<p>Well, on a wholly different front, real estate has turned the corner in our neck of the woods. Inventory is tight and there are bidding wars. </p>
<p>Wow!</p>
<p>Well, my Dad’s wife is still in the hospital, excepting for two horrible days ever since March 18, so most days I am going to see her, once by myself, once with Dad. They live over an hour from me, so I am getting pooped. I was pretty frustrated with her yesterday, perhaps unfairly, but she doesn’t advocate for herself enough, and as things are, I don’t see how she ever gets home. And as for doctors needing business degrees, geez! Why is the concept of hiring business managers so difficult? What is that business specialty called, or does it even have a name? This lady’s primary doc must think of nothing else, he is so rushed with them. Frankly, anyone with half a brain should have been able to ask her to stick out her tongue every day to avoid this last snafu. Maybe that will be a question I will ask future docs - did you study business? If so, I will keep looking for someone else.</p>
<p>With all of the new health regulations/rules/laws and low reimbursement rates from insurance companies healthcare has had to adapt to more lean business processes. H just finished a 6 month course and testing for certification in lean processing within healthcare. Interesting information as hospitals and medical practices adopt manufacturing lean processes and eliminate waste. Medical practice management can be quite difficult. Many young physicians are becoming hospitalists rather than set up their own practices. </p>
<p>When my mom was in the hospital, I arrived on day 18. What I found was that they had instituted a new electronic medical records program and the docs (who told us none of this) later complained that what started out as something to improve patient care was actually causing some patients to fall thru the cracks of the system especially if there were multiple docs on the chart. My mom and her H had been too patient and with her primary surgeon on vacation it seemed they put her in some sort of holding pattern completely “forgetting” that she was actually a cancer patient first and foremost. Long story short, we had to really be proactive to get her home on day 23. I don’t know what we could have done differently, and I know that all her docs were very good, but there just didn’t seem to be a offensive coordinator. I would suggest that you contact a patient advocate as simply asking for that seemed to help us get a far better flow of communication. There is a learning curve going on (in keeping with what NMN is saying).</p>
<p>I suspect having a patient advocate helps keep busy staff conscious of their team communication, which I think is half the battle. </p>
<p>So, I’ve been with mch for 15 years and in that time have never seen him physically sick to his stomach until this morning. It’s almost alarming 
Toughest part is convincing him he needs to stay in bed and not infect the employees when the shop is just next door…just made him go back to bed and am considering calling our developer and telling him to work downtown today.</p>
<p>If I am successful at making him take a day of rest, it will be his first sick day since 2000 when he had pneumonia. I’m off to the supermarket for sick foods. First time I’ve had to do that in years!</p>
<p>There is a bad stomach virus going around here. Good luck with the inexperienced patient ;)</p>
<p>Nm, I think we agree. Even if a Dr or group of Drs set up on their own, would it not be best to hire someone to focus on business aspects, rather than getting business degrees and thinking they can do it themselves? Why not study law, IT, etc too?? I think hospitalists are sorely needed, that or a greater respect for the coordinating efforts of nurses. I don’t know. I just think it is a dinosaur industry with regard to efficiency, at least from the patient perspective. </p>
<p>Survived hosting Book Club (in Cambridge) last night. The hosting part is no problem - wine + nibbles; the tricky part was our puppy was upstairs (in her crate) in the guest BR. The logistics were supposed to be that H & puppy stayed in RI, BUT at the last minute my father (86) wanted us to go with him to an Apple Store so he could talk to them about getting an iPhone. Since my father had a meeting in Boston today and was planning on staying overnight last night anyway, it made sense to do everything on this trip. Long story short: Dad got his phone, they set up his account, transferred contacts, etc; H, D, & Dad went out to dinner during Book Club; puppy cried some when people first arrived for Book Club but then quieted down. (It helped that D arrived early and ran around the yard with the puppy to get her tired.)</p>
<p>ANYWAY, this whole “lean healthcare” thing is what D’s new job at Boston Children’s is all about; improving processes, etc. Good stuff, as long as the “product” (in this case the patient) doesn’t suffer.</p>
