Training the EMR: A Case Based Perspective - Best Practices and Training the Trainer

Part Three of a Four-Part Series

It is estimated that only 5% of hospitals in the US have a completely electronic medical record system (EMR). Given this statistic and wide-spread public support for President Obama's healthcare reform initiative, the EMR is standing on the eve of an era of accelerating growth. In the first two articles in this series, Training the EMR: A Case-Based Perspective and Training the EMR: A Case Based Perspective - Drilling Down, I have compared this position to pioneering on a new frontier and have discussed some of the challenges and decisions clinicians and trainers face in "charting" new territory. In this third and final article I want to briefly comment on training the trainer and best practices in training the EMR.

Training the EMR: A Case-Based Perspective - Drilling Down

Part Two of a Four-Part Series

In the first part of this series, we took a look, from a case-based perspective, at some of the general complexities and challenges faced  in implementing a new Electronic Medical Record System. In part two, I want to drill down a bit more to look at some of the barriers and challenges that clinicians and trainers encounter as they try to learn and use an EMR. I will also offer up some suggestions, as a jumping-off place for considering solutions.

Stories from the Farm - The Adventures of Kate and Annie among the English

Or an impromptu tour of our neighborhood through the eyes of Kate and Annie ...

Monday evening around 7 pm, Benny was finishing up a fence expansion for the mules, and I, accompanied by my cat, had just plunked down on the white adirondack chair on our infrequently sunny back porch of late. With a glass of blackberry wine in one hand and my laptop in the other, I was ready to relax after a rugged day of landscaping, cleaning the carpets, and preparing for a flight to Dulles the next morning for my brother's surgery. I had barely taken the first sip from the glass when our neighbors Mike and Jacci pulled into our driveway. They climbed out of their Suburban to inspect the latest additions to our family, Kate and Annie - a team of Belgian mules who used to work for the Amish.

Training the EMR: A Case-Based Perspective

Part One of a Four-Part Series

I have had some interesting and intensive encounters with hospitals in the past six months. I am currently sitting in the rarified atmosphere of the Johns Hopkins Hospital in Baltimore, MD. My family and I are in the Family Surgery Waiting Area while my brother is two hours into a craniotomy for removal of a brain tumor. Only last December I spent about ten days on the East coast hanging around the Neuro ICU at Fairfax Inova Hospital in Virginia. In between I briefly worked as a trainer for a Electronic Medical Record System at a brand new hospital built by a local outpatient care organization in our community.

Meet Kate and Annie

In my previous post, I said that I had unexpectedly entered job search mode again - after a successful two and a half years in my field and then taking a new job. But in every life along with a little rain, the sun must also shine. :)

It's spring! And while I lost my job, it's been wonderful to have time to catch up with friends and family and work on spring-cleaning the house and landscaping the yard - which have been so seriously neglected since the job hunt, job transition, and a couple of family illnesses involving prolonged travel and hospital stays over the holiday season.

I haven't had this much uninterrupted time at our new home since - well, ever! (we moved here 4 years ago.) So I'm giving her the old white glove, while I have the opportunity! Of course I'm job-hunting too.

Benny was so excited when I got my new job this winter that he finally decided to pursue a life-long dream. Ever since we've been married, he's talked about owning a team of draft horses or mules. He acquired an antique wagon several years ago that he's refurbished and we've used to advertise his antique refinishing on this corner. So this late winter/early spring he set about building stalls in the pole barn and putting up fence - and the opportunity came along to buy a team of Belgian draft mules from our neighbors complete with harnesses for a really good price.

Kate and Annie are 18 years old and still in wonderful shape. They pulled Benny's wagon to Stockwell yesterday. They worked together for the Amish their first six years of life and have been owned by 3 families (including us) since them. Actually they were separated when the Amish sold them to the next family. The second family reunited them and then our neighbors have owned them for about 6 to 8 years.

Even though I lost my new job, I told Benny I sincerely hoped he would go ahead and buy them. His brother died of a brain tumor at age 65 - the same year Benny had his open heart surgery. And last year his sister died of cancer at age 74. I told him he'd better be doing some of his dreams while he still has the health to enjoy them. I have hope we'll be able to financially maintain - even if I have to work in part time retail or part time factory again. Like Kate and Annie, I'm hoping I still have enough of my wits, skills, health, and vigor, that some employer in my field will still find value in me. Whether they do or not, we are still blessed.

So without further ado, meet Kate and Annie!




JuneBug

Changes

A lot has happened since I first started this blog to write about my job search and photography/scrapbooking interests. After working in a few interesting stop gap jobs I found and have been successfully employed in a job in my field for two and a half years.

