Gone at Last

Where to start …

Work has consumed me. There have been so many changes this past year – it has at once flown by and yet it feels like time has stood still. And by that I mean, it’s the same day-in-and-day-out. The type of work I do is very repetitive, rooming patients, taking blood pressures, interviewing patients, scheduling appointments … but the patients and their individual problems, needs and personalities, mix everything up so I’m NEVER bored.

I now consider working my hobby. Does that sound weird? Nearly every waking moment I’m either thinking about work or preparing for work. Not the work itself, really, but I feel like I’ve spent so much time physically and mentally preparing for every work day that I’m determined to make it pay off. In fact, I put so much time and energy into my work day, giving 150% of ME into my job that I’m entirely knackered by the weekend and all I want to do is mindlessly watch YouTube videos or play Sims 4 – anything that doesn’t require any mental energy.

I’m not sure it’s entirely healthy to be that invested in my job, but I feel like it keeps me young, it also helps that I work with 20-somethings, as well. I’m always on my feet running around and really don’t sit that often and it certainly taxes my pea brain. Our brains are muscles and need to be stimulated – I feel like this job will keep me on my toes enough that hopefully I never have to worry about Dementia or Alzheimer’s. Yes. I think about those things. Getting older REALLY, REALLY, REALLY bothers me. I think my biggest fear, and I hesitate to even write it because if I write it then will it come true? Is becoming old. Like so old I can’t control my body or my mind. So old that I become a burden on our sons. Or so old that I’m no longer able to live on my own without assistance.

I’m very determined to not allow that to happen.

My dad’s dad passed away a few months ago. He lived on his own until about two-ish years ago when he was finally unable to get around without assistance and he went into a nursing home for veterans. I never visited him at his home. In fact, I hadn’t seen my grandpa in many (decade?) years. I have no excuses – I simply didn’t take the time out of my day to see him. I’m very selfish with my time. This is not a good thing and I feel like a bad person for admitting it but it’s true. I have many, many regrets when it comes to my family and to this day, I can’t really explain why I’ve been the way I’ve been – a recluse. Which is puzzling to me because I’m a realist and brutally honest with my feelings and openly recognize my flaws. Though I suspect the reason is there, bubbling under the surface, I’m just refusing to acknowledge it, either here or to anyone, really.

I admired my grandpa. He was a very stubborn man. He hobbled around on a bad hip for a number of years, by himself, with very little complaint. He fought living on his own and continued onward after my grandma passed away. And I know her passing was a terrible hardship on him – he worshiped her. I like to think I have my grandpa’s stubborn streak. I REFUSE to allow my aging to get in the way I live my life or how my family lives their lives.

I hadn’t really planned on talking about the aging process in this post but I’m allowing my thoughts and feelings to dictate this post so here goes: getting older absolutely terrifies me. I already feel like my body is not really my own anymore. I used to be able to control it and of course, I continue to control it today, but there has been a noticeable shift. Ever since I went through “the change” my body has been thrown off kilter. I’ve noticed more aches and pains since menopause. I tire so much more easily and I’ve been playing around with supplements because I know my body is not producing the nutrients I need anymore. I’ve seen, firsthand, what osteoporosis does to bones and what terrible things it can do to people – it can back people into an impossible corner – bones so brittle they literally crack and are so thin that surgery is not an option because it’s counterproductive to put any sort of hardware in bones that won’t sustain it. So I’ve been taking calcium and Vitamin D religiously.

I’ve been taking Flaxseed daily because I read somewhere that it mimics estrogen and it’s good for your heart and I honestly feel better when I take it – I can definitely tell when I forget to take it for a few days. I’m not anemic anymore since I no longer bleed every month but there are days I can’t even lift my arms I’m so fatigued, so I know it’s time to take some iron and I feel better. My nerve endings are so sensitive sometimes that I know it’s time to take Vitamin B, which calms them down. Your body talks to you, you just have to take the time to listen to it.

I’ve been under so much stress at work – I’ve never been under this much stress in my life. It sucks the very life out of me at times – and yet, I THRIVE on it. I can’t imagine being a doctor, or even a nurse, to be honest – I just don’t think I could handle the stress though now I fully appreciate why doctors are fanatics when it comes to exercising – because it helps counteract the amount of stress their bodies sustain.

Sidenote: I’m back to using my treadmill – even walking 30 to 45 minutes several times a week HELPS SOOOOO MUCH.

I’m a Medical Assistant. And the job itself is not really all that stressful, but, when you work with someone who doesn’t do her job, it becomes extremely stressful. Because I’m a perfectionist, you see. I am not wired to do a half-ass job. I want people to rely on me and know that if I’m doing a job, you can bet I’m doing it to the best of my ability. I want people to know they can count on me – that I’m loyal, dependable, helpful, fun, and good at my job. The doctor and PA I work for are amazing. They are truly amazing people and they inspire me daily. Our team, as a whole, is organized, efficient and patients seem to like us, at least, according to the scores we get. (Yes. The government scores doctors and their pay is directly proportional to how good their scores are – Medicare/Medicaid patients that is. On the surface, that sounds great. But when the government starts telling the doctors how they can/can not practice, then it’s not that great anymore and ultimately, the very patients they are trying to protect suffer. But that sums up government, doesn’t it. ). But when you work with someone who is clearly lacking work ethic, the whole team becomes stressed and strained.

So, I’ve been doing two jobs, off and on, (mostly on), for two years. TWO. YEARS. Working late became routine for me. It was unusual for me to arrive home before 7:00 PM most nights. I had a new normal, unfortunately. No. I didn’t HAVE to work that late most nights but if I didn’t, then I would begin the next day even further behind because then I would have to finish up the previous day’s work before starting the current day’s work. And because I was fighting an uphill battle, our phone calls were out-of-control. We were getting, AVERAGE, 30 to 40 calls PER DAY. And that stressed me out even more.

Yes. I complained. Yes. We had numerous “team” meetings, though the team meetings basically consisted of one person being told she needed to do better. And it would get better, for a time, before this person slipped back into her lackluster work ethic and ended up spending more time eating and shopping than she did actually working. I tried to be understanding and helpful at first. And I kept my thoughts mostly to myself. But after a while, it became clear that I was being taken advantage of and I ended up in the ER, twice, due to chest pains. (And after a stress test and a wearing a holster monitor for three days it was determined it was likely a panic attack).

