Healthcare Rant: When Quality Care Goes Wrong

As I've been dealing with many difficult health issues this past year, the U.S. healthcare reform debate has fallen below the Nicole radar. It surprises me that I've avoided it, as my career is in healthcare administration. I know it's an important time in my field, but seven months of unemployment have kept me out of the trenches. Despite a very concerted effort, I have not been able to find work in my field. Although I have skills that would be portable to many other fields, I don't want to give up what I love. I believe that quality care should be available to all people, regardless of their ability to pay. While it's true that many healthcare organizations offer charitable care to the needy, it seems like many people in need fall through the cracks.

I am currently insured through my husband's employer on a plan with Cigna. The plan provides excellent benefits at a low cost for in-network providers. I am extremely lucky to have $5-10 copays, and very reasonable coinsurance. Unfortunately, the Cigna network has been fairly limited in both the Atlanta and Wasatch Front areas. In Atlanta, I couldn't use Emory facilities in network (while working for Emory, and promoting their Campaign Emory fundraising). In Utah, 90% of Intermountain Healthcare facilities are out-of-network for Cigna. This is frustrating to me, as I'm a previous 4.5-year employee of Intermountain. I believe in their Mission, Vision, and Values, and want to support them with my healthcare dollar.

My previous positions with Intermountain were as an assistant to a medical director at LDS Hospital, and as a Patient Service Rep in Accounts Receivable Management. I have also worked for City of Hope Cancer Center, Prime Healthcare Services, and University of Michigan Medical Center. I have experience in customer service, billing, coding, transcription, Joint Commission an AOA accreditation, physician credentialing, training, research, and have processed countless financial assistance applications. I have participated in executive-level hospital management meetings. Although I am not an expert by any means, I can confidently say that I am qualified to have an educated opinion on what works in healthcare, and when healthcare goes wrong.

Case in point: My daughter Rosie has been sick for a few weeks with kidney problems. My otherwise lively child has been mopey and lethargic, and complains of pain daily. On Christmas night, Rosie was very sick and begged me to take her to the hospital. We left our family holiday party an drove to the IHC Provo Instacare (which is in-network with Cigna). I advised the Instacare registrar that I had submitted a financial assistance application to the Lake Park and Creek Plaza billing offices a few weeks prior, and was unable to pay a copay. The Instacare flat out refused to see her without a copay...so I ran out to the car, grabbed a Christmas card, and paid her copay with the Christmas cash I got from my grandma. And what happened then? They took her blood, scanned over the results, and told us to go across the parking lot to the Utah Valley Regional Center Emergency Room immediately (which we later found out was out-of-network).

The ER registrar was a little nicer, especially when I brought along the copy of my recently-completed financial assistance application. We sat in the ER waiting room for over an hour, and spent a few more hours in the ER room 9 (which had a broken recliner, and no other chair available). After 4 hours, they said her urinalysis showed that she had inflammatory cystitis. If the Instacare would have taken 5 extra minutes to take her urine, she could have gotten on antibiotics and saved us a 4-hour ER visit and copay.

When we arrived at Instacare, it was a few minutes before they were closing at 9 pm. They happily took us back to the room, but pushed us back out the door in 5 minutes.My question is: "If they were going to send her to the ER, why did they take my gift money to pay a copay for a "visit" that didn't really end up being a VISIT?" Luckily these visits happened before the end of the year, because we'd already met our deductible. Had this happened a week later, we would have been slammed with deductible fees.

A few days later, Rosie had another ER visit. Her symptoms had worsened, she had a high fever, and I drove her back to the UVRMC ER (still not knowing it was out-of-network). The doctor wasn't sure why she was in so much pain and guessed that she had kidney stones or appendicitis. He ordered an abdominal CT scan to see if the problem was GI or urinary. After 3 more hours of sitting on room 9's broken recliner, we found out that her scan was fine. Rosie got a pain pill, some "orange pee" pills, and a stronger antibiotic. Since then, we've been following up with a non-IHC pediatric urologist and she's doing much better.

I was going to just sweep this experience under the carpet, but then earlier this week I received several IHC financial assistance rejection letters. Besides the recent hospital visits, I had some outstanding bills from all of my sleep apnea visits. Apparently we are slightly over the National Income Poverty Guidelines (remember my husband is a struggling regional airline pilot?) Despite our unmanageable debt from student loans and my 7 months of unemployment, we do not qualify. When I called the billing offices to get more information, I was told that our income was slightly too high, and our balances were not high enough for them to make an exception. Gee thanks.

I know I'm not the only person to have an experience like this. After going through it personally, it has really lit my fire to get back into a position where I can help avoid situations like this. I'm going to keep working on my medical coding certification, which I've been working on from home to keep myself busy while looking for work. It's time to make my voice heard. I've been in both hospital management, and also at the receiving end of a "charity" denial. I hereby recommit my effort to apply for all the positions I am qualified for. I need to be a part of my field again.

