On call

10:52pm I’m in chandler. Sleeping in the couch. Girls are in my daughters bedroom. Wife and dog are in the master bedroom. I am administrator on call for work. We got a call around 8pm from a nurse practitioner for a STAT hospice admission. I spent the last two hours talking with my triage nurse and clinical director trying to get everything in place to take care of the patient. now the family wants to wait until morning. Frustrating from a care team perspective. Worrisome for the need of the patient. Luckily The patient appears to be comfortable and managed. We will do the admission in the morning. I appreciate the experience. I have to learn how to enter new referrals in the system and run eligibility. Skills I haven’t developed yet. This is a good life lesson. It is only when I am put in a moment of urgency do I realize what I don’t know but need to know. I will grow personally and professionally from this.

Not taking blame

It is 6:01am on Thursday morning. I am writing from my apartment in Chandler, Arizona. I am usually writing from my apartment in Chandler first thing in the morning. There is not much variation in my life. For the last couple of months I am either writing in Chandler, Phoenix, Palm Desert or Dana Point. It can be monotonous always doing the same thing. But then again it can be comforting to not deal with constant variation. Things are a little different today. I am sitting at my computer instead of using my phone on the couch. I had a scare this morning. I brought up the blog site and I wasn’t logged in. I worried I was shut out because I didn’t renew my other site. But I was able to reset the password and get in. Tragedy averted. Now I need to make sure my phone is working. I thought about place and life on my walk this morning. I want to stay in Arizona a little longer. I don’t want to move until the beginning of March, 2022. I don’t want to break my lease and I don’t want to deal with movers. Today is the five month “anniversary” of starting work in Phoenix. It has been an experience. The site I took over has been in turmoil. A lot of changes in leadership. Inappropriate admissions leading to paying back past payments. I thought I could come in and turn things around. I felt good about my abilities. But our census never went up. In fact it continues to go down. Revenue continues to go down as well. So much so that the business is in bad shape. If things weren’t bad enough the company announced on my third day of work they were selling the hospice and home health division. The sale just went through at the beginning of the month. The hospice was owned by a senior living company. We have the same name as the senior living company. We got over 90% of our business from the senior living company. The senior living company sold us. We are now owned by a hospital system that does not have a presence in the market. Many of the senior living communities in the area didn’t like using us when we were the same company. Now that we have been sold they have completely iced us out. We have only had three referrals in a month and a half. We are budgeted for 20. I have disassociated from the situation though. I am not going to take the blame. Normally I take all the blame. When something goes bad I say that the failure is mine. But I won’t this time. I refuse to own the sins of other people because I am not some magical savior. The deck has been stacked against success from the moment I walked in the door. I am not giving up. I am working hard. We have marketing plans. We can get business other ways. I am not giving up but I am not taking blame.

Low key and a glimpse

10:28am I drove to the office this morning to work on a presentation for tomorrow. As I drove I thought about chaplaincy, sales and operations. The three jobs I have had in my twenty two plus year career. Being the hospice chaplain was far and away the best. Sales were far and away the worst. I miss being the chaplain. I am relieved I don’t do sales. Operations aren’t bad. But not my passion. I am not a hard charger. A visitor who interviewed me for this job described me as “low key.” I get that a lot. “Quiet” “low key” “calm presence” those are good traits for a Chaplain, not as much for a leader. Definitely not good traits for sales. As I pulled into the office I had a glimpse of remembering what it felt like to be the chaplain. To not worry about job security. To not be constantly scared of reprimand or dismissal.

Change

5:40am I don’t know how to change. How to be different. I don’t know what I would do if this blog were “discovered.” How would my world change if I received attention? I work in hospice. I have a public persona but the real me remains hidden. Writing these posts is a way to put myself out there to be discovered. But there is dissonance. The hospice director is a carefully crafted facade. It serves purpose. It is a image I use to make money and care for my family. The post writer is the inner me. He is the voice in my head. My best friend. what would I do if people at work saw these posts? What if prospective employers saw them? Family, friends. Strangers? I want more than anything to be known. I want more than anything to remain hidden.

First time

1:43am this is my first time truly leading a hospice operation. I have been around hospice for over 20 years. I have been a director before. I am know what it takes to be successful. What good care looks like. but this is the first time I am in control. When I was the chaplain or in sales I didn’t control clinical services. The first time I was a director I wasn’t engaged. The second time I didn’t have time to get settled. I am in control. I expect excellence from people who represent me. I do not give up.

Wednesday night

7:29pm a referral came in late afternoon. Pt at hospital. Intake left a message for family. Expectation to admit tomorrow. I could have left it at that. But I am aware of my audience. My time on stage. Hospice is it. I went to the hospital. Met with the patient. Family was gone. Talked to the nurse. It wasn’t time consuming. I made the right choice. It disrupted my routine but I am better for it.