Alone with the facts: Hospital Medical Records Clerk

Hospital Medical Records Clerk

Another in a series on work called THE REAL WORLD

By Russell D. Hoffman. Copyright (c) 1996 by Russell D. Hoffman.

Thousands of records, thousands of patients, one clerk...

It was the last job before I became a computer programmer. I worked alone on the night shift in the medical records department of one of the busiest hospitals in Connecticut, weekends plus one or two weekday nights each week, and went to computer school (and slept) weekdays. It lasted a few months, till I got my first computer job at a bank.

Medical records are the life history of the sick, the unfortunate, the desperate.

The night shift basically had just three jobs. Our primary job was to pull records when the ER called for them. And Fridays and Saturday nights, that could be just about all you did.

The second job was to refile records that had been returned to the records room. This was usually handled by the day shift, so a lot of nights there weren't any to be filed, or very few, or there was a note telling us not to do it that night for some reason.

The third job was to pull records for shipment to a microfiche company that would photograph them onto microfiche and return the 'fiche' to us, and destroy the masters. We had a list of names and color codes to be pulled, and would pull them and put them aside and straighten them out, and put them in boxes. Straightening meant attaching all the EKG strips to the metal tabs, putting all the xrays in the front pocket of the folder, and similar stuff. I always worried that the records were inaccessible for a while, but I was assured that if I had to, I could call the microfiche company. (These weren't for deceased people; those records were pulled during the day and put in a different box, if I recall correctly.)

Records were sometimes ordered "stat" which means immediately which meant they wanted it ahead of anything else, even other records unless they had also been called for "stat". Sometimes the messenger would arrive breathless, sometimes it would be a nurse (that was always nice!) I was never asked to take a record up myself.

Records were color-coded so that if you knew how to spell the person's name, you could find it by color. So when you got a call for a record, you always made sure you had the spelling of the first few letters of the last name and the first name. Naturally, some records were out of place. Some were way out of place. And some were so big and pulled so frequently, that they were kept to the side of the shelf they belonged in.

Some Day This Stuff Will All Be Computerized...

One night, I got a call from a Doctor in Boston who had one of our patients in front of him, and he told me she was behaving as though she were having an appendicitis, but the scars on her belly indicated that she had had operations where they usually take out the appendix "as long as they're in there anyway." (C-section, I think.)

He wanted me to find her record and tell him if she had had an appendectomy along with a C-section at some time.

I took his phone number, repeated it, and told him I would call him back within five minutes and probably a lot sooner. The phone system in the U.S. being virtually 100% reliable, that was longer than either or us wanted to stay on hold. He had a patient to get back to and I had a record to find and scan. I'd call him right back.

The record was about three inches thick. I called the Doctor and told him that, and asked him what he wanted me to do. Should I call down a nurse to read it to him? No, he said, if I have the time--which I did--would I just look through it and try to find anything having to do with an appendectomy or a C-section?

I started flipping through it and pronouncing phonetically the title of the procedures, and pretty soon we found the section on the C-section. It was a single-spaced document about a page and half long, which he asked me to read to him. Every fifth word was about 8 syllables long, but after the first few lines it started to roll along, but it kept not mentioning the appendix. He was going to cut her open because I couldn't find a reference to an appendix in a three inch thick record!

We hung up, and I spent the rest of the night carefully flipping through the document page by page, looking for the half dozen medical terms he had mentioned. Then I wrote up the incident for the boss. The next night, I happened to see her when I came in, so I asked her if she had heard anything, but she hadn't.

I guess he found an appendix when he opened up 'our' patient.

A Common Cold?

How sick do you have to be to go to the emergency room of a hospital? Not as sick as you might think, if it's after hours. Coughing fits, a child's high temperature, a stomach ache. Don't be so sure you shouldn't go if you think you or someone you care about is sick. A lot of people think hospitals are for life or death emergencies only, but you have the right to go if you need care now. Don't worry, if there's a 'real' emergency they'll let you languish in the hallway till dawn. I'm certainly not recommending you go in for a nick when shaving. Or anything else you can take care of yourself, or that can wait. But if you're worried, you can go.

