Sunday, November 30, 2008

(somewhat) successful!

Nothing much new to report other than the SOPHAS application deadline is tomorrow (the centralized application system for public health schools), and my apps are complete and submitted! I was a little nervous for awhile because one of my profs, while assuring that she'd write me a good recommendation, was drawing out her submittal to the last minute and driving me crazy. It was all I could do not to continually pester her, but I held back for the most part (except for a couple emails I had to let fly--I couldn't help it!) and she did submit on time. I'm in the home stretch now, and just need to finish tying up some loose ends on a couple others, and I'll be all set, at least in terms of applying....obviously there will still be the whole acceptance/financial aid/enrollment aspect to figure out! But at least stage 1 will have come to an end.

This week it will be incredibly difficult to focus and allocate enough time to wrapping up this process, as I am helping out with the general orientation of all the new employees for the Phoenix hospital. The real goal of the week, other than distributing all the policies & procedures, HR benefits, and all the other paperworky-stuff, is to enculturate all the new employees. I'm really curious to see how this process unfolds, and to see how a group of strangers evolves from just that- a diverse group of individuals with little in common- to a unified organization of teams who must rely on each other to complete (in some cases) life-saving actions. All the hospitals have a little different flavor, and since we're openng up with 30% transfers, I'm also curious to see what the unique culture of this organization will be. Tougher around the edges but secret softies, like Philly? Slow-moving but incredibly warm and kind, like Tulsa? In the next month I'll get to witness firsthand how concepts and philosophies we've been tossing around for months in a tiny office down the road morph into a tangible culture and daily processes.

That is, of course, if any of these folks survive to see opening day....I've spent the last 5 hours baking loads of sugar cookies for my Team-building workshop, during which we'll be decorating holiday cookies in addition to all the normal, obscure-question-laced icebreaker games. Little do these poor souls know that within 48 hours of their employment, they'll be forced to suffer the disasterous results of my baking, something even my own mother won't willingly do without copious amounts of vino. Good thing I've got several dozen of the store-made variety as my secret backup. Ironically, the employees will probably bond as a team over their disgust over the burnt, sugary lumps I'm calling "snowment" and "Christmas trees." The good news is, if these new employees can survive my baking, they can certainly handle any conflict or situation that might be thrown their way....which is my intent, right?

Friday, November 21, 2008

wild wild west

As of Wednesday, I am temporarily living in Phoenix, AZ (well, technically Goodyear, AZ) for the next 6 months in order to help open our newest hospital here. I'm excited for multiple reasons, not least of which is the much warmer weather--I've set my iGoogle to show me the temps in Chicago and in Phoenix, and delight several times a day when I notice that the Phoenix temperature is 2x or3x as much as Chicago's.

The hospital opens at the end of December, which will make this holiday season even crazier than usual, as we will have only a few days to prepare for and pass state inspections, train the entire staff, and tie up all the loose ends required to get the place up and running. As for me, my "unofficial, official" task is to help get the Lean/Six Sigma department up and running. Lean and Six Sigma are two process improvement methodologies we use to eliminate waste (waiting time, etc), reduce defects (increase pt. safety), save money, and improve service delivery/quality of care. My responsibilities, besides setting up the various processes, programs, and training all employees, will include the implementation of several tools required to staff nurses based on patient acuity. For non-HC people, this essentially means understanding how much RN work is associated with a given patient condition, and then structuring staffing around assigned acuity levels so that patients get the best care and nurses are utilized most efficiently. Patient-based nurse staffing is mandated by Arizona state law and will require a tremendous amount of clinical knowledge and IT skill that I simply do not have....yet. I love the challenge of working on something that is completely foreign to me, and will help acquaint me with all the order sets, documentation, etc. that an electronic health record requires. Plus I'll get to hang out on the inpatient/ICU unit, and there's not much more I like than being around patients (as opposed to spreadsheets!)

Even more appealing to my creatively-inclined brain is the start-up atmosphere: the feeling of actually envisioning something and then creating opposed to most of what I've experienced in the corporate world, when implementing anything feels like a battle. It's an opportunity to help establish a culture that embraces process improvement and equips employees with the tools they need to create change, rather than just providing lipservice to the notion of employee empowerment. After spending years studying culture as a concept and the last year observing organizational culture in particular, I still have no clue...but I'm excited to find out!

Tuesday, November 11, 2008

a little bit of medicine....

In terms of grad school, there are a few more applications I have yet to complete. I've been a bit distracted lately (as evidenced by my lack of attention to this blog), by schoolwork, the election, a cold, wrapping up my finance stint in Philly, and getting ready to "move" to Phoenix (more on that later...)

My cold was minor: a little cough and a slight sore throat, accompanied by the requisite whining to my mother via throaty, whispered cell phone calls. I couldn't sleep a couple of nights, when it felt like there were several dozen hyperactive Boy Scouts attempting to build fires in my throat, and as I writhed in agony, I quickly lost my grip on reality and plunged into the depths of self-despair.

