Hopkins 1 Shelby Hopkins ENGL 1101 Ms.

Carrie Sippy

At Novant Health Rowan Medical Center in the fall semester of 2013, I was able to observe the telecommunication center. I decided to observe this community at two different times during the day so I could view all aspects of this environment. The first observation was performed at 8:00 in the morning on Monday, November 11th and the second set of notes was observed at 12:00 in the afternoon on Wednesday, November 13th. During my observations, I witnessed how employed individuals, all being women, within this environment interact with one another and how they communicate with the rest of the hospital; these interactions included employee-to-employee, employee-to-boss, and employee-to-outsider relations. Since the telecommunication center allows all other individuals within the hospital to communicate with one another, it is essential that this community run smoothly without any mistakes. My main goal was to discover what this environment revolves around and become familiar with the main features allowing the individuals to successfully perform the tasks within their office. Apart from my observations, I sat down with an individual from the telecommunication center named Jennifer and interviewed her about this community that she is involved in. I asked her several diverse questions to get a better understanding of how the environment works and what her roles was in it. She has been working in this center within the hospital for four years and has grown to love her job and the people she works with. Her previous job was in a similar environment but she was unexpectedly laid

Hopkins 2 off; she then gained this job because she was looking for another occupation in healthcare. While observing, I made assumption about the relationship between all of the workers within this environment but during the interview I wanted to know exactly how they were, not how I perceived them. She responded by saying, I have a good relationship with my supervisor and co-workers. We have respect for each other and work well as a team. We learn more and more from each other everyday. During this interview I wanted to know how she perceives the atmosphere within the office, especially since she is present in it everyday. Jennifer said, Its usually a good work atmosphere but there are a couple of co-workers who come across as negative most of the time and also complain about our supervisor quite a bit. There is gossip and people who talk about others as in any work environment. Mostly our department is a positive place to work. While observing the telecommunications center I did not witness any drama or negative individuals, this may have been because I was a spectator and they were acting professional and kind in front of me, as a visitor. One of the first things I noticed whenever I walked in the telecommunications center to perform my observations was the formation in which the room was set up. Three large desks were arranged so they were facing one another in a circular configuration. While continuing my observations, the reasoning behind the arrangement of the desks became obvious; it was so the women could communication with one another without hassle. They constantly talked between one another while being in this environment, discussing calls and asking questions. When observing and an alarm went off to indicate a code, the women immediately took actions that involved signally each other and communicating without trouble. If the women were not directed towards one

Hopkins 3 another than the communication between them would be delayed, causing postponement in the whole site. Considering the title of this office, telecommunication center, it is apparent that communication is one of the main keys among this group of women. The two main focal means of communication used within this environment is the computer and the telephone. The individuals were constantly answer phone calls that were coming into the hospital. Every caller desired special information or needed his or her phone call to be transferred to different destinations. After the purpose of the phone call was discovered, the woman who answered would type some type of information into her computers. Every task they performed somehow connected with the use of these two technologies; this showed me that this environment would not function without them and would be almost impossible to complete with the absence of just one of these technologies. The individuals within the environment rarely wrote any information down while I was observing them. There were a few instances whenever they wrote into some different notebooks that were specifically labeled on the cover. One of these instances occurred whenever a doctor within the hospital called the office and told them that he was going to be unavailable for the next hour and forty-five minutes. At this time two women were currently working and they both pulled out a green notebook and wrote Dr. Smith unavailable from 8:35 a.m. to 10:20 a.m.. Another occurrence where the notebooks were used was both days of the observations whenever codes were called. After the code was announced and everything was finished one of the women working pulled out a blue notebook labeled Code Logbook and jotted down the time, location,

Hopkins 4 and type of code that had formerly transpired. I assume that this type of information in recorded in order for the women to refer to if any questions arise within the office. While communicating with one another the women used certain words that I was unfamiliar with, as if they had created their own language within the office. This language includes codes of stroke, STEMI, and colors of blue, red, yellow, green, and grey. Alarms located around the office activated several times during my observations; immediately phrases were shouted aloud and several actions were performed. It was apparent that being knowledgeable of this language within this office was essential and if an individual did not know the office lingo, he or she would be lost. Until my interview with Jennifer, where she further defined words I did not know, I was confused about the dialect that was spoken during my observations. Jennifer stated, It is very important to know certain terms and to complete this job without errors; a small error can cause delays in patient care during a life threatening situation. One of the biggest impressions that this community made on me was the way they come together as a group instead of individual people. The conversation with Jennifer that amended me most escalated when I asked her about the feelings or emotions that were transferred between her and other individuals within the office. She answered by saying, We all take pride in what we do. We laugh a lot at ourselves and also things we hear on the phone. We talk about our families to one another and share the good and bad things that happen in our lives. We care about each other and give support and encouragement. Like all relationships, sometimes we get on each others nerves but I look at these people as my work family. Having this interview, mainly this conversation within it, made me realize that this community has been formed to resemble

Hopkins 5 qualities of a family; this allowed me to make the comparison between the telecommunication center and my own family; consenting me to better understand how the environment revolves around the reliance of one another, as a team instead of individuals.

