Sara's blog

I don’t know if I mentioned this before but Glenn Robinson, CEO of Hillcrest, has been kind enough to set up monthly one-hour breakfasts one-on-one with the residents. This is an amazing opportunity to ask questions, talk about current projects, career goals, general advice, etc. Just being at Hillcrest for the past couple of months, I’ve noticed how incredibly busy Glenn is constantly, so having an uninterrupted hour of picking his brain and learning everything I can is such a blessing. One of the things I asked him about was the same question I mentioned in a previous blog about career routes and getting started. Without going into too much detail, he said that he thinks I’m definitely thinking about it the right way. We also talked about possible paper topics and he mentioned the 1115 waiver. He then gave me his opinions on the topic and the reasons for his opinions. I pretty much agreed with all of his points. Now I need to determine whether or not this will make an interesting paper topic. I think there’s definitely enough research about it out there, which is a big plus. We also talked about books, both for fun as well as educational and healthcare related, and he gave me some recommendations. I look forward to reading all of them when I have more time again. But for now, I will begin reading “Lean In” by Sheryl Sandberg, which comes highly recommended by my preceptor. She has gotten many women at work to read it  so I feel that I need to as well so I can join in on all the fun conversations about it.

This past weekend was great! The hubby and I went home to Austin and we had a very special guest. Zahra came to visit from Houston!!!!! I’m always so excited to see her! It’s always fun to compare residency stories as well. I’m still hoping she’ll move to Austin, which I think she’ll do if she finds a good job there. Fingers crossed!

And what a better way to start a Monday after a great weekend than with a rotation in the surgery center. I watched the whole process of registering a patient, doing the pre-op screenings, etc. Then I actually got to watch some surgeries! I have to recognize Dr. H who was so welcoming and made me feel at home in his operating room. He actually explained things to me as he was doing them, had conversations about surgeon/administrator relationships, and invited me to stay and watch as many surgeries as I wanted that day. What a great guy! One funny and enlightening conversation that we had while he was operating was the following:

Dr. H: “So, Sara…you will quickly learn that surgeons will cry and complain to administration constantly.”

Me: “Haha. So you’re not one of those surgeons then?”

Dr. H: “Oh I definitely am! And I fully admit it! I’ve just learned how to do it the right way.”

Me: “Oh, so you know how to get what you want now?”

Dr. H: “No, not always. But I’ve learned when to keep complaining and when to stop. But I will not quit if it’s for the good of a patient.”

And I think that perspective is a good reminder of why we’re ultimately in this industry. We are here to save lives and do what is best for the patient, whether we are in an administrative role or a clinical role.

Last week I had one of the most interesting rotations so far. That, not surprisingly, was the trauma department. But it was interesting for some unexpected reasons. I learned all the differences between levels I, II, III, and IV. Hillcrest is a level II trauma department, which means we have a trauma surgeon and a neurosurgeon on-call 24/7. Most people associate trauma with the Emergency Department and they don’t realize that they are two separate departments. Yes, trauma patients come through the ER, but they are treated by the trauma team. But I digress… I got to shadow the director of the department for several hours, including morning rounds. This is a very interesting meeting where the whole team gets together and talks about each of the current patients, what their condition was when they came in, what their condition is now, the treatment plan, and the prognosis. Then I followed one of the nurses up to see a couple of her patients and talk with the families. Later on, the director talked to me about some more details about the department and everything they went through to get the level II designation. I also got to participate in a meeting for CLIP (commonly know as Lean Management everywhere else) where they were trying to improve the process of transporting patients from the ER to the OR (operating room). I can’t really go into more detail, but it was definitely fascinating and something I’d like to learn more about.