And then I became angry. I can’t believe I allowed an annoying, less-than-intelligent female to cause me so much grief. The stubborn streak I inherited from my grandpa kicked in. In my mind, allowing one person to affect me so much was allowing this person to have some power over me and I simply will not allow that to happen. EVER. So, I was on a mission to make some changes. I was no longer going to cover for this person. Every mistake she made, every time she procrastinated on something, I went to management about it. I took screen shots, I kept running tallies of things she put off for days, and shouldn’t have. Times were ugly because this person would get called into offices and lectured and still, STILL, she continued to laugh it off and/or have a ready-made excuse as to why things weren’t being done and/or why she was rude to patients.

There were areas I kept my hands completely out of in order to give herself more rope with which to hang herself. I was done stepping in and saving the day. And yes, it bothered me GREATLY and it was really hard not to take control and make things better and yes, it truly bothered me that patients had to suffer as a consequence, but if I wanted things to change, I had to allow these things to happen. I was confident that her piss-poor work habits would eventually catch up to her, and they did. Unfortunately, I can’t go into details as to what exactly happened, but suffice it to say, it was very bad and potentially dangerous. She finally got written up. But again, things did not improve. I think this girl had been so used to being compared to an “I Love Lucy” character and laughing her mistakes/antics off, that she truly thought it would save her – that people would just shrug and say, “Well, that’s _______ for you.”

No. Just no. That is not acceptable, especially when we have patients who are counting on us and trusting us to take care of them.

Finally. Finally. The doctor had had enough. He was having to step in and smooth the waters one too many times. He spoke to management. And the next thing I knew, she was being told she wasn’t a good fit and to find a new position elsewhere.

I had mixed feelings. On one hand, I was relieved. I felt like a huge weight had been lifted from my shoulders. On the other hand, I had such guilt. For though I wasn’t the one who was making the mistakes and had a piss-poor attitude, I felt responsible because I went out of my way to make sure the proper people knew about her screw ups.

She continued to work for our clinic for four weeks after she was told to find something else. Since she wasn’t technically “fired” and didn’t have any vacation time she could cash in and use, she stuck around for four weeks while she interviewed for a new position. She was present when we started interviewing a replacement nurse. She was present when our entire team went into another room to discuss the applicants’ pros and cons. She was present when these applicants were shown around our clinic, given the “tour”, if you will. To say this was an awkward four weeks would be putting it mildly. And since I was the one who had to see her every day and continue to work with her, it was hardest on me.

Which stressed me out even further.

I started having chest pains again though I told no one. I didn’t go to the ER because I knew what was happening – I was having panic attacks. I finally bit the bullet and looked up my chart and read the holster monitor report back when I wore it when I went to the ER two years ago. (I don’t have a PCP so the ER doctor didn’t have anyone to forward the results to so I never got the results). I just wanted to make sure that I wasn’t damaging an already weakened heart by NOT seeing a doctor. Everything was normal. Yes. My heart pauses at times, (skips a beat), and paused a total of 34 times in one hour at one point but apparently, it was still within the normal range so there was no cause for alarm. (Which seems weird that your heart pausing 34 times in one hour is still considered “normal??”) But the doctor recommended either magnesium and/or beta blockers for my chest pain so I thought I would throw in my magnesium with my other supplements and see how that worked. It worked, for the record. I haven’t had chest pain since starting magnesium.

This all happened in January of this year.

I was never so glad to see a month end in all my life.

This nurse and I are not friends – all ties have been severed which doesn’t bother me in the least. Not even a little. Yes. I’m a cold-hearted bitch. Tell me something I don’t know.

Look. Whenever a company is lucky enough to have me as an employee (*snicker*), I will give my employer 150%. The company is investing time and money in me, I’m going to deliver. I’m not working to become BFF’s or talk, endlessly, about my personal life with someone. Sure. If we get our work done and we have some laughs along the way, then BONUS. But to show up to work and expect to do little to nothing and be handed a paycheck? No. That’s not the way it works, or should work. As long as you do your job, then I don’t have a problem with you. It’s when you don’t do your job, that’s when the gloves come off and I get aggressive.

Our new nurse didn’t start until the beginning of March, this month. I can’t even begin to describe the night and day difference between these two women. This new nurse is enthusiastic and eager to do a good job. She cares about people and wants to help them. She’s happy to be a nurse and there is genuine joy in her. It’s such a breath of fresh air. We had a heart-to-heart the other day when our doctor/PA left for the day. She asked what she was getting into the middle of, that she had heard some things. I was completely honest with her. I told her what I just told you – do your job and we won’t have a problem. She said her interview was all about me, about how much they expected her to help me and to keep on top of my duties, to call patients back in a timely manner and to be proactive and keep on top of surgical requirements. I felt embarrassed when she told me that, I also felt honored and humbled. It’s nice to know the doctor/PA recognized the hell I’ve been living for the past two years and were trying to do everything they could to make my life easier. After it was announced the other nurse would be expected to find another position, my doctor and I had a sit down chat. He made me feel good in that he had no intentions of losing me. It made me feel appreciated.

I’ve been off the past few days, it will be interesting to see how she has done without me. Which is not to say she can’t do her job without me – any MA would be able to easily step in and do my job, but I got the feeling I was her anchor since she hasn’t really had a chance to hang out with the other nurses yet and learn the ropes. I feel sort of protective of her. She’s young though has been a nurse for a while and I guess it’s the mothering instinct in me to want to see her do well and be happy in her new job. I’m not completely heartless, you see.

My doctor is on vacation this week – he’s spending time with his kiddos for spring break, hence the reason I took a few “mental health” days off, but I’m looking forward to going back to work tomorrow and working with her. I have a lot of prep work ahead of me – getting ready for next week’s clinics and there’s a schedule I need to work on as my doctor has text me to say he will need to leave early next Wednesday so I can adjust his clinic schedule, but I’m approaching this change with fresh eyes and an open heart. I feel like Satan has really tested me these past few years and for the first time in months, I feel like I can breathe and genuinely smile again.

Four Weeks of More Work and More Stress

I like to think I get along with everyone – and I guess I do, on the surface. I try to get along with everyone, but I would be lying if I said I liked everyone I work with.