New Career Direction

So. I've been unemployed for 4 months now. I search job postings diligently, and there's just not a lot that I'm interested in applying for ($8/hr Kmart part-time cashier, anyone?) I've got mad skillz...the whole gamut of medical administrative experience (billing, insurance, transcription, scheduling, front and back office, database management, composing correspondence, terminology, medical-legal procedures, credentialing, executive meeting management, etc) I've enjoyed the last 8 years that I've worked in the medical field, and don't plan to stray too far from it. As I've struggled in this journey for work, I've been REALLY enjoying the time I've been able to spend at home. It's gotten me more interested in stay-at-home career opportunities. I've had a nagging desire for about 6 years to get certified as a medical coder. I have some coding experience, but not enough to get a job. Through the encouragement of some old coworkers who code, I've decided to go for it. Yesterday I signed up for the Inpatient/Outpatient Coding and Medical Billing course. If I work at it full time, it should take about 4 months. I know I want to finish my bachelor degree, but I've strongly felt that now is not the time for that. It's time to get a career skill that is more professional and portable....and one that will get me earning money faster than a bachelor would. So wish me luck, in a few months I'll have the CPC credentials after my name.

Just my luck...

Today I've got a job interview. I got the call at 5:30 pm yesterday for an interview just after lunchtime. It the first time I've planned to make my hair look really nice and wear full makeup in a few months. As I was getting all of my makeup out on the counter, I froze when I saw my bottle of foundation. It was practically empty in a rock-hard clump. Last time I used it, I'm certain that there was at least 1/3 left. I guess it's been a while since I've worn more than mascara and lip gloss.

I went shopping for an outfit to wear for the interview last night. Most of my work clothes are still in storage in Atlanta. After trying on stuff at seven stores, I only came home with a pair of black slacks. Everything else I tried on fit wrong, was too expensive, or made me look like I was 50. The blouse I'm going to wear is a bit on the casual side, but the color shows off my eyes really well. (Random fact: for every job I've been offered, someone in the interview complimented my eyes)

I don't have a printer at home, so I need to figure out a place to print copies of my resume in the next hour.

I've never felt so unprepared for an interview...

Rain Delays

This morning, north Georgia (as well as much of the southeast) was hit by some pretty crazy stomy weather. There were flooded streets, downed trees, torrential rain, wind gusts over 50 MPH, and many power outages. A huge tall tree fell just outside my work window. It's kinda hard to see from this pic, but on the left you can see the long skinny tree crossing the road. It took down a bunch of power lines in the process. The power went out in my building around 9:45 this morning, and I was allowed to go home around lunchtime.

Getting away from campus was quite a maze of downed trees, diverted traffic, and scattered debris. I used the afternoon do run some errands, do some shopping, get lunch, and work out. In the evening Rosie and I had to return a purchase in Buckhead, and luckily we didn't get diverted for any downed trees. Rosie needed a bunch of stuff at Target, so we stocked up on socks, underthings, pajamas, a swimsuit, etc. Now that she has fully stocked drawers, I won't have to do her laundry as often, or have the 7:40 scramble to find matching socks.

We also got a few discounted Easter candy items, but that's our little secret.

2008 Year in Review

I will not lie. 2008 was probably the most difficult of my life, right up there with 2003 (when my ex-husband went psychotic and we got divorced). To save you from reading my 249 blog entries of 2008, I have prepared my longest blog post ever to truncate the insanity of the year. Here's the rundown on what happened to me in 2008:

Jan 1, 6:00 am - Began driving cross-country to move to Canton, Michigan with my brother Jacob
Jan 4 - Moved in with the Pearce Family for two weeks awaiting our move-in date at our apartment
Jan 9 - While enrolled in 17 credits for school, began searching for full-time work
Jan 11 - Received a call that my father had been in a horrific car crash in Utah. He was taken in to a nine-hour surgery as I packed my bags and non-revved to SLC on the next available flight
Jan 12 - Appointed to by the family representative to make medical decisions for my dad
Jan 13 - Started his accident blog to keep family and friends notified (this link shows the extent of his injuries). Also told by Elder Dickson of the Quorum of the Seventy that the First Presidency of the Church was personally praying for his recovery.Word spread like wildfire and we had people all over the world praying for him.
Jan 14 - Called together a family counsel meeting with all family members, some extended family and our bishop to make a plan to run the family (groceries, paying bills, housework, etc)
Jan 16- Flew back to Detroit to prepare to move into my new apartment. Dad is trached and goes in for his third surgery. Still sedated and on life support
Jan 19 - Dad begins to breathe on his own without the ventilator, comes off much of the sedation. Rosie and I need a break, and go to California for 2 days to attend John and April's wedding reception.
Jan 21 - Dad's left leg is amputated just above the knee due to widespread necrosis. His right leg is injured, but not in as critical condition as the left.
Jan 22 - Flew back to SLC and tried to not get depressed with dad's ICU psychosis
Jan 24 - Dad is transferred out of the ICU to the 11th floor with the amazing mountain view
Jan 25 - I wait in the surgery waiting room for his "full amputation surgery" where the stump was shortened, revised and closed with sutures
Jan 26 - My friend Kathryn, a concert violist from California, gave my dad a personal concert in the hospital, and then we went out for some non-hospital girl time at the Tavernacle and Melting Pot
Jan 27 - My dear prophet, Gordon B Hinckley, passes away from incidents of old age

