Sunday, January 29, 2012

The Applicant

“What you’re describing is commonplace,” he said, “Business as usual. The applicant is unimportant.”

“It’s so inconsiderate,” I frowned, “So dismissive. Society in general is more callous; we are less attentive to the other. I am supposed to know that if they don’t call - even though they said they would - I didn’t get the job. And I do know - but I want to have a conversation - and that’s socially awkward.”

My friend Martin works in an ancillary industry to my own. His broad shoulders withstood my tears. “One of the ways our managers are evaluated,” he offered, “Is by how quickly they respond to phone calls, emails, requests, and applicants. They have 48-hours to respond, even if it’s to say, ‘I have no information and will have to call you back.’”

Brilliant. His company uses customer service as a measure for competency. I think most companies do. It breaks down internally when we do not consider employees customers - and treat them as such.

Five years ago, three nurse practitioner (NP) jobs at Kaiser were surgically excised from the budget to stem the flow of red ink. My termination notice arrived via email. (Yes, that raised more eyebrows than my own.) No exit interview, no apology, no semblance - even feigned - of care. I felt no administrative concern for my welfare. 

Courageous are individuals and organizations who can look within, identify weaknesses, and take steps toward remediation. If we are unable to accomplish change within our own lives; how quickly do we expect an organizational response? Organizational intelligence is hard won. Make no mistake, I believe Kaiser is an intelligent and responsive organization and employer AND we both have work to do.

Over the years I have applied for two nurse educator positions, a peri-operative NP position, and interviewed thrice for a position on a proposed cardiovascular team. They always say, “We’ll call you next week.” They never do. 
Kaiser’s cardiovascular (CV) team has experienced many setbacks and hiccups and is finally being assembled. I interviewed, yet again, in early December for a CV NP position on said team. The interview panel wore their best poker-faces and were difficult to read. 
“You don’t admit and discharge; do you?” I realized that my CV NP workflow at Mercy is exceedingly narrow and specific. I lack the broader skills an NP should have, like admitting and discharging. Nothing I couldn’t learn but in the current job climate, employers need not train. They can seek and hire persons able to don scrubs and start work.
“There could be resentment and animosity toward a Kaiser team inside Mercy. How would you handle that?” The questions went round-robin.
“There is resentment and fear already,” I said. “One of the cardiologists refers to Kaiser as the gorilla in the building.” 
“The gorilla in the building?” they snorted.
“Here’s the thing,” I continued, “They know when you put a full team in place, there will not be enough work to support all of them. I’ve already heard that docs are interviewing cross-country. They’ve been here many years; they thought they would work out their careers here and raise their children. Now they are looking at moving and uprooting their families. I have lots of compassion for that. But I never hear their frustration directed at people. They think highly of your surgeon so he is a good ambassador for Kaiser.”
“But how would you handle it?” someone pressed.
“Head on, by asking questions like, You seem irritated. Is there something I need to do for you that I’m not doing or something I’m doing incorrectly? Or is there something else? You know, I’ve been there for years; I know the people. There is nothing that can’t be handled in a conversation. It’s all about communication.”
The interview wore on. They showed little enthusiasm for my skill-set or what I could bring to the team.