Hopkins 6 Notes Day 1: Its 8:00 in the morning on Monday, November 11th at Novant Health Rowan Medical Center in the telecommunications center. 8:00- I walk into the office like room and I come in contact with one female, Denise, sitting at a desk with a computer in front of here and a phone located to the left of her. I quietly sit at the eating table where there is also a coffee maker and a refrigerator. The first thing I notice is how the desks are arranged, three rather large desks and in the middle of the room and theyre all facing towards one another. I believe this is so the individuals can face one another and communicate without hassle. 8:10- The first telephone rings and Denise answers it on the first ring. She answers saying, Novant Health Rowan Medical Center, how can I help you. Immediately she types some information into the computer. I assume the computer is her main source to get and give information. She tells the person on the phone that she is transferring the call to the desired patients room. She then hangs up the phone. 8:13- After getting off the phone she pulls out a binder, which is labeled physicians call schedules. She sorts through the binder while typing the names and times into a spreadsheet on her computer. 8:21- Another call comes in and Denise puts aside the binder and answers by the second ring. She answers this time by simply saying, Operator. After listening to the caller she says, One moment please and dials an extension number into the phone. She then hangs up. 8:25- At this time several phones begin to ring. She answers them one at a time continuing the pattern of asking them what they need and transferring their phone call to their destination. 8:27- Another female, Judy, enters the office carrying a pocketbook and McDonalds. She asks Denise how the morning has been and Denise replies that it has been pretty busy. Judy immediately places her belongings into the desk across from Denise and sits down into the chair. She logs into the computer using a username and password and begins answering phone calls. 8:30- Denise takes off her headset and gets up out of her desk chair. She walks over to the coffee pot and begins to make herself a cup of coffee. I assume because Judy is now her that Denise can take a small break because she has been working and answering phones by herself. 8:34- Denise is finished making her coffee and returns back to her desks to continue answering the phones. 8:35- A phone rings and Judy answers it saying, Operator, how can I help you. She then announces to Denise that it is Dr. Smith on the line and he is informing them that he will be unavailable for the next hour and forty-five minutes. Dr. Jones will take his calls until then. Both ladies then write this information into a green logbook located at each desk. 8:40- At this time, the communication supervisor, Angela, walks into the room and says, Good morning. She then walks over the door and begin to unlock it. I assume this is her personal office.

Hopkins 7 8:42- The incoming calls cease and Angela walks out of her office. She begins to talk to the two women about a crazy incident that occurred at her house last night involving her five-year-old daughter and some permanently markers. Everyone laughs, including me. 8:44- Angela goes back into her office and shuts the door. 8:47- An alarm goes off and the ladies jump to attention. There is a monitor that is mounted on the wall that reads, Code Blue ICU. Judy looks at Denise and says, Im going overhead then presses a few buttons on her phone and announces, Code Blue ICU. Code Blue ICU. Code Blue ICU. I assume she tells Denise this statement so she knows to be quiet while announcing on the intercom. These words were announced over the loud hospital intercom. Although I am not sure what the alarm meant, I knew it was serious because of how the women reacted. Denise says, I have the Page. Judy then got on the two-way radio and said, Switchboard to safety. Someone on the radio replied, Safety, go ahead. Judy said, Code Blue ICU. The man on the other side of the radio replied, 10-4. While Judy was talking on the radio, Denise calmly typed on her computer, I assume she was paging other staff about the code that was announced. 8:50- Judy locates a blue notebook that is labeled Code Logbook. She writes in it, assuming she is writing the code that was just called. 8:52- Several call lines are lighting up in the phone console. The women dropped everything whenever the code was drop. They now rush the calls and apologize the callers for the wait. 8:55- Judy takes off her headset, stands up, and asks Denise if she will be okay while she uses the restroom. Denise replies, I got it, take it your time. 8:57- A male in blue scrubs walks into the room. He tells Denise that his pager has recently broken and he is in need of a new one. Denise gets on the phone and calls her supervisor to come out of her office and get Dr. Brown a new pager. Angela opens her office door and says, Good morning Dr. Brown. Please come into my office and I will get you a replacement pager. They then both go into her office. 8:59- Judy returns from her break and sit downs at her desk. 9:00 Dr. Brown exits from Angelas office and tells the women, I hope you ladies have a great day!