<p>kmc - hope H feels better soon. </p>
<p>cq - hope D’s next interview goes well. </p>
<p>mp - hope you’re enjoying NYC.</p>
<p>Moda - appreciate the update. No matter what, these are tough times. When my mother died a year ago, my father simply gave me (only daughter) her jewelry. She didn’t have much - it wasn’t “her thing,” plus she couldn’t wear much other than earrings because of her severe eczema. When H & I got married, my father bought her a simple gold necklace to wear with the MOB dress. The day my father gave it to me I put it on and haven’t taken it off since. Whenever it is that my brothers and I have to deal with my father’s things, I don’t anticipate lots of disagreement. I’d just like to see certain things stay in the family. (of course, I could be proven wrong about disagreements, but I hope not!) Oh, and I don’t write many complaint letters/emails, but I’d probably do it re: that witch of a flight attendant. </p>
<p>One of my colleagues is one of the leaders in lean management for hospitals. It’s fascinating how much low hanging fruit there is. </p>
<p>My D printed out her spreadsheet she created when she started applying for post-graduation jobs in December 2012. She’s now applied to 107 positions! So far she’s had interviews for 25 of the positions (more than 25 interviews; some have included telephone and in-person rounds). She’s had some acceptances where she declined the position, and an acceptance in the temp position she’s in now. Here’s hoping this journey will be over soon!</p>
<p>S asked the college prez for a med school rec and was answered in the affirmative within the hour. Love that guy.<br>
He’s moved into his apt. rarely sees one roommate and the other seems to live a somewhat opposite schedule. I think it’s going OK. He took his quilt that I had brought to Mom’s, but is still in need of the delivery of a few boxes. Really should have done that this week… </p>
<p>Hey Missy - I just wanted to add that the sheer fact that your D3 referred to your trip as one of bonding is huge growth on her part and I just wanted to acknowledge how great I think that is. </p>
<p>My own d3 was absolutely amazing support at my mom’s memorial and throughout the weekend. However, when she was my audience for my speech, she kept telling me to look up until I explained that she was a primary trigger behind any tears!</p>
<p>My brother received most of what my dad had - a rolex, family crest ring, and a lot of cuff links. But he wasn’t much of a jewelry guy, nor did he have a lot of mementos. However, I have a very old leather cigarette case when cigarettes were much shorter. It is a perfect fit for a silver dollar we found together on the beach near his home in Naples. I also have a great pic of him at the age of about 15 taken at Kennywood park near Pittsburgh with a friend. </p>
<p>I have been in a bit of a down mood the last few days… I think the adrenaline was pumping through the move and my mom’s rapid decline and then of course, going down there for a week… all those huge life events have caught up with me. I want to start looking for a house. Last night some young women were just below our window chatting WAY TOO LOUDLY multiple times until around 4am. Obviously a party, and since it’s all non-smoking I imagine thats why they kept coming out. It’s pretty noisy where we are… and in some ways I like the hustle, but in other ways, I’d like to get on a more residential street sooner vs later.</p>
<p>CQ- that’s some serious organization! </p>
<p>Moda, its little wonder you have the post-adrenalin blues. Be kind to yourself. Maybe some real estate therapy would be up enjoyable…but the again, maybe that would ramp up into more shenanigans 
So ill send you the mojo for some gentle emotional regrouping, whatever that means for you ;)</p>
<p>I’ve been reading up on dog personalities and dog training since we’re (slowly) considering getting one. I read a sentence about a dog breed that really resonates with me as I suspect my own personality was reflected back to me.</p>
<p>The sentence was something along the line of a “smart dog requires a puzzle to prevent idle destruction” ;)</p>
<p>Yeah, that kind of fits…I always need these little projects to sort out extra-curricularly to prevent me from worrying those around me ;)</p>
<p>This week, for example, my armchair extracurricular quest was sourcing an affordable but superior Australian Opal for mcson’s gf as a graduation gift (She was born in AU, and I thought a bit of he homeland together with its protective significance would be a nice momentous, since she loves opals.)</p>
