PHN Research Agenda

30 April 2010

The Unanticipated

Some days seem to be plodding along, moving down the to-do list, but are suddenly blow apart. The flow stopped, screeching-breaks stopped, and the to-do list become irrelevant. Sure, we all know that these things happen, but we can never anticipate when or in exactly what form.  Today was one of those days.

I'll outline the issue and protect the innocent, as the saying goes.

A huge part of public health is working with public health professionals, while being steadfast to our agendas and intentions. We all try to do our best. We try to be clear communicators and excel at listening. We try to compromise and negotiate new paths toward the goal. We try to create and invent optimal solutions without stopping as we move forward. We try to cooperate with each other and still get done what we need done. But, we are all human and we sometimes fail at one or more of these. And, therein lies the bad chemistry, the frustrations, and the pitfalls.

Mix that with dis-synchronized timing, and there is no alternative but to stop and regroup. This can be a good thing, even while it feels really bad.  Unfortunately, the addition of caffeine and adrenaline only exaggerate the negatively.

So, to keep everyone pleased, on-board, one engages in humility, attempts behavior change, does a fair amount of backhoeing, and strategizes next steps.  

29 April 2010

Working from home: Luxury or not

Today I worked from home, spending time on email, revising a manuscript, working on reports, and reading student papers. It felt like a luxury to not be in office clothes (aka in a bathrobe) and staring out the window at my backyard. For the past 6 months I needed to be in the office every day for grant related activities, school meetings, or student advising. Most of my fellow faculty have regularly scheduled days for working at home. So, if I gleefully said to them I got to work at home, they'd have a puzzled look.

It ought to be a win-win; the university saves on office lights and computer electricity, and I save on commuting to the office. But, it's more complicated than that. I lose on my electricity bill and the lack of comradary. There are other losses for the university, and the need to have polices for working from home.  Nonetheless, I feel fortunate to have a job that makes it possible to work from home. Flexibility is a good thing.

On a more intellectual note ~ the theme for the day was publishing, peer reviews, and editing. The debate on the value of peer reviewing is alive and well, with science being generated on the topic. Seems tautological, but then...

27 April 2010

Meetings, meetings, meetings

Today consisted of back-to-back teleconferences and meetings. All useful, but 5 hours of meetings gets to feeling weird. Teleconferencing has become a norm, at least in my life. When you work with colleagues and scholars from around the nation, with three time zones, teleconferencing makes it possible. In the scheme of things, it wasn't that long ago when teleconferences were a big deal, special, unusual. Now we casually move the tripod mic from room to room, like carrying a jelly fish with all those wires dangling in a perpetual tangle.

What were the meetings about?
The first started 20 minutes late after a flurry of emails to find a working call-in phone number....gotta love technology. It was to bring two groups together with an eye toward stronger collaboration. But, well, it wasn't working for me. All I could think was "Does this mean that funding will be somehow cut for one or the other of us?" Without a doubt, efficiencies can be gained, but insecurity prevails.

The second was for my AHRQ grant. I brought together the speakers as a first step toward having a coherent set of presentations.  It was hard for me to interpret the silence; where there questions, was there teeth grinding, was the challenge a bit overwhelming? Time will tell. But, at least I now have speakers lined up.

The third meeting only had two people on the phone, with the rest of us in the room. It's the end of this grant intervention and the tasks are winding down. The mood was a mix of sadness to be ending, anxiety about the work involved to wrap up the evaluation, and casual familiarity. We ended the meeting with a discussion of how/where to celebrate the end. We all sat there, as though waiting for someone to say the end is not coming. We'll have to write some grants to have more projects together.

I ended the day by drafting a letter of nomination for myself. Those can be hard to do because it requires absolutely no modesty or humility, followed by prayers and finger crossing.

26 April 2010

Meandering Monday

This is one of those with low anxiety, low pressure, and without a clear theme, which makes it a day requiring self-discipline and self-direction. I worked at home for a bit before heading into the office. Specifically, working to identify one last speaker for the AHRQ conference. Once at the office, the morning meetings were short, efficient and laced with easy conversation. This afternoon will have more intensity, based on personalities. I MUST work on my editorship; I'm woefully behind on processing manuscripts. And, I need to be sure all is in order for the meetings tomorrow.

