up, down, and sideways...

that's life these days... this entry relates to work as of Thursday, but we'll call it Wednesday's entry because there was no Wednesday entry and it's way long enough to be an entry and besides, you know I like to pretend I can manipulate time... so being that this is Wednesday (just look at the date if you don't believe me), travel into the future with me now as I predict what will happen tomorrow...

yeah, life is up (promotion, respect, exciting changes at work, back to the same old same old at home), down (challenges at work, lonelies, lazies, carb indulgence, and the same old same old at home), and sideways (I love dancing in circles even if it gets me nowhere, I love roller coasters even if they go nowhere, and the same old same old at home), but at least I've got you guys caring to know and responding (thankee sai) and that helps keeps the ups up, the downs from dragging me down, and makes the sideways more fun... so from your inspiration (and my comment response), this entry grows...

after two days in my office it's about 70% organized (it looks better than it is, but that maintains the faith in me that the other directors seem to have as they continue to oooo and aaahhh over my used of office space... I'd mention that it's nothing that spending $500 in office supplies can't accomplish for them, but then I couldn't slip as many PO's (Purchase Orders) through the system by walking them to and from the CFO's desk myself)...

I've still got to get creative with space (as with many private hospitals, office space is small and overcrowded) and that'll take some more time... and the organization is still just surface (window dressing) because I am not actually using the computer (or communicating by email much) because the desk computer is old (Windows 2000) and won't import the mail (.pst file) from Outlook 2003, which slows progress as the laptop is old and has the same obstacle, but at least I am already using it, which splits my mail into two locations (better than three or more), which interrupts follow up... but the progress is much more visible and my vision for the department is much easier to organize now that I can set up my office...

and then there's the assistant...

now you may already know that I am tough on myself... I prefer a brick aimed squarely at my own forehead when I am delusional or just plain stupid about something... but I struggle with explaining to others why their shortcomings prevent them from doing what they think they can do, especially when they have been set up to fail and I've got to be the one to break that news... I'm much better when I deal with patients than peers...

if the assistant administration gave me sent in a resume I'd have never even called her in for an interview... but the Administrator wants to cut the budget and has been chopping jobs in half in all the departments... so they gave me the Medical Records Clerk half time to fill the full time Clinical Data Specialist position...

there is a reason the job title is Clinical Data Specialist... data entry is the last step, and the simplest, of the process... and the assistant they gave me wasn't cutting it as a Medical Records Clerk according to the Director of the department... she takes too long to process information, must be lead step by step through every process several times and still fails to grasp enough understanding to work independently at an adequate pace...

and gathering the data for the state reports is much more than merely copying from reports others do, the data is created by reviewing clinical evaluations and translating the words into terms and numerical data that require an understanding of the clinical terms, medications, diagnoses, and the therapeutic process and more than anything, being able to make clinical assessments based on reports from doctors and other licensed professionals...

the bottom line is one important way the effectiveness of our treatment is measured is by the data that is translated from written evaluations by the Clinical Data Specialist...

but either the powers do not realize this or they simply ignore it in an attempt to satisfy the Administrator's call to cut the budget... tomorrow morning, I shall put these facts on the table and let them stir them around because I decided, after two weeks and a day, that it is time to either go without an assistant or replace her...

simply, the data is falling way too behind and I am spending too much time training s I do not have time to do enough of the PI job... and I think I would not fall as far behind if I did it all myself (though I will make it clear that the data would fall behind and gradually become out of compliance if I had to do it all for long)...

I need someone who has some clinical background and experience... even more, someone who has the education and confidence in their ability to make decisions... we simply do not have the luxury of training someone for months and that is what would be required in this case to even get a mediocre level of performance (and even months of education might not be enough for the aptitude just does not seem to be there)...

some people process clinical information and numbers well and some people do not... and that is my task for tomorrow, to break this news to the Administrator, Personnel, and other Directors... and then, to this nice woman who was set up to fail...

sucks to be me tomorrow, but much more, sucks to be the nice woman who's Medical Record Clerk's job was cut in half and may not even have that if the Director of that department is as honest with herself and the Administrator as she has been with me (she's complained to me about the slow pace of her assistant and that is simply doing filing and checking that forms are in the records)...

I suppose that this is their first test of my managerial skills, can I play the heavy... and while I do not like it (and struggle with it internally), this will be far from the first time I've been faced with firing someone (it's just the first time in a long long time) and probably won't be the last...

I just wish they would have thought it through because I hate it when someone is set up to fail... if she was not an adequate clerk, what made them think she could develop and expand on skills she already demonstrated she does not have? (rhetorical question)...

ok, enough venting about corporate disorganization and wimpy management, thanks for listening...

on the positive side, the office is starting to straighten up well, despite the cramped quarters... and the maintenance department and business office is responding to my requests with amazing expediency as almost everything I am asking for is getting done asap on my first request (and immediately upon a second request when I need to remind them)... that pleases (and surprises) the other directors, who've sat back and left the reorganization of departments (the good {getting spaces set up and supplies for those who need them}, bad (moving the one-day-a-week staff out into the cubicle in spite of her passive aggressive stalling and whining}, and ugly {breaking the news tomorrow morning}... wonder where the credit will go, I muse knowingly) to me...

and today I walked into my office and found a comfy brand new ergonomic chair in front of my desk (as opposed to the cheap basic desk chairs most everybody else gets) and a brand new bulletin board on the wall over my desk (not included in the supplies I ordered... that's Safety/Building/Purchasing Director taking care of me as he did that himself among dozens of other things and favors he and the CFO provided)... gotta love that respect...

and that's the state of the work life as of tomorrow (getting better all the time, in spite of the sour spots)... next entry, maybe I'll wonder off into other subjects, as if I have a life outside of work life to relate (ahem)... thanks for being here with me on this journey through my mind... hope you are enjoying it too...