All day and night yesterday I worked on my cultural assessment presentation. I even woke at before 5 AM and started working on the last few slides. My paper to accompany this project was 2300 words - way too much writing for one day. My brain was too over stimulated. 

I had a difficult morning after attending a meeting - it is so hard when I have completely different viewpoint than some others. I really hope that making a change will help the frustration I feel. I then headed to one of the hospital campuses to conduct my boot camp class. Two nurses from the admission's team came and they really appreciated learning some quick tips.

After the class, I went to help one of the doctors and showed her how to manage her Outlook express. It was so funny when she wanted to clean out her inbox by dragging and dropping a whole bunch of emails at once. I told her I created another Liz Gaga "Little Monster." She loved it! Too funny!

Tonight I was supposed to go to ACCC for an Adobe Flash class - however, the catalog did not reflect that the instructor has pushed the class back by a day. Oh well - it starts on Wednesday. I was so tired anyway and came home and crashed in my chair yet again. I need some sleep.

Unfortunately, many days have gone by and it looks like my practicum has fallen apart. One, my mentor has not replied to a couple of my emails and second, I applied for another job. If I get the position as a clinical analyst, I will not be able to continue doing my learning agreement. This is probably the worst snag I have ever come across in my schooling. The only exception to that statement is when my dad passed away during statistics.May be I am exaggerating . . . I hope so.

I am excited about making a change though . . . my potential new boss mentioned that there is a person from a competing hospital that is going to be interviewed as well. Acquiring analyst build skills will make a huge difference in my resume and potential for becoming a consultant or working for Cerner. I only have 10 years left in my earning career. I need to do as much as possible to make the most money for the end of my working career.I would like to pay off my house.

School this week was a total confusion in doing a debate between two learning teams. The directions were all over the place, way too many posts!  I am behind by 100 posts - never have I been so behind! At least I met my obligations, but this was chaos.

This weekend I must create a PPT on a cultural assessment on a family. On Tuesday, I interviewed an Indian couple from the state of Gujarat. I learned so much from them! Wow, I wish American families were more influenced by their cultural values. 

Somewhere along the line, I found that ACCC is holding a 4 session class on Adobe Flash. I went ahead and bought the master collection so that I can actually create anything whether in print or on the web. This should be interesting. 

This was a busy weekend. I finished my schoolwork early on Saturday and handed everything in my 2PM. Dang - this weekend we get an extra hour and I did not need it! I did not work on my practicum at all and still need to reach out to my mentor. We have not connected in a couple weeks. 

Personal Stuff: I needed a weekend day to do 3 weeks of laundry, that actually led me to clean out my closet and get rid of so many clothes. I pared things down so that I have room in my closet. All my summer things now fit in my wardrobe, which will make switching things out next spring so much easier. Cooking today consisted of marinating a London broil and sauteing mushrooms, onions, and peppers. To round it out I made a baked potato - small amount of button and I am skipping the salt as much as possible, so I use lots of cracked pepper. Dinner was delicious. 

My eye is so much better - I feel slight pain when it is time to put in the eye drops. They have been a sight saver! My vision is so much clearer than it has been, so I am looking forward to fixing this for good.

Creatively, I read on the Delphi travel nurse site that next year for Halloween, everyone should dress up as an old fashioned nurse. I found a uniform store in Rhode Island that sells a white nurse's dress uniform and a nurse's cap. It is perfect! For $50, I have a great costume. I will be ready in 2012! I will need to find shoes though. 

Oh boy, I woke up with severe right eye pain at about 4 in the morning. I was able to get relief if my eyes were closed, so I went back to sleep. When I woke up, it was so red and painful that I took Motrin right away. As soon as I got to work, I called my optometrist office to see if I could get in to see the ophthalmologist - they had me come in right away. The doctor, who was very nice, put in numbing drops and told me that I have an infiltrated infection of the cornea, so uncomfortable and light sensitive. He feels I need to put strong antibiotic drops in my eye 4x a day for 2 weeks. Then I will need to use a low dose antibiotic drop for 2 months . . . this is a nasty chronic non-contagious eye infection. What fun . . .

Once I finished with the eye doctor, I stopped by AC Moore to pick up some carving tools for pumpkins for next year. I gathered up a nice selection of ribbon scrapers and xacto knives for more intricate designs. I might try carving a squash or a small pumpkin - maybe an apple! Hmm . . . that would be interesting. 

Back at work, I received a call that a patient disappeared from the chalkboard. It seems that whenever anyone does a change or any update in STAR to an actively admitted observation patient, they get kicked out of the system back into the undelivered hold section.  I had to ask our interface guy (long story there) to tell me what the transactions meant. Between him and the registration analyst, this is how I discovered what happened. I reached out to the interface guy at GE to see what is up with this.

One of the corporate educators stopped by and shared some angst she has been having with her office mates. That stinks but I can relate. I struggle at times with the same issues. She taught a class I had attended on Tuesday that did not seem to meet my expectations and she wanted to rectify that, but I understand the issues surrounding the residents concerns (see previous post). She just wanted a sympathetic ear.

By the end of this conversation, my eye was tearing and really hurting. I emailed my boss to tell her I was heading out to pick up my RX and would work later in the day once the eye pain stopped. It was not until about an hour ago that it subsided - 9:30 PM. 

I signed into class tonight and updated my learning team about my eye issue. I should be good to go by the AM. Tomorrow will be busy - my part of the debate opening statement and conclusion, plus the second DQ and class participation responses. Sunday, I am slating the day to finishing my bibliography. Three more weeks and this class will be done!