“We’ll call you next week.”
Neophyte no more, I clarified, “Either way?”
“Yes, either way.” 
I left that interview feeling inadequate and unqualified. 
Something didn’t feel right. “These interviews my be a ruse,” I told friends, “A fulfilling of their contractual obligation to post and interview for NP jobs before hiring PAs (physician assistants).”
“Remember,” a sagacious friend offered, “They will make selections based on organizational needs that may have little to do with you.”
While vacationing over the holidays, CV NP jobs #3 & #4 were posted on our jobs website. Though I had already interviewed, I applied for them all. They cannot say I wasn’t hired because I failed to apply. Just how many CV NPs work in Sacramento? A handful, I probably know them all. How many CV NPs at Kaiser? None. If we hire four people, one would think I was a shoe-in.
Regardless of words to the contrary, I knew she had no intention of calling me and she did too. I’ll call you next week is a social lubricant to get us over a sticky wicket. From the applicant’s perspective, continuing to see jobs posted without a word from the interview panel is very weird. They have no idea... After a month had passed I committed a social indiscretion, I called.
“I keep seeing jobs posted on the website and I haven’t heard from you so I thought I would call to touch base.”
“Well, I am not prepared to offer you a position today.” Her irritation was thinly veiled.
No duh! “That’s clear and not the purpose of my call.” I did my best to remain gracious, to check my ego and feelings. “What is going on?”
“We think we want people who can help in the OR and you don’t have that skill-set.” She was curt, pointed. 
“I can see that,” I said. And I can. Few NPs have operating room training. “If you are looking for people with OR skills, you will be better served by PAs.” I thanked her for her time and ended the call.  …as I suspected.
There is sadness for me in that I have worked split days off for five years, keeping a particular skill set alive, waiting for Kaiser to build a cardiovascular team. That time is now, the team is being assembled, and obviously, I will not be tapped. I am deeply disappointed. I don’t have to fix this for there is nothing to fix. Can I be with my sadness? 
I had hoped to discuss the interview. Most nurses are unskilled interviewees for lack of practice. We have had the good fortune of being highly sought and readily employed. I would love to use the experience to grow and expand myself. I was stopped by her abrupt tone. I may yet have that conversation elsewhere.
We are, for the most part, uncomfortable with the discomfort of others. We deal with our own discomfort by avoiding and fixing. Demonizing the perpetrator is common. Do I think they think the applicant is unimportant? No, though clearly not a priority.
Can I be with my disappointment? Can you? Can we include my disappointment without clich├ęs like: Something better is coming? Maybe it will, maybe it won’t. Can I include that interview panels never place follow-up phone calls to applicants? Can I do that without thinking them inconsiderate boors? Though they are? Can I treat the new Kaiser team members with the same consideration and respect for which I am indignant when absent? ‘Tis a bigger game; is it not? Who am I in the face of uncomfortable circumstance?
Last week, my twelfth patient weaned herself from insulin. TWELVE! And while twelve is a drop in the bucket, the social and financial implications of what I can cause and create – is gynormous.
I’ve received several offers to create a web-based program. One offer comes from a Silicon Valley software engineer with whom I would partner. Beyond organizational restraint and constraint is likely the place for a non-traditional path, the road less traveled.

