Saturday, August 1, 2020

Oh wow, so... hey

I forgot about you. I'm sorry. Life has been busy. Kids are teenagers, my dad (who moved with me to grad school and helped me with the kids during those years) passed away in 2018, and I'm still with the same hospital system. Had a couple pathologists retire and brought on some new ones.

We went live with Beaker, which is the EPIC lab module. It was a nightmare, but after two years we are more or less used to it. Beaker is an interesting LIS, in that while it is an EPIC product, it was put together in large part by the individual hospital's IT department. So if your build team is bad, you get a sub-par product. The EPIC employees we worked with weren't great. On the 60 day follow up visit, one of the EPIC guys actually fell asleep while on the panel addressing all of the problems that the laboratory had as a whole. Although, in their defense, most of the lab's stuff was functional. Pathology and microbiology were the glaring exceptions. For our go-live we were assigned an EPIC employee for the week, except he wasn't actually someone that used Beaker, didn't understand the lab, and he didn't pack his phone charge (it was a USB-C right when they came out so no one had one to lend him) so he couldn't even text or call his coworkers that might actually be able to help. His name was Lionel and after the second day, we never saw him again. It was an epic mess, forgive the pun. The most interesting part is since we switched, new pathologists and staff who have come in have asked us why our Beaker doesn't do X or Y. Our in-house Beaker staff and even our EPIC aftercare point person tell us that Beaker doesn't do those things. Until our new-hires point out that it did at their last hospital. It is very strange that EPIC didn't bother to copy the positives from Cerner Millennium or literally any other system that works well.

We are in the process of getting VoiceBrook now. It is a good company, and if I have to go back to voice recognition it is the best option. It sounds like in the four years since I last used them, they have implemented a lot of neural network-y smart technology stuff so I am excited to work with that.

Let's see... what else? In 2018, our autopsy business exploded, so by the end of the year I was actually much more comfortable with them than ever before. It turns out just doing a whole bunch of them was all it took. I stepped down from management in 2018 as well. I was working most weekends on top of 8-5:30 most days, to try to get the administrative stuff in on top of the grossing. With my dad being ill and my kids growing up so fast, I decided that I was going to prioritize my family. It was absolutely the right choice as it was evolving from a gross room supervisor position into an AP manager position with no bench time. I declined to apply for the manager position and instead asked to move to a staff PA position (one opened up six months later). I am not a fan of administrative work and meetings. They are endless and at the end of they day, when you're mentally drained and worn out from hearing people talk, you can't actually point to anything concrete that you've done. I like the simplicity of grossing and the neat little rows of blocks at the end of the day. Also, I clock out when it is time to go home and I leave work at work. Plus, I lobbied to be paid hourly, because if I'm going to be there over 40 hours I'm going to get overtime. One of the tricky things was being salaried the trade off is supposed to be that for the hours or days you work over, you should be able to duck out early on the slow days. Except... there were never those slow days. If there had been slow days, I wouldn't have been working Saturdays. Overtime is the absolute best.

I still love the work though. I like the busyness of the gross room and the rhythm of grossing. I like training the AP assistants on new things and watching people develop professionally. Our AP manager is settled into our organization and is doing great with all the administrative things that drive me mad. So many fights I didn't want to fight, like overhauling the entire billing process.

There is a pathologists' assistants subreddit, if you're someone looking at going to PA school. We're still not great at PR, but there is a little more out there if you're looking. New programs are popping up as well. I can't speak to their quality or admissions process.

Wednesday, August 2, 2017

Still going!

Oh my... hello! I'm woefully behind on blogging, aren't I? Terrible really...I suppose I could mention, in my defense, that I've been rather busy working, occasionally sewing, occasionally painting, sometimes writing, often cooking, constantly doing laundry, and partnering and parenting with my husband. All of the things that entail modern life.

Is there a great excuse in there? No... but it is the one you're getting.

Professional update: Four years past graduation and I've been certified long enough to have gone through recertification. I have a ridiculously high level of job satisfaction. I love grossing! And, not to toot my own horn (as I'm sure some horribly complex specimen will come along soon to keep me humble) but I like to think I'm good at it. My pathologists are happy anyway.

I am on my second job as a PA! I was at my first one for two and half years but the commute was killing me and I never liked SC. My parents had settled there and my husband's job was there so we had ties that bound us. My parents moved to be closer to my sister (9 hours away instead of 2), my dad (who you may remember from when he lived with me during grad school to help take care of the kids) had a hemorrhagic stroke resulting in paralysis, and I thought I'd try being a traveling PA so I could have more time off to help my mom out.