So during my past few rotations, I’ve been asking the department directors about career options. Luckily, I already have a good work history and experience with Medicaid, but this is definitely my first time in a real healthcare setting. So I’ve been curious about what types of jobs I should be looking for since I’d like to start applying this fall. My main question has been how to get my foot in the door with my degree but limited experience. And also, what departments are good for gaining valuable experience to make it to the next level? I’ve heard several different answers, all of which sound interesting to me. One director told me that quality, operations, and marketing are all good options. Another one told me that knowing supply chain management will always keep you employed. And a third one told me that finance is a good way to go since not many people go that route and there is always a need for finance people. I’ve also been told that clinic management is a good way to start. Now I don’t know whether I’m less confused than before, or way more confused! haha! But the good thing is that it sounds like there are plenty of options and plenty of directions to consider. I think I’d like to spend some more time in each of the departments I mentioned above. Hopefully that will help me determine the right path for me. All I know is that the next 10 months before graduation will certainly be interesting.

So I had my ablation on April 25th, slept like a baby for about 6 weeks with no problems, had my follow-up appointment, everything was great. Then a few weeks ago, I started having symptoms of the arrhythmia again. And it came back with a vengeance. There were several days (almost 2 weeks) where I had attacks about every 30 minutes, even during the day. That made work very interesting. I made another appointment with the EP doc who said he wanted to put me on a 24 hour monitor to see if we could get a good reading of an attack. After battling with Waco cardiology once again, I was able to finally get the monitor. Unfortunately, we did not get a good reading. So I’m getting a 30 day monitor again. Luckily, I will only have to wear it until we get a good reading. Please pray that it’s sooner rather than later. If I have to do the surgery again, I’d like to do it before the fall semester starts. Not to mention that I’m losing a lot of sleep with these attacks and I’d like to go back to the lifestyle I enjoyed for those 6 blissful weeks before this problem started up again. I’ll keep you guys updated as soon as I know something.

As the rotations continue and I get closer to seeing almost every department, I’m really getting a good picture of how the whole puzzle fits together. I know some of my classmates don’t like doing rotations and they think it’s a waste of time, but I think that’s a big mistake. In my opinion, that’s the problem with management, not just in healthcare, but across every industry. There are too many managers who have no idea what people do who work for them. No, I’m not shadowing people to learn how to do their job. But I am learning what they need in order to do their jobs well and now I understand some of the problems they deal with on a day to day basis. And I think that’s more valuable than a lot of people realize.

Lab: I didn’t realize how important the lab is to so many departments. They literally interact with EVERY department at the hospital! It was very interesting to see all the different processes they go through and I also followed a couple of phlebotomists to the patient rooms.

EVS (environmental services): This is another department that I think gets forgotten by most people until they work in a healthcare setting. They handle linens, scrubs, hazardous materials, cleaning, and so much more. They have a big effect on HCAHPS scores due to the perception patients have about cleanliness. Definitely another interesting rotation.

Security: This was a really fun department to visit! I walked around with one of the security officers, which she called “strolling and patrolling.” Then I rode around in the security car with another officer, which he called “rolling and patrolling.” The chief of security also showed me funny videos of some of the officers getting tazed during training. Pretty hilarious stuff!

Before the I35 campus opened in 2009, the main Hillcrest location was on the Herring Campus. I finally got the opportunity to go over there and see what they do. There’s definitely a lot more there than I expected. I was very impressed by the SNF (skilled nursing facility) and the rehab center. I’ve been to a few nursing homes and this was definitely a million times nicer and smelled a lot better as well. The patients really seemed to be in good spirits and one even told me that she thinks that’s “a heck of a facility.” It was also pretty cool to see patients actually going through PT (physical therapy) and OT (occupational therapy). I actually learned a lot just watching and asking a few questions here and there. I’m excited to go back in a couple of weeks and see the areas I did not get to check out.

One cool thing about being a resident is that they give us access to things like board meetings, which you normally don’t get access to as an employee. Obviously, I can’t discuss anything I heard in these meetings but I can say that just watching the dynamics between people has been very interesting. The only down side is that I’ve seen the same presentation several times now and I think I could even present it myself by now. Haha!

