Work, Work, Work and Adjusting to Work.

Hello all. Sorry I haven't made my blog a priority lately. As many of you know I started working about 4 weeks ago; hence, I haven't written in almost 4 weeks. Even though I am working part-time, going back to work has been an adjustment for the entire family. The kids are spending 3 to 4 days at Grandma and Grandpa's house. They are having fun playing in the garden and with their cousin; however, the first few weeks are always fun and reality has started to set in. Aisha, last week cried because she didn't want me to go to work and this morning she was crying for me after I left for work. Little Boo, on the other hand, simply loves the attention and interaction with a variety of people and activities. Dad and I feel guilty about not having one of us home with the kids. We have always been able to manage our schedules so that one of us was always home. We have never left the kids with anyone before, so we miss them and worry about them while we are away...as I'm sure many of you out there can relate to.

Work has been going well. The people I work with are very friendly and helpful. I have many things to learn. I am no longer a floor nurse. I miss it terribly, I love nursing. However, I wouldn't be the type of nurse I expect myself to be if I needed a translator to talk to my patients....my Arabic is coming along, but not to that level.

So what am I doing for work? I am working for a company that is redesigning the VistA program to fit the hospitals here in Jordan. What does that mean? Background: The King of Jordan has mandated that all Jordanian hospitals and clinic have a universal electronic computer system for documentation of hospitalizations and clinic visits. This documentation includes patient health history, medications, current problems, vitals, procedures and surgeries, lab results, radiology reports, consultation reports, an so forth. Jordan has chosen to use the USA Veteran Affairs computer software, VistA. VistA comes with many fixed functions that are used in the above mentioned documentation; however, it also comes with a vast variety of options so the program can be tailored to the needs of the hospital, physicians, nurses, clinicians and clinics.

What do I do as a nurse? In order to do this type of project, you need many technical people who know how to design the program to fit the optional functionalities with the hospital needs, but you must also have clinicians like me. Our company has 3 Registered Nurses (including me), 2 Pharmacists and a few Radiologists to help the technicians. They need our input to help design the program and to ensure that what is captured will be usable for the clinicians in the hospital and clinic.

This project is a huge project. We are just in the infancy. We have a consulting firm to help our new company with this process. Currently, we focused on 2 hospitals and 1 clinic in Amman. Most of our days are spend interviewing heads of departments about what their current practice consists of. For instance, when a physician orders a lab test. How does that MD order the lab, how does lab get the order, how is the specimen obtained, how does the specimen get to the lab, then what happens to the specimen, how do you know what specimen belongs to which patient, how are the results displayed, who gets the normal, abnormal and critical results, what is the policy for critical results, etc.....this is done for every single process that takes place throughout the hospital....in the lab, radiology department, dietary, consultations, pharmacy, new orders, nursing procedures, documentation, blahblahblah. I could seriously go on forever with all the data that needs to be collected: from the names of all staff members, lists of all medications in the hospitals, equipment that is used through out the hospital to prosthetics, flow sheets and current sheets for documentation, blahblahblah. It's endless. And these processes are different in every hospital, so it will need to be done for each hospital and clinic in the kingdom.

To make the project even more interesting, many hospitals (like one that we are currently working in) has not a single computer currently being used! Everything is done manually, in log books, files, charts, patients take home their xray films, there are no med carts or med machines..RNs walk to the pharmacy to get their daily supplies, they walk to the lab, there is n tube system...there are couriers that take it's place. We are also developing many many new policies and procedures for these hospitals to fit with what the computer syster require of them. It's all very very interesting. Thankfully, the other hospital we are working with is quite advanced and it is associated with the Mayo Clinic in Rochester, MN. The late King of Jordan, H.M. King Hussein, died of cancer 11 years ago and their cancer center is remarkable. So the processes in this hospital, and others as well, will be smooth sailing once all the data is collected.

I have so much to learn....I am using my nursing background, but I am not a nurse. Sigh, but so happy to know that I will be helping this country make a huge step into the right direction! With this electronic health record being implemented, it will change the entire health care system for the better! Better practice, better policies, better procedures, better patient outcomes, better service, better economics, better better better! This country is already in the forefront of health care in the Middle East, many many foreigners come here to get good care. This will set them so far above the rest! I am honored and excited to be working on this project with my wonderful and also proud Jordanians co-workers!