Now I am in job search mode again.

I didn't expect this to happen. Even though the economy was going bad, I had gotten a wonderful offer to work with the new electronic medical software at a new hospital- albeit under somewhat questionable circumstances. I wouldn't have started looking except that the cost of benefits was going to double in my current position come January - and I knew I was going to have to start working two jobs or find a better paying job. The hospital had just started up in October and we had heard rumblings - the friends of friends kind of thing that happens in a small community. The gist was that people thought the hospital needed a lot of help with their new system. So when an educator consultant position was posted that sounded like a match to my experience, education, and interests, I finished my online application to the hospital around 2 am one morning in November/early December, and the hospital called me back the same day. That just never happens. Their HR interviewed me in early December and set a second interview date for late December. It was evident the staff were very excited and proud of their innovative new hospital and approach to medicine. During that period my then current employer, a not-for-profit, offered to bring me on as a 40 hour FTE (I had been a 30 hour FTE) if I would agree to end the job search and stay with them - with the understanding that if the hospital made an offer, I would consider that one. But I didn't hear from the hospital after the second interview. I did make the prerequisite one or two follow up calls - and they did sound encouraging - which gave me hope. But time passed and I didn't hear - and I felt that I would be okay since I was now working full time for my then current employer. At least as okay as any employee can be during these uncertain times. Then the hospital contacted me at the end of January with a really nice job offer. My new boss wanted me to start as soon as possible. When I asked my then current employer if they had ever heard from the prospective employer, turns out the hospital never contacted them at all. We all thought that was odd. But to be involved in the health field with the new medical record software (I had helped bring in a new billing and patient tracking system to a University Health Center several years ago) and to bring in my instructional design and educational background as well just sounded like a wonderful opportunity in spite of the warning signs that the position/employer might be unstable/a revolving door. I said I needed to give my current employer two weeks notice, but could start immediately after that. So I put forth a monumental effort to finish up with my old employer and leave my position in the best shape possible for the new person to start. I even skipped vacation - which now adds up to amost three years in a row that I haven't had one.

I started at the new hospital February 16th. They kept me barely over two months and then terminated me at an early 90 day review. The decision seemed based entirely on less than a day's time spent with my new boss one on one over the entire two month employment period - most of it after he had threatened and intimidated me about something that was really no fault of my own. None of the decision seemed based on the assessments (what there were of them) of the capable trainer consultants who were training me or the nurses I trained. I had gotten the sense from their feedback that I was making satisfactory progress in mastery of the material and in my training techniques. They were complimentary when they didn't need to be. I was learning things of value to the organization - I thought. I was beginning to connect with the healers, the people I was hired to train. Not that I didn't have things to learn - but I was making satisfactory progress in the overall scheme of that department trying to get things done and implementing a new instructional delivery strategy for the hospital. It was actually a really cool time to come on board- I got to watch how the team worked together to put the new delivery strategy into action in the most effective way possible. It was impressive. The department hired one person after me - from within the ranks. She was onboard during the startup in October - so she had considerable expertise with using the software and supporting clinical staff in the units - but like me, she hadn't spent her work life as a professional trainer consultant.

So ... it was all very odd how the job ended and I found myself unexpectedly on the unemployment line having left a job who wanted to keep me to help a new hospital break new ground. But it was still a very interesting learning experience - and I got to work in a brand new hospital, learn an EMR in depth, and be trained through various methods in technique and content by some really great, professional trainers.

So while the stint was brief, I don't want to lose what I've gained, and I will be posting about Electronic Medical Record software ... the benefits and the challenges facing us. With President Obama's initiative, it's a hot topic. Stay tuned ...

You are Invited to Serve!

We're certainly living in exciting, albeit difficult times, aren't we? It's gratifying to see that my experience ten years back as an avid online campaigner and webmaster for an innovative television series hasn't been lost on the current presidential election, inauguration, and upcoming Day of Service which by and large have been managed online.

It all started for Benny and me before Christmas when, in response to an email request from the President-Elect's transition team, we hosted a Change is Coming Meeting at our local Barnes and Noble in which participants were asked to plan a service event. Up til then, our involvement in the 2008 political process had amounted to a couple of small donations and a sign in our yard - which was actually pretty good for two "old-timer" refugees from the 20th century, but fairly minimal compared to what others have done in this ground-breaking election.

However, when I read the the transition team's request in the December email, I thought, "This is something I can do. This is something I have done."

I had witnessed firsthand how people all over the world met one another online, followed up one another with face to face, formed friendships, and challenged and extended themselves to collaborate up close and over distance to get things done. So, I entered a Change is Coming event at the transition team site and seventeen people in the Lafayette area showed up to our Barnes and Noble meeting on a chilly December evening!