I have absolutely loved all the rotations I’ve been doing these past few weeks. Some of the recent departments I went to are cardiology, food & nutrition, and case management.

Cardiology: This was a rotation I had really been looking forward to especially with my own recent experiences. Coincidentally, my cardiologist was on call that day so I got to watch his perform a couple of cardiac catheterizations. I also learned that the cath lab has the highest profit margin since they’re able to charge high prices while the overhead is very low. I told the director than now my surgery bill makes sense. I won’t share my opinion about this here, though.

Food & Nutrition: This was a cool department and it was much more interesting than I expected. Yes, the cafeteria and patient meals are part of this but there’s so much more to it than that. I followed a nutritionist on her trauma rounds and got to see how they determine what to feed the patients. For example, there was a gentleman with a traumatic brain injury, so he is getting a higher calorie and much higher protein diet than someone who does not have those types of injuries.

Case Management: Boy, are these people busy! Not only do they advocate for patients and help determine what their insurance will cover, but they also often become the middle man between the patient, physician, and insurance company. I shadowed one of the case managers and saw what they go through on a daily basis. I can’t discuss much since it was very confidential, but I can say that I have a lot of respect for these people. They also know how to have fun and make the best of every day. There’s a lot to learn from this amazing group.

Today I spent a couple of hours with a manager from the food and nutrition department. He was so nice and showed me how the department runs while we had a really fun conversation. Next week I will spend some time with one of the nutritionists, so she’ll be able to tell me about that area in more detail. I’ll talk about that more after that meeting if I learn some interesting things.

I also found a time to set up a meeting for my low birth weight clinic project. I had to figure out when 5 very busy people could meet at the same time, which was a project in itself. I had all 5 calendars open and I was scanning them day by day until I found a one-hour window on July 3^rd that worked for everyone. I quickly sent the meeting invitation before anyone’s slots filled up. Phew! That was a relief.

I also found some time to work on my residency plan and will be sending that in soon. I’m really looking forward to my rotations next week, especially Cardiology on Monday. I’ll probably also have to spend some time following up on some emails to try to get the rest of the rotations scheduled. There are several departments I haven’t heard from yet, but luckily my week is pretty booked up, so there’s no rush to get them scheduled within the next week.

I’m also looking forward to seeing Glenn next week. He’s been on vacation since I started so I haven’t gotten to see how things run with him there. It’ll be interesting to see whether or not it’s any different.

And I realize this blog is kind of all over the place this time, but I guess it’s appropriate since that’s how the last couple of days have felt. And so far, I’m enjoying every minute of it!

I met with my preceptor this morning to talk about my residency plan and my major project. I’ve known for a while that I would be working with the Waco Foundation on a project called Smart Babies. The problem was that when I met with the Waco Foundation people, they couldn’t seem to tell me what my role would be and I was having trouble figuring out how that tied back to Hillcrest and my residency. I was starting to worry that it wouldn’t be a great learning experience as far as what we are trying to learn in the MBA program. But Marcy told me what my project actually is, and now I’m excited! I will be helping Hillcrest open a low birth weight clinic. I heard this is something they’ve been trying to do for years but the pro forma is consistently in the red, causing the project to be halted. Hopefully I can find some areas where the financials can be tweaked and put us in the black. I would really like to make this clinic happen before I leave my residency. I’ll keep y’all updated on what happens with that.

Another very exciting thing happened today! The marketing director came by my office and said that the lady who does all the flyers and videos for Hillcrest is going out on maternity leave next month and that he’s been scrambling to find someone who can fill in on some projects while she’s out. Hiring outside firms to do that kind of work in expensive, so they were hoping to find someone internally. Luckily, I had a conversation with David and Will about my undergrad degree and how much I love video editing. So we’re setting up a time for me to sit with the lady and learn how to use the software since I’m used to different programs. I’m extremely excited! I never thought I’d get the opportunity to use my undergrad degree and my passion for editing in a healthcare setting. I guess you really never know when opportunities can pop up since they usually come out of nowhere.