One time (years later) I was touring the Everglades in one of those shallow-bottom boats with the big fans on the back, and a bug flew in my eye (they have a lot of flying bugs in the Everglades). We were just docking, so I got in the car and left, but the eye swelled shut and turned beet red. This was about four hours before I had a lecture to give. I stopped and bought a gallon of water and stood in the parking lot and poured it over my eye, and that helped, but when I got to the city where I'd be lecturing, the eye was still pretty messed up so I went to the emergency room of the nearest hospital.

A triage system is one where they take the patients most in need of emergency service first, regardless of the order you come in. But who says who's how hurt? The receptionist I think, sometimes!

I waited over two hours. By then, the eye was actually looking pretty good, and it was seeing pretty well as well. The doctor put some drops in it that opened up the cornea and turned the white part some other color (purple I think). Then he studied it under a lens and pronounced me fit. He didn't know what kind of bug it was and didn't seem to care. Not being from the area, I was afraid I might have caught some deadly parasite for which the only known cure was only found at a hospital. He said I'd be fine. As far as I can see, I am.

Most of us don't want to loose an eye, most of all. We only get two and the next step--total blindness. Most of us, even mountain bikers, would probably rather loose an arm than an eye, both arms than both eyes. So I thought two hours before the first doctor looked at me was a long time for something called an 'ER'. Maybe they were busy, you say. Yes, the 'meat wagon' had come in with a load while I was there. But no: I saw who else was going in and out, who else was waiting in the waiting room next to me. They didn't seem that sick! One even offered to let me go ahead of them--they weren't loosing an eye! I really think the receptionist just didn't like me. I guess next time I'll go to some other hospital.

Juggling Responsibilities

Sometimes we had literally nothing to do at night in the medical records office. So I learned to juggle. A few years before someone had mentioned to me that the trick to juggling three objects is to start with two in one hand and one in the other, and throw one of the ones in the hand with two objects. Then throw the one in the other hand so you can catch the first object, and that just keeps on happening. I still juggle now and then. It's fun.

What room is in the basement of every hospital?

We were located in the basement of the hospital. Another room is commonly in the basement too.

To get to where the vending machines were from the medical records office, you had to pass the morgue. One day soon after I started working there, I was walking over to get a snack and I saw the sign on the door. It was a simple sign like every other sign. It simply said "morgue". It was right near an expansion joint in the floor of the corridor. I started thinking about it, and there just wasn't any other way to get to the vending machines. And you just had to walk around and get something once in a while or you'd go nuts! No matter what food you put in your lunch bag, you wanted something else, something only a machine could deliver. You weren't allowed to stay at in the food room to eat, because you worked alone and might be needed, but it was expected that you would go get something to eat or drink and bring it back now and then.

Working nights in the basement I usually never saw anyone except the messenger that took the records upstairs. But one day, finally, it happened. Two attendents were wheeling in someone under a sheet, someone who had been fairly rotund. When the rollers hit the expansion joint, the sheet wiggled. I continued on to the vending machines, stared at them for a few moments, and just went back to work.

Nosocomial is Not So Comical

One day our boss came back from a conference and had a pin that said NOSOCOMIAL IS NOT SO COMICAL, which she attached to something in her office. Nosocomial diseases are diseases spread through hospitals themselves, from patient to patient. I had to look it up, of course, but there were lots of places to do that!

Hospitals are dangerous places. People die there. People go in with one thing and die of another. Hospital workers have increased risks of just about everything that can be caught.

It's All Attitude...

They hired another guy, and apparently some of the other people didn't like him, but I told our boss he was a good worker. He explained to me one night, that the hose attached to the faucet in the janitor's closet was illegal and dangerous. If water gets left in the sink, the hose could suck up dirty fluids into the clean water system if pressure changes occur when the tap is open. And once in the system, they can be devastating, and very hard to clean out.

I told our boss he was a conscientious worker. She kept him, as far as I know.

In January, 1997 I received an email from a high school student asking for more information about the job of Medical Records Clerk. Here's that correspondence.

If you enjoyed this story, please check out these others:

(Highlighted entries are currently online. The rest I'm writing as I get time.)

Table of Contents

The Animated Software Company
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First placed online July 31st, 1996.
Last modified March 27th, 1997.
Webwiz: Russell D. Hoffman
Copyright (c) Russell D. Hoffman