August 31st, 2009 by khart
The popularity of Twitter, Facebook and instant messaging has begun to have a troublesome effect on communications, based on my purely unscientific observations.
In the past few years, we have been reading about how the Millennial Generation has trouble problem solving and employing critical thinking, because since childhood they have used computer programs with pull down menus to guide them. Seems when that is your frame of reference, you have difficulty finding the answers to life’s little predicaments. No pull down menu, what to do?
Recently I have noticed the effect of the abbreviated form of communication used with Twitter, Facebook and instant messaging on communication in general. Have you noticed how emails have been becoming briefer and that apparently those sending emails are not consulting spell check? Punctuation? What is that? Grammar? Not important.
I must confess, I find myself not even capitalizing the first letter in a sentence when I am IMing, to say nothing of using any type of punctuation at the end of my IM messages. And I am not by any stretch of the imagination, anything but a member of the Veteran Generation.
When one is encouraged to be as brief as possible (in the case of Twitter, messages cannot exceed 140 characters and messages in Facebook are pretty much in that ballpark, possibly because most folks tend to use both sites), forming a longer sentence becomes daunting.
Young people prefer texting over a real conversation and that medium has a lexicon all its own. Abbreviations, symbols, numbers-it is like aliens have taken over the English language. I pride myself on never having texted in my life (although why, I have no idea). Probably my one last protest over the constant change technology has wrought. When you have the choice of emailing on a Blackberry or similar device or texting, I just can’t fathom why you would opt for texting.
We have one young friend who insists on texting rather than calling us on her cell phone, despite the fact that we don’t even have a texting out option on our cell phones and that was a conscious decision. I guess this young woman cannot conceive of a human being who is not similarly infatuated with texting and wouldn’t prefer it over picking up the instrument one is using to send the text and actually calling the person with whom one wishes to communicate.
After she has texted us, I always call her cell phone and she is invariably surprised to hear from me. Does she not realize it is a cell PHONE she is using? Back in the dark ages, people actually used them to talk to each other.
Think of what this abbreviated method of communication would have meant to the great authors. Hemingway would probably have loved it. Tolstoy, Cervantes and Shakespeare, not so much. War and Peace would probably have been a modest one hundred pages if written today.
Are we only a year or so away from mini-books, composed of 2000 characters? Is social media creating its own Haiku? Are we miniaturizing our language and our thoughts and concepts?
I fear there is only one step left…and that is communicating with symbols such as nautical flags.
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August 24th, 2009 by kchristmas
There are few Americans on the fence about the current health care debate. To say there is a partisan divide is to overstate the obvious. In the conversations out there, some bemoan the politics, others are passionate in their defense of non-profit cooperatives or a public option, and still others read threatening intentions into the drive to reform health care.
Phrases like ‘death panels’, ‘socialism’ and ‘public option’ have had divisive effects on enlightened public discussion. Town meetings erupt into shouting, and politicians either face riled up constituents, rail back at them, or hide. None of these approaches are effective, and civilized discourse is lost in the chaos.
Very few (even pundits and politicians!) are well informed about the options on the table, but none are shy about stating their beliefs. Their points of view largely rely on what source they use to obtain news and/or their political persuasion. You cannot pick up a newspaper, read a blog or listen to a news broadcast that does not have something to say about this topic. A tremendous amount of misinformation is being broadcast, and the heated hyperbole in these conversations is tremendous.
No one disagrees that there are millions of Americans without access to coverage, or that the United States spends far more on health care than other nations. Most Americans are good-hearted, generous people who would wish their fellow men the ability to have access to affordable medical care. In fact, we are the only first world nation that does not ensure this basic right for citizens.
Given those points, why is health coverage such a polarizing topic? For decades, private and political groups from all persuasions in the United States have attempted reform, and few have succeeded. Cost is largely cited as the breaking point. Here is a brief overview of efforts.