Late in the afternoon, I have a skype conversation about my trip to Chile. More on that after the call.

Now, back to task.

23 April 2010

TGIF

Grey skies, cool temperatures, and empty halls. Friday. No classes, no faculty, no students. Just me and my computer. Well, and a few staff members and the Divison Chair. Time focused on grant work ~ planning next steps, editing documents, dealing with IRB and HR issues, making Editor decisions, surfing for ideal speakers, having too many documents open at once, and finally reaching "time to go."'  All the while streaming baroque.

22 April 2010

Joys and Toil

A rare event in my professional life occured today; a doctoral student defended her dissertation. Successfully goes without saying in this case. Sure, this time of year, across the nation, it's probably a daily event. But, each faculty has only 2-3 doctoral students at a time. So, for us, it's not a daily event, or even an annual event.

We spend years nurturing, reassuring, educating, guiding, mentoring. cajoling, learning from each doctoral student. It's a pregnancy that lasts three times longer that of elephants. Mostly, its a pregnancy and a journey we enjoy, that we take very seriously, and set as a high priority. But, like any pregnancy, some are easier than others and some "births" are easier than others. This one was almost like not being pregnant. Easy, enjoyable, with a smooth passage into the new life. Although the student would say otherwise.

A doctoral defense consists of the committee members meeting, the student presenting the research to anyone who chooses to attend the public presentation, then the committee meets with the student for in depth questioning and discussion, followed by an executive session of only the doctoral committee members. We schedule 2 hours for the whole thing. During the executive session, the group votes pass/fail. We all hope for a quick unanimous pass decision, as happened here. But, somethings things are not so smooth and the executive session turns into a battle between members over what would be required, beyond what was presented, for the student to pass. We have all horror stories of being involved in one or two of those, but thankfully those are the exceptions.

After the hugs and hand shakes and the relieved chatter, we meander back to our offices to face the more mundane. I  went to the office and faced human resources problems related to my KRISP grant. I reviewed for the last time the grant renewal application and made sure it was submitted via the web to HRSA. Done, and a day to spare.  Then I spent 2 hours with an RA (graduate research assistrant) re-coding statements from public health nurse job descriptions. Tedious, but finished. That too was part of the KRISP grant.

My day ended with a surprise visit from a friend. We sat in my office and chatted, happy to see each other. It was a great excuse and wonderful way to end the day.

21 April 2010

A Day in the Fields

Today was a reality check, and reality changing. Not to be grandiose, but tiny changing and solid reality.

The day started with a drive from Peoria (where I stayed with a friend and colleague) to the smallish building, literally in the middle of cornfields, also the geographic center of the county and chosen as the best location in terms of county politics. The fields are being plowed and planted; the dust makes a faint light brown haze that hangs near the horizon. I was there to speak to a group of public health nurses about the KRISP grant. I wasn't sure what to expect, and was prepared to ad lib a lot.

The room was full, with a line going toward the breakfast brought by the director. Food surely gets staff to an 8:30am meeting. I spent 1.5 hours talking about the project, about the public health core functions, about the relationship of quality improvement to nurse recruitment and retention, etc. The questions were good, including the one of "what does health care reform mean for public health?"  Answer: LOTS!  I left feeling hopeful that these public health nurses would be engaged and grow professionally over the next two years.

Then we drove back to Peoria and met with a small group of supervisors at that health department. Again, spending 1.5 hours talking about the KRISP project, answering questions that were thoughtful and beginning to move toward taking action steps. Baby steps, and that's fine.

After a brief lunch, we headed back to the first health department to meet with the health administrator. We talked for an hour, addressing questions, giving explanations, and finding common ground. 