I do not. In fact, there is one person at work I pretty much despise. She is everything that I can’t stand in a person.

She’s loud.
Rude
Obnoxious
Callus
Ignorant
Clueless
Self-centered
Egotistical
A little crazy
Lacks empathy
Lacks a filter
Short-attention span
Turns conversations back to her – every – single – time
Insecure

She reacts instead of interacts.

Everything about this person grates on my every last nerve. Just breathing the same air as her make me want to punch something.

But here’s the kicker, I have to work with her. And she has a sense of humor, and she makes me laugh.

And I feel a bit sorry for her – her life is not perfect. She has made bad/difficult choices in her life and she’s living with those consequences now.

I grit my teeth and get along with her. What choice do I have? I try and see the good in her, I try to be patient with her. I try and set a good example when I’m around her by being patient with people, with trying to point out that patients are not black and white, that you have to read between the lines with people and sometimes it’s more about what they DON’T say rather than what DO say.

She will sometimes speak to me like I’m an idiot. Or beneath her. And believe it or not, I’m not a confrontational person – I tend to just let it slide off my back, but this chick? Not so much. We have been called into the office numerous times to air out our differences with our manager as witness because listen here, chicka, you’re not pulling that “I’m better than you” ‘tude with me. It’s not gonna happen. Those conversations have been awkward and have made this girl cry, but BUCK UP SISTER – it’s time to grow up.

It’s not easy burying my thoughts and quelling my words. There are days I have to literally walk away and take a breath because her harsh attitude makes me crazy. Her priorities are not right because when I’m at work, that is what my sole focus is, to do my job to the best of my ability. It’s not to make friends, it’s not to crack jokes and be funny, it’s not to put stuff on the back burner and constantly say, “I’ll get to it tomorrow.” It’s not to text friends and family even though I get there is family drama to sort out.

When you’re at work and you’re working with me, do your damn job.

Period.

End of discussion.

Can we have some laughs? Sure. That picture above is proof that I can be a nutcase with the best of them, but by the end of the day – is the job done?

But then this girl got some bad news, potentially life-changing news, and I felt like an asshole for disliking her so much. We still dislike each other, but I’m not cruel – I’ve listened as she vented and worried and I tried to offer her some solid advice.

Again, I’m not an asshole.

And I’ve prayed for her. This potentially life-changing news was borderline dangerous and I wouldn’t wish it on my worst enemy. Though I intensely dislike this girl, she’s a human being with responsibilities and she doesn’t deserve potentially life-changing circumstances.

We have a grudging respect for each other, (well, I think she does for me because I’m pretty much the only person who stands up to her and her bullying personality, I still can’t stand her), but we talk. Or rather, she talks and I listen, (I rarely tell anyone I work with much about my personal life – it’s my personal life, butt out). She’s young enough to be my daughter, but only just, and I suppose her immaturity and self-centered personality is something her generation has grown up with, but I am trying to “train” her, if you will, into seeing life from other perspectives – it’s not all about her. I know that’s shocking, and I think it’s been shocking to her, but I feel like I’m making progress, I guess.

She has gone to a few appointments and thank God, her news is not as bad as it was first made out to be. It’s something that can be fixed. I’m glad for her. I’m glad that she will have her surgery and it will work out to include her vacation so she will be out of the office for four weeks to recuperate. And I hope she comes back to work with a new attitude – though I’m not holding my breath.

Again, it’s someone I work closely with so her being gone will directly affect me and normally, I would be stressed out by this news. But you know what? All I feel is relief. It will be a breath of fresh air not to have to listen to her brash voice and deal with her piss-poor people skills. It will put more pressure and work on me, but I’m ready for it. In fact, I’m embracing it.

I would rather deal with more stress and more work than deal with this individual.

How sad is that?

Fractured

Sorry about the graphic parts of the above video, but this is what happens when there’s trauma – it’s messy, gross and painful.

Our doctors actually see a lot of spinal/skull fractures. We would never see an open fracture because if someone presents to the ER with an open spinal fracture, they are likely paralyzed. If they present to the ER with an open skull fracture, they will likely require brain surgery stat.

The fractures we see in the clinic are people who had an accident, fell off something, or were involved in an MVA, (motor vehicle accident), or someone simply tripped over something and fell flat on his/her face.

There’s not much you can do when you fracture your spine – both surgically and literally. When you fracture your spine, you have technically broken your back but not severe enough for paralysis. Most of the time, it’s a hairline fracture and you will be required to wear a brace, sometimes for several months, to allow your bone to grow back. If you do not wear this brace, and you make the fracture worse, then you CAN possibly make that fracture worse and crack it in two.

Then you’re really in trouble.

No one likes wearing the brace. In fact, if the fracture is severe enough, our doctors will sometimes offer surgery in order to go in, brace the spine with rods to hold it in place, and then they come back and have the rods removed once the fracture heals. They don’t do this very often – I’m sure the circumstances has to be just right, but for some people, it’s preferable to wearing a very restrictive brace for weeks/months.

I’ve found that people are on the extreme ends of the spectrum when it comes to fractures. On one end, you have the people that are completely freaked out and are convinced one wrong move will render them paralyzed. And yes, sometimes fractures are that severe and you have to be very careful, but often times, it’s not as bad as one might think. These people are afraid of everything and are very tense.

Then you have people that are supposed to wear a brace and don’t. Those are the ones who aren’t taking the fracture serious enough and don’t seem to realize – a brace is there to prevent you from making the fracture worse. And again, if the fracture gets worse, you’re really in deep doo-doo.

If you have a cervical (neck) fracture severe enough, or close enough to your brain stem, you may have to wear a halo.

The ring is attached by four bars to a stiff, lightweight vest that fits around your chest. This keeps your neck and spine moving as one with your body so the spinal injury can heal. Most people wear a halo for 6 to 12 weeks. You can expect your neck and back to feel stiff or sore at first.

I had to assist a PA in removing one of these bad boys one day. When you wear a halo,  you have to wear it for weeks, and you can’t wash your hair, and it’s very hard to bathe at all. So when patients come in to have their halos removed, they stink.

BAD.

And their hair is greasy and stinky. It was enough to almost make me gag.

The halo part that goes around the skull is literally screwed into the skull on all four sides. I used what looked like a small crescent wrench and loosened the screws. I loosened all of them a little at a time until we could finally slip it off the patient. The patient will have holes in his scalp which will scab over and eventually heal and fall off. So they must be careful when he/she can finally wash his/her hair.