The first efforts began in 1910 when the American Association for Labor Legislation and T. Roosevelt’s Bull Moose Party made separate, compelling cases for a compulsory national health plan. Their efforts were quashed by U.S. entry into WWI and opposition from special interest groups, including the American Medical Association, who decried these efforts as socialism.
The decade of the 20s saw no attempt at reform efforts, although General Motors established health insurance coverage for their 180,000 employees during this decade.
After the Great Depression in the 1930s, Americans desired increased security for the elderly and unemployed, and again pushed for health care reform. The Social Security act was passed as a result, but without health insurance provisions.
In the 40s, employers on a large scale began offering health insurance as an employee benefit, and Presidents F.D. Roosevelt and Truman proposed health reform bills that were voted down. Truman’s proposed government-provided system to cover all Americans was vilified by the AMA and denounced as a Communist plot.
In the 50s, the first dialysis machines were created, and the first organ transplant done. There were not enough machines or organs to treat every needy patient, so care was truly rationed for the first time. Medical/ethics panels were set up to review criteria to determine which patients would most benefit from treatment and which chosen would have the most successful outcomes. The polio vaccine was created, and the cost of hospital care doubled.
In the 1960s it was clear that the poor and elderly citizens who could not obtain insurance through an employer needed some type of assistance to afford hospitalization, and Medicare and Medicaid legislation were passed into law by the Johnson administration.
In the 70s, both President Nixon and Sen. Edward Kennedy proposed separate bills for compulsory national health coverage, but both were defeated and Nixon’s was left behind in the Watergate scandal. HMOs came into play. These caused public outcry because of ‘gate keeper’ strategies that patients viewed as obstructive.
Corporate for-profit entities came into health care in the 1980s, and Diagnostic Related Groups (DRGs) were introduced by the Reagan administration as a way to cut costs by creating a system that paid a pre-determined amount per diagnosis. Private insurance quickly jumped on the DRG bandwagon as a way to control costs.
In the 90s, another proposed federal health plan was defeated in Congress, and health care costs rose at double the rate of inflation. HMOs were reformed to diminish the intrusive role of gate keepers, although to this day, most insurance plans require some form of pre authorization for hospitalization and most procedures.
In 2003, during G.W. Bush’s administration, the Medicare Prescription Drug, Improvement, and Modernization Act was passed. Unfortunately, there were no provisions in the act to pay for the additional services, and the cost is estimated to exceed $500 billion. In enacting legislation without a way to pay for it, there is no sure bet that it will move forward.
The current administration has a real challenge. People are warier than ever given the high unemployment and the spiraling deficit. Politicos of every stripe are presenting their viewpoints, and the lobbyists and special interest groups on all sides add to the confusion.
As a nation with increasing disparities in health care access across racial and economic lines, and catastrophic illness the leading cause of U.S. bankruptcy, it is imperative to rationally look at the issues and establish priorities.
Reform or the lack of it will have a significant impact on everyone and, specifically, health care employers and insurers. What are you doing to find out more and let your voice be heard?
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August 16th, 2009 by Margie Kasse
Mystery shopping began in the 1940s as a way to measure employee integrity. The most common venues where mystery shopping is used are chain and retail stores, movie theaters, fast-food chains and high-end restaurants, apartments, health clubs, resorts, banking and financial institutions, and more recently, medical facilities and health care organizations.
Mystery shoppers are paid to enjoy great meals (and in some cases not so great meals), view free movies, play a few free games at their local bowling alley, enjoy a free workout a local gym and even have a relaxing overnight stay at a Five-Star resort.
Mystery shopping has also been developed as a strategy to rate recruitment departments and evaluate company websites, ease of online application, response back to candidates and the overall recruitment process.
One of a health care organization’s most precious assets in a competitive environment is its reputation for customer service, which directly impacts its customer (and employer) brand. We all know satisfied customers are repeat customers. And too often, information gathered from patient satisfaction surveys does not yield enough good data to drive needed change and improvements.