I failed as a traveling PA... but in the best way possible? I only traveled to one place. I really liked it and they liked me... enough to create a PA supervisory position to entice me to stay. I'm four hours away from my parents, which is close enough to go up once (sometimes twice) a month to give my mom a weekend off. My husband resigned from his job of ten years and the whole family moved up last summer. I love our new state. I'm happy to be out of the heat of the south! Of course, I still go back to Durham now and then! Up until I moved, it was every month or so now it is every three months or so. The town has changed a lot and new things are happening all the time. I should go back to visit Duke some time but it is someone else's time there now and there are fewer familiar faces. 

Now I'm in charge of two other PAs, one OJT PA and one from the Canadian program. We have four lab assistants and eight pathologists. I think we'll break 28,000 specimens this year. Autopsies vary but we do a few a year. Never been my strong point... I think it wasn't to my benefit that most of mine during grad school were with residents instead of the autopsy PAs. I'm not as confident at as I am with surgical pathology and we eviscerate differently than we did at Duke but it also happens with a lot less staff. It isn't bad though. 

That's it for now! I'm really glad I became a PA and while school was grueling, it is now over and done and I couldn't be more pleased with my profession. 

Sunday, November 30, 2014


The other PA where I work has been promoted to interim lab director in a week or so, which I hope will be a good experience for her! As a result I'm now verifying the charges for the cases we do. I haven't  dealt with that much since leaving school but it is a good skill to have. It goes a lot faster now that I've refamiliarized myself with things and I don't have to think about the specimen types we see all the time.

I have other things I need to blog about but because of those other things, I haven't had too much spare time! Maybe in a few days.

Sunday, November 9, 2014

Revisiting Duke

So last month one of my favorite bands was playing on a Monday night in Chapel Hill and I spent the preceding weekend in Durham revisiting old haunts. Since I was there on a weekday, I thought I'd take the opportunity to go back to campus and the hospital (the VA was closed since it was Columbus day). There was a bakery in the little town that I lived in that makes these amazing yeast donuts and I would bring them in sometimes, so I had called ahead and ordered five dozen to commit myself to going to visit (so easy to have the intentions but elect to sleep in more otherwise).

I got to see the renovated autopsy suites (SO BRIGHT!) and they've added lifts to help move the bodies, it is a nice improvement! Plus it was good to say hi to the autopsy folks and I popped into say a quick hello to Pam, the course director, and drop off donuts with her for the PA students.

Getting donuts to surge path was an ordeal... they moved to a new lab and it is further back from public areas. I didn't have an ID badge anymore or the number for the lab, but I ran into some residents I knew (they weren't going to surge path unfortunately) that gave me the direct number which helped immensely. I was able to call and someone came out so I was finally able to make the donut delivery!

It should be noted, that it makes me intensely uncomfortable to be somewhere like that without context. So I didn't stick around. It is nice to see people and catch up, but I'm also aware of the fact they're working and I don't want to overstay my welcome. Plus I had one more donut delivery to make! A small thank you for the friend that gives me a place to stay, who works downtown close to everything.

The concert was amazing and I had a great time in Durham, as always, and I felt slightly less bad about always going back to the area but never visiting!

Thursday, October 2, 2014

A week with Voicebrook

First off, I'm so pleased at how much I remember about navigating the software. Go me! It has made the transition smoother than it could have been otherwise. That and my keyboard is a lot more accessible than it was last time I started using voice transcription software. Right now I'm doing things around 80% with voice controls and 20% with mouse clicks and typing.

Second, it makes everything take longer. A big contributor to that is how long each window takes to open, and that we're opening more windows than before. It is 5-10 seconds here and there, but it adds up. Then there's the proofreading and the editing, but I'm sure that will improve as I use it more and the software gets better trained. At least I hope so. I'm used to being able to cut while dictating instead of having to stop every time I say something to watch the words going into transcription to make sure they are the right words in the right place.

The net time turn around time is lower because it doesn't have to get dictated, go into the queue for the transcriptionists, and then transcribed. But it used to be handled by me and the transcriptionists, instead of just me... Meanwhile, the transcriptionists, who are still doing a bit of transcription (we'll just say that the doctors are easing into using Voicebrook, rather than going cold turkey), are picking up other administrative duties in addition to the ones they were already doing. What will happen long term remains to be seen.

Overall the software works well, the accuracy is 95%+ and that's good. But oh, that few percent that it isn't getting can be so frustrating!! Cholelith vs choleliths and having to correct things like 3 vessels to three vessels. I remind myself that it comes with training and it isn't nearly as bad as it was the last time I went through this 4 years ago.

I have added to the stock of templates with some personalized ones. Also, I've prefilled some bits with things that are the case much more often than not, like the aforementioned three vessels. It saves time to default to that and change it when it isn't right than to dictate something over and over. I'm working on maintaining a good attitude about it, mostly because I don't have a choice in the matter so might as well suck it up and forge on with what I have to work with. Hopefully speed will pick up.