Software Developer

Computers & Technology, uncategorized

1:06

Q: Would you please state your job title, where you currently work, and how long it’s been since you graduated from college?

A: Wow. Um, so I am a senior principal engineer and senior director of visualization solutions at Intel corporation. Oh, and it’s been–

Q: Ballpark’s fine.

A: Thirty five years.


Q: Okay, and of that time, how long have you been in your current field?

A: Um, interesting how you would say that. Probably– depends on what you mean by current field, but in software development and whatever, whole time.

Q: Whole time? Great, thank you. Can you provide a brief description of what your primary job functions are?

A: So I manage a team of engineers, software developers, who develop graphics rendering and visualization software used mainly for two purposes: one is to make animated movies and special visual effects using a technique called ray tracing, which is algorithmically something, a compute task that models the physics of light, so you can get photorealistic things out of it, and secondly, scientific visualization used on high-performance computing supercomputers across the world for visualizing and seeing 3D models of processes and effects and cosmology and the weather and all that stuff. So the two things are kind of related, in particular in that in the last three/four years the ray tracing side of things, the need to actually see these processes more like a human sees photographs ever has actually come about, and it gives more insight into the data, like fibers attaching to a molecule, or things like that. So while it probably makes sense in the movies, because you’re trying to match, it actually makes a ton of sense in scientific vis–

Q: So this has applications in all kinds of different disciplines then?


A: It actually does. Gaming companies use our software, Dreamworks, Pixar, Illumination use it for making their movies, but I also work with Stephen Hawking’s team to watch black holes collide – things you can’t physically see but know physically are happening in the universe.

Q: Wow that’s incredible. Could you estimate, basically in an average week, what percentage of your job requires you to write? So zero to 25 percent, 25 to 50, 50 to 75, or 75 to 100?

A: I’m probably not going to use the right one; it’s right around 50 percent. Actually, most of the time I spend writing. So, it’s 50 to 75 I would say.

Q: Okay, great, excellent. What forms or types of writing are you most often asked to complete? Any particular modes or audiences, for example memos, emails, reports, proposals, those kinds of things?

A: Right. Yeah, audiences are varied, from communicating more deeply what I just told you, so lots of Powerpoint but with writing and visuals. And the audience can be technical sales people at Intel, it can be NASA Goddard, who I just visited [chuckle], so it can be NASA large supercomputing centers, or these same companies I talked about, Dreamworks, things like that. Internally also, I have a foot in the technology and the business end of what we do, so senior management’s VPs at Intel, present to them at well.

Q: Sure. So when you’re talking say, specifically or writing to sales folks at Intel, are you basically trying to express to them how they can market this technology, or what’s–?

A: Yes, that, and also, there’s one piece of thing about the technology that we do that is non-intuitive, which is, we do all our great visualization and everything on the processor, not a graphics processing unit or a GPU. So everybody thinks GPUs are by far the best thing for visual processing, but for the type of processing we do, they are not, the Intel CPU is. So we help enable Intel products that are– now Intel has GPUs, but they’re normally not very powerful or not in very powerful processors, from my perspective – I’m not saying Intel processors aren’t powerful – I’m in the data center group, so where your computer there might have two or four cores, sometimes if your boss will upgrade you, you might get six cores, I work with computers with 56 cores, and the technology that we use does require that hard performance to get that quality and the visual effect because as I said, we are essentially doing physics processing, and then turning it into a visual as well.

Q: And so then, and again, you don’t have to go into any details with your meeting with NASA, but when you are meeting with an organization like that, is that similarly sort of sales focused, in the sense that you’re trying to get them to use or participate in a certain process, or is it more informational in that they’re after you to help explain processes?

A: It’s always a little of both. I think again, with my technology, because of that non-intuitiveness– so I will tell you a little bit about my NASA visit.

Q: Sure, whatever you’re comfortable with.

A: There’s multiple NASA major sites, this one’s here in the Washington area, NASA Goddard it’s called. There’s also one called NASA Ames, right out in San Francisco area. NASA Ames completely uses our technology up and down. I was showing the NASA Goddard people what the NASA Ames was doing with our technology. The NASA Goddard people hadn’t heard of our technology, I was introducing it to them for the first time, while NASA Ames had used it for four years, five years, six years, something like that, heavily. So I was educating that their own organization used it, but in a sense selling as well, to say like, “Hey, you know, maybe you guys could benefit like the other guys do.” There’s all these benefits to it. And as a more engineering-focused person, I’m not going to sell them a bill of goods or anything, I’m just going to tell them, “This is how it works, this is why I think it’s good, these are the pieces of how you could use your system with this.” So it’s education with a sales twist I guess. You’re trying to get somebody to understand that you’ve maybe got the greatest thing since sliced bread, but maybe they need to see the sliced bread, you know, maybe they’re used to the other. So it’s a little bit of both whenever I’m talking to anyone.

Q: Sure. Great, that’s really helpful. So, we’ve maybe covered a little bit of this but, and maybe you can use the same example if you’d like, but could you walk us through the process of maybe one specific recent project that you’ve had, kind of going from the time that either assignments are given to you, or the assignment is sort of formulated, what kind of preparation you do, what kind of steps you take in your writing to see the project through to completion?

A: Okay. Well there’s– one of the reasons, so I, I mean whether this is recorded or not is fine, do you want to talk about the books I’ve written, or do you want to focus on what I do day to– you know, are you going to jump to the books, or do you want me to introduce those to you?

Q: Sure, if you’d like to, yeah.

A: Okay. So because the process of the books that I’ve been involved in writing, to me was really interesting, and also very, very detailed. While the content was detailed, the actual process of making sure that that book came out was– one, I have a writing partner, James Rinders, who we hope joins you, and James had written books before, so that was very helpful to me. And then once I understood his background and his perspective, that’s basically a huge learning process, but we mapped out everything. We would sit down, write a bunch of stuff down, you know, white boards, all that kind of stuff. But then we would turn it into an Excel spreadsheet, that– the process of writing a book, for me, after years and years of I think pretty successful software development in a variety of fields, was the most detailed – not the writing part – the saying, “this has to be done by here,” because we’re talking 20-25 chapters, 600-800 page book, deeply technical, but the writing part was close to the easiest. I mean, you would get writers block and all that stuff, but at other times you would just flow and be able to do it. And that was also challenging and enlightening, you wrote and rewrote and rewrote, and then we would share it back and forth. But to me, the thing was the de– was so interesting and unexpected, was the level of detail that we had to go through. Like, if you’re not done on this day, and we were aligning, most of our books were aligned to the release of an Intel product. So we were pre-writing it, and getting the product– so we were writing stuff about pre-launch products– if you don’t know how people build processors and everything, there’s a thing called a stepping, and almost always there’s at least two steps, if not three or four. And by stepping, we mean like, we build one, or we build 100, put them in computers, and try to make them work. And then you find out if there’s a problem, if there’s a performance problem, for high-performance computing, performance is everything, right? So anyway, we were in this process of dealing with the fact that we had a pre-production product that we were trying to write the production manual for. Not really manual, but the production, sort of a technical English version of how to use this thing, and then were learning how to use it as we did it. But the, as I said, so this was all aligned with, “well, product will launch here, we need the book to launch here,” and the detail behind that was really something. We met every week, we met for an hour, hour and a half, just going over the spreadsheet, not writing.