Now, more than ever, health care organizations are engaging customer service mystery shoppers to help them step past the competition to understand the customer experience and perceptions about their organization. Customer service mystery shoppers can dig (in real-time) beyond the patient satisfaction surveys to reveal issues health care organizations wish to address.
By engaging customer experience mystery shoppers, health care organizations gain valuable insight about their staff’s interaction with patients and visitors. These ‘shoppers’ are better able to identify areas of improvement regarding the care and treatment of patients because they have been trained to look for gaps in the customer experience. Customer experience mystery shops also reveal and report environmental impact factors that may require correction. Reports include recommendations for improvement, which may include staff training, scheduling adjustments for both staff and patient flow, and a variety of environmental strategies.
Let’s face it…perception is reality and the patient’s/visitor’s perception is all that really matters. Health care organizations that use customer experience mystery shoppers say the reports have led to a significant number of improvements in the patient care experience. Everything from better signage to better staff communication and courtesy (and everything in between).
If your goal is to capture the customer experience in key department/areas through observation of staff with patients and visitors, environmental assessments, telephone calls to key areas and follow-up calls to patients, a customer experience mystery shop can help improve your customer service and enhance your reputation in the community as a premier provider. Our own experience in customer experience mystery shopping bears that out.
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August 10th, 2009 by kchristmas
by Kate Christmas
Tumultuous Times
With the prolonged economic downturn and the continued threat of unemployment looming, I find a tremendous amount of emotional struggling going on. It is a challenge to keep equilibrium and positive energy in the current climate. The relentless focus of the news media on the most recent bad news certainly doesn’t help.
Recently I spoke to three good friends who are in career turmoil. Their companies are unstable, their job futures are unsure and they are not finding viable job prospects out there. Another just moved his family across country for an opportunity, because he could find nothing in the southeast. All have had decades-long careers in health care.
One recruiter I spoke to mentioned they will start their third round of layoffs in just over a year. Morale at her institution is dismal. Two small business owners I know have had to trade expansion plans for workforce cutbacks in an effort to keep their businesses afloat during this crisis. One is a family business that has been in operation for 52 years.
Business slowdowns, cutbacks and shortfalls due to the fall of the stock market and banking crisis are evident everywhere you look. Last year, the unemployment rate in North Carolina, (where I live) was under 3%. In June 2009, it was 11.2% - nearly quadruple - in one year.
Several friends who had planned to retire this year will not be doing so because of plummeting home values and catastrophic losses to their IRAs. Three RNs I know are simply holding on, aging, ailing and unable to leave the workforce because they need the health insurance.
Still others, who continue to work very hard, are finding less return for their efforts. Some who were at the top of their game are frustrated and guilt ridden because those efforts are not producing these days.
This is reality at the moment. The recession dominates the mood and creates fear and instability.
Finding Balance
Numerous studies have proven the impact of relentless, negative stress on the body and mind. And the results are not healthy.
So the question is – how does one find balance, and discover positive energy during such challenging times? The answer is, it must be searched for. You can help to improve your own outlook by seeking opportunities to relax and find joy in life.
To the point — in the midst of all this worry, when was the last time you took a break? Got away from the day-to-day grind to celebrate the little things in every day – a sunrise, a walk, a day at the beach or the lake, a simple picnic in the park?
We could all take a page from the younger generations in the workforce. Unlike Veterans and Baby Boomers, their personal identities are not completely wrapped up in their careers. They actively seek time off to do civic work, and to spend time with their families and friends.
One friend I know has a mountain retreat she goes to on weekends. The beauty of the natural surroundings reminds her that there is more to the world than work. Another meets with a group of talented women, and every two weeks, they complete a beautiful quilt for one of their members. Another is an avid tennis player, competing in matches every week. Playing and singing music is my own salvation. A night of singing harmony with friends lifts me like nothing else can.
