9/13/11: routine interruptus

I’ve been away from home, from my computer, and from my usual routine. Last week I was in Seattle learning to work with an electronic medical record (EMR) system that Planned Parenthood has just started using in their clinics. All medical care facilities are bringing medical records online, in part because the government offers a monetary incentive to do so. Like most medical providers, I have mixed feelings about them. It’s great to have information easily available and transferable from one facility to another; but it’s awful, in my opinion, to be typing and looking at a screen while trying to have a conversation with a patient. And the entire sense of the patient’s story or narrative gets lost in these systems. Anyway, I’ve used many EMRs before this, and this one is no worse, and certainly no better, than others. Lots of point and click.

Then, I spent the weekend on the Oregon coast at the first Poets on the Coast Writing Retreat for Women, offered by Kelli Agodon and Susan Rich, 2 wonderful and generous poets who made it a very special event for the 17 of us who attended. As a retreat, rather than a workshop, we mostly ate, read, walked on the beach, and shared ideas about writing poetry. It was very relaxing. I believe they are planning to do this again next year, around the same time. I drove back up Route 101 hugging along the Oregon Coast, and it was a grand view all the way.

I highly recommend both of these poets’ recent books: Kelli’s Letters from the Emily Dickinson Room (White Pine Press Poetry Prize, 2011) which had roots in the actual Emily Dickinson room at Sylvia’s Beach House at Nye Beach where the retreat was held. (I stayed in the Gertrude Stein room!) And Susan’s most recent book The Alchemist Kitchen (White Pine Press, 2010).

This week I have 2 or 3 days of clinic work ahead, and today I’m trying to figure out a more concrete plan for blogging and poem-writing. I don’t think I can continue to blog everyday and write a poem everyday. I knew this would be a difficult transition for me, this summer of writing everyday has spoiled me. I want to be both realistic and persistent.  Blogging daily has been a way of staying alive as a writer, testing my ability to share my particular and peculiar  thoughts; and posting poems everyday has been an amazing journey.

I think I’m going to cut down the blog to once a week for the time being. I’m going to see if, despite a new work schedule, I can still get a poem posted everyday. Or close to that.

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6 Responses to 9/13/11: routine interruptus

  1. Susan Rich says:

    Hi Risa,
    So glad to meet you in person this weekend and to find you here out in the ether. I’m so glad that you enjoyed the retreat. I did as well — and am having a hard time getting used to regular life and keeping the retreat mind at the same time… Love the Frida Kahlo background. There is a Mexican restaurant in Lynnewood called Casa Azul with a full Kahlo theme — and the best Mexican food this side of the border…

  2. mark says:

    Whenever you write it’s like home to me but right now I want to wish you all the best with the new job!

  3. Robin says:

    So, the research says that if you don’t look away from the patient for more than a minute at a time (I’m not sure of the exact number, but it’s around that), the patient doesn’t experience it as distancing — I suspect it’s related to professionals who look at the paper record, or some other written material, under the “old system”. I don’t know how you train yourself to re-engage that frequently, but I thought it was an interesting result.

    I think that soon EMR access will be on tablet computers, and it will be a much easier to stay engaged while updating the record. But some of the problem is that medical folks are required to enter much more data than they did under paper conditions, which is another mixed bag. With luck it leads to better care.

    • Thanks for your thoughts. Interesting research. The “much more” data entered is simply for capturing billing elements and preventing liability, I don’t experience that it improves care in any manner (other than being legible and tractable), and detracts from the ability to think of the encounter as “listening and recording the patient’s illness story.” Unfortunately there are ergonomics involved also. I will be working in a dozen or more different clinics, each with 2-4 exam rooms. The location of the new computers in each room ranges from “not too bad” to “see my back”. This particular program is also not at all intuitive. In the past, I’ve always completed the encounter and then filled out the EMR, sometimes much later into the evening. This job requires that I complete documentation before the patient can leave. So I’m sure I’ll get used to it and be glad to be done with it. Regardless, I do think the machine-in-the-middle does have a distancing effect on the relationship, which, as you know, generally involves about five minutes of intimate conversation that may or may not establish a therapeutic relationship.

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