Q: Sounds like a ton of project management.

A: Exactly. Project management up the you know what. We used Excel, I mean Excel was perfect for what we wanted to do. But we would end up sheet after sheet, and we’re here, and then a couple of times, we had other collaborators, we were more editors. So we did two books that were a collective, and managing all those people, one book we had 60 some odd contributors, like multiple per chapter, because of their different expertise, and getting everything from, “well we want to put all your pictures in the thing,” we had to actually program manage getting a headshot for everybody. So it’s very rewarding, but if you’re going to approach doing a book, any kind of book, but in the case of a technical book where you would think, “Well, this person’s a guru, they’re just going to write it, and maybe they need an editor to help them write it,”– interestingly, we both were pretty good at English, I had a Catholic upbringing, all that stuff. So we did have editors who helped us, but they were more asking us questions like, “Should you say it this way or that way?” But anyway, all those books were a project similar in that vein. So I found that really personally interesting when I engaged in the writing. Now in the daily writing of like emails or preparing Powerpoint slides or whatever, the key thing is to think about the message that you’re trying to send. And I don’t always do this, I’m not perfect at it. Often in this hustle-bustle engineering world, you’re trying to get stuff out the door and meet customer demands and all this kind of stuff, sometimes you forget that, and it’s not that you get in trouble, it’s that you end up in a thread back and forth, like, “Oh do you mean this or do you mean that? Do you mean this, do you mean that?” So but for peers, executives, and again, like NASA or whatever, you really have to think about, “What do I want the result to be?” and then work from there. Often you just say, “Oh I know everything about this,” and you just start writing, you think about the education part, but really in the end, if you walk out the door, are they going to forget everything? Usually it’s the classic, leave them with one, two, or three call-to-actions, or just, “I hope you got this.” So that’s one, this is not me, but a manager that I had who’s actually a good friend as well says, “Tell ‘em what you’re going to tell ‘em, tell ‘em, tell ‘em what you told ‘em,” [laughter].

Q: That’s perfect [laughter]. That’s perfect.

A: And that’s a good way, you know, it’s not always every time the right way, but think if that is what you need to do, yeah.

Q: So it sounds like you have a lot of diverse writing experiences. So in the book writing world, when you’re doing this heavy collaboration and project management, and then in your sort of managerial role, when you’re kind of maybe giving directives or sort of setting the agenda, do you find that you prefer collaborative writing versus like, when you get to be the point person? Or do you see similarities or stark differences between when you’re in that sort of collaborative author mode, versus when you’re kind of in control of–

A: Yeah, I think there’s actually differences, yeah, I think, yeah, your role of the moment, right? Sometimes, you know, as a manager or technical leader or whatever, you do need the combination of listening to all the inputs but making a decision. Or you’ve already heard all the inputs and something new comes in and you know what to do. And you’re always balancing a sense of urgency with a sense of correctness. If you can get them both, sense of urgency and correct, usually you should go for it, right? Or at least move the ball forward, if it were, and you know, beg forgiveness later. Sometimes you have to do that. Other times it’s the worst thing to do. You have to listen and collaborate. On any kind of book paper – the other thing that my team does is academic papers, even though we’re a corporation, we do the equivalent of academic papers, we submit them to conferences, all that kind of stuff – and those are always, I haven’t seen one paper from my group that didn’t have at least two people, they’re almost never individual, and they like it that way. With a book, I think I possibly could write one myself now, but I still, just, I happened to get a collaborator who we really, we both thought alike, but we thought differently enough that we could you know, finish each other’s sentences, which sometimes you have to do in a book. And if it’s technical/engineering oriented, you basically always need someone to check your work. You know, always, if you want to be credible, it has o look credible, and you can just [speaker makes sound effect 17:06] fly it out there. So it really depends on the circumstances, I would say lean toward collaboration more. When I work with my team and everything, I don’t consider myself a dictator, I get all the input and everything. Now I sometimes drive them to do stuff, but it’s based on what they’ve done already, so usually they agree with me when I like pick a particular project or whatever. So for instance, the annual supercomputing conference is coming up in Dallas in November, and since we’re so visual, our software and everything, it’s great for demos, it’s great for in the booth, and you can show real live stuff. I tend to listen– most cases we try to get external partners, like the Texas Advanced Computing Center, which an NSF supercomputer, Argonne National Laboratory is going to partner with us, and we use their data and stuff. But one thing is, it’s one, hard to actually get agreement, to use that data, scientific data sometimes is held close, and then it’s brought out to the public, so we’re kind of in there. I often suggest, like we’re going to do one of these, you know, the structure of the demo, how the booth’s going to look I often do myself, but then, and say like, “Hey, you know, we’re going to do this,” but then I spread it among the team members to shepherd it to the end, so.

Q: Interesting. So, this kind of brings us luckily to our next question. You talked about how early on, you know, if you think of like, you know,  tapping a guru to write a technical book, you think it might kind of be easy because they have obviously the knowledge base and the technical skill, but you’ve also detailed like how there’s so much more that goes into actually writing than just having the knowledge base, so how did you know how to do the kinds of writing that you’re doing? It’s obvious that you have obviously the technical skill and experience, but how did you know how to then be able write about that stuff in a way that’s effective for your audience and with your collaborators?