Feb 2 - Michigan receives a huge dumping of snow and Rosie's school is canceled. We travel into Ann Arbor for a day of frolicking and for two Fox Elipsus shows
Feb 3 - President Hinckley's funeral, and a special fast is held for my dad's recovery
Feb 4 - Thomas S. Monson is appointed the new president of the Church of Jesus Christ of Latter-day Saints, and dad passes his swallow test and celebrates with a chocolate milkshake
Feb 5 - I celebrate my 28th birthday with lunch at Chili's with Taylor and a homemade cake. As the greatest gift imaginable, my dad was transferred from the hospital to Aspen Ridge Transitional Rehab, which will become his home for the next 4 months. Also have a super-fun birthday with Taylor's pilot friends and a few neighbors a few days later.
Feb 10 - Rosie and I go back to SLC for 5 days to spend with dad at Aspen Ridge. Dad gets to visit home for the first time since the accident. Taylor's beloved car, The Silver Bullet ('97 Accord) bites the dust, and he replaces it with a green 2002 Civic
Feb 19 - I go to California for 4 days of ME time. Disneyland with Grant and Hollie, Disneyland with Clint, Liz time, and a lovely day with friends with Nathan McEuen in Ventura
Feb 22 - Dad has his 6th surgery, this time on his right knee. The damage is much worse than originally expected, and the long-term prognosis for the leg's usefulness is realized.

March 3 - Have two awesome interviews at University of Michigan Medical Center, and we celebrate as a family with Turkey O'Toole's at Bennigan's
March 7 - I get offers for both jobs at U of M, and accept the postion in Thoracic Surgery
March 8 - Rosie and I take an impromptu weekend celebratory trip to Providence, Boston, and New Haven to see 3 more Fox Elipsus shows
March 13 - I ship off to Boston for 5 days of Irish fun with my Irish Princess friend Nicole, and we spend the next few days with Terawrizt, Lethal Dialect, The Bawston Strangla, and Shaymin. I come down with a nasty illness that will plague me for the next month
March 18 - Drop Cola off at the airport, and drive to Nantasket Beach to watch the sun rise over the Atlantic Ocean, before returning to Boston for a few more hours of sightseeing and flight back to Detroit
March 20 - In an impulsive moment, I agree to head up the planning committee for my 10 Year High School Reunion
March 25 - Take one last trip to SLC before taking on the shackles of full-time employment. Nathan McEuen gives my dad a concert at Aspen Ridge
March 31 - I start my job at U of M, and New Kids on the Block officially announce their reunion tour

April 16 - Saw Ben Folds in concert at Adrian College with Mike and Erin
April 20 - Went to the ER for an grapefruit-sized ovarian cyst rupture. Diagnosed with PCOS.
April 25 - Assist Utah does an evaluation of my parents' home in Murray, and decide that the renovations to the house are too extensive to warrant a renovation. They will need to find a new home.

May 5 - Began my parent-dentist relationship with Dr. Kam, who received thousands from me in the next 7 months. He did a great job, unlike my CA dentist
May 15 - Complete the most difficult school semester of my life, and have to take an incomplete on my first class ever. Flew to California for two days for Chris and Mary's wedding, a trip to the Huntington with Liz, and to celebrate Syttende Mai with Brett
May 23 - Take a two-day trip to Palmyra, NY and Niagara Falls, by way of Ontario, Canada. We stayed with Alan, my old HS boyfriend, in Rochester. He treated us to Dinosaur BBQ. Yum!

June - My summertime slump. Thank you Prozac for fixing me.

