A Typical Day at Confederate

              TODAY'S NEWS TODAY—WITH TODAY'S PICTURES THE SHREVEPORT JOURNAL, SHREVEPORT-BOSSIER CITY, LA., THURSDAY, APRIL 13, 1972
If you think the average
hospital is busy, you should
spend a day at Confederate
Memorial Medical Center!
Working in the admitting
area of any hospital is no easy
matter, but when it's in a
state-supported hospital it be-comes
a hectic, sometimes
frustrating, experience that
requires all the patience a
person can muster.
IT'S EVEN MORE compli-cated
in a place like Confeder-ate
where the words "admis-sions
room" and "emergency
room" don't really tell what
actually goes on. In fact, the
words are misnomers — what
takes place in this particular
area of the hospital is a lot
more than the names imply.
Picture a large free general
practice clinic handling an
average of 300 patients a day
and you can get a small idea
of what Confederate's admis-sions
area is like.
LET'S SEE what happens
when you go to Admissions for
the first time. Arriving pa-tients
must be screened for
eligibility — to determine if
they are e n t i t l e d to free
medical care. Only a few of
the factors considered here
are income level, living out of
state w i t h o u t returning to
Louisiana for six months, and
welfare recipients.
However, eligible or not, all
patients will be seen by a
doctor to determine if they
have a serious condition that
requires hospital admission
and immediate treatment.
THIS FIRST s c r e e n i n g
takes time and patience —
both on the part of the clerks
handling the admitting desk
and the 100-200 new patients
who arrive for t r e a t m e n t
early each morning.
But it is a necessary part of
the hospital. Because these
patients are seeking treat-ment
in a free institution
maintained by the taxpayer's
money, state law protects the
t a x p a y e r by requiring the
screening process to find out
who really needs free care.
The process is shortened for
those persons bringing their
welfare cards because this
lets the hospital personnel
know at a glance they are
eligible for treatment.
WHEN A PATIENT visits
the hospital for the first time
and has been determined to
be eligible, he is given a
screening number. The admit-ting
desk also gives him an
admitting form to fill out.
This form — which includes
eight carbon copies as re-quired
by law — will be
entered into the hospital's
permanent records files along
with the screening number for
future reference.
The length of time it takes
to go through the screening
process has come m for
considerable criticism in re-cent
weeks. However, once
you spend a day in the admit-ting
area and see the vast
numbers of people who daily
come for treatment in the
v a r i o u s out-patient clinics,
you begin to understand why
the process takes so long.
FOR EXAMPLE, on one
Monday morning 398 persons
were seen in the admitting
room alone. In the various
out-patient c l i n i c s — ear,
I nose, throat, ob-gyn, eye oral
surgery, urology, etc. — an
additional 443 persons were
seen during the day. Consider
this number and then think
about the time it takes for a
doctor to give the patient an
examination. A thorough ex-amination
is going to take,
time, not a mere five minutes
or less.
You also need to take into
I consideration that there are
I only seven doctors per 24
I hours to cover this load. On
I this particular Monday, how-
I ever, there were eight doctors
I for the 24-hour period.
DOCTORS ROTATE their
I shifts. For instance, three will
I be on the 8-4 shift, three on
I the 4-11 shift and one on the
111-7 shift.
The patients seen on this
particular Monday, says one
emergency room physician,
I typify the spectrum of pa-
I tients seen on any given day
I at Confederate. They are the
I ones who come, in for lab
I work, routine chekcups, and
I of course the severely ill.
MEDICAL. AND traumatic
I emergencies are not mixed.
I Stretcher cases take priority
I — those both from the Shreve-
I port area and out-of-town.
Time slips are kept on ambu-lances
in an effort to docu-ment
the length of time they
I have to remain at CMMC.
"People come from as far
I away as Jackson Parish,"
I says Freda Fordham, R.N.,
I supervisor of the area. "At
I least five or six p e r s o n s
I arrive every day from the
I Jonesboro area even though
I they are closer to Monroe
I than to Shreveport. Pregnant
I mothers ready for delivery
I have arrived at the emergen-
I cy room after a drive from
I Alexandria. We've also had
I people come from as far away
I as Lake C h a r l e s to take
I advantage o f Confederate's
I services," adds Miss Ford-
I ham.
RECENTLY THE hospital
I has had to take g u n s h o t
I victims and other cases from
I p l a c e s like Center, Tex,
The View From 'Admissions'—
A Typical Day
At Confederate
By Merrilee Learherman
Journal Staff Writer
1. Waiting to see the doctor in the
general practice clinic are some patients
who have c o m p l e t e d the screening
process.
2. Freda Fordham, R.N., supervisor of
the admissions area at Confederate,
knows hectic times as a 10-year-veteran
of the h o s p i t a 1 's now controversial
department.
3. Admitting clerks find little relief
in their hectic jobs at CMMC. During
the day, they wiil process an average of
300 patients — that adds up to about
140,000 patients a year.