A: Well, I mean, I reach back a little to my, you know, education kind of forced, at least the Catholic schools are known for that. I don’t want to necessarily say that public schools aren’t or whatever, but that focus in the end was the right thing, you know, for me. You really end up kind of communicating in various ways, a lot through writing. And having that confidence in writing I actually think is extremely important to get up in front of an audience and speak, which I now do fairly regularly, which I was horrible at at first. Even you know, but, kind of recognizing the key things in the writing, you know, the plot, whatever the, I guess the messaging is the plot, you know, that kind of thing. So you still kind of, you know, if you engage in that educational form, you have a start, but I do think you have to branch out from just– you’re forced these days to branch out into like I said, like a technical paper, you know, as you get in master’s or whatever you’re now writing. You know, whether you’re a biology PhD like my son is – he’s a writer/editor, he does all this similar stuff – because if you can’t communicate your knowledge, you’re basically going to be locked in– it’s fine if you’re a super mathematician– I remember one time I was with a different company – I won’t say any specifics, – but we were going to hire a math guru, and we talked to him and we just said, “If we hire him we’re going to just shove him in a room, and give him formulas,” and you know, write down what he wanted to do. But he was not going to communicate anything, we would have had to communicate for him. So there are people who are very, very good, very [inaudible 21:22] but in the end, you’re going to have to tell somebody what you did in order to get a raise [chuckle] even, or to keep your job. But from that standpoint, you know, there’s just a lot of experience. Some of it’s trial and error, some of it’s like, “Oh, you’re a new manager,” whatever, I’ve been doing it for a while, but when you first go into management, you actually don’t realize how much writing you’re going to have to do, and communicating you’re going to have to do. You kind of say like, “Okay, hopefully it’s not the Peter principle, right?” But you need to think about that, you know, what’s the message? Who am I communicating to? Who’s the audience? All that stuff is extremely important and extremely easy to forget.

Q: Excellent. Again, brings us to our next point. Can you think of a time, maybe early in your career, where you felt unprepared as a writer at work? Is there a kind of task or skill that you do in your current job that maybe you hadn’t been asked to do before, or you didn’t feel confident in?

A: Oh, I think I would say, again I think a lot of people don’t realize this as writing, but translating words– I’m kind of verbal, and I’m somewhat verbal in my writing, I’m not as terse as I should be, it’s one of the little management criticisms I get. Which meant, taking your knowledge and putting it tersely on a Powerpoint slide was, so when I– this is only the last ten years, I joined Intel ten years ago. And I was mostly used to face-to-face conversational stuff, the occasional – I don’t know if you call it memo – you know, emails, basically emailed memos, basically where you know, “We’re going to do this, we’re going to do that, here’s the status.” You know, status reports, stuff like that, where the detail is needed, you know, you could go a little crazy, the occasional trip report, that kind of thing. But when I had to, I was like, “I can’t do it.” I took this job, it was meant to be sort of a communication-oriented job, and the one thing in the whole interview process and everything they failed to mention was, all our writing, all our communication, almost everything is with Microsoft Powerpoint. Everything has to be boiled down into again, same manager, “Give me three bullet points with no more than, five words is better, eight words max, boom boom boom. And that better be your whole message,” and everything else like that. I was like lost. I was just like, “I’m uncomfortable with this.” I was extremely uncomfortable because I like to get the whole truth out, you know, and nothing but the truth, but to do that in five words? You know, how do you do that? And I still struggle a little bit with it today, but I’m much better now, I’m now comfortable. For instance, I gave a Powerpoint presentation to NASA; of course the good news is is over the ten years I’ve got a whole boatload now of presentations in different forms and stuff, so you do kind of want to get that collective thing, but occasionally I have to start from scratch and do something and it’s challenging. But for the NASA thing, for instance, I prepared for an hour on Saturday to go in front of one of the top customers, you know, or partners/customers in the world, rocket scientists literally, and I just did it in an hour, and you know, comfortable enough with what I’ve done. Other times you can take weeks to craft that thing and hone it, and I start doing silly little things like, “Is there a way to remove a word from this?” you know? And you’re there, can you make it either more powerful or communicate it with more white space? It turns out that people hate, when they see a Powerpoint, to see all words on it. At the same time, I do lots of imagery on mine, but that can be overdone too. You know, you have a pyramid that does this that and the other thing, and you think that just gives the message, and people go, “Huh?” So some of the best ones I’ve seen have been these, the only faintest imagery. I’m all about imagery, so I use a lot, but yeah, like the, “line one, concentrate on this,” you know, the build down there. Other things– people tend to hate builds, but if you use them right– you know what I mean by a build, right? Where you really could do it all in one slide, but the slide builds up over time.

Q: Sure.

A: The best builds actually are the ones that have little very little fanciness to them, and just put another bullet point, another bullet point. And again, there’s two sides of that coin, because as I’ve said before, “tell ‘em what you’re going to tell ‘em, tell ‘em whatever.” Often it’s good in certain cases it’s good for them to be reading this live while you talk, other times they might read bottom up [chuckle], where your message is down here, they’re reading bottom up, and you’re talking about this. So sometimes if you want to lead them somewhere, it’s better, if you’re going to do almost an educational, if it’s more educational you’re going to lead somebody somewhere, then builds are typically good. If you’re reinforcing a core message that they either know or they want to be refined, then sometimes it’s better have everything up there.

Q: Great, thank you. So you’ve talked a little bit about what you’ve already done to overcome those issues, but one thing that struck me when you were talking about sort of your initial discomfort in boiling down something to five or eight words – did you find that your discomfort came from like, your fear of losing, because you’re taking a really complex idea and putting it in so few words, that you were going to misinform somehow? Or was it more kind of in the communication side that you felt like you weren’t able to express yourself or your ideas or your mission as efficiently in those few words?

A: Yeah, I think there’s two things that I’m still, I won’t say struggling, but I still am conscious of it. The other thing with this kind of bullet point communication, if you want to call it that, is the, you’ll often hear somebody, particularly a senior manager or somebody like that, say, “Give me very little, just give me the three words, and just, let’s just talk to it.” I actually found that very difficult. I am very much reading the words on the slide, and then, you know, embellishing. Where sometimes it was, you know, like “What? Question mark,” and then you just, and you know, that’s not going to get you anywhere [chuckle], that you can’t leave it behind and any of that, and you just have a conversation. Again, it’s all about the context, it’s all about where you are. But I still struggle with that. What I find I don’t do too much is actually memorize the slides. The other thing I don’t do, which apparently is really really bad – I almost never rehearse, ever. I just wing it when I go. And that works two ways. One, the rehearsal would make me more nervous that I’m trying to fit within a certain thing, but for me, people say that I’m more real and more enthusiastic when I haven’t done a rehearsal, you know what I mean? So anyway, this is me. I know tons of people including senior managers and stuff, all the time– I actually was good friends with Intel’s number one senior executive, you know, helped them present. He was a good friend of mine, I had him come into my staff and everything, he was there like, “Oh no no, you rehearse four times the amount of time than it takes for you to do, you know, if you have an hour presentation, you rehearse a minimum of four hours,” literally in front of mirrors and all the kind of stuff. And I just can’t do it, my head can’t do it. But so, anybody who reads this, you still might want to rehearse [chuckle] but for me, I found it makes me, people’s feedback normally is is like, “Wow, you were into it!” or “You’re passionate about what you do,” or whatever, “It felt real,” so for me, that’s what we’re–

Q: I find that, for myself too, when I teach, you know, just have just a basic outline of a lecture, rather than have the whole thing in my head, because you’re– if it’s all in your mind already how you’re going to say it, what you’re going to say, you kind of get tripped up in the rehearsal, and you’re not thinking about the things you’re saying. It becomes rote, and you’re not engaged, so you can’t be flexible, you can’t change course, but you also can’t really show a lot of passion about the thing, because you’re not discovering the thoughts as they’re coming–

A: Right, you’re just worried about it, “Did I say everything I was supposed to say?” even though it’s your talk, right?