Removing the halo was both gross and fascinating and I’m glad we don’t have to do those very often. But I’m glad the PA gave me the opportunity to remove it, at least once.

Patients with fractures don’t normally require surgery but they must be monitored. We usually see fracture patients back about 4-6 weeks after the injury with an xray prior to see how the fracture is healing. If it’s slow to heal, because the bones are weak, or the patient hasn’t been wearing his/her brace, then the doctor will have them come back in another 4-6 weeks with another xray until he/she is finally released from the brace and the fracture has healed enough not to cause damage.

I thought the part in the video above, how the calcified bone surrounds the injury and makes new bone was interesting. I didn’t know that part, Isn’t it fascinating how our bodies heal themselves?

It’s funny how we evolved like that, huh. (Inside joke between me and Kevin – every time something fascinating happens with the body, Kevin likes to snicker and make fun of evolution – which we obviously don’t believe in).

Fractures are painful an there is little you can do for them other than suffer through them until they heal. I always feel sorry that come in with fractures as we don’t do anything other than monitor how they are healing. Our doctors don’t prescribe pain medication  unless patients have had surgery so we get a lot of upset patients when they come in to see us.

You can’t really avoid fractures, enough stress and your bone will simply snap, but you can keep your bones strong so that they are less likely to snap. A lot of times, if fractures take a long time to heal it’s because the patient smokes (which SEVERELY limits healing of any sort), or the bones density is poor and the bones themselves are brittle.

I’ve started taking calcium, magnesium, zinc and vitamin D every day now. I mentioned in another post how my body was simply aching whenever I went to bed and I’ve noticed it doesn’t seem to be aching as much since I’ve started supplementing my diet.

So seriously, if you’re getting older, pay attention to your calicum/vitamin D intake. You could save yourself from a broken hip later in life.

Patience: Ain’t Nobody Got Time for That – Or Alternatively Title – Waiting for the Doctor

I’m not sure I can write about this topic without coming off as preachy because it REALLY STEAMS MY BROCCOLI, but I feel like it should be addressed and discussed:

Waiting to see the doctor at the doctor’s office.

Believe it or not, making you wait for your appointment is not some evil plan we concoct to torture you - people will be people.
Believe it or not, making you wait for your appointment is not some evil plan we concoct to torture you – people will be people.

First of all, I read this Huffington post and that was my first mistake. I should never have clicked on the link because everything about Huffington Post rubs my last nerve – their mentality, or overall premise, is this is what we believe, therefore it’s the only way to believe, and if you don’t agree we’re right, or you dare to offer an opposing view, you’re racist/homophobe/sexist … blahblahblah

*eye roll*

But secondly, I’ve had a pretty hellacious week and nothing irritates me more than people who can’t wait ONE COTTON-PICKIN SECOND while I’m literally running my ass off (I achieved 6,000 steps by 3:00 PM on Monday) so that I can try and get people shown back to rooms in a timely manner.

For the love of God, you had to wait 20 minutes to be shown back, CHILL.

Okay, look, it’s super annoying to have an appointment at the doctor’s office at 11:00 and not be seen until 11:45. And before I started working for a doctor, I felt the same … wait a minute, no I didn’t. Because I had patience. Because I know people will be people and I always took a book, or something, to occupy myself because time never moves more slowly until you have nothing to do.

(Translation: TAKE SOMETHING TO OCCUPY YOURSELF AT THE DOCTOR’S OFFICE. PEOPLE. SHEESH)

I can’t speak for what goes on in other doctor’s offices, but I can tell you what goes on in my doctor’s office and possibly, just possibly, something similar may be going on at your doctor’s offices, too.

Before I present the doctor’s office side of things, let me preface this rant by saying, yes, there ARE doctors who take their sweet time and you end up waiting on them – a lot. But consider this, they’re spending a lot of time with their patients, which means, your turn will come, and then, when it’s your turn, and your doctor spends time with you, thereby making other people wait,  will you be as irritated?

Or, another doctor has called for a consultation on a tough case. Or, the doctor is studying films and preparing to give good/bad news to another waiting patient. Or, they are filling out test results. The point it, doctors are busy doing something. They aren’t just sitting around waiting for us to give them charts to review.

Or in my specific case, my doctor is a surgeon, which means he has patients in the hospital, recuperating from surgery. So the nurses taking care of those patients call us A LOT with medication questions, or updates, or God forbid, problems, or to tell us the patient’s family has arrived and would like to speak to the doctor because they have questions.

What’s he supposed to do, ignore those patients because we have patients in the waiting room ticked off because they weren’t shown back ON THE DOT?

Here’s the thing: we live in an INSTANT GRATIFICATION and IT’S ALL ABOUT ME society. I want it NOW. I want it PERFECT. I don’t want to WAIT FOR ANYTHING. I don’t want to be INCONVENIENCED in any way because I’m special and three minutes is just too long to wait my turn, damn it!

*eye roll*

Here’s something that people forget: Healthcare, Medicine, is not a one-size-fits-all industry. You’re not getting your oil changed, you’re not going in to get your tires changed, healthcare is not a precise process.

Far, FAR, from it.

It’s a personal, and oftentimes, embarrassing and intimate process. You are seeking help from a professional about your most bothersome issues. Issues that are preventing you from comfortably living your life from day-to-day. Every problem is different. Every person having an issue is different. Loved ones are concerned and need more explanation. Patients have been given bad news and are in denial – it takes a few minutes for the bad news to sink in and then more time to answer any/all questions patients/loved ones have every right to ask. Patients have the right to be educated about a specific condition/treatment – THAT. TAKES. TIME.

Would you rather have a doctor step in, take one look at you, maybe do a quick exam, give you a diagnosis, then step out without really speaking to you, or treating you like a human being? Because that’s precisely what needs to happen in order for him to run EXACTLY on time. Perhaps doctors need to treat people more like cars – as emotionless objects who simply need a part replaced now and again.

Call me crazy, but somehow, I don’t think people would appreciate being treated that way.

There are different types of doctor’s schedules: first come, first serve, cluster scheduling, (you schedule all well patients, all sick patients), and wave scheduling, (you schedule three patients per hour). There are more, but I can’t think of them right now.