<p>Yesterday, the quest to rebuild the lodge that collapsed under the snow had me, together with the lodge leader and another member, chop up a big fallen tree so we could use another part of the back field by the woods for the new lodge. (I got around mch’s ban on my using a chainsaw by using my friend’s little electric one. Eventually I got the hang of it with stern guidance from the owner, who agreed I looked a little left-handed and unwieldy with it…but I got better and now want one of my own ;)</p>
<p>It’s too bad that cleaning my own house didn’t interest me as much as my “projects” because I’d likely save myself a lot of money…my new cleaning service starts tomorrow and while this was part of the deal when we moved part of the studio home (increasing the square footage around here that requires cleaning) there’s a part of me adding up what fun I could have with the money I’ll be spending if I could just find the time and interest in deep cleaning which history shows, I can’t!</p>
<p>CBB, how’s the training going with your Wheaten? Early weeks report has sounded a bit tiring…I have to make sure I have the attention span for a long haul project like training a pup :)</p>
<p>Along with selected terriers, we’ve been looking into a breed called pbgv – basically a French hound with a wire coat considered to be lower-allergenically. I need to do some allergy re-testing first, I think. I did have the immunotherapy shots for years, so I may have increased my tolerance substantially. I will be having a pay date at a local breeders sometime in the future to see how I react as well.</p>
<p>kmc – puppy training is going much better. Yes, the first weeks were VERY tiring. It’s pretty much like dealing with a baby! But, she’s very cute and loving/lovable. I guess I’ve come to terms with the fact that H really isn’t going to share equally in the training/care. To be honest, if I’d known this ahead of time, I would have been more hesitant about getting another dog. But, I also know from prior experience things will calm down some fairly soon.</p>
<p>The other night Kiley was outside in the penned off area out the back door; H was trying to get her inside so we could all go to bed, but she thought it was playtime and was running around. H just stood there yelling at her to “get inside now!” I finally went outside, grabbed her and put her in her crate. H then said, “She doesn’t listen very well.” What? Does he really think she was born understanding English? :)</p>
<p>Lol. Yes, perhaps I should carefully consider how up for this I am. When it comes to the question of who will be chasing an errant pump around this complicated yard – or worse – an escape into the woods – I’m pretty sure I know who will be nominated perhaps a slow-moving breed is in order…but I’m not sure they come in that speed!</p>
<p>On the good new/bad news front mcson AND gf appear to be planning a visit for Easter…except I may have to fix his car or go fetch them to make it happen Poor kid…my prophesy about how having a car at this juncture would be a financial drain was a little too accurate. He’d just gotten it back on the road a few months ago and now the power steering has a major leak.</p>
<p>Good Morning! Spent the day yesterday scrubbing carpets while H painted the family room. Still have to paint the kitchen, dining and living rooms. Nothing like a summer wedding to get you to do some maintenance work around the house. Heading back to the lake tomorrow after a tasting meeting with the caterer. Hoping for some R&R there. Also had my yearly “maintenance” exam yesterday. Waiting on my test results but my dr. thought I looked healthy. D1 started work at her new location yesterday and things went very well. </p>
<p>Good luck to mcson and his car. Hope it is a quick and inexpensive fix!</p>
<p>I am still trying to train D1’s dog. I just can’t seem to break her of jumping on people when she greets them. She is incredibly friendly. Still working on it!</p>
<p>Moda…thinking of you often. Take some time to yourself to process and grieve. Good luck on the house hunting. When are you leaving for the Nook? D2 and fiance are currently apartment hunting. They are shocked at the rental costs. Just saw a story on ABC this morning about how rental rates have soared around the country. I hope they find something reasonable!</p>
<p>missy…are you back from NYC???</p>
<p>As much as I love dogs, part of me is looking forward to not having the responsibility. The upside: got to see the lunar eclipse at 2 am!</p>
<p>Please send fairy dust/positive vibes around 3 pm Eastern, 2 pm Central, 1 pm mountain time, noon western time for D’s interview. She feels like she has done everything humanly possible to get to this place and would really like to have an offer. She does have an interview with a different company tomorrow morning before she comes back, so is not shutting any doors just yet.</p>
<p>Positive job interview prayers on the way! </p>
<p>Ditto…</p>
<p>I have been following but have had much to add. so sorry about Modas mom and what a wonderful ceremony you provided for her.