As already noted, at that meeting we were asked to plan a service event to coincide with the Martin Luther King Holiday and with the Presidential inauguration. Early in January, a member of the inauguration committee called and requested that we post our service event on their website. Just this morning I received a call to service and link to a video by Michelle Obama inviting us to join her and the President-elect in a day of service. She and President-elect Barak will perform their day of service in their new community Washington D.C. However, in her email she also included a link where everyone can search for service events (or add them) for their local communities at http://www.USAservice.org/. Our Change is Coming Service event is listed there - if you're from the Lafayette area, look us up!

During the presidential campaign and afterwards, there have been myriad sites - the mybarackobama site, the transition team site, the inauguration team site to name a few that I know of. It's nice to see the Washington folks have come up with some hopefully enduring names that communicate an ongoing, inclusive, and bipartisan collaboration for change:

http://www.usaservice.org/
http://www.change.gov/


JuneBug

More of Aunt Firma's Paintings

Here are pictures of two really nice little paintings (9 1/2 x 7 1/2) by Firma Phillips on ebay over Christmas - from a seller in Springfield, Illinois. I wanted to bid on them myself, but didn't really have the money.

JuneBug

A Furniture Refinisher's Newsletter

Check out the 2017 ebook version of this post!

available at Amazon and Google Play Books

 

2008

Back when our furniture refinishing and antiques business was truly "on the road," I used to have a scrolling news page at http://www.secondlooks.biz/ called On the Road with a running account of our activities. When we cut back to do just the refinishing and caning work (after Benny's heart surgery), I took that page down. But now that I have this blog site, and because it's "that time of year (when people write newsletters)," I thought here might be a place to maintain news about our furniture refinishing business. This has certainly been an exciting and historic and, financially, a difficult year for all of us, hasn't it? We have not participated in any shows or had any ebay activity this year, but Benny stays pretty busy refinishing furniture and caning chairs. Here's a picture of a wicker seat from a governess cart that he repaired this summer. Unique!

I also have pictures of a very unusual sofa that he put a cane back in:

Maybe it's time ...

With kudos and apologies to the Teen Haven Ministry which was started in inner city Philadelphia in 1963 by evangelist Bill Drury, and which has engaged and changed so many lives, and which remains a vibrant and viable ministry to this day - http://www.teenhaven.org.

During the years of 1972 through 1975 I worked in an inner city youth ministry right out of college. I joined the ranks as a summer staff member a couple of weeks after graduation, and stayed on as full time staff. It was during these years that I first started seriously keeping a diary. I think I started it because we had to write a monthly prayer letter to supporters back home and because I kept seeing and discovering so much, both without and within, and so many people's stories worth telling were building up inside of me until they just had to spill out.

As promised, a posting about my Uncle Tom Durant's paintings

My cousin Anna and I grew up with Uncle Tom's paintings adorning the walls of their Greenwich Village apartment. Anna of course lived there, and I visited there often.

Uncle Tom grew up on a farm or property on the outskirts of Chicago during the depression. His father's lineage was French. I believe his father was blind in his old age. Uncle Tom met my Aunt Joan in Detroit where they were both active in helping auto plants to unionize. After the war, they found an apartment on the top floor of an old brownstone in Greenwich Village (my aunt was from New York City, the Bronx) - and they have lived there ever since. Uncle Tom has a passion for gardening from his midwestern roots and I've enjoyed many a lunch on my aunt and uncle's roof garden with the sky scrapers towering all around us. One of us would carry the water, the wine, the cheese, the bread, and the condiments up the little ladder and hand it to the person already on the roof. My aunt and uncle's brownstone also featured a charming little exterior iron grill window seat, accessible from their bedroom window where one could enjoy a quiet cup of coffee or read. The noise of 14th street greatly diminished toward the back of the apartment. Sadly the roof garden is no more, because my uncle also has failing vision.

I believe I'm correct in saying that Uncle Tom's paintings were part of the Abstract Expressionist movement. I remember he introduced me to abstract painting when I was a child. His paintings have been described as dreamlike, often of trees, and fields, and woods, and rivers - and people frolicking in the water. The colors were greens and blues, sunlight and shadow. He once told me Illinois was so flat and dry, that trees and shade were valued and considered an oasis.

Here are a couple of pictures from his Gallery Exhibit in 1965.










I will also post a few pictures I have taken in more recent years. I don't remember this one as a child - Uncle Tom told me it was a shotgun wedding. Hee.



And this one hanging above my grandmother's clock ...