My doctor operates under the wave scheduling. Yes. Our template schedules three patients per hour. And here’s why: Two spots may be for new patients and one spot may be for a recheck patient. (Patients who come back for an ongoing issue, or as a check-up to make sure they are doing well after surgery). My doctor likes this type of schedule because while his PA is interviewing the new patient, he can go in and see the recheck. Then, the recheck appointment concludes, the PA comes out and gives him details about the new patient, he reviews the new patient’s films, then goes in and speaks with the new patient.

We’re all helping patients throughout various stages of the appointment all day. Then, on the half hour, we have a post-op patient come in. The PA sees the post-op patient, takes out his/her staples/sutures, makes sure the wound is healing properly, prescribes more pain meds if necessary, then sends Mr/Ms Patient on his/her way.

This all sounds efficient on the surface, and yes, it is, WHEN EVERYTHING RUNS PERFECTLY AND THERE ARE NO HICCUPS. But guess what, remember that little detail I brought up earlier? We’re dealing with people, and people are not one-size-fits all.

You have the chatty ones.  You have the ones who are in more pain than others and require more TLC/attention, you have the ones who ask a lot of questions, or the weepy ones who need a moment to compose themselves.

The patients who drive me nuts are the ones who bitch because they’ve had to wait 30 minutes to be shown back to a room only to take up my time when I room them by telling me more than I need to hear, or whining about this or that, or bitching because he/she is in pain and what – suddenly those patients we left in the waiting room are just supposed to somehow magically get shown to their rooms? Who do you think rooms them?!? But I guess it’s okay if THEY wait because you have my attention now and damn it, you’re going to take your sweet time.

And then I rush/rush/rush around to hurry and bring the next patient back, sweating and dying of thirst because I have to literally gulp down a swallow or two of water because I’ve been talking so much only to be greeted by snotty, holier than thou pissants who are ticked off and annoyed because I didn’t show them back to their room ON THE DOT.

Newsflash! Look around – you’re not the only person waiting to see the doctor. Take a moment to consider the possibility that maybe, just maybe, they deserve attention, too.

*takes a breath*

And then there’s the doctor, who is trying to explain to the patient what is going on with his/her body and his recommendations. Then the ball is thrown to the nurse who follows up with the patient by making appointments for more testing, or surgery, so that the patient leaves with a plan.

This process takes time. This process works. This process is efficient. And it takes finesse because we’re trying to get all of this accomplished in a timely manner without the patient feeling like we’re rushing him out the door.

Because then we hear about that, too.

We can’t win, we truly can not win. We are trying our best to provide the best, most thorough and precise care we possibly can. And if people were more like machines, your wait time would be less, but people are not machines and we refuse to treat them as such.

Contrary to popular belief, doctor’s do not schedule more than they can handle. Doctors approve templates that will move the maximum number of patients in/out and be the most efficient use of their time. Yes. Part of the reason is compensation, doctors care about people, but it’s also how they make their momey, but the other reason is because there are way more patients out there than doctors in our world nowadays and if they scheduled one patient per hour, true, there would be little to no wait times when it came to the appointment, but then it would take MONTHS to get IN to SEE the doctor. Is that a better solution?

So yes, you’re going to have to wait when you go to the doctor’s office.

But if you truly want quality care, isn’t it worth the wait?

I Am a Certified Medical Assistant

I passed my Certified Medical Assistant test. I went through this site, in case there are any other medical assistants out there thinking about taking this test.

cmaWhat does that mean, exactly? Well, not to belittle the position because DUDE, I KNOW, it basically means I’m mentally capable of being a doctor’s minion.

The test was … harder than I thought it would be. It went beyond simply knowing the information, they asked questions that applied that knowledge. For example, phlebotomy, (which is the name of the specialty for people who draw blood). “If you’re drawing blood to test for this condition, what color tube would you use?”

ACK!

That was pretty much my first question and I immediately broke out in a sweat. And FYI: KNOW PHLEBOTOMY inside and out. There are a TON of questions on the test about this area. Oh, and EKG’s, but mostly phlebotomy.

Let me back up.

The hospital presented an incentive for medical assistants to become certified. They promised a pay increase and a bonus – you got so much money up front and if you stuck around for one year, you would get the other half of this bonus. Sweet deal, right?? Not to mention, having more certified staff makes the hospital look good, right?

For those of you that don’t know, I sort of fell into this whole medical assistant thing. I have never had aspirations of doing ANYTHING in the medical field. And my end goal is not to become a nurse – nurses are great, legendary really, but I have neither the patience nor the desire to become a nurse. I’m happy where I am, thank you very much.

No. I applied to the hospital back in 2011 because of Obamacare. I was concerned for my family’s healthcare. Kevin’s company had liquidated and he was setting up his own business, which meant we didn’t have healthcare, and the healthcare we could qualify for was astronomically expensive. I was thinking about going back-to-work at that time anyway, (I had been a stay-at-home mom for seven years), so I applied at a local hospital.

I feel like I’ve told this story before. Sorry if you’ve heard this one …

I got an interview. It was with the insurance processing part of the hospital. My first interview went really well and I landed a second interview with my peers. That one didn’t go as well. I guess they didn’t like me because I didn’t get the job.

Then I got another interview. It was for a scheduling position with neurosurgery. I didn’t even know what neurosurgery was.

I landed that job and started in September of 2011. It was AWESOME. It was fast paced and challenged me daily. So much so that I would often go home crying with frustration because in essence, I was being asked to learn a whole new language – adapt to a whole new world, really.

I took care of three, sometimes four, doctors’ scheduling needs. Once the patient had seen the doctor, they would be asked to stop at my desk and schedule follow-up appointments and/or testing. I loved it. I’ve always been a good multi-tasker and it took all of my “talents”, if you will, to do this job.

About three years into it and things started changing. The hospital needed to downsize and they were eliminating the scheduling jobs. So, we could either become medical assistants or lose our jobs.

One guess which option I chose.

I was thrust into a world I neither knew, nor really wanted, to be perfectly honest. But never one to turn my back on a challenge, I dove in, head first.

I listened. I read. I absorbed every aspect of the job. Google became, (still is), my best friend. Some of the best advice my old boss gave me was, “patients will never know you don’t know what you’re doing if what you do is with confidence.” She was absolutely right. I became a master bull-shitter.

