The State of Medical - 5 Months Into The Reforms

Hello! Loremaster Jackboot here. In August of 2017 I worked with members of staff to restructure the medical department's many jobs and outline how they relate to each other and what they're supposed to be doing. Thanks again to all involved.

It's now 5 months into this new golden age and I want to take this time to gather feedback and see how this has affected medical. If you play in medical it would be GREATLY appreciated that you answer these questions for me so that we can understand how the changes have affected your playstyle and enjoyment of the department, and in what areas we can improve or address issues that went unnoticed.

1) Are the roles of each position in medical clearly defined and easy to understand?

2) Have you been able to memorize the guidelines and rules of your job in medical or is it too complicated?

3) Have staff been enforcing the standards in your view?

4) Are there any medical jobs that you have seen plummet in usefulness and/or fun?

5) Are there any problems with medical being bottlenecked by a lack of a specific role? Is any role TOO specialized? (For example, no surgeons)

6) Have nurses been sidelined or are they still useful/fun to play?

The answers to these questions will really help us out. I am very eager to understand how this has impacted the department. Negative feedback and positive feedback are both really needed to let us get the full picture.

I also want to briefly re-state the goals of the original reform and the new expectations.

The primary goal was and is to strike a balance between realism and game flow. Hospitals around the world are radically different, and we wanted to form a cohesive NanoTrasen way of tackling it. We also wanted to make sure that every job in medical has something to do and knows what they should be doing. We want to give some roles specializations to make their presence important and valuable. And finally we wanted to balance the specializations with redundancy and overlapping responsibilities so medical could function reasonably well even in deadhour.

I think Virology/Viruses needs a rework of some sort. I hardly see anyone playing virologist and that's probably because you hardly see anyone play virologist. They're cooped up in the sublevel away from everywhere else, pulling levers on a slot machine.

Hi! I mostly play med, so I do hope my answers are relatively accurate (and useful.)

1: I'd say so. I've never had much confusion about what individual person does.

2: See answer 1.

3: Kind of. I've seen more than a few psychiatrists or chemists treating patients, but it's a pretty rare occurrence.

4: I don't see virologists get played very often, and I can see why. You've got one very specific job, and the only real fun is if there's a virus outbreak. Chemists may have to mass-produce a drug during a crisis, and doctors are always being called around, but virologists just have very little to do. Which makes not having one during an outbreak all the worse.

5: See answer 4. The biggest problem I've experienced was during graveyard shifts, with neither a chemist nor a surgeon, when somebody's cloned. That person has brain damage, and without either A: Having a character experienced in chemistry, B: Power/metagaming to make alkysine, or C: Praying/Faxing, which always feels a bit like overkill for 5u of alkysine, there's essentially nothing you can do. This bugs me greatly, as the whole part of playing Medical is that you can almost always do something to treat wounded people.

6: I don't see Nurse getting played a lot, but I do see it every now and then. I'd say the biggest problem with it is that a nurse's role would be things like administering injections and treating basic damage, the main problem being that in 70% of any given round, the actual doctors/surgeons/paramedics are fighting over the tiniest scrape because there's not much to do. While I find people playing the nurse incredibly useful during crises, they have the virology problem of not having much to do until their specific skills are required.

Thanks for the read, and sorry if it was a bit long.

I agree that virology is the least-utilized. Some sort of reform of the way it works is about the only thing I can think of to really fix that problem, though.

One thing I will note is the difficulties in being an Emergency Physician. It feels like EPs and Paramedics step on each others' toes. Further clarification on where one job ends and the other begins would help those of us all two of us that play EP fit in better with the rest of the crew. Surgeons do surgery. Chemists mix the things. Emergency Physicians--oh. Well. The paramedic already DID that, so...

1) Some info on residents, who they are, why they're here, might be nice. People just see it as "assistant with medbay access", they don't realize they are actual doctors already, and don't realize they're meant to have specialized in something before they got here. Also others dont seem to know that residents can do normal doctor things as long as they have a supervising. But again thats a problem with people not reading

2) ez

3) If it's noticed and reported to the CMO/HoP/Cap that a 22 year old somehow got hired as a doctor without a degree, and they can't be assed to enforce hrp guidelines on an hrp server then elevating it via a staff evaluation should hopefully get results, if the appropriate people manage to act like they care. That'd be good enough for me but thankfully it's been handled on station

4) No

5) Please just get rid of Emergency Physicians. They're a relic from before the EMT role existed. No one knows what they are and why they are and they don't want to. It's just used as an extra paramedic slot and because it has "emergency" in its name and starts with a high vis jacket on, CMOs tend not to care. While its all fine and dandy for most people on the outside looking in, as a Paramedic with already little enough to do, its an annoying feeling to have to compete with these people because they have more access than you and more permission/ability to turn around and drag the patient deeper into the depths of medbay for surgery/treatment/cloning too. Imagine it as if Forensic Tech exists, but also Security Officers were fully able to do forensic investigations too and had access to everything they needed, only difference is Forensic Techs just have a tiny special little room to sit in. In game, the specialized role of "stabilizing people for further treatment" in between medics and the other doctors is of no value.

6) I only ever see nurses there to talk and be cute anyway, no change

Thank you for the fast feedback already! It is already very insightful. I've read every point but I am just going to respond to what I consider the ones that really stuck with me and I think bring up points that should be addressed.

I think Virology/Viruses needs a rework of some sort. I hardly see anyone playing virologist and that's probably because you hardly see anyone play virologist. They're cooped up in the sublevel away from everywhere else, pulling levers on a slot machine.

