Monday, March 7, 2016

Dazed and Confused - How I Feel While Training in the Intake Department

Well, I've been training as a relief Intake Coordinator for 6 night shifts now and after the first two, I thought I already had enough learning to be able to do it independently soon and I told the charge nurse so. Boy, was I badly mistaken when I finally trained with Jonathan, the Lead Intake Coordinator, on my third shift.

The first night, I was oriented by Marlana, one of the night shift coordinators. That time, I observed what she did and took notes, then compared my notes to the resource or reference book that the department had. I noted as much details as possible, or so I thought. I never got a chance to even answer any phone calls because the only 3 or 4 that came were answered by Marlana and after that no other calls came in. I didn't even touch the computer that night. I typed up my notes in my own computer, which I kept adding on to later after subsequent training nights.

The second night, again with Marlana, I went to the intake department at about 10:40 p.m., having been asked by the charge nurse to help in the detox department first since7 p.m. By the time I arrived at the intake department, there were no more beds available in the hospital's psych units and with the phone calls I answered, I only had to tell the callers that we were full. No computer work again that night.
After somewhat digesting the notes I had in combination with the resource book, I thought I had more or less a grasp of what needed to be done. I still needed to be connected to a shared network drive though, to access some logs that the Intake Department used. The hospital uses the Epic electronic medical records system and I thought that I was already set up to access all the sections that the intake coordinators used. Of course, was mistaken, as I learned later.

Finally, this much older Kwai Chang Caine had the opportunity to train one night under the Shaolin master himself - Jonathan. After setting up my personal desktop on the hospital's computer network, we found out that I still needed access to the shared network drives that the intake department used, as well as areas in the EPIC electronic medical records system that I had no access to as a Behavioral Health Worker. Jonathan asked me to contact the Information Systems office so they can resolve these issues. Eventually, after a few phone calls and email exchanges with Information Systems, I was finally given access. In addition, the hospital's admissions department gave me a username and password for the Passport One Source insurance verification system.

On that first night with Jonathan, he went into finer details about medical insurance companies and verification of coverage, what insurances we accepted and what we didn't, Medi-Cal from other counties, and I finally had the chance to enter information on EPIC after we received some calls regarding possible admissions. Entering information was where I started getting bewildered because there were so many things to remember, e.g. - click here, type a note here, close here, open this section, pend here, sign here, reserve here, and so on and so forth. It didn't help that I didn't sleep well the night before and my concentration was already poor. Jeez, how am I going to remember all of that and even if I did then, will I remember them again on the occasional times I'm going to be asked to relieve the full time intake coordinators?

I told the charge nurse the night before, that perhaps I may be ready to undertake the job on my own after orienting with Jonathan for one night. When the charge nurse asked me how I felt at about 3 a.m., I told her I was dazed and confused and that my brain felt so numb, like I just finished 3 finals tests in college. It was then that I asked her to give me as many training nights as possible. In the back of my mind, I was thinking I was never going to figure out the system and was reconsidering whether I still wanted to do it or not. Boy, oh boy, what have I gotten myself into?!

A few nights later, I was able to train with Shaolin Master Jonathan again and he let me sit on the captain's chair. We answered the phone on speaker and he was able to listen in and help me answer questions from callers which answers I didn't know. When it was time to enter information into EPIC, I would turn around to him to ask for clarification on what data to enter and where, since I had already forgotten most of them from a few nights back. It was a pretty busy night because we were barraged with calls from 7 p.m. until about 1 a.m. It was a great challenge to try to multitask and I was glad that Jonathan was there when I couldn't catch up. But, on a good note, I had a lot of opportunities to enter data on EPIC and it was very good practice. Still, I had to turn my head backwards to Jonathan so much that night that I may have gotten whiplash if not for the swiveling chair. Towards the end of the shift Jonathan told the charge nurse that this grasshopper was doing a pretty good job. He was being supportive of course because I felt that I didn't do as well as he said I did.

Did I tell you that I developed insomnia while I was training in the Intake Department? Well, when I tried to sleep, things I was trying to learn and how to do them kept creeping into my mind and made for bothered sleep. I kept thinking about how to do things the right way that it was starting to stress me out.

On my fifth training night, I was with Jane. Jane was a little bit more animated in the way she taught me as compared to the more relaxed way that Marlana and Jonathan did it. I still had to refer to Jane a lot that night when I had doubts on what to do next. One thing different that Jane taught me was to create a template for the End of Shift Report. After five training nights, I still didn't feel comfortable with the process.

It helped that I was able to orient with three different coordinators and I was able to see how they did things their own way to arrive at the same result. Hopefully, I will be able to incorporate the information I learned from all three into my learning process.

On the sixth training night, which happened to be the first time I trained two nights in a row (the others were separated by several nights off or working on the psych units), I was back with Marlana. I took all the calls that night other than one when I was using the bathroom. Between referring to my notes, a cheat sheet that Jonathan had given me, the resource book, and an occasional look back towards Marlana, I seem to have navigated my way through the system, remembering the sequence of steps to be taken, inputting which data and where, and doing updates as necessary. There were only a few calls and that helped me pace myself, and other than a few frantic moments towards the end of the shift, I thought I had done a fair job. I'm off from work for a few nights and so far I haven't received any feedback negative or otherwise, by email or by phone, so far.

Do I feel a little bit more comfortable with the system now? Perhaps I do with the routine stuff, I but I still have much to learn about the finer points of medical insurance verifications, of course how to answer phones in a tactful, customer service-oriented manner, and how to multitask when calls come in simultaneously. Lord knows what's going to happen if we don't get paid by the insurance company for a call I took. My boss is probably going to chew me out!.The job is much harder than I initially expected. I remember back in the mid 1980's when I was working for Tenet Los Altos Hospital, and had to occasionally take intake calls at night. All we had to do was ask the caller a few questions and arrange for him/her to come in for a free evaluation during the daytime, and if he/she came in, I would get an extra $10 in my paycheck. It's much more complicated now and I hope I hadn't already forgotten what I've learned so far after a few nights off. Can this old dog still learn new tricks?

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