July - Attended Grandpa Dale Bullock's funeral, dealt with a bad month of Taylor's schedule, cut 7 inches off my hair, Lissy's twins Sarah and Phoebe were born, spent a weekend in Northern KY with my old Ricks College roommate Stacey, and I went insane planning my HS reunion. Dad is done with Aspen Ridge My parents move out of their home of 15 year on Green Oaks Drive in Murray, and move into the Brigham Apartments in downtown SLC

Aug 2 - MHS X, the high school reunion, came off much better than all the nightmares that plagued me about it for weeks. I already knew everything going on with the people that attended because I read their blogs. I relinquish the responsibility back to the class officers for the next reunion
Aug 8 - Enjoyed the 2008 Beijing Olympics. I was a total Phelps Phan.
Mid-August - . Grandma Joyce in Portland decides to sell her house and move to SLC. My parents house goes on the market. I also reconnected with a bunch of my old Balmoral ladies through blogging
Aug 30 - My coworker Kay gives me the hook-up through a friend for tickets to the Utah - Michigan football game at the Big House. We wear red. Utah wins.
Aug 31 - Receive a random, smug message from Tim, the guy I dated right after my divorce, that temporarily sends me into an emotional tailspin. (History: I was madly in love with him, we were planning our wedding, and then he suddenly breaks up with me in a email. No contact for almost 5 years, then a message at 3 am after finding my blog) Actually, this is the year that EVERY man I ever dated got in touch with me through my blog or Facebook. Even Niko from Finland. Kinda creepy. Rosie and I drive to Lansing on a whim to meet up with Taylor for the night at his crew hotel.

Sept 2 - Rosie begins 2nd grade
Sept 13 - We spend Rosie's birthday in SLC, and have a wonderful family turn out for her
baptism
Sept 21 - After months of deliberation, Taylor decides to take the CRJ-900 upgrade in Atlanta. He puts in his bid for January, he gets assigned for training in October.
Sept 22 - Taylor turns 29. One more year till 30!

Early October - Begin revising resume and applying for jobs, and enjoy the most beautiful autumn that I've ever remembered
Oct 8 - Taylor and I celebrate our Four Year Anniversary We spend the weekend in Atlanta checking out neighborhoods and apartments, and prepare for Taylor's move to ATL.
Oct 17 - Spend a family day in HELL, MICHIGAN and go to the Christmas Store in Frankenmuth
Oct 22 - Taylor leaves for Memphis and Montreal for 10 days of upgrade training. The pilot widow lifestyle resumes...
Oct 25 - Rosie and I attend the New Kids on the Block reunion concert at the Palace of Auburn Hills. Best concert of the year
Oct 31 - Rosie and I fly to LAX to spend a warm Halloween Holiday in Cali.

Nov 7 - Have a phone interview with Emory for a position type-cast for me. A few days later I go to Altanta to have an in-person interview. Best one I've ever had.
Mid-November - I give my notice at work for mid December, and everything goes downhill fast
Nov 21 - Have a Girls Night Out with Hillary and Erin to see Twilight
Nov 25 - Start a Twitter account. Post 211 tweets in the next 5 weeks.
Thanksgiving - Road trip to Atlanta. A feast at Golden Corral, and a late dinner at Waffle House

Dec 1 - Accidentally inhaled an industrial chemical at work, and am sent to the ER for breathing treatments. Two weeks of asthma follow.
Dec 5 - I receive the job offer from Emory. Also, I blog about other significant December 5ths in my life
Dec 12 - Last day of work at University of Misery. Begin packing for 16 day trip in carry-on bags
Dec 13-15 - Snowy visit in Portland with Grandma Joyce
Dec 16-21 - Visit with family in SLC. Another ER visit. Attended Grandma Mary Taylor's funeral in Spanish Fork. Get upgraded to First Class while non-revving to LAX
Dec 22-28 - Visit with family and friends in Cali
Dec 29 - Pack up my apartment in Michigan
Dec 30-31 - Drive with a loaded car from Detroit to Atlanta, overnighting in Knoxville
Dec 31 - Ring in the new year with Taylor, Rosie, Hank, and Marissa in Atlanta

Woo Hoo!

Nicole is jumping up and down with glee.......she got the job at Emory!

Today I was offered the long-awaited position at Emory. I'll be an Admin Assistant in Development and University Relations. My first day is January 5th. Taylor and I also decided on the place we'll be living in. It's a 2 bed/2bath condo in North Druid Hills, 4 miles from Emory. Let the packing begin!

Inhalation Hazard

It was inevitable. Every hospital I've ever worked at, I've been a patient at. I thought I'd be getting off easy with a freebie at U of M Hospital, but I proved my precedent correct yesterday.

I was feeling a bit exhausted from Sunday's roadtrip, but otherwise with no illness symptoms. Right after lunch, I went into the tiny closet restroom across from my office, and was floored with a terrible smell. I really needed to relieve myself, so I thought I'd quickly finish and leave. Upon the throne, my eyes, throat, skin, and lungs started burning. My skin started to blotch up. I looked up in the air, and saw little particulates dancing around. I became lightheaded and dizzily fell off. Someone had used the industrial strength disinfectant spray (for cleaning bathroom surfaces) as an AIR FRESHENER, and sprayed it all through the air.

