Work. Work. Work.

I know you all are just dying to know if I actually do work over here. Sadly enough, I do have to work, at least just a little bit. ;) I did post a lot about what I do several weeks ago but since I've been at this for a little over a month know I have had a chance to get into a groove and know a little bit more about what my job entails.

As I mentioned before, my role at the DWMMC (deployed warrior medical management center), is only one of several keys things that happen when a patient is transferred from the desert to Landstuhl, Germany. Once a patient has been flagged for a need to come here, that's where our team comes into play. We coordinate the flights and necessary medical equipment and persons needed to get time safely to Germany. Once they get here to Germany, a team of air force med techs transports them off the plane and onto a blue bus and then drives them across town and up the hill to LRMC (Landstuhl Region Medical Center). Once here patients are unloaded and brought either straight up to the ICU or if they are more stable and here as an outpatient they are all brought into a room and briefed about what how to process through here. Based on the reports we get from down range, we know what the patient is here for and are able to put in whatever consults to specialist they need to see. Now, all this that I've said so far is done by an awesome team of nurses, or clinical flight coordinators. They do a great job and getting all the right info, entering the consults, etc.

After patients have seen their specialists, had whatever labs or CT scans or MRI's if necessary, they are either determined to be able to return to duty (RTD) or transferred for continuous care (TCC) back to the US. They then see a case manager and finally come see me. I met with patients to make sure the meds are all written on their patient movement record (which essentially serves as their boarding ticket), that all their information about medical attendants, blood type, vitals, etc is written out correctly, they had a traumatic brain injury screening, and that they have all their medications in large enough quantities to get them back to the US without running out. I remind them of important side effects of their medications, sign off on their check list and send them on to get their flights arranged. As you can see not a lot of patient care. The only time that comes in is if they have something that develops during their stay hear, such as a cold, stomach virus symptoms, etc and I can see them for that. I often find that I end up talking to them for a few minutes about what life was like for them down range and pretty much every time make sure to thank them for all they did! Sometimes I have to straighten or clarify a few things and I take the time with them to do that, which they always seem to appreciate. That's when I know I'm doing something important and feel like I'm here on a worth while mission. I can only stamp and sign so many papers as a check and balance before I start to feel like I'm not doing anything for these guys! It's really interesting though to hear what some of these soldiers have seen and what they dealt with. It makes me appreciate my freedom and lifestyle that much more!

The other big part of my job is seeing patients that have been cleared to RTD. I have to make sure their diagnosis fits within these guidelines that were created that outline what sort of diagnosis and or treatments prevent someone for being able to deploy into the desert. It's pretty interesting what fits and what doesn't. So far I haven't had to question what a specialist has determined (thank goodness!! This is the least favorite part of my job because I would hate to have to question a specialist...) but I did have to get involved on one that my supervisor had found to be not fit to return even though the specialist said RTD. That was kind of intense and I'm glad it's over and done with!!

One thing that's so unique about this place is how much I work with my sister branches. It's crazy, I'm stationed at an Army hospital but I'm technically assigned to an Air Force unit at the army base so my flight commander and technical supervisor is AF even though I rarely see them. To top it off my clinic, the DWMMC, is totally run, staffed, and administered by the Navy! I very rarely interact with Air Force people over here.  It's kinda fun to see us all working together, with a few friendly jabs about which service is the best.

Because our office is ran by the Navy, some of my patients can be sailors who have been mobilized to work here at the hospital. There are other sailors working in various parts and clinics in the hospital besides the DWMMC. If they have an acute issue they can come see us for care. Every once in a while I'll see them, which does give me some patient interaction.

We do have to have a provider on call in case a late night/early morning flight of patients arrives and needs a bridge of medications to hold them over until they see their specialists.  So about half the weekends I will have to be around and able to come over to assess the patient and assist in that way. One those weekends I will hang out for a few hours in the fast track of the Emergency Room to help them out and continue to work on my skills. So far I have only done it for one weekend and it was so slow that I ended up seeing a total of three patients in a 5 hour time frame! It'll be interesting to see if every weekend is like that...we'll see what happens this weekend and next weekend.

That's my job in a nut shell, so for all those curious minds out there. Yes, I do work, but I must say it's not as demanding and time consuming as what I do back home. I enjoying being done in the evening and still having time to cook supper, hang out and relax before going to bed and waking up to do it all over again. I'm getting spoiled in that regard and will have a hard time re-adjusting back to life in Virginia...on that sad note, here are a few pictures of my office and clinic and even some showing what happens as patients are unloaded from the bus.

Team opening the doors to start the unloading process of the bus.

Handing a patient off

Here is an even better picture of how they transport patients off the bus onto the gurney to bring the patient inside. This patient is quite a bit sicker then the majority of patients. He went directly to the ICU because of his injuries and level of care. I personally don't see these kinds of patients but the rest of the DWMMC does work on getting his transfer here as well as back to the states once he becomes more stabilized.

This is where I work. The white trailers to the left of the ER is the actual DWMMC. That's where case managers, the nurses, administrators, and all the people who work on the logistics of getting our patients on planes to come here and leave. My office is in the actual hospital, connected to the ER. There is a little ally way between hospital and first trailer - if you go down that you'd walk past my office.

Hard at work inside my office; sorry for the blurriness.

The rest of my office

You know you're legit when the office is labeled with your name!