Another David Grossblatt Painting Discovered!

I received the following email and photographs from Kyle Johnson who has graciously allowed me to share them with you.

Hey, I'm Kyle. So I was searching google for David Grossblatt because I'm here in Washington, DC helping my great aunt clean out her house and in the basement I came across a large painting sort of hidden in the corner. So I took it out, looked at it and say Grossblatt signed on the front and on the back it read David Grossblatt NY, NY. So here I am, searching google when i see that you have a blog about him and some of his finds and I thought I'd let you know I found one. Story behind it goes my great uncle's friend knew David, who at the time was trying to go to Paris. Before Grossblatt left, he wished to have a typewriter, which my great uncle's friend traded to him for this painting. And somehow it was traded to my great uncle where it was placed on a wall for a while till the wall was painted. This is how it ended up in the basement to be forgotten until I came upon it. Attached is some photos that I took earlier this morning. Enjoy

Here are Kyle's photos:





For those of you just coming in on this discussion, David Grossblatt was the co-owner of the Cafe Rienzi in Greenwich Village and he held quite an influence in the abstract-expressionist art movement. I have been posting tidbits of history about the Cafe Rienzi because my Aunt and Uncle helped to start it. I remember my Uncle Tom Durant taking me to his art studio one day and teaching me about abstract paintings. He let me try my hand at one - I was about 8 years old. Just from that little memory, and looking at the painting, I think David Grossblatt was a big influence at that time.

JuneBug

One of these days I'll get around to posting some of Uncle Tom's paintings.

Heads Up for All You Firma Duchene Watchers!

Just thought I'd let you know that one of Aunt Firma's paintings sold on ebay for $350.00. Here's the link (for as long as ebay keeps it, anyway). And here's what the seller wrote about it:

• 
  
  Beautiful Southern Indiana Landscape by Indiana Artist "Aunt" Firma Duchane Phillips.


• 
  
  Oil on Canvas measures 36 x 24 inches - 42 x 30 overall in very good frame.


• 
  
  Painting is in excellent condition, very bright and vivid with excellent detail. No chipping or tears.
  
  

Cedar Waxwings and Robins

Just posting briefly to share some pix! Not great shots, but you can tell what the birds are. We had a tree full of cedar wax-wings and robins at work last week. And after just three days, all the berries on the tree were gone, and all the birds were gone. :)


The pictures were taken with an 8 megapixel HP camera, 3x optical zoom (not quite enough).

Little Masked Berry Bandit

Profile View of Cedar Waxwing

Waxwing and Robin

Heads up on SharePoint Services - A Great Online Collaborative Tool

Per the title of this post, probably something many of you already know, but here's my story.

I currently work for two not-for-profits as a compliance specialist. With all the regulations surrounding grants and contracts, social services people have a boatload of information to keep track of. So we started off by tackling reporting - and I modeled a report tickler system in Outlook that went a long way toward gathering all the information we needed in one place and helping us meet our compliance goal of getting reports in timely. However, I remained convinced that a truly collaborative online work environment was what we needed.

By October 2007, I had been given charge and custody of a product called SharePoint Portal Server by my boss and the IT director. As I looked it over, I recognized the potential SharePoint Services held for giving our agency an intranet and a truly collaborative workspace for report writing, grant writing, and other endeavors. Best of all it was intuitively accessible through our web browser. But first it took a thoughtful observation from a co-worker to get the ball rolling.

One day a co-worker made a thoughtful comment about something I'd already started to realize and try to simplify during the formative evaluation stage of the Outlook Tickler System, namely that receiving all those information-laden tickler emails could feel overwhelming - particularly during a heavy reporting cycle - which for us came quarterly, semi-annually, and annually. During those times, we could have as many as 22 reports going out to funders in the space of a single month and involve 25 to 30 staff members from the different programs in the process. Since over half the reports had a financial component as well, business office staff might find themselves responsible for getting out 15 reports in a month's time after running monthly financials. With a tickler email going out for each stage of our compliance strategy, the business office person could receive potentially receive 60 emails in a month's time. At that rate, even with everything embedded in one email or Calendar entry for a particular report, it was still difficult to get a handle on what was due when, and where to find it.

"I know," I responded. Then, "But at this point I don't know how to fix it."

"I know you don't," she replied patiently - as if, "Who would?"

We left it at that, but that brief exchange started the wheels turning in the back of my head.

... I wonder if there's a way ...