This chemical spray, which should only be used in a WELL VENTILATED AREA...not a little closet bathroom whose fan turns off with the light. And it wasn't like a little shot of potpourri spray, it was full-on 80's AquaNet-like sprayage. It was as potent as oven cleaner. There's a demon sprayer in my department (I still haven't figured out who) and I've left notes before to please be considerate when using this CLEANER to "freshen". I'm pretty sure I hit the brunt for a very recent spray. For some reason, the environmental services team leaves this aerosol in the department at all time, just because it's kinda far-flung from the rest of the public restrooms in the building. I started using those far-flung multi-stall public restrooms, but I didn't yesterday. I learned my lesson.

I immediately sent an email to Safety Management services, who advised me to go immediately to Employee Health. They said they'd send out an "environmental industrial hygienist" to check out the ventilation in the room. My favorite coworker walked me to the Med Inn and waited for me to be evaluated. Employee health checked my vitals, gave me a puff of Ventolin, and had me rest in the lobby for 15 minutes. Still felt shortness of breath, chest tightness, and eye stinging. They suggested that I be evaluated in the ER. So they wheeled me down, I waited an hour to be triaged, another 45 minutes for chest xrays, and finally 3 hours after the exposure got the breathing treatment.

The morning after, I still feel yucky. My eyes still sting, my breathing is slightly labored, and I really don't feel like working. However, I've got a dentist appointment this morning that I have to get out of bed for. They'll be checking the tooth abscess from the root canal and see if it's healed enough to do the crown prep. Haven't I been through enough already?!?

Plan for Today

1. Get ready for work
2. Pack up the car
3. Drop Rosie off at daycare
4. Endure a day of work, trying to get ahead enough to enjoy a 5-day weekend
5. Try to be patient for "the call" from Emory that should come today or tomorrow
6. Pick up Rosie from daycare
7. Drive 275 miles to Stacey's (my old Ricks College roommate) in northern KY
8. Enjoy a visit, while still getting enough sleep to have energy to drive to Atlanta tomorrow

Will I be successful? I only got about 4 hours of decent sleep. I've been having terrible early morning insomnia; I can fall asleep fine, but I wake up WAY too early and can't get back to sleep until it's time to wake up and get ready for work. Caffeine may be my constant companion today.

On the Chopping Block

Work has been really rough since I gave my (premature?) notice three weeks ago. I guess I should have waited to tell my boss that I was leaving until I had a job offer...but I decided to be a KIND employee so she could rehire without being left stranded at my departure. Six weeks notice is definitely too long for an outgoing employee's sanity. Hopefully I'll hear back on the Emory job Tuesday or Wednesday. I was so ready to commit career suicide yesterday...

First Down

Yesterday I had my first interview for a job in Atlanta at Emory University. It was a phone interview, but it went really well, and they want me to come down next week to interview in person. The interviewer said, "We've gotten a lot of applications on this position, but you were the only one we've wanted to actually interview." The position sounds right up my alley, even though it's less healthcare-focused than I'd intended. It's still administrative, but it's with the med school.

Since I gave my notice at work in Michigan last week, there's been a marked change in my happiness there. The past few weeks had actually been under control, as far as my workload, and I was feeling a tinge of sadness that I was leaving. But after a difficult experience Monday, and a ridiculous meeting Wednesday...I'm having a hard time imagining staying through the next few weeks. The surgeon who I've been working with since March leaves this week (for Atlanta, consequently) and I've been given a lot of the office's grunt work to fill my time. I'm so glad it's Friday!

Taylor's on reserve in Atlanta this week. He got to play with Clint for two days after returning from California. Yesterday he got called on a ferry flight to Cincy, and then got extended overnight for a few more legs. He didn't bring any extra clothes or his toiletry bag because when he left for the airport, he was supposed to be back in 6 hours. Hopefully he won't have to work much this month....he really needs to finish his algebra class.

Resuming Resume Revision

Now that we've come to the decision of moving (which took nearly 3 months to do), it's time to iron out the details. Moving trucks, apartments, new job, new school, new gym, good neighborhoods, commutes, distance from airports, etc.... It's a pretty daunting task to come up with a new life when you've never really visited the area. Next weekend, Taylor and I are planning to fly down to ATL and drive around and get to know the city, check out some apartments, do some touristy things that we won't have time for once I'm working. It's the weekend of our anniversary, and it would be nice to do it without Rosie (so much harder to non-rev with a kid), but finding someone to watch her for the weekend would probably be harder than bringing her along. Taylor and I get so little alone time these days, and it's only going to get worse till we move.

I dusted off my resume, and added in the details of my current job. Even though I've only been in my position 7 months, I've acquired some good new skills (OR scheduling, cost accounting, charge entry, physician recruitment and relocation, and the lingo/procedures specific to thoracic surgery) and fine-tuned some others (transcription, purchase requisitions, procurement, more complex call schedules, etc.) I've been my department's Joint Commission Accreditation and safety specialist, and know all the ins and outs of NPSG's and SCIP and all the other acronyms.