That’s not to say I didn’t do my job correctly, I just made damn sure the patient didn’t doubt what I was doing.

I learned to take blood pressures. I learned to take out sutures and staples. I learned to read, and respond, to verbal cues and body language. I learned when to be seen but not heard around the doctors. I learned to gauge the doctor’s moods and adjust accordingly. I learned when to ask questions and when to listen.

I assimilated to a world I knew nothing about. I’m sort of proud of myself for that, truth be known.

Here’s the kicker: I don’t really like people. I mean, I’m okay being around people and I’m genuinely interested in their stories, for about two seconds, and I’m both sympathetic and empathetic to their complaints , but given the choice of being around people all the time?

Not so much.

When the hospital started pushing us toward certification, I became concerned. I already felt like a fraud because I hadn’t gone to school to do what I was doing and most everyone I worked with had years of medical experience in different departments, they already knew medical terminology, physiology and anatomy, I did not.

Most of my peers passed their certification in no time flat. “Oh, you’ll do fine, Karen. Don’t worry about it,” was their confident responses to my doubts but bottom line?

I didn’t know squat.

So. I started staying after work and studying. And unlike my peers, I didn’t tell anyone when I was planning on taking the test. That way, if I bombed it, no one was the wiser, right? I wouldn’t have to endure pitiful looks of sympathy.

This test cost $150 dollars. So if I was going to commit to this, I WAS GOING TO COMMIT. That’s a chunk of change to just throw against the wall and hope it sticks.

Studying was difficult. I felt like I was cramming four years of medical school into six weeks. But once I got into it, a light bulb sort of went off and I started to “get it.” And it was interesting. I made flash cards and started searing the information into my brain. It took me close to six months of studying after my peers had already passed their tests before I felt comfortable enough to take it.

I registered, paid my money and committed to a date.

The date approached and I started to panic. In fact, I woke up a few nights in a cold sweat and my heart going crazy. It was another panic attack. I knew I wasn’t ready. I couldn’t do it. I didn’t FEEL ready. So I called the company up and re-scheduled my testing date out another four weeks.

I hit the material harder than before. That was all I could think about for that four weeks. The date approached.

The nearest testing facility was in Aurora, Missouri, at a teeny, tiny airport. That was about 45 minutes from Springfield. What a weird place to have a test. Kevin and I drove out there the weekend before to find it because I know me – if I got all stressed trying to find the place then I would be too stressed to take the test. (It is across the street from the old drive-in in Aurora, for those of you from the area).

I took the Friday off before the test date (it was at 8:00 AM on Saturday morning) so I would have one last chance to cram for the test. I’m so glad I did that, I think that really helped calm my nerves as opposed to working all day the day before and not really having a chance to look over my notes before getting up at the ass-crack of dawn to get ready and drive out there the next day.

THE DAY ARRIVED.

I was nervous, but not petrified. I felt confident enough that I could squeak by. I needed a minimum of 70% to pass. No one would need to know my score. The only thing I needed to do was just pass the damn thing – that’s all the hospital really cared about.

I got to the airport at 7:45 AM. It was completely dark and there wasn’t a soul to be seen.

I went up to the door, knocked, cupped my hands over my eyes to see if anyone was inside. Nope. No one.

Now I’m starting to get annoyed. I went to all of this trouble of preparing, of sweating, of being nervous and no one bothers to show up?!? About the time I finish that thought, I see an SUV coming down the long road to the building. And my very next thought is, “I hope that’s the testing person because how creepy would it be to be out in the middle of nowhere and some guy drives up and I’m by myself, not a soul around ….” Then my imagination runs away with me, which is par for the course for me – was this all a set up to get defenseless medical wannabes out in the middle of no where and kidnap them? Was I going to be a sex slave?

I wonder how much they would charge for my services?

Wait. Where was I … oh yeah, the car is driving up.

A man, a woman and a teenager get out of the car. They open up the building and ask me to take a seat. About five minutes later, a guy walks in. “Is this where you take the … ” the last part of what he says fades away from me, I simply nod my head. Let’s get this party started before I forget everything! Was what I was really thinking. I didn’t want to do a brain dump before I took the test!

We checked in, he checked our ID’s, then we were asked to put our phones, purse, (well, I was the only one who had a purse), jackets and yes, even my fitbit, into a basket. We were then escorted into a tiny room off the main office area. There were two computers with a partition between them. We sat down but were asked not to touch anything. The guy pulls our specific tests up (because this is a test site for all sorts of licenses and certifications) and we are asked to log in but not to start the test.

We have one piece of paper and one pencil. That’s it. And we’re instructed to leave the piece of paper in the room, we are not to take it with us when we leave.

We have exactly 120 minutes to take the test. Then we begin.

I had already taken a practice test (well, several actually) so I knew there would be plenty of time to answer 200 questions. But still, the first question threw me for a loop and I started to panic. All of my confidence flew out of the window and I started sweating. I took a breath, forced myself to calm down and re-read the question. I processed it by eliminating the “no way is it those answers” and gave it my best educated guess. The second question was easier and I knew the answer to that one, so save for that brief terrifying moment of getting past the first question, it wasn’t as bad as I thought it would be. However, I REALLY wish I had studied phlebotomy a bit more. Not so much the technical aspect of it, but the WHYS of it. (Let that be a warning to anyone out there wanting to take this test).

The only thing I used the paper for was one calculation on how many beats per minute on an EKG strip.

The guy who was taking a test with me got done way before me. But that was okay. Again, I just forced myself to breathe and focus on passing this damn thing. It took me a little over an hour to complete the test. But I felt like I had to guess on so many phlebotomy questions, that I left the facility QUITE convinced that I had failed.

I was devastated. I cried on the way home. But since I had to drive 45 minutes to get home, I had come to terms with my perceived failure by the time I arrived home. The big con to this entire process was you didn’t find out your score right away. But there were a few of my peers who had taken the same test at the same test site and said that I would be able to sign on to my account on Sunday, sometime, after they emailed me, to find out my score.

I tortured myself all that night. “I’m so dumb! What was thinking?!? I didn’t know what the hell was doing. Why did I just blow $150 bucks??” It went on and on.

By Sunday morning, I was already past my self-loathing stage and planning to take the test again. THANK GOD I hadn’t told anyone I was taking the test that weekend!! I’m not sure I could handle the humiliation.