Q: Exactly, exactly.

A: So, yeah. So that’s one thing I do. But the other thing is is, I do need those clues, I mean, one of the worst things that can happen to me still today is that I physically can’t see the slide, like it’s behind me. I’ve seen people do that, you know, the Bill Gates of the world go in there, you know, and sometimes you have the thing in front of you or whatever, but I really need to see that slide to keep me on track, but then I’ll talk to it. So, anyway.

Q: Great, thanks. So you’ve hit on this already with your book writing and the collaboration, but for Intel, right now, does anyone specifically oversee your writing, or are you kind of– ?

A: Well, at Intel, this will be interesting for you, the people who oversee my writing the most are Intel Legal.

Q: Okay, interesting.

A: Because Intel’s a large corporation, has been involved in, you know, lawsuits because of, whether it’s impressions or whatever, of monopoly, that kind of thing, we actually have to be very careful about utilizing– there’s a couple things we have to be careful about. Not losing or genericizing our trademarks, you know, things like that, so, there’s various trademarks– Intel itself is trademarked, and utilizing that properly within the scope of legal trademarks is usually reviewed. So mostly it’s that. The content itself is not reviewed, you know, they might come back and say, “Boy that was dumbest sentence I ever had.” But they rarely will do that. They’ll just say, “You used Intel wrong here, you used trademark xyz wrong.” We have tons of trademarks, you know, Xeon processors, you always have to use– there’s all these rules. Like you have to say “Intel Xeon processors”, you can’t say Intel Xeon, you can’t just say Xeon, you can’t, you know, all this stuff. And so we have to keep track of that. I’ve learned a lot about that, so mine are normally there. And as far as a monitored no, it’s my job to get– so a review is expected, but it’s my job to either have a peer or somebody on my team work together with me. So I normally don’t do all my own stuff and then go. Someone reviews it somewhere, not because they’re overseeing me, because that is one somewhat standard, and two, the sort of collaborative practice. So I would always have one of my team members, and vice versa. I normally review my team members’ stuff, particularly when they’re going to present like a paper or stuff like that. Actually, I’m required to review their papers, but only for technical like, they accidentally spilled by some IP, some trademark, not trademark but a trade secret, or something not yet patented that we want to do. I normally do it for that. I actually let them collaborate themselves and get the English right and everything, I just sort of– one, I don’t have all that time to do that in what else I do, but for the most part, yeah, Marketing will review when it’s like a conference or anything like that, so it’s, again, depends on the circumstances. For instance, the stuff I did today for NASA, nobody reviewed it, but I used slides that had been reviewed, just the stream and everything I did. So in that weird way, if it’s been legally reviewed, I can use any slide I want in any order I want. It’s not the order with which it is, it’s, “is this legally correct?” And then I can usually do that comfortably. I occasionally go, “Don’t write this one,” [chuckle] no, I try to avoid that, but sometimes you’re asked to do something a day in advance. You know, “Go talk to GM,” or something. And you just go like [speaker makes sound effect 35:05], “this is what you’re going to get.”

Q: So it seems like Legal is mostly judging success of your writing in terms of, does it follow the sort of established protocols for trademarks and legality, all that kind of stuff?

A: Yes, yeah, occasionally, and then if it’s a sort of a Intel-sponsored public event – again we’re actually about to sponsor, you know, be in a separate hotel from the conference and do an Intel thingy – something like that will be reviewed inside out. But mostly they call it legal review. But the person who manages legal review is usually a marketing or communications specialist, like a PR person. They will actually review it for, “Is this just messed up?” So they normally will then come back and comment.

Q: So they’re maybe focused a little more on the persuasiveness of the writing– ?

A: The message. So they’ll come back and say, “This would be better,” particularly if the, there’s usually like a marketing or a sales owner for any of these conferences or one or more, and they typically get some of that stuff. The other thing we write a lot, just so you know, with a technical product, that most people don’t see, even most people at Intel don’t see it, but the people in the know do, are what’s called Q and A’s. So when we’re going to announce a product, or we’re going to have a bunch of demos or whatever, there’s this 40-page thing that says, “If somebody asks this, what’s the answer? If somebody asks this, what’s the answer?” all that stuff. And technically all the people who go the show and represent Intel enough will have read that. But normally they just, and then we document all that. So I might have ten things that I have to provide answers for for the Q and A. Ninety-seven percent of the time if they hear a question in that realm, they go, “Go over, talk to Jim,” [laughter] so they normally won’t answer it even though they’re supposed to. But anyway, that’s actually an important – at least a corporation like Intel – an important aspect of the marketing, sales, and technology. Writing all that down in 100 percent, you know, whole truth fashion, while still having to consider the audience, is a bunch of sales and marketing people, I guess many of them are engineers themselves, who only have a certain amount of time to do things. So again, you have to balance it. But it’s a different style of writing, you know, think what somebody might ask. Often you have the same question, but written in different ways. And sometimes you even give a different answer even if it’s the same question, or sometimes you say, “the answer’s above there,” because you realize, you know, so, it’s pretty interesting. The Q and A’s typically have the same context or same question, but in a different manner, you know, words moved around in how you can question, and you do your best to put two or three of those down for not every question, but a question that could be asked in a funny way.

Q: Sure, yeah, that’s really interesting. How long – and this may vary because you’ve talked about a lot of different kinds of diverse writing projects that you do – how long typically do you have to complete a writing project? Deadlines you typically work in?

