maintaining the pressure/vaccum

Technology is designed, and then it is used. Once any technology is put into use, it needs some form of maintenance. Looking at the maintenance required of pneumatic tube systems reveals all forms of tinkering and improvising and adapting.  

                   

For example WIRED did a wonderful piece on the maintenance of the pneumatic sanitation system on Roosevelt Island. They talked to the Swedish contractors who "crawl through the pipes, find holes and repair them”, and find "all manner of things down the chutes that clog up the system ... Christmas trees, exercise equipment, computers, shelving and vacuum cleaners in the pipe. An electric frying pan jam turned out to be particularly troublesome". The engineers at the facility maintain the system with inventive practices, including devising ways to "drill long metal rods through the jams and then pull them out".

And whilst job advertisements for pneumatic tube system on-site Field Service Engineers state that the engineer will "provide preventive and corrective maintenance, emergency and paid service, start-up of current systems, user training, and promotion of company products & services as required", the job will no doubt involve all sorts of inventive practices that can never be captured in a job description.

Hospital pneumatic tube systems need a lot of maintenance, with their heavy traffic flows. By looking at how these systems are maintained, we can learn a lot more about the colourful life of the technology and about the creative ways in which humans will tinker with its parts.

Photo of pneumatic waste disposal system on Roosevelt Island 06, originally uploaded on Flikr by urbanomnibus.

the inadequacies of job descriptions

At the beginning of his popular presentation for TED, Barry Schwartz outlines the job requirements of a hospital janitor. He points out that none of these requirements mention anything that involves other human beings, yet when janitors were interviewed by psychologists, much of their work involved human interactions and a degree of improvisation and 'practical wisdom'.

I was interested in the job requirements of hospital technicians who may be dealing with pneumatic tubes, and came across these job advertisements for a lab tech at Ochsner Health System and a diagnostic scheduling technician at St Luke’s Health System:

Lab Tech: Gross Room, Ochsner Health System

Duties: Accessions surgical cases, biopsies and autopsy specimens from various departments, and clients via Central Specimen Receiving (CSR), the train, pneumatic tube or courier. Verifies patient’s demographics, accessions patient information and test requested in Laboratory Computer. Accurately labels specimen containers tissue cassettes with assigned number. Assist Pathologist and residents in the gross dissection room. Maintains record of Gross Room workload and data entry. Records all specimen errors or discrepancies. Performs staining, autopsy specimen procurement under direct supervision by a Pathologist, Pathologist Assistant or Histopathology Supervisor. Demonstrates actions consistent with Ochsner Expectations as duties are performed on a daily basis.

Diagnostic Scheduling Technician, St. Luke's Health System

Duties: 7. Operates medical center equipment such as computers and software, phone systems, paging systems, intercoms, fax machines, copy machines, pneumatic tube system, and printers in order to perform the duties of the job. Accept change in a positive and professional manner while willingly learning unfamiliar tasks.

Whilst the job descriptions do mention work with other people (I have only included a section of the second job description), they do not explicitly describe the work that I am interested in: the adjustments, the ‘repair work’, the tinkering that technicians perform to get their work done. There are hints of this buried in words such as ‘record discrepancies’, ‘accept change’, ‘learn unfamiliar tasks’, however so much is left out. Although when does a job description ever really describe a job?

a brief tour of a hospital's network

Yesterday I was at my old fieldsite hospital for a meeting. Wanting to linger in the place I had grown so familiar with, I thought I'd visit the bowels of the building and find someone who might know something about the hospital's pneumatic tube system. The corridors down below were deserted. It wasn't long before someone saw that I looked lost though, and I was soon directed to Engineering Services. Again the place was deserted, empty desks showing signs of everyone at lunch. After more wandering I came across the Operations Coordinator of the department (pseudonym Frank). He sat me down and listened intently to my interest in the pneumatic system. Without hesitation he then sprung off his chair and whisked me into the corridors for his tour of the network.

Waiting for the elevators, I found out that the tube system dealt with 2,400 'transits' a week, servicing over 30 units within the hospital. All computer controlled - Frank could even manage the system from his home computer. It was fast, he said. Fast communication; "a highway hidden from the cosmetic face of the hospital". The system meant that the doctors and nurses didn't have to run around with samples. The workload is increasing he told me. Increasing because of the number of tests they are doing, and because diseases are becoming more complicated.

Soon we were heading down the corridor to the pathology department where we were admitted into a humming hive of pathological activity. Majestically, at the end of the room, stood one of the largest pneumatic tube processing units in the building; the endpoint of three separate railways throughout the hospital. Frank showed me how the pathologists used to put too many canisters in the system, and how his technicians had adjusted the infrastructure so that the pathologists could only fit one canister. There were towels lying in the troughs, hospital towels, ready to catch the falling tubes. I loved these signs of adaptation of the system.

On our way out of the pathology department Frank told me that the whole system depended on its users. When things went wrong he knew who to blame - the doctors. "The illogical things that humans do ... humans don't realise the logic of machines". He told me that the doctors would put samples in the canisters incorrectly, leading to spillage. His team would have to clean the canisters carefully, with antiseptic. Even worse however, the fluids would leak into the vacuum, causing trouble. Frank very carefully explained to me the difference between pneumatic and vacuum, which I still don't understand. I was puzzling over these simple engineering facts as we walked back along the corridor. He pointed out the window to the top of the other side of the hospital building, to the plant room, where the pumps for the system were housed.

It was time then for our tour to finish. Frank had to get back to work. His pager had remained silent but there was always something to do. He was a tradesman, he said. A tradesman who loved hospitals. He had worked in the hospital for the last 21 years. Almost everyone we passed in the corridors had said hello. I could tell there was much more to learn from Frank. He gave me his business card (after rifling through his stack, most with little notes to himself on the back), and I will call him again one day.