In looking toward my next best place – 

it may well be precisely where I am planted- 

the confluence ancient wisdom & modern medicine. 

The doctor of the future will give no medicine, but will interest her or his patients in the care of the human frame, in a proper diet, and in the cause and prevention of disease. ~ Thomas A. Edison

Monday, January 16, 2012

Bacon's 2012 New Year Letter

Baconz 2012 New Year Letter 
Hau`oli Makahiki Hou!
For the past 30-something years, my next line would read: May the new year find you in good health and spirits. That sentiment still resides in my heart for you AND I am learning that good health is relative and unattainable for some. This has been an area of focus this year, that of thriving and the created dimension of wellness despite bodily limitations, failure, and the absence of good health. Or to say it newly: optimal health and wellness despite one's circumstance.
This year I've learned that my patients feel hopelessly doomed to a life of amputation and heart attack. I've begun to acknowledge and address that in my classes. Then I paint a picture of diabetes control, management, even reversal, and invite them to play.
"It's not for everyone," I say, taking it away, "But if you desire better diabetes control and the health benefits it confers, Kaiser has an enormous department of people like me to help you. Here's what you need to do to engage us."
The doctors of  Medicine-3 (my docs) say their diabetes statistics are their best ever.  (I doubt it's true but they say it nonetheless.) There IS mucho energy and juice for me in empowering patients to effectively manage a disease that has had them by the tail. Retiring resignation and empowering patients toward optimal health and wellness despite their circumstance IS the name of the game. 
I attended three conferences this year, all included at least one session focused upon disease reversal. For a full accounting of my trips to Cleveland Clinic, Chicago, and Portland, see my blog (address provided at end of this letter.) You've heard idioms alluding to: you are what you eat and the company you keep. A plethora of scientific evidence favors the adage. Choose your foods and friends with care.
Kaiser is finally assembling a cardiovascular team for which I interviewed, along with two others. While one would think this is a slam-dunk, it is not. This job is in interventional cardiology; there are skills I would need to learn and master. I left the interview feeling anxious and inadequate. "We'll call you next week," they said over a month ago.
The Holidays are difficult for me. It seems like a time for couples and families. I feel alone, left out, and that my tribe is elsewhere. This, by the way, has no basis in reality as I am surrounded in friendship and love. But post-interview insecurities compounded by seasonal blues created two days of angst and sleeplessness. It had me reexamine some of my life's choices and contemplate a change in direction.
I am more and more convinced that upon retirement, I'll return to the islands. That being said, I have ten years to create something juicy and exciting in California. I released my suffering over it all. Nurtured by family, flowers, and culinary delights of Hawai'i, my attachments are more easily identified and released.
Most of you know my father died this year after a protracted decline with Alzheimer's disease. His death was a blessing as his mind had long dispossessed its withering shell. He died at home with family in attendance.
In Home Depot recently I heard a young boy holler, "Hey Dad!" I was instantly overcome with tears in the realization that I will never-ever direct those words to my father again. Still, my remembrance of him is sweet. While he was a man of his time - stern and reserved - he possessed a clear moral compass and provided for my mother in ways she continues to discover and appreciate.
Mom is doing well. She continues to attend Look Tung Ken, her 6am Chinese exercise class on most days and has begun a weekly practice of Tai Chi. She is amazingly mobile at almost-87 and we are planning a fall trip to China.
Yes, I continue to backpack. (See bear print?) Last fall we explored north Yosemite Park one week before the gates of  Tioga Pass were bolted for winter. The Sierra high camps had been disassembled and removed. We placed our base-camp at their scenic sites next to lakes and thundering waterfalls for extensive day-hikes surrounding Glen Aulin and May Lakes. We also stayed one night at Hetch Hetchy, providing a glimpse into that luscious valley,  the object of John Muir's last battle.
John Muir lost that battle, allowing the City of San Francisco to flood Hetch Hetchy valley for drinking water. The war however, was won, forever changing national policies and never again permitting such pillage of a national park for private use. (For the record, I favor dismantling said dam and returning Hetch Hetchy to pristine wilderness.)
What's in store for 2012?
Travel: China.
Backpacking: To hoodoos and red rock swirled like water; the parks of Utah.
Music: My Kamaka ukulele, a 10th birthday gift from my parents, visited its Kaka'ako birthplace (factory) in 2011 for restoration. I intend to take ukulele lessons in 2012.
Professionally: I am creating a 5-month curriculum for heart/diabetes disease reversal. I have preliminary support to run a trial. My friends and  colleagues at KP- Santa Rosa run such a program for heart patients. Methinks it would be neato-keeno to work in that arena. (Actually, this kind of work is more inspiring and far-reaching than daily rounding for the CV team.)
Exercise: the Tarahumara Indians of Mexico are known for the absence of heart disease and ability to run hundreds of miles - barefooted. In recent years I have decreased my mileage and frequency of running secondary to post-run, pelvic bone/joint pain. I am changing my foot/heel strike to the softer landing of the Indians and hope to resume a more regular running regimen once again. Last year I took a beginners yoga class and LOVED IT. I intend to resume that practice more regularly. Still riding my bike - natch.
Writing: still crafting. Follow my blog at:  Contact me if you want posting notifications.
Spirituality: I continue to dwell in that confluence of a spiritual walk, in a physical body, on terra firma. My goal: to leave people empowered with an experience of love. It's a tall order, one requiring a focus on others. It's a practice - and boy do I need practice.
Community: say YES more often. YES shatters the status quo. YES is the door to new possibilities.  YES allows me to more fully live in community with others. In 2012, I intend to say YES more often.
Golf: saving it for my golden years.
Many Mahalo's to  you for your cards and well wishes. LOVE your newsy updates.  
Lokomaikai hoomaikia ia maluhia ia oe ka oukou - a no la a me mau.  
Bountiful blessings and peace unto you and yours - now and always. 

Hau`oli Makahiki Hou!