Glad to see kids are surviving and thriving and moving forward. CQ sending good vibes for your D.
My oldest is doing well in her job and well thought of. Her BF as well and they are spending time working toward their personal goals.
Youngest s loving her school. and got her first co-op in oncology.
H had a stress fracture from running on the treadmill, (don’t do that) plus if you have pain you should stop. He is in his usual way of healing well and quickly.
I have had some issues and my body needs “maintance” hopefully it will be ok. This has thrown me for a loop and made this time of year more stressful. I hate to post negativity so I tend to back off.
I am still very conflicted for a person my age I think, it frustrates me. I will have to look up healthcare as you describe it. I am tired of it affecting the people who are actually doing it . I would love to understand why they are pushing on us and yet receiving big bonuses. My bottom line has always been the patients and I have to get into the modern world as business is the bottom line. I think its time for the younger people as this is all making me grumpy and miserable. I cant do things fully the way want to and I am frustrated. I don’t like me. It is also sad for e to know that what I do is not appreciated by( anyone but the pts themselves). and that they would glad to see me and my knowledge go because I make too much. I don’t want to just be a bystander right now but that is inevitably what I feel . I guess it is common in the working world and has come late in nursing.If I want to really push it, I could, but I am also tired from so much illness. ad maybe it is just time to relax, no matter how much in my nature that is not. Funny I have received so many compliments lately from patients.
So much on the Boston Marathon one year anniversary. I hope there are no shenanigans this year. I will be working. D will be there as she was last year. Happy Passover Happy Easter</p>
<p>Back from NYC. Turns out that younger D had strep, because I came down with it exactly a week later (during the first act of Phantom of the Opera, to be precise.) My doctor said there are lots of false negatives on strep tests, but that the treatment was the same anyway. I just had to get through the last day of the trip sick, and got to the doctor first thing Monday. She forbade me from going to work yesterday (contageous) and didn’t want me to go today. I promised to quarantine myself in my office.</p>
<p>c-q, I’ll be sending good vibes up to your D. Also to treetopleaf and her dad and his wife, and to moda and to NMn’s daughter. Did I miss anyone?</p>
<p>I have to tell one trip story. The theatre teacher who didn’t cast younger D in the musical was one of the teacher chaperones. On the morning of the last day of the trip she took D aside to appologize for not casting her She said D’s vocal audition was not very good; D agreed, saying it was in her “break.” (“The Passaggio is a popular term that denotes the mid-point between what is commonly referred to as the chest voice and head voice. Commonly referred to as the “vocal break”, the Passaggio is probably the biggest nemesis to singers.”) [For reasons unknown to me, at vocal auditions for the musical, each student is required to sing the same song in the same key.] Anyway, the theater teacher told D that when D’s jazz ensemble came into her classroom to do singing Valentines, D was standing right next to her…the teacher heard how good D’s voice was and said she almost cried. She said that in all her years of teaching, she has rarely thought she has made a casting mistake, but with D she was sure that she did (by not casting her.) She said she was very sorry and hoped she had not added too much drama to her senior year. She also said that in the future, she was going to have several options of audition pieces for the students to sing. D was classy enough to say that she had seen the show and really enjoyed it.</p>
<p>MP are you still doing yoga? t seems you have been sick a lot lately and maybe your immune system is down. Are you taking care of yourself. So glad your daughter got the validation she dserved</p>