Notes Day 2: Its 12:00 in the afternoon on Wednesday November 13 at Novant Health Rowan Medical Center in the telecommunications center. 12:00- Denise and Judy are at their desks, answering phones as I walk in. I once again sit at the eating table that I sat at Monday. Angela is in her office and the door is cracked. 12:05- Strobe lights begin flashing and sirens immediately begin screeching in the hallway. Denise reaches for a wooden box that is mounted between the desks, so everyone can reach it, and presses a button that silences the fire alarm. She writes down information displayed on the box into her green notebook at her desk. Denise pressing several buttons on her phone, looks a Judy and says, Im going overhead, and then announces on the intercom, Code Red, 3rd floor Break Room. Code Red, 3rd floor Break Room. Code Red, 3rd floor Break Room. She then gets on the two-way radio and said, Switchboard to safety. Someone on the radio replied, Safety, go ahead. Denise says, Code Red, 3rd room Break Room. The man on the other side of the radio replied, 10-

Hopkins 8 4. While Denise was talking on the radio, Judy types on her computer and pages several different staff informing them about the code that was announced. This is the same process that occurred Monday during a Code Blue. The fire alarms are still flashing in the hallways but the sirens are silent. 12:15- Judy takes her headset off and places it on her desk. She then gets up and asks Denise if she wants anything from the cafeteria. Denise replies, No thank you, but enjoy your lunch! 12:20- Angela comes out of her office and sits down at the desk Judy just left. She puts on the headset and I assume she is helping Denise answer the phones while Judy goes to lunch. 12:25- Denise walks to the refrigerator and gets a Diet Mountain Dew. She offers Angela one and Angela says no. Denise walks back to her desk and resumes answering phone calls. 12:31- On the intercom, a lullaby begins playing. Denise says, Awh, a baby. I assume this music plays every time a baby is born within the medical center. 12:35- A female wearing a white lab coat walks into the office. She asks the women how they are doing and they reply that they are doing okay. She then walks to the empty desk where there is a bowl that as full of candy. She grabs a snickers bar and says, this is just the thing I need to get me through the rest of my shift. All the individuals laugh as the women exits the room. 12:39- The phone continues to ring while the women answer them and direct the callers to who they intend to talk to. This process continues until Judy gets back from lunch. 12:43- Judy walks back into the office with a Styrofoam cup in her hand. Angela sees her and jumps up from the desks and announces that she is now going to lunch. 12:45- Angela goes into her office, grabs her purse, and heads out the door. 12:50- Between calls Denise asks Judy what she had for lunch. Judy replies and says that she had a cheeseburger and fries from the caf. 12:51- A female, Lauren, walks into the door and says hey to Judy and Denise. She then sits down at the third desk and turns on the computer. While waiting she looks at her cell phone. 12:53- Denise begins to pack up her belongings around her desk and turns off her computer. She uses antibacterial whips to sanitize her station. I assume Lauren is taking her spot because her shift is almost over. 12:55- Angela walks into the office and says she is going to eat lunch in her office because the cafeteria was too full. 12:57- Denises shift is over, she puts her belongings into her rolling book bag and says bye to all of her co-workers. They all reply with a friendly bye and she exits the office

Interview Questions Thursday November 14th, 2013 I completed this interview with Denise after my observations day 2 at the hospital. We sat outside of the office where the individuals of the environment usually eat lunch or dinner while on break.

Hopkins 9 How long have you worked in the telecommunications center of this hospital? I have worked here for four years. What made you decide to apply to this job (become a part of this environment)? I got laid off and way looking for another job in healthcare. How is your relationship with your boss? Co-workers? I have a good relationship with my supervisor and co-workers. We have respect for each other and work well as a team. We learned more and more from each other everyday. What role do you play in this environment? I have an integral role in the communications network for our entire hospital, connecting patients to doctors, doctors to doctors, doctors to other hospitals, and family members to patients. Describe feelings or emotions that are transferred between you and other individuals within this environment while communicating. We all take pride in what we do. We laugh a lot both at ourselves and things we hear on the phone. We talk about our families to one another and share the good and bad things that happen in our lives. We care about each other and give support and encouragement. Like all relationships, sometimes we get on each others nerves. Do any emotional moments come with this job? We are happy when we hear the lullaby and saddened when a patient has passed away even when we do not know these people. Would you say that there is a bond between you and these individuals? I guess this is my work family. We definitely have a bond and just like a real family, we have ups and downs! How important is it to complete your job without error? It is very important most of the time because errors can cause delays in patient care in life threatening situations. How is the atmosphere within the office? Does it differ whenever you are working with different people or whenever the boss is absent? Its usually a good work atmosphere but there are a couple of co-workers who are negative most of the time and complain about our supervisor quite a bit. There is gossip and people who talk about others as in any work environment. Mostly our department is a positive place to work. Out supervisor is pretty laid back therefore it is usually the same whether she is there or not. How do you deal with conflicts with individuals that call the hospital? I remain calm, listen to them, and then offer a solution. If following these steps do not work than I contact my supervisor or patient advocate. Usually they just want someone who cares to listen to them. Compassion