1eclecticwriter

As I headed toward the employee entrance to Presbyterian Tuesday morning, I flashed on an old movie – a Charlie Chaplin, I’m pretty sure but I don’t recall the title – of flocks of workers pouring into a plant, each showing an ID card and punching in before taking their places on an assembly line. In Albuquerque on Tuesday, we were a smaller clutch of workers, each wearing an ID badge which provides access via a scanned bar code, through multiple levels of security-locked doors, to our classroom, desks, and computers. How did I get to my seventh decade without ever working in such a large, regulated establishment? Even the government programs where I’ve been employed feel relatively small by comparison.

In orientation, we were told that Presbyterian hires about 2000 people per year, employs more than 8000, and receives over 100,000 applications for the annual openings created by turnover or – in the present case – by the expansion of its Medicaid program services. We were congratulated on being “special” because we were part of the select group chosen to be hired. I listened to the numbers in some awe, not in self-congratulation but rather in disbelief. What have I gotten myself into?

These past two days my subgroup (half the class of new Care Coordinators) received training on the still-being-completed-and-tested computer system which will be the primary support of our jobs. We will receive our assignments, create our case files, document our time and our activities, meet State and Federal mandates all within this one system. Given that there are quite a few bugs in the program, and pieces that have not yet been implemented, the training was likened to teaching us “to run the systems that fly the plane that the State still hasn’t finished building.” Take off is set for January 1st. Ready or not, off we go.

What fun!

Assigned to work within the Presbyterian computer system from my hotel room, I spent two hours in frustration at my inability to get through multiple layers of access in order to connect my highly secured work laptop to the hotel’s Internet. A classmate finally figured out the path, based on issues she’d had previously with her connectivity from home. I remember, back in the dark ages when they were new to the workplace, how we were assured that computers would make things easier.

Hah!

My homework included an opportunity to provide feedback on fixes the system needs to make it into a more effective tool of care management. The programmers have had barely seven months to design a system that normally is budgeted for a year or more of development and testing. I do appreciate being given a voice – I just wish there were fewer issues for me to speak up about! And that the changes and improvements could come sooner than the projected six months out from “going live”, which happens in less than two months.

Is any of this beginning to sound like Healthcare.gov?

Remember, Niki, you were hired for your “adaptability, independence, ability to think on your feet” and your implied tolerance for a very unstable and changing work environment. I do have those skills in person, and person to person. I’m not so sure I have them when it’s a matter of interacting with “technology”. I still complete the cards my students earn in their CPR certification classes on a (gasp) typewriter because that is easier for me than trying to create a computer template that will instruct my printer to produce them with all the right info in the correct small spaces.

Call me a Luddite – I’ll wear that badge proudly!

Until now, even the “field” workers for Presbyterian have been based in offices in towns and cities. They speak of those of us who will be working from our homes scattered in rural areas as working on the “frontier” – but still plan for us to use systems that rely on urban technology. I’ve only been able to access DSL at my home within the past year. If I lived a mile farther up the road I would not have it at all, would be dependent on satellite (or dial-up) and couldn’t get my work computer even to boot up due to timing out from the connection. As it is, the DSL flickers enough to pause my work on my fast and lightly loaded personal laptop – it repeatedly froze me out on the work computer which is slow and cumbersome, weighted down with multiple very complicated programs. Yet the concept is that I will take the laptop with me to client homes, to complete interviews and assessments.

I don’t think so.

Not when most of those homes don’t have connectivity at all – isn’t that what’s meant by the frontier? Out where people are living simply, often in the same way as their parents, grandparents, great grandparents, etc.?

We’re told we’ll be given paper copies of all the documents we have to fill in – and that we can then scan and send them to an assistant in the central office who will code them into the computer. That procedure will allow me to get my work done within the established time frames. It is offered as a support strategy – so why do I feel as though it means I will be dumping chunks of my work off onto someone else?

Because in my 20 plus years as regional manager for a home health agency serving that same rural frontier, I had no administrative support? If I needed copies, I made the copies. I typed my own letters, entered all my own work into the computer systems, and was the support for my staff when they got behind, or needed help tracking certification due dates, etc. We were a branch office of 5 with a case load around 300 clients and a field staff of close to 350, for whom I was the top-of-the-chain-of-authority supervisor.

(Now you know why, as I went job-hunting this past year, I determined I wanted a position in which I would only be responsible for my own work product!)

Had all those employees come into the office every day, we would have looked like my experience of this past Tuesday, or the Chaplin film, minus the time clock and swipe cards.  But my field staff were dispersed across a quarter of the large state of New Mexico. I went to them (as I will be doing to member homes in my current position) rather than bringing them to me. In between visits, I communicated with them by phone – either directly, or via their supervisors.

My new supervisor expects me to communicate primarily be email – with phone calls when email isn’t available. The company does recognize that even cell service is spotty “on the frontier” so they are acquiring a few satellite phones to be checked out to staff when they may be needed. I suspect, if I end up covering the same area now as I did for the home health agency, I will have one of those phones permanently in my car. Along with my emergency survival kit, including an extra book (paper, not Nook) to keep me entertained if I’m stranded.

Along the Open Road

My new job will definitely be an adventure! I’m curious to see how the blending of futuristic programming and frontier life plays out. I look forward to working in an environment that stresses being part of a team, offering clerical and administrative support I’ve not been used to receiving. I’ll do my best to not be a burden on my support staff, which means I’m committing to becoming as proficient with the computer systems as my connectivity will allow. I’ll need encouragement to resist being tempted by my paper “backup” procedures.

Will you come along on this adventure with me?