4. At this time of the year, the ENT
clinic is extra busy. But the physician is
on hand to offer relief to patients such
as this man, a prey to sinus woes.
5. The examination area reveals three
types of patients who utilize the
admissions and emergency areas at
Confederate. In one booth is a patient
with an ingrown toenail; in the second,
a routine pelvic examination; the third,
a burn victim.
(Journal Photos by Lawrence Lea)
6. In a general practice clinic, pa-tients
come in with all kinds of ailments
— even in-grown toenails. They take
care of that at Confederate too.
"But," says the 10-year veter-an
of the admitting area,
"What else can you do? You
can't just turn them away."
These are not infrequent
occurrences, as one would like
to believe. Records on the day
I visited the hospital will show
p a t i e n t s coming from the
following parishes: A c a d i a,
Allen, Ascension, Assumption,
Avoyelles, Beauregard, Bien-ville,
Bossier, Caddo, Calca-sieu,
Caldwell, Cameron, Ca-tahoula,
Claiborne, Concordia,
DeSoto, E. Baton Rouge, E.
Carroll, E. Feliciana, Evange-line,
Franklin, Grant, Iberia,
Iberville, Jackson, Jefferson,
Jefferson D a v i s , Lafayette,
Lafourche, LaSalle, Lincoln,
Livingston, Madison, More-house,
Natchitoches, Orleans,
Ouachita, P l a q u e m i n e s ,
Pointe Coupe, Rapides, Red
River, Richland, Sabine, St.
Bernard, St. Charles, St. Hele-na,
St. James, St. John the
Baptist, St. Landry, St. Mar-tin,
St. Mary, St. Tammany,
Tangipahoa, Terasas, Terre-bonne,
Union, Vermillion, Ver-non,
Washington, Webster, W.
Baton Rouge, W. Carroll, W.
Feliciana, Winn and out-of-state.
BOTH THE EMERGENCY
room physicians and Miss
Fordham admit that problems
arise when you are seeing this
many people in any hospital
— whether private or charity.
Certainly, tempers are quick
sometimes, but they say this
is rare. However, in a charity
institution, one must take into
account the "people factor'
and, realistically, the socio-economic
levels dealt with.
For instance, explains Miss
Fordham, many persons who
come to the admitting desk
cannot read or write, so the
clerks must fill out the forms.
Many of them spell their last
name several different ways
or change them between visits
to the hospital. And, said one
admitting clerk, "many times
they'll tell us, 'just spell it
any way you want to.' " All of
this takes time and a lot of
r e c o r d searching to avoid
duplication of files.
THE PEOPLE themselves
cause many of their problems,
say the a d m i 11 i n g clerks.
Many times they don't show
up on the days they have been
assigned to certain clinics;
instead, they show up on a
different day or at a different
hour. And they don't bring
their welfare or Confederate
eligibility cards and other
information needed by the
clerks. This slows the whole
process.
Other factors costing time
in the admissions area are the
P i n e s Sanatorium patients
who are brought by ambu-lance
to the hospital daily to
be seen, or CCI prisoners with
various complaints who are
brought in by guards. (Inci-dentally,
one of those prison-ers
suddenly got well when he
was informed that CCI had
released him and that he
could go home as soon as he
was through at the hospital.
He left without seeing the
doctor).
AND THEN THERE are the
stretcher cases — the serious-ly
ill who obviously need
immediate medical attention
— and get it as soon as
possible, even though it means
that the less ill must wait a
while longer.
"Not only does the admit-ting
area take care of all
this," says the supervisor,
"but it is responsible for the
morgue."
THE ADMITTING desk also
spends a lot of time recording
where the patient is and at
what time, as well as answer-ing
the phone and giving out
appointment cards.
While all this is going on in
the a d m i 11 i n g area, those
patients who have passed the
initial screening are having
their tests run. The nurses
draw all blood for ordered
blood tests, says Miss Ford-ham,
and this slows every-thing
up, too.
AFTER LAB work and X-rays
are taken they will have
to wait again. Many of the
patients waiting in the ad-mitting
area merely are wait-ing
for the test results to
come back so that the doctor
will know which clinic they
need to go for treatment.
After the tests are back, the
doctor sees the patient again
for consultation and referral
to one of the c l i n i c s , if
indicated.
IT'S A NEVER-ENDING
hectic process. However, with
the volume of patients seen —
it adds up to about 140,000
patients a year — and the
length of time involved in the
lab work-ups and X-rays,
explains M i s s Fordham,it's
obvious why some people have
a long wait.
"Sure, the facilities need to
be updated," says Miss Ford-ham.
"We have a shortage of
doctors and nurses, a shortage
of space and no funds in sight
to hire any additional person-nel,
but we are doing the best
we can in an over-saturated
area."
ARTOME PRICE, an aide
who happens to be black,
agrees. "We're doing the best
we can with what we have."
She doesn't understand how
anyone can think otherwise.