A: Yeah, I would say, we are, for one of these conferences or something like that, it can be, probably the shortest is two to four weeks. And often it’s 16 weeks, even if it’s a Powerpoint presentation or whatever. Again, because of one, if every presentation has to be read by an Intel lawyer, believe it or not there aren’t that many Intel lawyers [chuckle]. There’s a lot of them, but there’s not enough to do it, so they have to get them in advance. We also have this notion that I don’t think is a problem revealing of, 50 percent, 75 percent, 90 percent, and then 100 percent done. So 50 percent is normally the outline/abstract and a flow of slides with maybe the titles on them, and then 75 percent in to 90 percent is pretty close, that’s usually what’s legally reviewed, then it comes back and then it’s, you know, made that way. That’s not for everything, but that’s for one of these Intel public things. And my favorite one which is, there was one Intel event that they held yearly, they don’t hold it anymore, where they had actually the legally qualified, they weren’t lawyers, but legally qualified to review stuff. So I often I had presentations that were 102 percent [laughter] because I would go, “Well, I put this in two weeks ago, and you know, the world changed or something, and I want to add this,” and they actually knew that that would happen, that was fun. So occasionally I get 101 percent or something like that.

Q: That’s excellent. So you mentioned your experience as a student in Catholic school, and it being writing-intensive. Can you think of the kinds of writing that you were asked to create when you were a student, whether high school, college, or whatever, and in what ways do you think your college writing experience, or even if you want to go earlier than that, prepared or did not prepare you for the kind of stuff you do in the workplace now in terms of writing?

A: Umm, yeah I mean obviously grade school through high school, the book report was one of the driving things. When we went towards mid high school is when they would give you more of a research paper type thing, you know, “This is what you’re going to encounter in college.” Or like a creative writing thing or something like that. And then into college, you ended up having that. I remember when I was in high school, and I went to a public high school actually – so I went to grade school Catholic and then public high school – umm, I did feel, obviously it wasn’t hugely prepared, but at least I had seen one or two of these things where you have to do an outline, and structure with the outline, you know, begin filling it in, conclusion, and the whole kit and kaboodle. And in the end, even in bachelor’s degree, I had a seminar course that I needed to pass in order to get out, it was a business management seminar course, and I had to do a whole study on actually a technology company, and I would say– so part of that course was surveying a variety large businesses, it was so that you could do some kind of market analysis when you got out. So the teacher kind of helped with that, but mostly they counted on you having the structure and everything, and I got an A. And it was one of those classic all-nighters, you know, three days before I’m supposed to put on a cap and gown [laughter], you know, typing it up, you know, writing, and then typing, and you know, because I am old enough that it was a typewriter that I was working with, right before computers became super useful in that respect, word processors. And yeah, I felt that that education got me to that point. What I would say though, I ended up mostly going into software development and everything else like that, and for mainly I wrote code for a while, and would have to do a little bit of design, a little bit of writing. Actually now I’m going to reverse myself. There was one big project I did where I wrote a 40-page design document which kind of was like writing the book, but I actually didn’t draw on that until you just reminded me, but I remember this design, “This is who this thing works, and this is how it’s going to work,” and defining the programming interface and all that kind of stuff. So you, yeah, actually and it’s a very similar structure. So I would say there’s some measure of preparedness that I had probably I would say, particularly for a technical person, I’m actually guessing, I would guess and I didn’t have this, is something like a creative writing course actually would be good because of the whole thing about the messaging and everything that I was saying – I think I learned that more on the job and more in response to not doing it well. But if someone is more looking for a technical job I would not eschew things like creative writing. I don’t think you have to take seven years of it or whatever, but definitely take a creative writing course and force yourself– and if you’re going to be technical at all with a research bent, then you’re going to have to write papers. And so I think gaining any of that experience, you know, get over that fear. I would say for me, I kind of eschewed that. I was, every course technical, every, you know, whatever, catching up although again, I had these course where you’re required to do it, which was great. But I think the flip is creative writing. I think that that may actually make some sense in the technical engineering world, just that structure that you have to do to– because I know it’s really hard, actually. I know to be creative you actually, you have to pound your head against the wall. So anyway.

Q: That’s good, that’s something I try to convince my students of. And maybe they’ll believe it coming out of your mouth [laughter]. So you’ve hit on this a little bit, what’s at stake in the writing that you do? I know you talked about like bumping into legal and marketing and stuff like that, but what would you say are the stakes for the kind of writing that you’re doing for your job?

A: Yeah, there’s two or three that I’m thinking of. So one is simply getting it right – effective communication. Clear, as concise as possible, do what I say not what I do, and you know, making sure that you understand the point you’re getting across. Think about that in advance, and you will forget it multiple times, but go back to that. Another thing I would say also in the business setting and the higher up you get, it’s often a good idea to wait ten minutes, particularly if you’re responding to something and you feel anxious about it, either negative, like you’re about to type something negative or whatever. Think about it, and I’ve screwed that up too, it usually doesn’t work out too bad, but it can. Frankly these days you really have to be careful with any discriminatory language at all, not because you should use it, but you just have to make sure that you don’t accidentally use it. Particularly if you are not discriminatory at all, just be careful, you know, with making sure you consider the population that may do it. The other thing, that this is highly related, is, don’t necessarily think that only the four people that you sent your email to will actually see it. Not because the corporate gods are looking at everything, because they may forward it, okay? So, you’re often writing an email as a message to somebody else who’s not on the line, that you expect them to forward it to. They’re not required to, but that happens. So just, anyway, that sort of goes back to the, you’re writing to four people who you think are colleagues, but personal friends, you have to be careful. And then, for Intel, like I said the legal thing is a big deal. If you are going to write something disparaging about a competitor or something, again, that sort of goes back to discriminatory, but in the context of Intel, we’ve been put in front of you know, judges, for being anticompetitive, or whatever the right thing is. So you know, those are the stumbling blocks. But usually in the end, it’s about truly effective communication. The other things are just, you either learn or you, you know, they’re more I guess somewhat mechanical in a way, just make sure you keep your head on straight. But yeah, I mean, I think the other thing for young people is to realize that corporations, even big corporations like Intel, are surprisingly flat. So you might have just joined, you got out of college, bachelor’s, master’s, whatever, you join some company, some VP who’s two steps away from the CEO, even if you’re in 100,000 person company like me, there’s a good chance they’re going to hear about your stuff, okay? For good for bad.

Q: Wow. Right. So that adds stakes to everything you’re doing.