As I've already stated, around that time, the IT Director came to me with a manual and a CD on SharePoint Services. As I looked it over, it dawned on me. Instead of a tickler email for each report, there would be a tickler email for each person - and the email would simply contain the due dates and a link to a worksite for each report. The link would be accessible through the person's web browser. There would still be a tickler email for each stage, but an individual would receive only four tickler emails at the most during a month's time. The report worksite would contain all the resources previously embedded in the tickler emails and calendar entries. . . report instructions, contact information, report formats, report procedures, previous period reports, and funder reporting schedules. Best of all, the worksite would be interactive. No more passing documents back and forth via email. We could all literally be ON THE SAME PAGE. There would still be a calendar but it would be primarily for me, to remind me to get the ball rolling. The calendar content would be much reduced, containing for the most part just the link to the worksite.

On the eve of one of our busy reporting cycles, I spent an intense week learning SharePoint and constructing worksites - which delayed send-off of the Stage One ticklers about a week. Generally, I prefer a piloting or phased implementation plan as opposed to quitting "Cold Turkey." But in this case I went with a gut feeling. While the Outlook-based tickler system had helped us achieve our goal of timely reporting, most of my report writers were still resorting to email as a main resource for finding and relaying what they needed- simply because using Outlook's public folder didn't seem to be catching on. So, relying on their knowledge of the web, I emailed each person a brief (and enthusiastic) STAGE ONE tickler email. It contained a list of their reports due with the links to the worksites, the compliance strategy due dates, and who currently "had the ball." I invited people to try out the links and to contact me with any questions. To make a long story short, the SharePoint Services worksites have been very favorably received to date. While SharePoint interactive worksites do have a singular look and feel, the fact that people were already quite used to finding information and interacting through their web browsers (as witnessed by the success of ebay, and blog sites) worked greatly in our favor.

From the Report Tickler System it has been but a hop, skip, and a jump for us to create worksites for other purposes as well and voila. Another intranet is born ... We still have a lot to learn about it - myself and the organization as a whole. Recently I was asked to do a presentation on SharePoint to get middle managers started thinking about the potential. Here's the link to the presentation and the notes. This is also available from my linked-in public profile and at slideshare.

Betty's Roses

We drove away and left Betty buried on a hill in Slaughters, KY on the first day of March with the promise of spring in the air, but the ground still bare and stark. I so much wanted to take pictures but I didn't dare be inappropriate or intrude on the family's grief. I took some outside pictures of the old Slaughters Christian Church where the funeral service was held. Actually I've often wanted to take pictures in Kentucky - Betty and Hal have such a lovely place. The surrounding countryside is so quaint and picturesque with its hills and "hollers" and back country roads that wind up steep hills through narrow tunnels made of trees. We'd often sit on the front porch of Hal's home place where he'd retired and built a new house after working as a professor from Purdue and enjoy just looking out at the fields and tree lined hills across the way, and watching the birds in the stately trees that lined the long driveway and admiring the flowers and the garden. Hal and Betty named their place Morning Song.

I guess those pictures will have to remain as pictures in my mind and in my heart to be painted with words and perhaps incorporated into my dreamscapes … Like the images from the day we put Betty to rest. Granddaughter Amber standing tall and slender on that hillside, the wind sifting through her long blond hair as she held a red rose from one of the graveside flower arrangements against her dark plaid winter coat, her slightly freckled face and grey blue eyes surveying the grave sites of her ancestors with perhaps a newfound interest in her roots. Her mother Becky standing along side explaining who was who. Becky with her short dark curly hair and mischievous brown eyes was the one everyone called "Grandma Bonnie" at the viewing because she so reminded anyone who had known Bonnie of her.

Paula holding a red rose against her neat black coat, the daughter who looked so much like Betty, today her straight black hair and intense brown eyes contrasting against the pale winter sky. She had stood watch with Jenny and Hal the last few days of Betty's life. Becky and Mark were in Pennsylvania with Amber and her husband.

Daughter-in-law Penny, son Brian’s wife, an engaging young woman and mother with brown eyes that dance, and their two small boys, Colden and Hal Robert (Beau), the youngest grandchildren, had gathered roses from the graveside flower arrangements and handed one to each of us. These added sparks of color to the brown and gray of winter as people scattered to visit gravesites of family long passed on.

The expression of grief that always seemed to return to youngest son Brian’s face in the inbetween moments of chasing after toddlers and joking with family and friends – he had made frequent trips back and forth from South Bend, Indiana these past few months and had been fighting off the same cold as Benny the last two weeks.

Jack's face, his eyes red from weeping – the oldest son and the first grandchild, who had come back and forth from South Carolina during the few months of Betty's illness - but still functioning with composure, humor, dignity, and grace. And Mary Ellen his tiny wife who was keeping her mother who was suffering from Alzheimers. I had worked with her mother many years ago at Duncan Meter. Jack and Mary Ellen had brought her along but left her at Hal and Betty’s with the lady who came to clean their house.