It's a tedious process, especially to focus on finding a new job in a new city, all while being exhausted from a hard day at work.

In a Pickle

Today was my second day in my department. The person training me only sat with me for one day, and today I was on my own. I booked a few surgeries, did some misc scheduling for my surgeon, took some online training modules, got my pager, attended a class, and some of my other job duties too boring to mention. I think I'll like the position. As long as I can handle the parking situation, I'll be sticking around UofM for a while. I purchased a yellow parking pass, which is supposed to be the closest lot to the hospital...almost walking distance if you have enough time. Yesterday I drove around for almost a half hour looking for parking. I ended up down the road at the orange lot, and took the shuttle over to the hospital and was 15 minutes late on my first day. I was worried about being late, but everyone expected it and laughed it off when I walked in totally flustered.

The funniest thing of the day was the gift that my new boss gave me...a pickle. She just got back from Disneyworld and Epcot, and gave me a shiny green pickle Christmas ornament. Apparently, pickles are a German Christmas tradition. A pickle would be hidden somewhere in the boughs of the tree, and the first child to find the pickle would get an extra gift from St. Nick for being so observant. Not sure how that translates to my new position, but my new cubicle is graced with a decorative pickle.

I'm still not better from the illness fiasco I've been dealing with for 3 weeks now. I finished up two rounds of antibiotics, but I think the infections aren't gone yet. My throat still is swollen, my ears and eyes hurt, and my sinuses are tender and stuffy. I've been coming home from work and crashing on the bed to recover from these long workdays. At least I'm not sick like my friend Erin, who at 23 years of age came down with the chicken pox this week. My teeth are also still hurting like mad. I've been having these frightening, recurring dreams that all my teeth fall out while I'm giving a public speaking address. I've been brushing with Sensodyne again, but the nerve pain lingers. I opted for my insurance benefits and dental plan today, and pretty soon I'll have the info to find out what dentist I can see. Until then, it's Motrin every 4 hours for me.

Random thoughts on my last afternoon of freedom...

Yesterday I started my orientation with UofM Medical Center. Yesterday was a full day of patient safety, corporate culture, medication error reporting, HIPAA and JCAHO regulations, customer service videos, and all the other junk you're required to review upon hire at a hospital. This morning was a little better...ID badges, benefits, retirement, and parking. They let us leave at 11 am, so I spent the afternoon with Taylor unpacking. Yes, we've lived in our apartment for two months now...but with all the travel, we still had a lot to do. We cleared out about 15 boxes, organized our bedroom, spent 2 hours on Rosie's bedroom hurricane, and put up a few pictures on the wall. I start my job for real tomorrow.

My teeth have been hurting so bad lately. I'm not even sure it's my teeth, more like the nerves to my teeth. I had so much dental work done in November and December (over $3000 out of pocket after insurance) and I've never felt back to "normal." The left side's bite still feels wrong after two adjustments on trips to Cali, and the nerve flare ups have been occasional, but never less frequent than a few times a week. Since I got back from Utah, it's been constant pain on both sides. My new dental plan was in effect as of yesterday...and for the first time ever I have dual coverage. I need to talk to my new supervisor and see how soon I can take time off to see a dentist.

I'm so geeked for the NKOTB reuniting on Friday morning. If only I started work next week, I would SO be there...I'd fly out to Rockefeller Square and hold up my big sign while screaming till my lungs gave out. Yesterday, Taylor found a Russian legal download site where we found the whole NKOTB library for 10 cents per song. I downloaded about 30 songs. Unfortunately, my Ipod is on the fritz. The night before I left for Utah, my iTunes crashed, and I lost EVERYTHING. I had to do some mad file transferring to get it back, but I lost about 8 of my 25 GB of music. It's been syncing for 3 hours now...

Oh, and I got a call from Becky Anderson, the guidance counselor from MHS. I was having terrible luck getting anyone to call me back about renting MHS for the reunion, but she called me back (the day after Robin got the info). We chatted for about 10 minutes...she ended the call with "Glad to hear that you've turned out to be such a success." I smiled.

A battle of wits and wisdom

This morning I got a call from the Thoracic Surgery department administrator, saying that they were very interested in meeting with me again, and interviewing with the surgeon that I'd be working for (if I chose this position.) The only time that he's available to meet is Thursday morning at 7:30 am. I have my PEP interview at 9:00...so this works out fine. When I mentioned that my Pathology interview went really well, and that they wanted to hire me...she said they were willing to fight for me. Does this mean I have leverage for a better salary?

In other news, I have been laid up in bed for most of the day. I have been feeling shooting pains and spasms. I don't know if it's from Clint's adjustment, or from using muscles not usually used while swimming...but I'm pretty sore. Hopefully I'll wake up without pain and be able to trek (through all these new inches of snow) to the gym.