A: Yeah, so your personal career stakes typically, you know, you’re not obviously not completely on the line, you know, if you’re a little huffy with your manager or something like that, or we often talk about bringing out the elephants in the room, if there’s something that needs to be said but you’re afraid management will take it the wrong way or whatever, sometimes you do need to say it. But you know, again, make sure that you’re confident that you’ve done the do diligence. That probably for a young person, it’ll be, “Oh of course this is wrong, or right,” or whatever, just take a moment, think about, “Are there other ways that this could be read? And did I do all the do diligence behind what I’m about to say?” You know, like, “Hey we should go into the gaming market!” or whatever, when the company doesn’t do that, or whatever. Now that may be the greatest thing, you actually might be right, that might be the elephant in the room. Just make sure when the exec says, “Yeah, but what about” and they’re completely right, and you’re [speaker makes sound effect 51:24] like that. So just, again, that’s not afraid to do that, because that’s actually how you move forward in your career, just one more, you know, extra thought, “Could there be a different way this is presented?”

Q: Sure, great. That’s fantastic. What would you say the most difficult thing about writing in your field or your particular position right now would be?

A: Um, one, it is most difficult? It’s not really difficult, the legal thing is more of a hassle, I think. Really it boils down to the sense of urgency, or the, basically, you were asking me how often, you know, what kind of time I do. Sometimes, you know, that’s a real mix bag for conscientious writing your presentations or whatever, technically you’re supposed to be told in advance, like, “In three weeks you’re going to go to meeting X and do Y,” right? That’s like 90 percent of the time, 85 to 90. Ten to 15 percent of the time, it’s you know, “We know you’re the expert in this area,” or, “We know you know about this,” or, “You complained about something, we want to hear it,” and it’s the next day. And so it’s more the, all those considerations I just said here, is when they get squashed, where you’re not comfortable anymore, that you have done your do diligence and everything because of it. Now typically, in the right circumstances, you can, not fluff it off, but you can just say like, “Consider that I’ve only had a day to,” you can say that, okay? But sometimes you can’t. Sometimes you’ve been invited to a key customer technical meeting, where you’re the expert ,and you’re supposed to come in as if you thought of everything for the last seven years, and you’re just telling them that. Where actually you only had, the person said the night before, “Oh crap, this person should be there.” So that’s a difficult circumstance that you sometimes have to go through, and it works about 75 percent of the time, and 25 percent [chuckle] you get whacked. Just be aware of that, and again, have good relationships with your peers and your management who know that you are technically skilled and everything, and you just got kind of thrown under the bus.

Q: Right, yeah. Great, that brings us to the next um, has anyone helped you with your writing, either formally or informally, since you left school?

A: Oh yeah. I mean, well I would say again, James was very, very useful. I do think I had the basics, and I think maybe even he might say that I helped him. He helped me more, by the way. But yeah, the partners, collaborators, managers. A good manager will help you with this context, you know, this move for conciseness, powerful concepts, you know, I’ve definitely had managers, friendly peers, all that stuff. I think something I did learn after I left is this notion of collaboration, actually asking for help. Often you think you’ve been directed, particularly when you’re younger, your manager says, “Go such and so and do a trip report. Go out, meet a few customers, come back, give me a trip report, tell me what you found.” And you actually go do that and never had anybody read what you wrote or whatever, and you handed it to your manager. Other thing you can do is, typically when a manager wants that, he wants to forward it somewhere, just like I just said. So what you actually can do is, write up the outline, write a few key points, and hand it to the person who asked for it, and say, “I’m not done yet, but this is the direction I’m taking, is it okay?” So you feel like you’ve been dictated to or whatever, often the right approach back is just to say, “Can you just look at this, make sure I’m on the right path?” Actually it feels like that’s hard to do, or you don’t think of that, but that collaborative nature to– and then they’ll give you guidance, they actually feel good, they feel like a mentor as opposed to like a manager or whatever, and people like that. Now some people will be jerks, but that’s a very tiny percentage. So I would say, you know, even if you did everything I said here, creative courses, everything, “I’m good to go!” the review and the breadth of reviewers is actually something that’s, and again I forget it sometimes with timing or whatever, but it’s way better to pass it by either a friendly reviewer or the person who wants to see the end result. Because typically, particularly in the business world, they want to see the end result because it’s going to help them communicate, they don’t have all the time in the world. They’re giving you an opportunity, you know, and if they’re giving you that opportunity, and you have a good enough relationship, you can always just show it at 50 percent.

Q: Sure. That’s great, that’s fantastic to hear. Just a few more. How do you feel that you’ve most evolved or improved as a writer over the span of your career?

A: Oh I think that yeah, probably the biggest thing is, and again, I think this is where the creative writing is attempting to reduce the verboseness, which tends to turn something more powerful. The problem is, of course, if you overdo it, then it tends to be confusing, right? And then you might have a lot of big words in there and it doesn’t mean anything. But yeah, the notion of thinking about the message – really important. And then delivering that message in the fewest amount of words. And that’s not always the right thing to do, you know, you’ve got technical papers and things like that, where you literally have to prove that you know everything, you’re basically writing a proof, that’s a lot different than writing, not an opinion, but a fact-based communication. So I think the biggest thing that I look at when I write is trying to be more concise, and I’m still working on it, and I will be until my grave.

Q: Yeah, I think it’s always an ongoing process, but that’s fantastic. To what extent do you think writing is valued in your particular organization and then in your field as a whole?

A: That’s a great question. I think it is. I’ll give you one anecdote. You know, I think it is, but I also think it’s, in a way it’s expected, right? So there’s an expectation that everybody can do it, and at the same time, I think that everybody are very nervous about doing it, right? So there’s an expectation that you’re going to do it right. But for me, the biggest thing that shocks me is that, this is mostly for the books, when you have done a book like that– so after I did the first book, I didn’t realize that something was going to happen. So the book was Intel-oriented, it was sort of around an Intel technology, but it was a technical book. Intel wanted me to sign books [laughter]. They wanted to give away books, they would buy the books, we would go to these conferences, and then like I’m this weird kind of 15 minutes of fame celebrity? But what shocked me was the number of people who would line up and thank you, and shake your hand, and be thrilled, from all over the world. So for me, I just thought, well I mean, I’m happy I did the book, I think it does what it’s supposed to do, it educates, it talks about our thing or whatever, but actually the value to the community outside Intel was very high. So James and I would often – he was a pro at it because he had done it before – but again, when it first happened it was new to me. And I’ve done a total of four books at this point, and each one just shocked me. I went and did a talk in Seoul, South Korea, shortly after I did one of the books, I was talking in my technology area, but then they had arranged the book thing, and everyone in the conference, I mean it was a volunteer thing, but everyone in the conference lined up like out the door, and they’re like, I literally go like, “Are you sure that these people care that much about this?” [laughter]. So what I say is, is it is valued, it’s certainly valued, if you do it right, then it’s valued outside. It’s a very tiny, you know, I forget, I think I’ve sold maybe 10,000 books total, something like that? But when those people, and they were getting it for free, but they also could have walked away with the getting it free. But they were like, “Thank you,” and then they would say like, “Can I have one for my buddy?” That was always funny, like, “Uh, I know I only get one book, but Joe Blow had to be at something else or couldn’t come with me,” and sign it. So you would do that, it’s you know, both a nice gesture and kind of nice, but then throughout that conference, they’d like wave the book at you, and “Hi,” and you know it was, and anyway the bottom line is, is that’s my anecdote, not really about me, but about other people, of valuing somebody who took that time to do that.