I agree! I already have a proposal up for this. Your post actually triggered my memory about this as one of the issues I had set aside at the time. This is different from my original plan but it's what I got.

https://forums.aurorastation.org/viewtopic.php?p=91882#p91882

One thing I will note is the difficulties in being an Emergency Physician. It feels like EPs and Paramedics step on each others' toes. Further clarification on where one job ends and the other begins would help those of us all two of us that play EP fit in better with the rest of the crew. Surgeons do surgery. Chemists mix the things. Emergency Physicians--oh. Well. The paramedic already DID that, so...

The Emergency Physician is meant to run the trauma center. They are MD-lite. Their specialization is a little redundant but that is by design. They can dabble in EMT as well as MD areas, and can even do bone-related surgeries. They can do things that EMT's and paramedics can't do, but also do things that MD's shouldn't do. I can understand that there is some chafing though, especially when medical isn't exactly swimming with patients. In an ideal situation the paramedic/EMT should be handing the patients to the EMP once they're actually in medical. EMP's are meant to be a redundancy that can be a crutch for either a lack of first-responders or a lack of MD's. Is this redundancy so annoying that they are genuinely better off being removed, [mention]Munks[/mention]?

5: See answer 4. The biggest problem I've experienced was during graveyard shifts, with neither a chemist nor a surgeon, when somebody's cloned. That person has brain damage, and without either A: Having a character experienced in chemistry, B: Power/metagaming to make alkysine, or C: Praying/Faxing, which always feels a bit like overkill for 5u of alkysine, there's essentially nothing you can do. This bugs me greatly, as the whole part of playing Medical is that you can almost always do something to treat wounded people.

That is definately an issue. An unstaffed chemlab makes cloning a very cumbersome and frustrating experience. I am not fully sure how to address this issue without completely making the chemist role redundant by letting more medical staff do it. I personally think every other scientist could argue that they know how to make alkysine, but that's straying out of the medical lane and into RnD. I can talk with staff about the possibility of letting scientists be loosey goosey in their chemistry qualifications during deadhour.

6: I don't see Nurse getting played a lot, but I do see it every now and then. I'd say the biggest problem with it is that a nurse's role would be things like administering injections and treating basic damage, the main problem being that in 70% of any given round, the actual doctors/surgeons/paramedics are fighting over the tiniest scrape because there's not much to do. While I find people playing the nurse incredibly useful during crises, they have the virology problem of not having much to do until their specific skills are required.

Nurses being too redundant to do anything was a concern of mine. I've seen a handful and I even played as one to get a feel for the new state of things, and I have experienced how territorial doctors can be with patients. They do have the constant expectation to do all the general paperwork duties, but that can be so eye-wateringly boring that I understand that they'd rather focus on helping with actual treatment. I am not entirely sure how to address this issue without some more feedback, especially from nurse players.

EDIT:

I forgot to mention medical residents - I believe some wiki maintainers are working on a Medical Resident page and that should be around sometime.

The most annoying thing is that some people don’t even acknowledge the titles. A CMO brought a Suergon out for a basic medical field call when there was a serveral MDs and a EMT doing nothing. This might have been due to metabudding but it’s stilly annoying.

1. yup

2. yup

3. yup, when theres no cmo i remind MDs that they shouldnt be doing surgery

4. viro is boring and lonely, you get stuck in a sublevel behind 4 locked doors, and if theres a tesloose you cant even be down there

5. yeah, if theres no chemists that makes medical a little harder because instead of cloning paitents and giving them the brain healing juice, you gotta do brain surgery on them and noone wants to be stuck in surgery after already being dead :c

6. i rarely see nurses and medical residents, and when i do theyre are usually graytide/idiot doctors that act like cmos (an md that tried to cut someones arm off because it had an infected wound, mrs heckling staff and paitents)

overall i think its fine where it is except for viro, and maybe give nurses something more to do, like surgical assistants. thats fun c:

Chemistry/Pharmacy is hardly a full-time job. If you know what you're doing, you can make yourself redundant 15 minutes in to the round. That's why chemistry is staffed either by incompetent people, or not staffed at all.

I've been around for a few months and... I don't think I ever saw a single nurse! No one plays that. Perhaps some incentive should be made for nurse roleplay.

Virology is useless, so nobody plays that (and those who do SSD quickly), so that's that.

I've seen a few suggestions on how to deal with this on the suggestions forum. Here are a few:

https://forums.aurorastation.org/viewtopic.php?f=18&t=9548

https://forums.aurorastation.org/viewtopic.php?f=18&t=8878

https://forums.aurorastation.org/viewtopic.php?f=18&t=10113

https://forums.aurorastation.org/viewtopic.php?f=18&t=10302

1) As I have only focused on playing Medical Resident and Medical Doctor, I have no real opinion on the others, but those I have read have been understandable

2) Yes

3) There has been, to my eyes, some overstepping of bounds in emergencies. But when it's a quiet round and only one patient to deal with then there have been no issues.

4) I believe the issues of Virology and Emergency Physicians has already been brought up, and I agree with the points there.

5) The worst bottleneck on the station would be the surgeons. As it is, since the new cerebral trauma addition, if you don't have a surgeon you might as well not clone anyone because they'll only end up a drooling mess. MD's can't perform brain surgery and the anti-trauma medicines work very sporadically if they work at all.

Currently, as it is, if you are on a graveyard shift then the priority for personnel would be Surgeon -> Chemist -> MD.

Surgeons can do everything an MD can do, but an MD can't do everything a surgeon can do. (Well, except Virology. But a viral outbreak is only once in a blue moon)

6) The two jobs I've seen nurses do is to either sit in the lobby and greet guests, and watching the sensor monitor, something that otherwise usually is done by the EMT. There's RP opportunities, but every job they do could be done by a resident instead.