All the men standing in front the old Slaughters church, gleaming white in the sunlight as we drove up - Jack, Brian, Benny, Tootsie, Mark, all dressed in solemn dark suits, there to direct the parking and to fit all the cars in a place not accustomed to such an attendance.

Donald Qualls girlfriend's dirge, the only song of the service, sung acapella straight out of 19th century Appalachia.

The wonderful country dinner at the church afterwards. Pecan pies and apple dumplings and chocolate cakes and banana pudding – ham and fried chicken and slaw and cornbread, corn from the garden and green beans …

Brother Gary Ashby's message about the pages of Betty's life - those we all were in, those yet to be written - Brother Gary always has a unique perspective in his sermons.

Amber's husband Brock, a seminary student in Pittsburg, who at the last minute was invited to speak and gave a thoughtful reflection and explanation of a passage in Ecclesiastes - the one that says that it is better to be in the house of mourning than in the house of mirth - the kind of foolish mirth that detaches itself from life ... whereas the house of mourning is a sort of reality check that touches our hearts and allows us to become better people.

Watching Hal Ray stand solitary beside Betty's casket graciously greeting and welcoming the long receiving line of neighbors and cousins and friends at the viewing, some from close by, some who had traveled distance - perhaps the professor’s longest and saddest lecture. As people came in, he greeted us all by saying, "I'm hugging all the pretty women tonight," then told his friend Bob, "That includes you," and hugged him as well.

He told me he'd first seen Betty when he was in second grade. They were high school sweethearts, someone else commented they had probably never dated anybody else. Someone said he'd told them, "I had my eye on that girl for a long time."

The eulogies and tributes to Betty included, of course, her cooking – I believe it was Brother Gary who said, "That woman could take dirt and make it taste good."

She had welcomed me into her lovely home and accepted me and fed me well and hosted me so graciously so often over the last twenty-eight years - if it was an imposition, it never seemed like one. Betty was always ready and she made everything look easy.

Sister-in-law Betty Winstead rode down with Benny and me - her first trip to Kentucky to see the family after Paul died. Paul was the first, but not the oldest, of the Winstead siblings to go. Betty has gone through a long mourning period. She says she journals and is on her third journal of letters to Paul. She said in her very first letter she asked him, "Well, what's your baby brother Jerry Alvin like?" Jerry was born between Betty and Jenny but had only lived a few days. She said Paul often mentioned that he wondered what Jerry would have been like.

I remember Betty Roach when Paul died. Everyone met at our "new" old farmhouse. Betty and Hal changed in our study. We all stood in the receiving line with Betty Winstead. I remember Betty Roach standing by Hal, her trim and slender appearance in her "little black dress" and black pumps belying her 72 years, as she greeted folks from Dayton she probably hadn't seen in a while ... Hal told me last fall that they'd gotten married when she was seventeen and he eighteen, and in his mind, Betty was still seventeen.

And I remember sisters-in-law Betty and Jenni busily cleaning all the marks off my new glass top range.

I discovered that Paul's Betty wrote Betty Roach every week of her illness - she said she knew she could write but just couldn't trust herself to talk on the phone after losing Paul to the same illness in such a relatively short time. Betty Winstead kind of stayed away from the family for a while ... to get back on her feet I guess.

When we pulled into Jenny's on Friday afternoon, there she stood stirring a big pot of homemade soup and pressure-cooking some beef. Jenny told us she had had about three hours of sleep in three days. The hospice people had been telling them the end was near for a couple of weeks – a few hours, a day, perhaps through the night. Tuesday night they’d had to call them late to increase the pain medication. The hospice people told them then it would be a matter of hours. By then Hal Ray wanted someone by Betty's side holding her hand the whole time and wanted everyone to do it in shifts so they wouldn't wear out - he and Jenny and Paula were the ones who stood watch those last few days and Betty passed shortly after Brian arrived back down there.

The thoughtful and inclusive obituary obviously written with what Betty thought important in mind. No one was left out. No one. I think if Willie, their little dachshund had still been alive, he would have been listed too.

Betty lay in a hospital bed in the living room the last two weeks of her life and Jenny stood by her bedside practically the whole time.

It's been a rough winter all around - Kentucky has had two ice storms in the last three weeks. Tree branches were piled everywhere, barely clearing some of the narrow country roads. Betty and Hal were without power for four days - Betty too sick to go to a motel so they had to tough it out, Hal said. Jenny's son-in-law Mike brought them in a kerosene heater and whatever else they needed.

