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9:45 a.m. Only one chart left. A coworker updates Barnhill about a patient who was misidentified at a hospital. A hospital claimed the patient had surgery and sent the clinic the paperwork. During an exam at the clinic, it became clear that the patient could not have had the surgery documented in her chart. When they asked the patient about the surgery, the patient panicked.The hospital was contacted to correct the information.
10 a.m. Barnhill is paged into an exam room to translate. Barnhill is the only staff member who is medically certified as a Spanish translator.
10:10 a.m. A volunteer nurse asks for Barnhill's help. The nurse doesn't think her patient, a single mom in high school, can afford a $4 prescription."I've been there," Barnhill says, relating to the patient's situation. They look at the wall with the "freebie" medications, mostly donated from pharmaceutical companies. They find an antibiotic.The nurse says,"OK, let's give her our last bottle."
***
Safarik describes Barnhill as constantly moving." You can interrupt her and it is not
a problem," she says. "She will still give you a smile."
★★★
Barnhill is back to the eye exam patient. She looks at an Excel spreadsheet on the computer to find a volunteer doctor who is available.
10:15 a.m. Another page, this time to fill the role of clinical nurse. She looks for her stethoscope. "It must be in my other desk," she says laughingly. She finds it at her desk in the nurses' office, throws it around her neck, and escorts the Spanish-speaking patient into an exam room. He is a male in his 40s with bronchitis. The patient's mother-in-law is in the waiting room, wanting to pick up the family's prescriptions.
10:30 a.m. On her way back, she is handed packages full of donated medications from pharmaceutical companies. "Back to the meds," she says with a laugh. She opens and organizes them while calling the doctor to schedule the eye exam. She then calls the patient to let her know.She gets up to fax the patient's information to the doctor's office.
11 a.m. Back from the fax, eight more charts are stacked on her desk. "Wow, look at the stacks, I'm so happy," she says. "Yesterday I
had them piling up back on the shelves. At some point, I may eat breakfast." As she sits down, the nurse practitioner asks her to come translate the medication instructions for the bronchitis patient.
11:30 a.m. The school calls. "They are on a hunt for my husband," she says with a smile. She calls her husband. He says he is on his way and asks if she has eaten. "I get caught up and don't get a chance to eat," she replies.
She goes back to the charts. One patient is getting out of jail and requested refills on her medications, but because it has been so long, her paperwork has expired. Barnhill gets the proper forms and starts filling them out for her.
Photo by Tyler Waugh
Another page. this time a patient calling to ask about a doctor's referral. Barnhill answers the phone as an office worker delivers the patient's chart.
Lining the shelves: Lixel Barnhill visits the medicine cabinet a countless number of times a day to fulfill her dual role as clinical nurse and medication coordinator at the Health Care Access Clinic of Douglas County.
Noon Barnhill opens the medicine packages and starts organizing them. She explains that the amount of medications coming in isn't even half the amount that it should be. She looks up at the shelves of medications. "Right now we are really low," she says, "Believe it or not."
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February 26, 2009