What the heck have I been doing these past two days? Whew . . . yesterday I was busy from the get-go. I received a call from the help desk from L&D staff saying that a patient was admitted to the recovery room, however, the fetal monitoring strip was not showing - for 5 hours. I could not hold it in - I reinforced the correct process which is to sign into the system to double check that the paper strip running matches what is seen on the PC monitor. Once again, they did not follow process. The issue was a GE setting on the workstations that our technicians and their system engineer needed to troubleshoot. We shall see how long these settings hold.

Then I wanted to just stay at the hospital, but the rest of our team needed to conduct a meeting in our travel space. I grabbed a small salad and headed back to my office. I am glad I did as I got some things accomplished. Hopefully, this weekend I can finish my bibliography and work on our web page - it needs a serious overhaul. I ended up staying until 6 PM to clean up my email and get things done. 

Once I got home, I fixed a plate of pork and sauerkraut - even better than the first night! Creatively - not much occurred yesterday - but I managed to talk to my children and my mom doing a very old fashioned thing - use the phone! We organized Thanksgiving and it is pretty much the same as all the previous years . . . at my sisters.

Today, I attended a 2-hour presentation on active listening and constructive feedback this morning. It was a repeat of content presented in the Foundations of Leadership course I did last year. I tried to learn how to handle the frustrated people that call about computer issues and are so distracted or just plain rude to us . . . and instead of an answer, I had a resident rudely tell me what "I should do . . . which is provide them in person help 24 hours 7 days a week.." Wow . . . he also tried to tell me that patients die because of the computer. I reminded him that during medical emergency and code calls they need to use the crash cart and not the computer. He also pointed out the 700 million dollars the organization made and that we could in fact afford Apple computers! He could not relate to us "less educated" people. Wow . . . I was a bit off put by his attitude, but it was a perfect example of what we go through. The corporate education instructor tried to be diplomatic, but that was impossible with this resident. He has his agenda and I had mine. This was perfect example of silence versus violence. Guess which one I used? Exactly!

For lunch, most of the team went to lunch at a local restaurant and I managed to get the car serviced nearby, too (rear brake light, and windshield wipers all fixed).  That feels good to have the car readied for winter. A coworker picked me up and then brought me back to pick up the car when it was done. We finally took down all the Halloween decorations, too. Lots happening today.

Tonight - I met my commitment for school , but I am so burnt on writing papers. Really done and now need some serious sleep.

Finally, our fix is installed on the GE fetal monitoring system and . . . we wait . . . of course, no observation patients have been admitted so far. Figures, as we are all checking and rechecking to see if it worked. I did my phone calling this morning to give a head's up to the staff about the change and they are to reach out to the help desk if the patient does not cross over into the correct bed. Non-stress test patients (since they changed the process) do not get picked up by the interface - it will remain a manual process. The only issue is if an NST is going to be admitted as an observation or admission, the patient needs to be put back into undelivered hold to be picked up correctly by the registration interface. This keeps the patient connected with the system no matter where they become admitted or transferred.

As for school, I must digest all the instructions for the project due on Sunday. We need to conduct a debate on how the environment positively affects a family's structure and function. This should prove interesting.

Creatively speaking, I received an blog update from Thom Khulman and he describes his mini training job aides as coursels. I think a more appropriate name is "info-morsels." This is copyrighted (by me) and I can already see little candies graphic links taking people to their appropriate training guide. He also stresses how important it is to develop training courses that are not automatic. The end user should drive the speed of the presentation. I agree and will try to start doing that. 

Update after class: Tonight I had to teach a class on the electronic medication reconciliation process - four people were originally signed up, one dropped the class and only two people showed. At least they were grateful because they learned some tips and tricks. I helped them customize their computer settings and create favorites to save them time . . . the ED nurse even said that it was worth the 45-minute ride to create her own PowerPlan. That made it worth it for me.

Today was an early day so that I could participate in a teleconference about correcting the interface issue. Last week we updated our fetal central monitoring and the outpatient types did pull the patient out of the hold unit and place the patient into a bed. This was challenging because four different systems were involved to make the one work. Our registration system (STAR) is different from our primary health information system (Cerner HIS) and from our fetal monitoring system (GE Centricity Perinatal). Then we have an interface engine called Cloverleaf. Now all these players had a chat this morning to try and figure out what was wrong . . . let me just say this . . . GE knew exactly what was wrong, but becasue they scheduled our update last week when key personnel were on vacation, we had to wait a week before the issue was corrected. I look forward to the day we are a partner with Cerner and will implement all their solutions. Then we can sundown the GE system!

What did I learn:

1. Check who is going to be on vacation - schedule around those "irreplaceable" people (system engineers & interface people on either side especially) 
2. Have plan B - we had a work around for the staff to do a manual transfer of the patient from the undelivered unit into a bed
3. Google anything - I cannot remember what the HL7 messages such as an AO11 means - dang - still can't remember at 1 AM - but I bookmarked them
4. Be direct and specific with all email and information provided while troubleshooting - keep things very simple and restate next steps
5. Make screenshots of everything and put that in with the request for change (RFC) paperwork - this just might help someone else or myself down the road

This took most of the day until we reconvened at 4 PM. Our interface specialist did not want us to put the fix into our production system then because if the "fix" breaks something else it is after hours and again - personnel will not be available. So, GE will be putting the fix in at 0800 today. My job is to notify the L&D unit and to ask them to check observations and admissions to see if the ADT interface is now working. Here's the rub - I am supposed to work tomorrow night teaching a medication reconciliation class form 6 to 9 PM. Another long day . . . 

So, back to schoolwork (I am so sick of writing papers - just thought I would share), I finally finished my paper and I think it is decent. We shall see what the instructor thinks when he posts our grades. That was my day . . . I don't think I can fit in much more. 

I do not think I did anything creative today . . . double dang!