First week on the job

Fifth email, sent April 6, 2013:

"Well, I survived my first week on the job.  That's probably because it was very nearly all orientation.  I am now oriented to a lot of things (our health sciences library is great!), though navigating the hospital building itself, not as much.  Part of the problem with navigating, besides the fact that it's a large structure, is the fact that various parts of the building were built at different times.  Floors don't always match-up, hallways take unexpected turns and some elevators have "G" as the main level while others have "1" as the main level.  Plus, the whole thing is on a hill, so a basement/lower level may in fact be above ground at the outside doors.  Not to mention, artwork is sparse; artwork serves as a Hansel & Gretel-like breadcrumb navigation system for me...recognize the artwork and I'm probably on the right track.  The other day I walked in to a part of the building (a new entry point to me) at ground level.  I assumed I was entering on level 1.  As I walked further on to try and find the area I thought I should emerge, I passed an elevator bank that said I was in fact on the second floor.  Hunh, I was not expecting that.  Fortunately, fire safety being what it is, there was a stairwell nearby.  I went down a level and emerged at the place I wanted to be.  Needless to say, I've snagged a map of the hospital from the patient information desk; it's no google maps but it helps.

Through all this orientation, I've come to realize I am fortunate to be part of the Geisinger employee force.  This is one hospital system and health plan that is obsessed with being the best.  Abigail Geisinger (an 85 y/o widow) founded the hospital in 1915.  She hired Mayo-trained surgeon (he literally trained under the Mayo brothers), Dr. Harold Foss, to be her chief of staff and charged him to, "make my hospital right...make it the best."  After her death, he stayed on as superintendent and chief of staff until 1958.  The saying, "Make it the Best," is literally printed on every employee's I.D. badge.  At every managerial level of the hospital, there is a physician-business administrator team.  They hold the same amount of responsibility and accountability for their department/region, no matter if it's on the medical or administrative side.  This business-medical partnership started with the Geisinger-Foss team, and is one of several aspects of the Geisinger Health System that makes it unique among hospitals today.  GHS is a non-profit that is doing so well they are hiring about 1200 new employees each year, and buying up failing hospitals in the region just so the competition won't be able to.  There are multiple quality measures for GHS.  Included on this list are: using up to date, evidence based medicine to deliver quality health care, patient satisfaction, family satisfaction, employee satisfaction, and accountability to patients, community and Abigail's request to "make it the best" (I'm telling you, that's a big deal quote around here). Financial stability/profit is included in their quality measures, but it is not the primary goal (i.e. patient's are not dollar signs and bonuses, they are people and should be treated as such).  The people delivering my orientation classes and appointments, readily admitted GHS is far from perfect.  I think that in striving to "make it the best," while accepting that humans are imperfect, some of the humanity has been preserved in this corporation.

I finally got to really see my department on Friday.  I'd had lunch with the PA I'll be working with, Nevin, on Tuesday, and had a meeting with my supervisor, Susan, on Thursday.  But I hadn't had a tour and in-depth look until Friday morning.  Karen, the RN who works exclusively for Thoracic Surgery, gave me a tour and overview of the clinic.  I then got to round on an inpatient being discharged and observe in the OR on a quick, straightforward case (resection of a 3cm x 2cm x 2cm chest wall mass laying just below the skin; like a cyst or lipoma, but his had a lot of blood vessels.)  The mass probably could have been resected in an office setting, but this 67 y/o male had transposition of the great arteries at birth (a condition where the aorta comes off the right side of the heart instead of the left and the pulmonary artery comes off the left instead of the right; so deoxygenated blood goes to the body, while oxygenated blood goes right back to the lungs) and a heart transplant within the last 5 years (he will be on immunosuppressing drugs for the rest of his life.)  With such a history, they deemed it better to do this procedure under sterile OR conditions, rather than mostly sterile exam room conditions.  After the procedure, Nevin and I went to lunch and he started to teach me about the chest-tube vacuum machines they use for lobectomy patients (aka had a lobe of lung removed).  I can tell there's going to be a good amount of pressure/volume Physics involved in this position...

Warren left Denver Thursday morning and arrived here late last night (2:30 am).  I am so glad he is here safely and without incident.  I'm excited to show him around and point out the new things I've learned.  For today though, he's sleeping and unpacking.  The weather here is sunny and warmish (should get into the low 50s), so I'm going to go help Laurie plant the fruit trees she bought last week (two apple, two peach and one pear) and go for a ride.

I hope you're all doing well!

Kristen

p.s. Geisinger provides free pedometers to their employees.  I'm going to get one so I can see just how far I walk each day.  I walk to campus, then all the way across the hospital and up to the 5th floor, just to get to my office.  The locker room and OR is on the 3rd floor.  The brand new cafeteria is on the lower level (it's a walk-out basement, with two-story windows in the eating area.)"