Archive for May, 2016

Return to Nebraska

May 31, 2016

I wonder what could be cuter

Than an easy to use computer

But here is the deal

For the ones that are real,

You need a professional tutor.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, travelled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. A winter in Nome, Alaska, assignments in rural Iowa, a summer with a bike tour in Michigan, and Urgent Care in suburban Pennsylvania stretched into the fall. Last winter found me working in western Nebraska and, later, in coastal Alaska.  After the birth of our first grandchild, I have returned to Nebraska. Any identifiable patient information has been included with permission.


Western Nebraska has greened up since I left in January. The temperatures hover near a perfect 66F.  But the same pure white clouds scud across the same clear blue sky.  I walked into the hospital where I worked last winter.

I called it the most reasonable job I’d ever had. One Saturday clinic every 4 weeks, no nights, always finished before 6:00PM and almost always before 5:30PM.

A lot of people grinned when they saw me.

I heard about two of my patients, one with a neurologic problem and one with a chemical problem, who had started to improve with my care and had done very well since.

I also heard about the transition to a new EMR, so that the outpatient and inpatient sides could talk to each other. And, indeed, my task to day consisted of learning the new system.

Superficially, it looked familiar, but I have learned 11 new EMR systems in the last 18 months. I try not to get whiney about quirks that impede work flow and make no sense; I just try to master the task at hand.  However, RPMS, the system I used in Alaska from February through April, made the most sense, and I found it the easiest to use.

I got back my old office here, but the temporary CT scanner trailer outside the window has left, giving me a very nice view of the sky.

I spent more time with Continuing Medical Education (CME) than on computer training in the last year and a half, but not by much. The worst training was from a person who wanted to get her 15 students out early and went way too fast, the best was from a gifted teacher who worked one-on-one with me for three days, combining orientation and EMR.

Today I sat in front of a computer screen and talked to a trainer in Arizona over a speaker phone. Parts of the system looked familiar, most didn’t.  Real fluency and economy of motion will take time, but I have to start somewhere.

In small towns like this, the sound of a helicopter means someone’s serious illness. I heard the unwelcome thwap thwap thwap of the rotor blades while I talked to the Arizona trainer about some of the fine points of documentation for billing purposes.

I prefer taking care of patients to dealing with computers, but here I found myself torn: my favorite patients have problems where I get to think, I don’t find them on the brink of death.

The chopper landed just outside my window. I had to ask for half a minute of quiet at the peak of the landing noise.  Then, while unspeakable drama ran rampant elsewhere in the hospital, I went back to the intricacies of an Electronic Medical Record system.