And, why the hell don't we have a national immunization registry, instead of state by state?! What century is this country in anyway? Why not have a web-based system that all providers and parents can access? It's a no-brainer. We have the technology, but not the collective will. How can the health departments do true quality improvement processes without having current data? It's mind boggling. Yes, 2 minutes on this soap box brought knowing but resigned smiles and nods from everyone. After all, they were the choir....

The reality checks were: unions must be included in planning and brought along in a positive way; the state has not paid counties for services and that means hardship for the county health departments; everyone has a boss that needs to be attended to; people are in public health out of passion and commitment rather than for the money, I love getting involved, and the whole experience is better when shared and mutually supported by a colleague.

20 April 2010

4 hours and counting

This morning I set out to work 4 hours from 7am to 11, but it end up being closer to noon.  I stream radio when I start work, pause when I get up (bathroom, tea, stretch, check Blog or Facebook), and resume the clock and stream when I resume work.  All those little "breaks" take a huge chuck out of a work day.  Still, the 4 hours were productive, resulting in small progress on the AHRQ conference grant.

Now, I need to shower, pack and hit the road barely ahead of rush hour traffic headed out of Chicago. I'm off to see, not the Wizard, but two of the local health departments that participating in my KRISP grant.  Tomorrow will be heavy "This is public health."  I still need to work on the ppt presentation for the 8:30am meeting. I also need to choose a  few handouts for the meetings.  I'll do that in the shower.

It's a long drive for two short meetings, which are a 30 minute drive from each other. Sometimes, physical presence is required to nudge things along and lend credibility to the project. I'm not complaining. On the drive down to Peoria, I'll be rehearing what I'll say, strategizing how best to get buy-in from all the nursing staff, and thinking about manuscripts that can come from this. Car time is not for books-on-tape, not when it's work travel. The clock will be ticking; thinking and driving does count as multitasking.

19 April 2010

Meaningful Meetings

When faculty say they have meetings, most eyes glaze over out of fear of boredom. Their fears, my fears are only partially justified.

Three types of faculty exist: those who bring piles of other things to do and pretend to be multitasking, those who only bring a smart phone and are constantly looking in their lap, and those who bring nothing except a cup of coffee. Oh, the fourth type is those who don't show. I tend to be slightly like the first group, with a heavy dose of the third type.

The MCH (Maternal and Child Health) faculty met for 1.5 hours. We meet in a room with mid-20th century hospital green tiles that remain from when this building was a psych hospital. We use this room for all the department faculty meetings. We sit around one long table with the teleconference phone in the middle of the table, regardless of whether anyone calls in. Today, we were fairly focused and moved through the agenda, until we got taking about the characteristics of students and how best to help them learn. At this point, the meeting takes on a faint flavor of group therapy, sharing of horror stories and frustrations. But, in the end, our focus returns to "what can we do" to improve courses and curriculum.

We finished early so I did email. Thankfully nothing urgent. Then off to the next meeting.

The all SPH Faculty meeting is held in a decent room with the new meeting tables arranged in a very large square that does not accommodate everyone. Amazingly, the room was full for this meeting. The room is so large that a second TV screen is mounted on the wall in the middle of the room, so those in the back can see the presentations. The agenda included 45 minutes focused on implementing a intranet in the SPH. (We are so last century!) 

This was followed by a lively discussion of revision of the MPH. Faculty ranged from engaged, defensive, and concerned, but most were moderately supportive. This discussion, while a bit tedious, was true faculty governance; The faculty making decisions about curricula, taking a leadership role in making things happen. The Dean listened, providing occasional reassurance that resources will be available for the revisions, whatever those might eventually be. 

The dilemma was the same ~ how to best structure the courses and the curriculum so that the MPH graduates are ready for jobs and life long learning. It's not an easy dilemma to solve, and that's why we spend so much time focused on it. The world changes, our students change, we change (or not), and all that requires that we do the "same old" in a new way.  The product must evolve.

18 April 2010

Student Dilemma #1: Post-doc or not?

Working with doctoral students has its own set of challenges. The closest analogy is to having teenagers who are moving out and starting their own life. What to do you say to make everything okay? How can you love and support them while letting them go? The uncertainties of which path to take will soon become a past memory, but at the moment those uncertainties loom, casting self-doubt and creating uncomfortable decisions.