Two Awesome Interviews

This morning is the first time since December that I got up, did my hair and make up, and dressed myself in business casual. I did my last resume revisions, filled up the gas tank, and drove to Ann Arbor. I gave myself an extra hour to get there, just in case random road hazards or parking situations came up. So I arrived in the UofM parking structure at 10:06 for an 11:00 interview. I listened to some Colbie Caillat on my Ipod to pass the time.

The first interview was in Thoracic Surgery. I could tell that the two ladies interviewing were both impressed and entertained by me. The job would be a direct secretary and assistant to a surgeon just out of his residency, plus one other surgeon that would be starting in July. I'd be planning travel, reconciling expense reports, coordinating his surgical and clinic schedules, and transcribing consults. It's a lot of independent work, and the surgeon expects 100% effort 100% of the time. I also met with the department administrator, who told me she was pleased with my qualifications and would be contacting my references.

I had an hour to kill before my next interview, so I chilled in the cafeteria with my bagel dog and Tazo tea. It was fun to watch the full spectrum of diners...students, doctors, patients, techs, and important people in fancy suits. I could tell UofM takes a lot of pride in is Ultra-Academic environment, and I know I'll love being a part of it.

My pathology interview was at 1:00 in the path conference room. I first chatted with Craig, who just barely was promoted to anatomic pathology supervisor. He looked like he was about 25, but when he said that he had 16 years of path experience and a double-masters degree, I figured it was just his dual ear piercings that threw me off. I also met with Beth, who was the AP Manager. The synergy of the interview was great. They were grinning from ear-to-ear, and skipped over the lame, stock HR questions...saying "We already know that you're a pro at that." It was awesome that they were already familiar with Dr. Geyer's publications, and they said it wasn't necessary for me to name drop Dr. Warren for them to be impressed. I left the interview feeling warm and buzzy.

I made a few phone calls to give the dish on my interviews on my way home, then threw my phone on the couch when I got home to take a nap. When I got up 45 minutes later...
I had a voice mail from Craig saying that he was very interested in hiring me, and I just needed to finish up some pre-employment junk with HR before he could extend a formal offer. I set up my PEP interview for Thursday, and I should have the details on the formal offer by the end of the week.

Another UM job interview on Monday

Market Title: Admin Asst Inter Healthcare
Department Name: Pathology
FLSA: (exempt or non-exempt) non-exempt
Salary Range: (optional)
Pay Grade: (If applicable)
Hours: 40 Shift/Days: Mon-Fri, 8-5 pm

Provide administrative support to the Director of Autopsy and Forensic Pathology Services and two additional faculty members. Coordinate, schedule and maintain calendar, serve as coordinator of the Forensic schedule and other administrative tasks associated with this service. Coordinate travel reservations and itineraries for Director and visiting faculty; assist the Director in the preparation of the annual report, manuscripts, presentations, etc. as required. Candidate must be proficient in Microscof Word, Excel and Powerpoint. Excellent written, verbal and interpersonal skills. Reasonable knowledge of medical terminology. Ability to establish priorities.

Monday's Job Interview at UM

Market Title: Admin Assistant Intermediate -Thoracic Surgery FLSA: non-exempt Hours: 40 Hrs Shift/Days:Days/M-F Provide administrative support for surgeons in the Section of Thoracic Surgery. Maintain and reconcile faculty research and CME accounts. Maintain faculty calendar and update faculty curriculum vitae. Organize travel. Collect, enter and extract clinical data into a database. Knowledge of patient operating room scheduling system desirable. Requirements: High school diploma. Two to three years of previous office experience. Excellent verbal and written communication skills. Strong customer focus and ability to interact with a wide variety of individuals. Proficient in microsoft word and excel. Desire powerpoint and access experience. Excellent organizational skills, ability to multi-task and remain flexible during changing daily activities. Strong ability to work as a team member and independently.

To work or not to work?

A few weeks ago, I'd made the decision to just stay at home and do school full-time in Michigan. I'm still wavering with the idea of working, because I know that our bank accounts are pretty dry and it's not going to get better anytime soon. So I was looking online this morning, and found this job that I want. This is the type of job that will get me out of bed in the morning!!! I applied, but I'm not really hopeful (It required a bachelor's degree plus experience) I don't know the pay either, but I have a feeling it's pretty commensurate with what I made in Cali.

We are currently seeking an Epidemiology Research Associate in our Ann Arbor, MI office. The Epidemiology Research Associate will work closely with project teams to assist in administrative and epidemiologic aspects of studies.