That is, until the next morning when I was traipsing around the hospital affixing asset tags to capital equipment (read: the most mind-numbing job ever), I stopped to chat with a kindly-looking elderly man wearing an Ohio State cap. As we chatted enthusiastically about the impending Northwestern vs. Ohio State football game, I noticed him grimace in pain several times, although he wasn't moving in the slightest, and his face blanch as whatever was bothering him grew increasingly worse. We finished our friendly conversation, and as I trotted away he quietly offered me the traditional Ohio parting words of "OH," to which I gleefully replied, "IO," secretly delighted to find a small piece of home in a faraway city.

What struck me more than our easy Midwestern camaraderie, however, was the chronic pain my newfound friend was clearly experiencing that day, and most likely every day. (Assuming, of course, that his pain could not have been in response to my pitiful predictions of an NU victory.) I thought about my cold and how annoying it was, and the gulf between the sick and the healthy opened in my mind. I have always taken my health for granted. Except for minor illnesses and surgeries, I have never experienced protracted or dehibilitating pain. If I ever did encounter such a misfortune, I could go to a number of specialists, get a few scrips, and be done with it by day's end. I think about all those with no or insufficient insurance, who have no choice but to live with the pain, the discomfort, and much worse than the occasional sore throat until it gets better...

or until it forces them into the ER.

After experiencing life from the student and provider's perspective, I understand the implications of this country's paltry emphasis on preventative medicine & primary care from a conceptual (and financial) perspective: predispositions, poor health behaviors, or chronic illnesses left unadressed until more costly, time and labor-intensive acute care is the only available alternative. What I forget--or simply can't imagine-- is what it must feel like to be that individual with high blood pressure who can't buy their medication or to have strep throat without access to antibiotics. I can't imagine living in constant pain, rendered unable to participate in my own life, a helpless bystander watching as my body betrays me. Once again, I am grateful for the opportunity to work with patients who distill the articles, theories, and philosophical pontification in which I so often lose myself, and illimunate real life. I hope that grad school--and especially public health internships--will help expose me further, because I know I must understand before I can help.

And on that note, back to applications!....

Thursday, November 6, 2008

stop the bickering, children

I would be remiss not to mention the most historic election day I've experienced (and probably will experience again....until, that is a woman becomes president!). In the midst of these troubled times, I can't help but delight in that little trill of hope that is radiating throughout the nation, and I am excited to see how "change," a term that is in my opinion overused as it is elusive, will be embodied and enacted by the Obama administration. Lord knows we need it.

...and perhaps this makes me a bit of an apolitcal anomoly, but I'm also relieved that the election is over. While I'm looking forward to watching and experiencing the dynamic shift in policy-making we're all hoping this administration brings, I'm so tired of reading about the election. I'm tired of hearing about Sarah Palin's jacket collection (if I wanted to read about fashion, I'd be reading Vogue not the New York Times, thank you very much), or psuedo-Marxist comments made by Obama's pastor's fifth cousin twice-removed, or what a sexy silver fox Joe Biden is (OK, I just made that one up!). I'm excited and proud that this election finally engaged and provoked Americans--and my apathetic generation, in particular-- but I despise the moment when thoughtful arguments about important issues regress into petty bickering and an endless tirade of "he said, she said." It seems as though, during a particularly heated and protracted election cycle that included hard-fought primary races, that moment occured eons ago.

Indeed, a recent article in the Washington Post, while admitting a liberal bias that came as a shock to no one, also shed some light on the media's sensationalization of bickering and diminishment of issues:

(By Washington Post Ombudsman Deborah Howell, commenting on the frequency and kinds of stories published since Obama's candidacy was finalized in early June)

"The count was lopsided, with 1,295 horse-race stories and 594 issues stories. The Post was deficient in stories that reported more than the two candidates trading jabs; readers needed articles, going back to the primaries, comparing their positions with outside experts' views. There were no broad stories on energy or science policy, and there were few on religion issues."

Thus the public were forced to search to find straight-forward and reliable information about the issues at hand, unadultered by scathing barbs or catty remarks uttered by one candidate or another. Maybe I'm just a wuss. Admittedly, I refuse to watch Olympic ice skating because it pains me to see the athletes stumble or fall on a jump- I hate watching failure or humiliation, however minor and in whatever form. I'm not non-confrontational (as anyone who was around me from ages 15-19 would tell you in a heartbeat!), but I think this country and our problems are messy enough without exacerbating the issues by meaningless bickering. Productive, constructive conflict I am all for. Name-calling and rumor-spreading, I am not. Kindgergarten recess time is over, and it's time stop pointing our sticky, jam-coated fingers and move on.

Now that the election's over, I'm glad there's a ceasefire, however temporarily, between our rivaling parties. I'm even more hopeful that my morning paper will begin to illuminate what "change" really means for us as a nation as we move past the bickering and begin to witness the policies, actions, and political climate this new administration will create.

I am less hopeful about one thing, however: that SNL will continue to be as entertaining as it has been in recent months. Buh-bye, "Sarah!"