K.J. Page, a nursing home administrator in California, walks down the corridor
and heads into the meeting room. She smiles at the supervisors who are seated
around the table and sinks into the same seat she takes every morning.
"Every morning we meet so that we can catch up on what's up for the day,"
says Page. "It's also a chance for me to hear about the kinds of things that
have happened in the last 16 hours."
This morning, Page wants to discuss a new resident that is having difficulty
adjusting to life at the nursing home. The problem is simple to solve: have
the patient bring in her personal possessions and speak with her and her family
to find other ways to make her more comfortable.
The rest of the meeting covers other issues, some more difficult to resolve.
"It's my job to coordinate all the activities that are needed for care,"
says Page. "I have to know what's happening with the staff on the floor. My
job is then to supervise supervisors."
Every move that is made at the hospital ultimately falls under Page's responsibility.
"I don't do all this work, but I have to make sure those who need medication
have it on time, everyone is showered and dried, those who can't feed themselves
are fed," she says. "I have to make sure everything meets state requirements."
Page spends a good portion of her day in her office going over budgets
and writing reports. Yet her role is not confined to this space.
"I'm out on the floor every day," she says. "I know all the patients and
I know their families."
Page and other nursing home administrators have the chance to develop relationships
with the patients because homes are generally smaller, and because patients
often stay for long periods of time (compared with an acute care hospital).
Page tries to make her hospital a comfy warm place by talking with patients,
and by good financial management. It's tough. "We have under $95 per person
per day to look after food, medication and facility costs. It's very difficult."
In order to get the most out of a budget, Page has to understand all aspects
of running the hospital. "I even have to know a little bit about roofing,
so that we'll get a good bid," she says.
It's the variety in this job that makes it so interesting.
"This is a very varied job," says Kristin Schmitz, a nursing home administrator.
"You have to know about financing, budgets, writing letters, and you also
have to like going on rounds to visit with patients. Being able to do so many
things is also one of the most rewarding parts of the job."
Other health services administrators agree that the job is rewarding. The
highlight for Garth Pierce was being responsible for designing and building
a brand new health center.
"I'd say that's probably my biggest accomplishment -- the one I'll want
to tell my grandchildren about," he says.
The many challenges of this job can also translate into stress.
"You're dealing with sickness and health," says Pierce. "The number of
people needed to make a hospital run is phenomenal: doctors, nurses, pharmacists
and the list goes on. You're trying to do more with less in a world of rapidly
changing technology. The diagnostic equipment they have today I'd never heard
of five years ago. The drugs they have today I'd never heard of one year ago.
So I guess you could say it's stressful."
Pierce didn't always want a career in hospital administration. He was actually
studying to become a doctor when he spoke to some people about hospital administration.
Something clicked.
"The whole field sounded so interesting. I was really excited," he recalls.
So, he switched programs and graduated with a master's degree in health-care
administration.
The many changes in health care have meant that over the years Pierce has
had to close wards and lay off employees. While Pierce doesn't like the human
cost of downsizing, he says the exercise of figuring out how to do things
better for less is fun.
"Every day is different -- there's never boredom."
It's also a challenge to make sure the hospital keeps up with the recent
diagnostic and surgical innovations.
"A patient used to take six days in hospital to recover from a gallbladder
operation....Now there's a surgical procedure which is less invasive and it
means they only spend one or two days in hospital."
Pierce says a two-day stay in hospital is better for the patient and the
hospital. With fewer beds to go around these days, administrators want to
make sure only the people who are really sick are kept in hospital.