Here's an example, from PhD student who will graduate this summer. A bright student, quiet and determined.

Student Question: I have been offered a NRSA Primary Care Research post-doc fellowship at Nameless University and I am also being considered (flyout this Friday) for a Sr. Researcher position at Famous Company in DC leading the Healthcare Cost and Utilization Project for AHRQ. While the post-doc would provide me with additional skills, training, and publication opportunities with the strong mentoring team they have in place, I am eager to enter the workforce and start earning a salary again in a position that has a balanced work/life schedule. Also, I am not sure that I want a long-term career in academia because of the high expectations and immense pressure to publish or perish. In addition, I would love to be immersed in the health policy world of DC and I cannot see myself staying for an extended period in Texas. Thus, it would be an opportunity cost and tiresome to keep moving locations. Any suggestions would be greatly appreciated

My reply: First, post-docs aren't for everyone. It's got to fit with long-term goals and having a strong mentor as part of the post-doc. Don't feel bad about turning it down. I understand about not being set on an academic future. The publish or perish mindset does vary by institution, so it IS possible to find an academic job that would have less pressure. But, I'm not sure you'd be happy in such a university.

Second, always go with your passion! It is impossible to predict where your passion will take you, but you'll be doing what you love along the way. That counts for a LOT. Also, following your passion is likely to have a theme, and you'll build your expertise around that theme. Which is good scholarship, wherever the scholarship is practiced.  Remember, life tends to be "better" when we move toward what we want, rather than when we try to avoid something.

Third, moving has gotten harder over the years. No doubt about it. We have more stuff; there are more new number sequences to memorize; and, building new place-bound friendships is harder. In short, I emphasize with the desire to minimize the moving.

No comment on Texas, except to say that everything is big in Texas ~ big belt buckles, big hair, and big egos.

17 April 2010

Saturday Work Plan

The clear blue sky and the mild temperature are weighed against the To Do List, and more importantly against the anxiety that I know will come if that list is ignored. It's not bad, as my lists go ~

(a) Edit the narrative for the non-competing renewal application for the KRISP grant. This I can do sitting outside. With the deadline for submission only days away this has high priority.

(b) Read and edit student papers. Also an outdoor possible. Can I count it as multi-tasking if I am tanning my legs and swearing at students?

(c) Do a manuscript review for Public Health Nursing. Half doable outside.

(d) Type up the minutes from the CHS Curriculum Committee. A late night burned out activity.

(e) Work on the AHRQ grant. This is the biggie with lots of active avoidance attached. But, the deadlines give me no choice. I must work on the budget and speaker list.

Blog Impetus

Blogs have an impetus for being. The impetus for this blog was a conversation during the doctoral seminar yesterday morning. The seminar is designed for PhD students as a means for them to get to know each other, aka create cohort cohesion, and foster professional development. We hold class in the lounge area on the 6th floor of the School of Public Health, mostly because I did not feel like having a classroom atmosphere and knew that with a small number of students a casual environment would be a good fit with the intent of the course.

The 8 women, first and second year PhD students in Community Health Sciences, had lots of questions about "academic life". I found myself acknowledging that the general public, or even my family, does not have an accurate idea of what professors do, their full set of activities. Then, I found myself saying that it's our fault for not explaining our job. Maybe a blog would help. Their faces lit up and gave a resounding "yes, you ought to do that." It's one of those ideas that sounds good as it travels across the air, but gains weight as it passes through the gray matter.

As I drove home on the slow freeway, 7 hours after class let out, I resolved to blog. Not as an act of arrogance that my academic life is special, but as a humble act to rectify the gap we had identified hours ago.

For those who don't know me, there's my Community of Science profile with all the academic credentials and products. For a peak at the slightly more personal, I'm on Facebook, but be sure to mention that you are a blog follower in your friend request. But neither of those virtual presentations of self convey why I work 50 hours a week or what I do during those 50 hours. For that information, I blog.