Tuesday, April 01, 2008

The Ramblings of a Sleep-Deprived Service Tech

Working in a hospital engineering department has always been a combination of monotony, maintenance, and surprise. I tell people, "If you can think of it, we probably have at least one of them." We supply air, water, gases, nuclear medicine, etc.
One of the capabilities that we have is the capacity to generate our own power. Part of our responsibility is to assure that that power is always available, and able to come on line within 10 seconds of city power loss. So, for example, someone checks our generators 3 times a day, to make sure that the switches are in their correct positions, that there's fuel avaiable, and that the batteries are charging. Once a month, each generator (we have 3) is tested under an actual load, and they are all run once a week. This means that, twice a month, a couple of us get to come in at 0430 to run them under a load on a scheduled basis, at the least disruptive time for all of the activities that happen in our happy little hotel. We sometimes have to postpone a test if there's a trauma or other unscheduled surgery going on - even though those areas are protected by Uninterruptable power supplies - we do not take the chance that someone might be plugged into the wrong outlet. I'd want to know that if I were on the table. Today was my turn - to do the test, not for an operation.
Getting up at 0330, even to go fishing (which I've never actually done), is like getting up in the middle of the night. Fortunately, wearing a uniform means that it's relatively easy to get dressed in the dark. Stumbling out to the car - I've worked there so long that I really don't have to think about where I'm going - my 16 year-old buggy knows the way. Traffic is light. Who knew?
The hospital is lit up, as it always is. With the exception of different faces, and less of them, it really doesn't matter what time it is in the hallways. The Generators are out back, sequestered in buildings that block a majority of the noise that they make. We check the fuel, check the oil, check the radiators, write down the vital statistics, including the hour meter readings. We are in a constant squeeze between regulators; the Air Pollution Control District only permits us to run these mammoth diesels for so many hours a year (excluding actual emergencies), and the Joint Commission for Hospital Accreditation sets the parameters for testing them, including how much load to place on them, for how long, and when. These agencies do not communicate with each other.
The Generators, themselves, are big, with big old radiators on the front, the actual generator on the other end, and massive exhaust systems crammed into the building to keep the noise down. Ear protection is required. Heaters keep the engine warm, to help them start more quickly. When running under load, they are actually turned on by Automatic Transfer Switches, which either sense the drop and switch automatically in an emergency, or via our building automation softwarem, on a PC when we test. So, you press a button with your mouse, the lights go out, and within 10 seconds the switches switch, the behemoth awakes, takes the load, and everything springs back to life. Thirty minutes later, the switch back is just a 'bump'.
There are lots of things that can go wrong, and they do, although rarely. Today, all was just peachy. We fired it up, made sure that we were delivering over 300KV (30% of the generator's 1000kV capacity), checked the temps, hertz, amps, and stood around for 45 minutes while it did its' thing. The crescent moon was lovely, through the clouds. We ran the other two 'no-load' for 10 minutes apiece, filled out all of the paperwork, and it was time for breakfast.
One of the things that I've always taken great pride in is that even these industrial actions that we take can be and are related to taking care of patients. The people that are the best at this kind of work are those who relate what they do to the greater good. I like watching "Dirty Jobs" on TV because Mike Rowe understands and promotes the concept. To be quite honest, my paycheck isn't enough to drag my tired butt out of bed to do something like this, knowing that it is important makes it happen.Yes, this is one of the reasons that your hospital stay costs so much. There's a lot to this facility that most people never see in redundant systems and things like fire safety. There's a lot wrong with healthcare in this country, but there's a lot right, too. I know that in my house, you're going to be safe, secure, and the lights will be on, if I have anything to do with it. We might even make you comfortable, every now and again. but that's another story.