Harborview, the House of Hope and Pain

I did a travel assignment at one of the other hospitals in Seattle. The doctors and residents all told "horror" stories about Harborview. It was the hospital that all the trauma went to until they were full and diverted to the other area hospitals. The place was always busy. I did an interview with the OR manager there before I took the other assignment and she told me that if I wasn't ready to give up my free time, then I didn't need to come there. I don't know how they ever got travelers to work there.

All I gotta say is that other hospitals will do anything to send uninsured patients to Harborview. Why, b/c we take all patients, regardless of their ability to pay. I had a guy that was airlifted halfway across the state to Harborview b/c of some supposed urethral injury. I got him on my acute care floor after the ER was done with him. Basically, his scrotum was a little big bang up but no surgery needed. Guess what, also was unemployed and drug seeking. The whole time, he kept saying he was in severe pain but the doc only gave him Oxycodone Q3 b/c he said that the pt's injury does not require anymore med than that. The whole time he was there, he kept eating and eating. Left the next day.

When I was a traveler in WA, I wanted to become staff there. At the time, the economy was worsening, but not bad yet. I played hardball and basically had a "Will only accept a staff position in the ICU, otherwise I will continue to be a travel nurse" attitude.

About six months later, the recession was in full swing and I ended up taking a M/S staff position. I often wondered what would have happened had I taken the M/S job there instead of back on PA.

Harborview stays afloat like any other public hospital, medicare, medicaid, state funding, federal funding, dispro funds, etc. No matter how bad it gets, those large public hospitals will not close because those hospitals are the safety net for everyone. Look at any large city and you will see the same thing. Cook County in Chicago, Detroit General, LA County, Jackson in Miami, Charity in New Orleans, Ben Taub in Houston, etc. The ED's are overcrowded, wait times are very long, lots of people using the ED as a place for minor, primary care. It is the nature of what they do and it won't change. When I was in the ED at Ben Taub that is what we did and that is what they do now. It never changes. The only thing about Harborview that is especially different is their catchment area. They have a larger area to cover by their flight service for emergency patients (into other states) that do not have Level I trauma centers available.

harborview changed my life in a lot of ways. I did a "health occupations" program in high school that facilitated CNA licensure, introduction into A&P, and an 8 week internship at harborview. it was my first real hospital experience on the side of medicine, not as a patient. the social issues presented there were heartbreaking, the personal tragedies were always present, but there always seemed to be a sense of progressiveness and excellence. if i ever move back to seattle, i will bang on that BICU door until they let me back in.

it's not perfect, but it certainly is nice to be at a place that isn't as wrought with corporate greed like many institutions are (even, or perhaps especially, the "non-for-profit" ones).