Finally, about 1:00 in the afternoon, I received an email. My test score was online! I signed on and I literally closed my eyes and then peeked with dread at my score.

I PASSED!!!!!!! True, my score wasn’t as high as I had hoped it would be, but it wasn’t as bad as I thought it would be either. And the section I did the worst on? Yep. Phlebotomy.

hoorayScrew it. I PASSED!!

A huge weight was lifted off my shoulders. I told my boss that next Monday and an email was sent out congratulating me. Everyone was so nice and supportive. My boss notified human resources and they got the ball rolling on my monetary reward. They gave me a new badge with CMA on it and I proudly wear that.

I do have to take so many credits every two years in order to keep my certified status. And of course I have to pay to renew my certification every two years, but the continued education are short courses you take online, through the site, that is included with your renewal cost, so it’s not all bad. And honestly, I’m sort of looking forward to reading the material because it will only help me understand my job that much more.

Damn dog, I’m a CMA!

Too Many Changes in Too Short of Time

I can honestly say, these past three months have been the most exhausting, frustrating, rewarding and fulfilling months in my life. Well, maybe not my life, but they certainly rank in the top five.

1. We moved offices.

It was a confusing, whirlwind mass of chaotic activity. We all knew we were going to move to our new office at the hospital, it was inevitable, but we were told it wouldn’t be until closer to Thanksgiving, so though we knew we were moving, we weren’t really PSYCHED to move. Suddenly, our new office was done and the CEO of the company didn’t see the need to delay the inevitable so we got the green light to move.

It wasn’t a slow, organized move, it was a crazy, throw everything in boxes and load up our cars move.

We moved on a Friday but we didn’t close up shop to move. It was business as usual and we packed our crap up in between patient phone calls. Each team was allotted about two hours to pack our crap, load it up and drop it off at the new office. Then, once the phones shut off at 4:30, we all went into frenzy mode and moved the rest of our stuff. We unloaded just the stuff we knew we would need for clinic on Monday and the rest stayed in boxes.

It was a crazy, disorganized but sort of fun time. And we survived our first clinic in our new place. My doctor was pretty patient, (what choice did he have?) and when we explained the situation to the patients, they were pretty understanding and patient, too. (Again, what choice did they have?)

I love this office. I truly do. It’s spacious and still has that NEW smell. We’re located on the 7th floor and we have a spectacular view of the city. We are the only specialty on our floor so we have the place to ourselves. I’m proud to work here. I know it’s impressive and people are impressed when they get to us.

We’ve had issues. We’ve had doors that wouldn’t open and doors that opened so fast that they were seriously a hazard to anyone within slapping distance. We have been unable to locate light switches and we still have problems with light-motion sensors that are too sensitive and often shut off leaving us in the dark and either having to wave our arms to bring the lights back on or we have to work in the dark until we physically get up to turn the damn things on again.

The toilets flush so loudly they are seriously damaging our eardrums and everyone has to hold their ears when they go off to protect ourselves. At least we won’t have to worry overly much about clogging them as I’m pretty sure they have so much suction they would suck a small child down the pipes if given the chance.

Our docs don’t have offices. Instead, we have collaboration spaces within each “pod.” We have five pods total. In fact, I’m using a collaboration space right now to write this. (More on that later). These collab spaces are intended to allow the physicians to sort of disappear whenever they need a break or want someplace private to eat their lunch. These collab spaces also double as meeting rooms or in my case, study spaces. Since the doctors are only in the clinic two times a week, they are in surgery the rest of the week, they didn’t see the need to have permanent spaces for temporary occupancy.

We’ve been in our space now for three months. Three months, in some ways, it feels a lot longer. We still don’t have enough stools to sit on in the exam rooms and supplies to supply 55 exam rooms. (Each pod has five exam rooms each – we also have one large procedure room in case the doctors need to treat wounds or more complicated issues). For several weeks, we didn’t have enough scales and we had to routinely share and move scales around in order to work our clinics.

Even though we are the only specialty on our floor, we still have room to grow. The front part of our floor is undeveloped and locked off. I have no idea what the hospital plans on doing with this undeveloped space and can only guess that it’s intended to add on more doctors, but we’ll see. So that’s exciting, knowing that at some point, there are likely more changes in our future.

If you can count on anything in business, it’s change.

Let me see if I can explain this set up for you …

When you get off the elevators, you can only go one way and that way is to a centralized podium. The person at the podium then “blues” you in on the schedule so that people like me will know you’re on the floor. The podium person will then direct you to the pod where your doctor is located. I work out of pod 5. Patients will then settle into our waiting room and wait for me to call them back to a room where I start their charts and get their vitals.

On Wednesdays, we share the waiting room with another doctor and last week it was so crowded it was literally standing room only. It’s so weird how the patient flow works out – we will be an hour ahead of schedule and suddenly, we have an influx of patients and we’re an hour behind.

I think this week, I’m going to ask my doctor if he would mind if we used the main waiting area – the area that people see when they first get off the elevators. It’s just too confusing for patients and awkward for me to try and keep track of everyone.

I’m all about efficiency. In fact, I’ve sort of developed a reputation for being “on top of it.” I probably over plan clinics but in my mind, a little preparation goes A LONG WAY towards a more organized clinic. In fact, I’m pretty sure my doctor has come to expect this preparation from me now so there is no way I would NOT plan my clinics, I wouldn’t want to disappoint him.

Which leads me to the second big work change ..

2. We finally switched over to the hospital charting software program in August.

The hospital has been “warning” us for years this change was going to happen so it’s not surprising that it happened once we moved onto the hospital campus.

We spent weeks staying after work transferring people over on to the new schedule program and into the new charting system. It was exhausting but it allowed us to make extra money and to familiarize ourselves with the new program so that ultimately, we taught ourselves how to get around it faster than if we hadn’t stayed to do data entry.

The first week we went live, we had software representatives available for questions. Which sounds awesome on the surface, but wasn’t really awesome in reality. Though they knew their way around the program, they were unfamiliar with our specialty and our specific needs. I can’t tell you the number of times I heard, “well, this is the way it’s supposed to work, but the feature is not working now.” After a time, they were just in the way and became super annoying to have around.