Q: Exactly. You don’t always, and not in every field where you get that kind of like instant feedback.

A: Yeah, exactly, exactly.

Q: You know, if you spent your life writing scholarly stuff you’d [crosstalk]–

A: And we would, yeah, and we had like a website, you know, and occasionally we would get a question, but often we would get like, “Wow, I read chapter blah-blah-blah, and now I know more, and just wanted to let you know.” And so that was always fun.

Q: That’s great. Yeah, even just to have that quantifiable appreciation is [crosstalk]–

A: Yeah it’s really nice and I actually didn’t expect it. I actually thought it was, you know, at a way good for me, but also, mainly good for Intel in a way, I wrote it. I knew that it would be something I wanted to achieve, you know, a bucket list kind of thing, and yeah, when you asked that question, you know, that’s what I think of, of the response on the outside. And the same thing with, I know with the papers and stuff that my team– I’ve actually been co-author only on paper and my team has done otherwise, they’re really deeply technical, but those folks are, you know, sort of considered rock stars out in the world when they go and they do a presentation, and then people gather around you, and it’s– so even when you write something, if you write an important paper, seminal might be a strong word, but if you write an important paper that people get out of it, then they have very high praise for that. And the only reason they have high praise is because the paper communicated to them, it was written well. If it wasn’t written well, I won’t necessarily if they don’t have high praise if you’re a technology guru or whatever, but if it’s written well, then they respect you more.

Q: And it’s going to hit a lot more people too.

A: Exactly.

Q: Excellent. So very last question – how did you define successful writing when you were a student, versus how you maybe define successful writing now? And would you say that you consider yourself a successful workplace writer?

A: Okay. I think the student one’s easy and rote [laughter]. If I got a C minus, or a D plus, A, whatever, if that, and you know, I do think when the professor says something like “well written” or “liked it”, just that other little extra. You know, the A or B or whatever’s good, but if they say like, you know, circle something, “I really liked this part, you really got it.” So that was, I think that extra note maybe back, or even sometimes, you know, God forbid you had to read it in class, or you had to share it as a team member and a team member would say that, that’s good, because I don’t think people do have to do that. And now I think, yeah, the satisfaction’s a little less overt other than the one I just talked about it, you know, people wanting you to sign a book or something. But it, right or wrong, you left a meeting and they said, “Thanks, we really got it.” Or, for instance, my NASA meeting today is, is, “We’re going to download your software and start using it.” That’s, you know, that’s pretty good feedback. So, I think the answer is, is pretty successful, always working on it, stumble across those non-thinking mistakes a lot, not always, but you know, it is one of these things where I’ll have to go back and remember to do what I said to do. But I think yeah, I think it’s– sometimes all it takes is, you can tell when, there’s almost always a “thank you”, but when it’s a sincere thank you, when you really feel that, that’s when you get it, you did a presentation, you did a talk, you wrote something, or somebody goes like, “Wow that’s good, I really get it,” okay? And you don’t always get that, and very often you get this, “Ah, okay, thanks for presenting,” you know, “Checkmark done, Jim presented this week.” That’s sometimes what happens in the workplace. Other times when they think they’re going to give a checkmark, and they go like, “Wow, you enlightened me,” or whatever, or, “Wow, really thank you. We didn’t get it.” Hopefully you get that 30 percent of the time [chuckle]. I think if you do get it 30 percent of the time then you’re winning, yeah.

Q: Alright, thank you.

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Labor & Delivery Nurse

Sciences, uncategorized

Labor & Delivery Nurse

33:17

Q: Would you please state your job title, and where you currently work? And I know, you know, we talked just before starting to record, about how you just transitioned jobs, so if you could just give us the context for your old work versus your new work?

 

A: Okay. My old job title was as a registered nurse, I recently graduated from Frontier Nursing University with my masters in nurse midwifery. So my new job title is as a nurse midwife, but I’m going to be speaking I think to my last position as a registered nurse with Inova Alexandria Hospital on labor and delivery.

Q: Wonderful. And how long has it been since you graduated from undergrad?

 

A: I graduated from undergrad in 2014, May of 2014.

 

Q: Okay, okay. So about four years. And how long have you worked in nursing?

 

A: Eight and a half years. I had my associate’s before I had my bachelor’s.

 

Q: Great, okay, perfect. So could you provide sort of a brief description of your primary job functions as a floor nurse?

 

A: So as a staff nurse on labor and delivery specifically, my primary job would be to care for generally one to two patients in the labor, delivery, and recovery setting, which can be everything from giving emotional, physical support to the laboring woman, providing them with medications, whether it be for pain control or to augment labor, to stop labor. We also had a high-level NICU at our hospital, so I would care for high risk antepartum patients – so patients who are pregnant but not trying to deliver at the time – and generally your function there is to provide medication and monitoring to assess the wellbeing of mom and baby, and the safety of them, and hopefully to stall their labor if you could. And we also have three operating rooms, so we also cared for and circulated in c-section cases, and had a recovery unit for that.

 

Q: Wonderful, okay. Could you estimate, in an average week, what percentage of that job required writing?

 

A: How many words together counts as writing [laughter]?

 

Q: I’ll say two [laughter].

 

A: Two, okay [laughter]. Okay. How many hours in a week?

 

Q: What percentage of the week?

 

A: Umm, let’s say maybe 20 percent of my working time?

 

Q: Okay, and could you tell me a little bit about the forms or types of documents that you were writing?

 

A: So most of the writing that takes place as a staff nurse is on an electronic medical record, where we joke that it’s an elaborate billing system, because it is [chuckle], but they try to make it as easy for the billers to use as possible, and as easy for you to not get yourself in trouble as possible. So they do a lot of like, selecting options for charting, so it’s like a column where you select options, you can type in things like, you know, blood pressures, or temperatures, and then you can select options for pain levels, or assessment findings, like color of the skin, they’ll give you options like, “appropriate for ethnicity, warm, dry, clammy, red, hot, weeping”, like tons of different options. And then also an option to click and write a comment, so if you were writing something that was a like deviation from expected, you’d probably want to put a comment to explain why, or what you did about it. And there’s also notes you write that are more narrative. Generally you would write a minimum of one of those a shift, but depending on what you were doing that shift, especially if it was a more complicated patient, you could have like ten.

