and be capable of responding:

we're aware of the issue.
We are addressing it. We have maintence or contractors addressing the thermostat relay and have since learned the part won't arrive for 4-7 more days.
In the interim, this is our solution: suck it up? we are bringing in fans? We are bringing in miniature cooling units for rooms. We only have x units and ask that people pre-coordinate to use in Offices XYZ and allocate more sensitive patients to those rooms.

This is what admin is supposed to do. This is what they are supposed to communicate. Not put heads in sand and reduce risk by doing in person discussions. This is why people take a relative pay trim, when working for Big Box shops, so that the army of admin will address these things. They are literally paid to do or coordinate these things. If they aren't they will sell you out for still seeing patients who then pass out in your office...

@Celexa Good work on doing the safety report.

 

[Candidate2017]

I've put in orders for ice cream TID, future diabetes be damned.

Anyway, for any med students debating between highly paid procedural specialties and psych because they "lurv hearing people's stories", let this thread be a warning.

 

[Bartelby]

Anyway, for any med students debating between highly paid procedural specialties and psych because they "lurv hearing people's stories", let this thread be a warning.

You could, or you could take a look at this thread that is currently a few posts down on the first page: Residents/Attendings, are you happy in Psychiatry?

If income and prestige are the main considerations then procedural specialties win out. Most people I have met, though, are quite happy with psychiatry. And being interested in people's stories and genuinely invested in helping them is nothing to sneer at.

 

[hamstergang]

Anyway, for any med students debating between highly paid procedural specialties and psych because they "lurv hearing people's stories", let this thread be a warning.

The OP is talking about the heat in general medical floors, not the psych unit. And my story about the outpatient space occurred in pediatrics clinic (most subspecialty offices were there) not the outpatient psych offices which were elsewhere.

 

[Candidate2017]

The OP is talking about the heat in general medical floors, not the psych unit. And my story about the outpatient space occurred in pediatrics clinic (most subspecialty offices were there) not the outpatient psych offices which were elsewhere.

Ah, I see.

Still, it is true that basic requests in psychiatry (by patients and psychiatrists) are largely ignored by health systems. But for a couple of VAs and CMHCs, I've never seen any nice psych facilities, even if remodeled. Though I've caught glimpses of a number of multi-million dollar waiting rooms at surgical/cardiac/cancer "centers of excellence" on my way to psych facilities. I once told someone about water dripping from the ceiling on me while interviewing for a job on a psych ward and their response was "OMG my uncle was a patient there years ago and he complained about the same thing!"

If income and prestige are the main considerations then procedural specialties win out. Most people I have met, though, are quite happy with psychiatry. And being interested in people's stories and genuinely invested in helping them is nothing to sneer at.

Happy or not (and happiness in psych is highly correlated with being a practice owner), there needs counterbalance. Med students, the majority who will continue the trend of employed work for large systems, don't appreciate how hard or easy it is to advocate for themselves and their patients based on the relative profitability of their specialty.

 

[Merovinge]

There's good data on higher heat in prison's leading to more violence. Good luck in the swelter.

 

[whopper]

Put the known malingerer in the most uncomfortable room on the unit.

When I ran a forensic unit I put new patients I had reason to suspect were malingering with another patient I nicknamed Stool Pidgeon Jim. Jim narced on fellow patients all the time and his testimony was always honest. E.g. one patient literally told other patients he was planning on causing a scene down to exact time cause he didn't like the TV shows being presented on the unit and discovered the shows he wanted to watch were played on another unit. Jim asked to talk to the treatment team and told us the other patient's plans and true to form it came out just as Jim said it would.

We had another patient that was highly intrusive and wouldn't shut up. So patients who were malingering, acted disorganized after about 3-4 hours with this guy would all of a sudden go to the nurse's station and quite coherently asked to be switched to a different room. The nurses knew I'd want to know about this, so they'd beep me to come to the nurse's station, and I asked the suddenly coherent paitent several questions, like "are you sure," and "just to make sure you can concentrate, can you remember 3 words for me?" and pretty do a MOCA test, where they almost always scored perfectly. Then within 24 hours we often times shipped that person back off to jail.