Major Responsibilities

• Prepare agendas and take minutes at meetings
• Data entry as needed
• Assist in preparation of tables, reports, presentations and manuscripts
• Work directly with project managers to identify other related tasks needed for project
• Coordinate medical chart abstraction effort involving assistance in setting a timeline, utilize Access databases, mail letters and forms, participate in the creation of abstraction tools, assist with the development of training materials, train abstraction firms, track medical charts, follow up on pending charts, contact with abstraction firms, hospitals and doctor's offices as needed
• Conduct literature reviews and summarize findings
• Other administrative tasks deemed necessary
  

Qualifications:

• Bachelors Degree plus experience (in related field)
  
• Interest in public health, epidemiology and pharmaceuticals
  
• Experience with Excel, PowerPoint and Access
  
• Experience with medical records and/or claims data a plus
  

Three Weeks Notice

Today I submitted my letter of intent to resign. According to Lizzie, I wrote a picture-perfect letter of resignation. My last day will be December 14th-ish. It was going to be the 14th, but that's the day of our big formal Christmas party and the managers will all be busy preparing...so in order to give me a proper send-off (i.e. free lunch) my manager crossed off December 14, and penciled in December 17.

So I've done it. I've made an official step to moving to Michigan. Sure, looking for jobs and apartments online is part of the process...but now it means no more procrastination. I'm bringing home empty boxes from work, mentally inventorying my closets and bookshelves, and savoring some of the things that are truly California (currently I'm eating a teriyaki bowl from Spikes.)

According to Rachel, I'm not allowed to talk about "Turkey Day." But hopefully in the next day or so I'll post a Thankful For list...stay tuned

Grrrrr! Thanks, but no thanks...

Sometimes I just don't get the curveballs that life sends me. I just checked my email and got the most generic "Thanks, but no thanks" email. But let me backtrack…About two weeks ago, right when I got back from my trip to Utah, I received a call from the recruitment department at the IHC Employment Center in Salt Lake. They said that they had an excellent position available and wondered if I would like to be considered. Off the cuff, I had a phone interview, was told all about this very prestigious senior executive assistant position for the LDS Hospital CEO. I got the impression that I was exactly what they were looking for. We talked about the negotiability of the salary, and I thought it would a feasible employment option. The recruiter excitedly told me to anticipate a call from the hiring manager within the next week for a phone interview.

The idea of a completely different life change in a short amount of time really threw me for a loop. I looked at a horoscope that basically said that events from last August (starting my current job) would open up a new opportunity around June 28 (the day I got the call) that would suddenly come into my life that would turn my life upside down, and the rest of the year would be much easier. Coincidence? I thought not. Lots of prayer and pondering occurred, and I felt like this would be a good opportunity for the family, even though a move right now would be difficult with Taylor in another state. It was a more prestigious position, at a more prestigious hospital, and I thought it would be good for my career, and good for the family. I rationalized around all the reasons I should stay in Cali, and decided that I would take the job if it were offered to me. I took the risk of talking to my boss, letting her know about how serious I was about considering the new position. I was pretty confident it would work out.

I had the phone interview yesterday, but it wasn't with the hospital executives as I was originally advised on my first call from the recruiter. It was the administrative assistant that works in the department, who would have been my coworker. She asked a lot of the generic HR questions, described the position, and said that 2^nd interviews in person would be scheduled in the next week or so. I didn't really get a vibe either way on if she liked me or not, and figured that she left the door open enough that I was still a candidate in consideration.

All day today I've been poring over the possibilities of moving, stressed over my possible life changes (as well as Taylor's airline interview that was yesterday…which he's had no answer on yet). My work internet has a new filter that wouldn't let me into my hotmail. I opened up to a few coworkers about the possible job, and started looking into airline fares for coming up for a 2^nd interview. When I got home this evening, I opened my email to read this…

We appreciated the opportunity to discuss your experience and background related to this position. We have narrowed the field of candidates to those whose training and experience most closely matches our needs. Unfortunately, you are not among the final group of candidates being considered.

Talk about an impersonal way to respond to a candidate that was RECRUITED by the company! If they weren't genuinely interested in me, why did they think about putting my life through mini-hell for the last two weeks? Why did they hype up the job so much…telling me I was a perfect candidate, and one of the most qualified so far? I like IHC, and had a lot of good experiences as an employee, but I also have had a lot of negative experiences.

For instance:

Two and a half years ago, I interviewed for a position at a clinic within IHC. I had a fabulous interview, got along great with the staff, and was practically dragged from the parking lot back in to have an immediate 2^nd interview. That interview went well; I was given a lot of reassurances about how I'd be a great addition to the office, and left feeling pretty confident. Within a day, the clinic manager called me to say that I was their top candidate; they were finishing up the hiring process, and would be extending the job to me as soon as HR finished their stuff. Two days later, a 30-second phone call from that same manager advised me that HR overrode their decision and decided to hire someone who had previously worked in that office.

How does a large corporation get away with this? It seems the human in HR has turned inhuman.

I need some reassurances that I'm still a good person and qualified individual. I know I am…but sometimes I just need to hear a few compliments. Can you give me a few comments? Any unleashed rage upon the company that's left me in such a whirl the past few weeks?