But perhaps I digress. Betty has been on my mind frequently for the last few weeks and she and her family will remain on it for some time to come. She passed 1:00 am on Thursday morning February 28, 2008. We got the call at 8:00 just as I was leaving for work. I went on in to work and did a few things and then turned around and came home - cleaned the house and got ready for the trip to Kentucky. The neat thing was that I'd been feeding birds outside my kitchen window this winter. A pesky cardinal and his mate were the ones who started it all - he kept attacking my kitchen window last spring so I put out food to distract him. But Friday I looked out and there were all kinds of birds including a tiny black-capped chickadee - oh, he was so cute. First one I've ever seen around these parts. Betty loved birds. I think I've always taken them as a sign - silly, but the rare visitor reminding me of Betty's spirit on the wing, free and spry once again.

On Romance with Age

Well, I've already written what my obstacle course is along the path to Romance - in a notebook, not on this blog. Yet. I've moved beyond it and I would like to quit reliving it. :) God only knows what my partner's ostacle course was, but if his childhood was anywhere as painful as mine, and it was, we'd barely have a chance in hell in the romance department. Those white hot sheets of blinding emotional pain layered on top of one another to the vulnerable who have no protection, getting at the core of who they are and destroying their confidence ... Because anytime something happens to remind me, it sends my Venus running for deep cover. In a way it's too bad our psychological scars and wounds aren't ... more obvious. If they were as evident and easy to see as a disfigurement or a missing limb, or blindness, or whatever, our fellow men would have a better shot at understanding us, and thereby sympathizing with us and knowing how to approach us.

Sterile Design Environments vs. Fertile Design Environments

When you've been at something as long as I have, and witnessed first hand the desktop revolution growing up from the first dos machine to the internet and world-wide web, you arrive at the point where you feel you can form some opinions about design. I have worked in the computing field in one way or another for twenty-five years, mostly designing solutions from the tools at hand.

I have worked in computer shops and it departments. Those were my sterile design environments. That's probably a misnomer. They were rich in access to technology, often the newest technology. They were rich in access to creative and capable colleagues in the IT field. But they were sterile in the sense that they were not intimately "wedded to" or "situated in" the areas they served. In a sense their knowledge and skills lived in a vacuum.

Then I have actually worked in jobs where I had to design tools for myself and for a whole group of people to solve a problem we were all grappling with. That kind of job is fertile in that your computer knowledge does not sit in a vacuum with nothing to do and you have inner access to the people and problems that you design solutions for. In fact part of the art of design is engaging users to design solutions along with you.

While the knowledge and skills from the first environment are essential, I think that designing in the second environment produces better products.

It makes sense in the light of modern learning theory which espouses "situated" learning and constructivism.

I have two degrees (well, three actually, but two technology and design related) - an associates degree in computer programming technology and a masters degree in educational technology. I think the two complement each other well. Both teach systems design. However, as I often say, educational technology fills in some gaps in systems design theory, especially when you are designing tools to scaffold people's cognition. And today, with the information boom, and the cognitive overload that inevitably results, those type of tools are more needed than ever. In fact, I think and predict that providing tools that help people effectively manage and use the amount of information that is available to us today and that is required today will be one of the greatest and growing requirements and fields of this new information age - right behind, if not alongside, the computer security field.

Traditionally systems or design theory teaches (sort of) that if you build it they will come. Modern learning theory and constructivism says instead, if they build it, they will use it. This is more than just change management and 'buy-in". Knowledge is socially constructed and negotiated - if something is to be used, it must go through some process of social knowledge construction. If something is designed in isolation, people won't even know it exists and they certainly won't use it. And we've all heard the horror stories about systems "passed down from on high."

Not that these were bad systems. They just neglected to go through an important part of the process.

Tools that scaffold cognition must provide an evironment and the tools for the user to construct and negotiate knowledge. Too often we want to say "out with the old and in with the new," in one fell swoop. This is a mistake.

Windows SharePoint Services provides the environment and tools to help employees manage information overload both in a "top down" and "bottom up" sort of way. Kudos to Microsoft - hey you guys do it right once in a while! ;)

More on this topic later.

JuneBug

Summer Hummers

Have to try out Blogger's new video upload feature, hee hee! This vidlet was taken inside from the window over my kitchen sink with my Olympus C5050 digital camera.

I have enjoyed feeding hummingbirds for many years and was surprised to host so many of the tiny visitors this year. Perhaps it was the drought and the ready availability of a refreshing drink that drew them in. They would drain my feeder dry in a day. At times I would even see four feeding simultaneously – a first that I tried hard to capture on camera but alas it was not to be. Hummingbirds don’t share their space easily, and one extremely territorial little guy soon started successfully taking on all comers.