A west coast friend is active in her local homeless shelter. She says nothing snaps her back to how good her reality is than spending a few hours with those less fortunate.
What about those long-standing summer escapes – a good book or a summer blockbuster? Taking a few hours away from the chaos can set you free, open other vistas, and put things in perspective.
I recently had a long discussion about how one friend’s priorities have changed as a result of this recession. She is working, but her spouse was laid off and has been unable to find other employment for six months. Her youngest child is heading to college this fall, but will have to take on student loans because of the change in family fortunes. Her two older children, who have already graduated and are in the workplace, have pledged to help their younger sister with college expenses. My friend and her spouse are sad about this, but realize their family has become more open in their conversation and closer as a result. She feels she has gotten to know her children in a way she might never had, if circumstances had not taken this downturn.
So, to be cliché – look for the silver lining! Keep working hard, but do not forget the importance of balancing the stress and worry with healthy pursuits that lift your spirits. After all, what goes down must (at some point) come up!
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August 3rd, 2009 by pdaurizio
I wanted to take a few minutes to reflect on the economic times and the fallout the economy has caused on workers. I doubt that there is one of us who does not know someone who has lost his job and in some cases we may know several who have lost their positions. The American culture defines itself by what we do, so for many to lose a job is a very devastating event on many different levels.
A wide range of emotions will be experienced- from shock, disbelief and “why me?” to anger and outrage- very similar to those stages described by Elizabeth Kubler-Ross’s in her work on the death and dying continuum.
Losing a job is a profound loss, especially if it comes very suddenly and without warning. Even if you were unhappy with your position, you had a sense of control over what you wanted to do. When that control or the choice to walk away from a job is taken away and you are told you no longer have a position, your very being feels a profound loss of control and dignity. There is no opportunity for closure or to say goodbye, to wrap up loose ends. Along with those feelings comes a heavy dose of self-doubt. “Maybe if I had spoken up more or volunteered more or if I hadn’t said that in the last meeting this wouldn’t have happened to me.”
Anyone in the position of having to let someone go will often say something like, “This is not personal, but a business decision.” However, because of the pride we feel in what we do and the importance our culture places on this, while we can rationally understand it, we have difficulty emotionally. Self-doubt will be a large factor that must be overcome. Going through the entire cycle and having support while doing so will help with the self doubt and self blame, but you must be aware that it will still exist.
I urge all of you who may be experiencing this or know others who are, to work through the cycle until you reach closure. It will come, but it does take time. Reach out to others who have had the same experience. Open yourself to new opportunities; you can never go back to what has been but need to look at what will come. This may be the perfect opportunity to look at something else that has always interested you or something you have done for fun or as a hobby. When I experienced this personally, I transitioned from the acute care setting to home care and it opened an entirely new career for me. I also worked for an attorney doing medical review, working with expert witnesses and actually going to depositions and court hearings with the attorney. I would have never even considered either one of those positions had I not been “displaced.”
For the survivors of reductions or restructuring, there is a sense of fear that “this may happen to me.” For others there is a sense of guilt about still having a position when your peer does not. When you see colleagues leaving your facility or your local recruiter chapter it is important to reach out to them.
Many people feel uncomfortable doing this, partly because they don’t know what to say and partly because of that survivor’s guilt complex.
Look beyond how you are feeling and try to put yourself in the other person’s shoes. It brings a tremendous amount of comfort to have someone pick up the phone or, in today’s day and age, email or Twitter just to say, “Hello. I am here for you. “
Having had this happen to me, I know I will never forget the day I was “displaced’” and how that felt. I will also never forget the people who called and reached out to me. People whom I was never especially close to reached out, which really touched me, and I have never forgotten that. On the other side were people whom I was very close to who didn’t call. I made the conscious decision to call them because I valued those relationships and they were very relieved that I did. They fell into the “survivor guilt” category and just could not bring themselves at the time to call.
One last tidbit: keep your sense of humor-that is something no one can ever take away from you.
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