You could FEEL the tension emanating off our bodies that first week we went live. IT. WAS. FRUSTRATING. to say the least. And it’s still frustrating to this day. It’s hard to find anything, let alone quickly. Everything is filed into folders, each doc has a folder, I have a folder for all of the documents I put into the patient’s chart, every type of document has a folder, days have folders, it’s pretty insane, quite frankly.

And the programs, the charting program and the scheduling programs, are GLITCHY. Things will disappear, or we get error messages, or the program will just shut down. And our servers SUCK. They are SO SLOW. In fact, these programs are SO glitchy and slow that our ER finally put their foot down and refused to use it. They use something different.

It’s not unusual for me to completely shut down my computer, several times a day because it just locks up.

AARGH.

I think our docs had the most trouble with the program. They were definitely not set up the way our physicians wanted them to be set up and we’re constantly coming up with ways to get around restrictions. The hospital will likely figure out some of the workarounds we’re doing but that’s the only way our physicians can get their work done so I’m sure the hospital, at some point, will no choice but to make those changes. In the interim, we make do.

So. We moved on July 17th and went to a new software system one month later.

I was working 60 hour weeks for WEEKS during this process. I’m just NOW getting to a point where I’m now going home at 6:00 instead of 8:00. I haven’t seen my family in three months. Truly, I haven’t been home to have dinner with Kevin or the boys, during the week, in three months. I haven’t had time to stop. It’s been crazy.

Some of that crazy came from our phones.

3. We FINALLY went back to voicemails.

Some knucklehead had the bright idea that answering all of our calls live was the way to go. And for a while, it seemed to work. We answered live calls and did our best to help the patient with his/her questions/requests. But after a while, that’s ALL we did. Let me break it down for you.

Monday – I was in clinic. So I didn’t answer calls. I focused primarily on making sure the clinic ran smoothly.

Tuesday – I needed to schedule the Monday clinic patients for testing, but I didn’t have time to do that because I was in the pit answering live calls. So, I was taking calls for other doctor patients who had to tell their stories, from the beginning, to me because I was not familiar with their background. And then, being on a new system, it look three times as long to look anything up because we couldn’t find the damn information. AND/OR we had (still have to) access our old system – so in essence, we were working out of four systems, our old charting/scheduling programs and our new charting/scheduling programs. And when you answered live calls, you had to stop what you were doing before the call, to take the call, and when you hung up, you didn’t have time to start your own work because the damn phone would instantly ring.

Can you tell I LOATHE the phones??

Wednesday – I’m back in clinic. And I haven’t had a chance to touch my Monday clinic.

Thursday/Friday – I’m back on the damn phones. And again, I do not have a chance to get my clinic work done because I”m now forced to take care of patients for all of the docs. So the ONLY time I had a chance to clean up my week’s clinics AND prepare for my upcoming clinics, was after hours.

It was an insane process.

And to top it off, I started having chest pains. I don’t know if it was because I was under so much stress and working 60 hours weeks, or if it due to gas from starting to take Coconut supplements, or maybe a combination of both, but I ended up in the ER one night.

I was working clinic on a Wednesday and I just couldn’t breathe. I felt like I had to continuously take large breaths in order to function. I made several trips to the restroom just so I could pause, close my eyes and force my body to settle down. I took my blood pressure and it was way high. And my heart rate was over 100. I had chest pain but no arm/jaw pain so I really didn’t think I was having a heart attack but something was OFF.

Then that night, I just couldn’t sleep. My heart was racing double time and I was laying down!! I started hyperventilating and text Kevin (because he was at band practice) and he rushed home and took me to the ER. They hooked me up to an EKG machine and luckily, I wasn’t have a heart attack. They put me into a room and gave me liquid Ativan. Liquid GOLD, I say. That calmed me right down and my blood pressure went back down to normal. They didn’t give me an explanation for my crazy, but I’m pretty sure I had a panic attack. I think the pressure just got to me and I snapped.

I haven’t had an attack since then. I’ve adapted and learned to cope with this stress.

We had another person in the office break out into a rash because of the stress. When the director of our department found out about our physical manifestations to all of this stress, he put his foot down – it was time for changes.

We narrowed down that the phone situation just wasn’t working for us. So, we called our communications department in and they set it up so that each doctor has a voicemail now. Now, I can get to phones on MY time. And I’m already familiar with my doctor’s patients so that cuts down on response time. And I can return phone calls all at once so it’s way more efficient for everyone.

We’ve been back on voicemails for several weeks now and everyone is WAY more relaxed. We have time to BREATHE. We can all go to lunch together, if we want. We’re more in control of our processes and time. And that has left more time for me to pursue my next goal …

4. I’m studying for my CMA test

The CMA test is the Certified Medical Assistant test. The hospital has put together a pretty sweet incentive package for the medical assistants to become certified. It’s better for us, for the doctors and of course, for the hospital. So that has motivated all of us to study for the thing. A few of use have been staying late, or coming in on the weekend (like today – but I’m writing to you instead because I was feeling it today), to prepare for this. It costs $150 dollars to take the 3 hours test so I’m also motivated to take this pretty seriously because I don’t want to blow $150.

I’ve purchased study materials and I plan on purchasing a practice test so that I can focus my studies on the sections that will be on the test. I’ve only really been studying seriously for the past several weeks and I already feel like I’ve learned a lot. It’s stressful though – I feel like I’m cramming four years of medical school into about six weeks. I’m not going to tell you, or anyone I work with, the actual date I plan on taking this test, that way, if I fail, no harm, no foul. My goal is to just announce to everyone that I passed. If I told everyone my plans, took the test and then failed, I’m pretty sure I would be too mortified to show my face again. Everyone is wanting to go take it on the same day, but I simply can’t do that – I will be a bundle of nerves anyway, let alone taking the test with a bunch of people I work with.

The hospital is not only offering a bonus for becoming certified, but they’re also offering an hourly pay increase. And it’s a pretty sweet jump, let me tell ya.

So yes. I’m focusing my energies onto passing this thing now. I’ve been staying after work not only to finish my work, but on collaborating with my fellow co-workers on studying for the CMA.

I’m looking forward to the day when things get back to normal. Our entire worlds, and not just working worlds, but personal worlds, have been turned upside down these past several months.

But then I’ll have continuing education requirements after I pass the CMA in order to KEEP my CMA status.

It just never ends, does it.