I named him “Rambo.”

I tried various distractions on Rambo but nothing seemed to work. Finally I hung another feeder at the back of the house, behind the summer kitchen, on the clothesline post, well out of Rambo’s sight - so the other birds would at least have a chance of getting a sip.

About this time we were preparing to go on vacation to a family wedding in Kentucky and then on to Myrtle Beach to visit our daughter. Our friend Mark who rents our summer kitchen had agreed to bring in the mail and the paper and to take care of the dog and cat. Having gone vacationless for two or three years while we changed careers and dwellings, I guess I must have been manifesting some serious separation anxiety because Mark commented to a mutual friend that I would probably leave little reminders and notes for him all over the house. So the night before we left, Mark commented, “Guess what I saw outside my window this morning - a hummingbird feeder! Is that your reminder for me to feed the hummingbirds?”

Actually, I thought it was rather sweet. :)

(And true to character - lol! I had left hummingbird brew in the fridge, intending to tell him to refill the feeders. )

Hummingbird Wars

Watch him spread his little tail feathers when another enters his territory!

JuneBug

Remember the Mariner

In January 2005, thanks to a discovery by our daughter and her boyfriend who had moved to Myrtle Beach, my husband and our dog Hazel and I spent about 3 weeks in a charming little motel-type resort called The Mariner. Nestled amidst the high rises on Ocean Boulevard, the Mariner is only one short block from the ocean and easy public access to the beach. We could see the ocean from the front door of our first floor suite which also opened up on a lovely outdoor heated swimming pool.



The Mariner is both pet and pocketbook friendly, especially during off season. Built sometime in the 60's, it was laid out in weathered wood, brick, and stone with care and imagination in every step. Buildings, gardens, wading pools, and dog walks wind in maze-like fashion about the grounds presenting the visitor a unique view at every turn. Our suite even had a small patio in the back. The motel features several outdoor swimming pools, and even a tennis court. Various authentic nautical devices adorn the grounds and buildings along with wall paintings inside and out that echo both the gardens and the nautical theme. Staff served a complimentary outdoor continental breakfast each morning in the Carolina room. A grill by the pool offered guests opportunity to socialize and cook out on a whim; it was also used for a complimentary weekly Wednesday night dinner, with guests involved in preparations as much as the staff.

Benny, Hazel, and I met people (and dogs) from as far away as Canada and New England who wintered in the Mariner - all pet owners. Some had been making the annual trek since the 1970's. Many had become friends over the years. They reminisced about floating in the heated pool, a glass of wine in hand, watching the snowflakes drift down. While we were there, the temperature was 80 degrees and gorgeous however. We didn't complain. Nonetheless, when the owner left for the day, someone always managed to sneak into the room where the pool heater resided and crank up the temperature until the pool was almost a sauna, the mist rolling off into the cooler night air. While we enjoyed walks along the beach and wading in the ocean, the air was a bit cold for swimming that time of year. At least we thought so. We had just made our way down through an ice storm that came within 20 miles of Myrtle Beach, after all. But it was wonderful to practically step outside our door and into the heated pool midnight, dawn or anytime inbetween.


In September of 2007 when Benny and I returned to visit Bon, we chose to stay at the Mariner, even though Hazel didn't accompany us on this shorter stay. In contrast to January, September's ocean was warm and relaxing to our travel weary muscles. So was the pool. I found one late afternoon especially gratifying when the three of us swam together in the Atlantic. The swells, slightly over our heads, were gentle and buoyed us up before they broke closer to shore. Unlike my beloved blended family, I had grown up near the Ocean. It felt good watching these two people enjoy something I'd loved since childhood. By this time motel had changed hands. Breakfast was no longer being served, however the room service was excellent. We heard that the Mariner would probably not be maintained and that eventually it would be razed to make room for another high rise luxury condominium. Luxury high rises have their pleasures and conveniences (as we knew from previous visits and also from availing ourselves of the gift shop, delicious restaurants, money machine, and occasional complimentary cup of coffee at the Ocean Reef across the street). But they just don't offer the same experience, I reflected as I sat outside our door one morning, enjoying a cup of java brewed in our room, and feeding leftover crackers from our long drive down to the friendly squirrel and birds at my feet.


With that thought in mind, I decided to take pictures of everything I could - so that future generations would know that there are choices in how to live, and that things don't have to be just one way.

Remember the Mariner!

You can browse more pix of the Mariner and the Carolinas at Jeanne's Photo Gallery