 

Q: I see, okay. And so, could you tell me a little bit more about what those narrative pieces sort of look like or sound like?

 

A: You have to be really careful when you write a narrative in the chart, because you definitely don’t want to double chart, because that’s a waste of your time, but also because you are trying to make sure that you’re staying consistent. And it’s really easy when you’re using click boxes to fill in your answers to, if you’re not being careful, just fill in like your normal answers, like the standards, and then if you write something different in a note, and it contradicts what you already charted, it makes it look like you’re not competent. So you’re trying to make sure that you’re being consistent with what you’re writing unless it’s actually discussing a change. And you have to be careful when you’re writing it to not, as a registered nurse, not make any medical diagnosis, and also not to like throw any other providers under the bus. So a lot of the notes were intentionally vague, in writing things like, if I was concerned about a patient, let’s say she had chest pain after delivery, and I was concerned, and I took some vital signs and everything was normal, and her bleeding was all normal, and everything was great. But I’m still going to definitely go the physician, and let the physician know, “Hey, she’s having chest pain. This is her blood pressure, this is her heart rate, this is her temp, this is what her bleeding is like.” And if they say like, “I’m not worried about it.” And then I’m like, “Well, don’t you want an EKG?” If the provider’s like, “No, I don’t.” Okay, so I don’t want to write a note that says that exactly, because it makes them look like they’re not doing their job, even if I feel that way. So I have to write, for example, that note would say, “Patient complained of chest pain.” I might like list the vital signs, “Provider notified, no new orders,” [laughter].

 

Q: Interesting. So this vagueness is to make it cover yourself while making sure you’re not throwing someone else under the bus?

 

A: Right. To say, “Look, I did my job. I followed through, but I can’t speak to whether this other person did.” And if it’s really a safety issue, I mean to be 100 percent honest, there’s obviously a chain of command you follow. So if I really didn’t agree with what that provider said, there’s another physician above that one that I can always go to. So I don’t want to like, speak to them [crosstalk 6:53] with that, but that’s like a really easy example of how and when you would write it.

 

Q: That makes perfect sense, yeah. And to be clear, you talked about this system being sort of like an elaborate billing system. Obviously the billing folks aren’t the only audience, who else would look at these notes? Both the narrative and the sort of standardized pieces?

 

A: I would say your most common audience for that would be your other nurses. It’s really common when you start a shift to kind of – you get a report, generally we would do bedside handoff, so you would discuss the patient’s care side to side, at the bedside, with the patient so they can speak up if they’re awake – but then it’s a really good idea to go through and take a look at the notes. And especially when you’re working with a patient who’s been there for a long time, it’s really easy for stuff to get missed. So going through and reading the narratives can say a lot more about what has and hasn’t happened, and what’s been tried and what hasn’t been tried, and how things are responding, than just looking at the – we call them flowsheets – like the excel spreadsheet that has values in it.

 

Q: I see, okay. That makes a lot of sense. And to clarify, those narrative pieces – it sounds like they’re relatively brief, even though they’re pretty important?

 

A: Generally. There are probably some nurses who write longer narratives, but most of what you should be writing should be like, especially nowadays, should be easily found in the flowsheet, and that’s the prefered way to document, because it’s an easy way for the system to keep track of what’s going on, and you can’t do metrics, for example, from notes. So if someone in the background from the education department is trying to track a new kind of epidural medication, for example, and I’m just writing notes about a pain level, you can’t just pull that up and track it. So I’m only writing notes about things that, or making comments about things that are maybe a deviation from normal, or it’s something that really needs to be explained.

 

Q: Got it, got it. And one more follow-up question. You said you also have to be careful not to make any sort of medical diagnosis. I didn’t realize that that was a position that a nurse is in. Can you talk a little bit more about that?

 

A: Yes [chuckle], so in nursing school, you learn a lot about nursing diagnosis, which just really a fancy way of describing symptoms. But making a medical diagnosis is practicing medicine, and that’s reserved for people who are licensed to practice medicine, so your nurse practitioners, midwives, physicians, etcetera. So if you are handling a patient who looks like they have the flu, and they clearly like, have the flu, as a nurse I can’t write a note that says, “Patient presents with the flu,” unless it’s been diagnosed by a provider. I can say, “Patient presents with fever, runny nose, body aches,” you know, malaise is a nursing diagnosis, which means not feeling well [laughter]. So I can describe it all, but I can’t say, unless it’s been diagnosed by somebody else, I can’t literally say that they have the flu.

 

Q: That’s fascinating. Okay, okay. I’m sure that makes writing especially tricky, because you’re sort of talking around this really obvious thing that you know, right?

 

A: Yes. Yeah, absolutely.

 

  1. That’s really interesting, okay. So, as you are writing these sort of typical documents – let’s talk about that narrative piece, because that seems like you have sort of the most leeway in those–

 

A: Yeah.

 

Q: –when you are writing those, is there any preparation or steps that you take prior to writing?

 

A: Yeah, and especially depending on what the note is talking about or how maybe sensitive the issue is, I am probably going to be looking through the previous notes to make sure that I’m not, again, contradicting something really obvious, unless I have to. So, a big example was for a while, we had some anesthesia staff who would use an incorrect method of measuring a patient’s temperature – not that it wasn’t like, it was a fine measurement for temperature, but our unit had made a policy against using this temporal scanner, because we didn’t find it to be as accurate – and we had some anesthesia staff who were still using it because they liked it, and it was faster, and it would give them slightly warmer values on a patient coming out of the operating room; and one your risks after having surgery is having a low body temperature. So having anesthesia write in their flowsheet that the temperature was 97.4, and I’m getting a temperature of 96, I need to make sure that I see what they charted, what time they charted it, and then I have to be careful with how I chart it, and I might want to explain like, in my note, you know, “rechecked temperature after anesthesia, value 96.0 orally,” and make a note explaining what I had to do thereafter, without having to say like, “they were wrong or used incorrectly equipment,” or something like that. So I have to like, review what they actually charted, when they charted it, and make sure that my note kinda goes along with it without, you know, saying anything negative. So it’s a lot of previous chart review.

 

Q: And when you’re trying to be really diplomatic in these notes, what are the repercussions if you were not diplomatic? If you did call someone out for something like that?

 

A: Probably most of the time nothing. The issue’s going to come if they’re– I mean, maybe the physician reads it, but a lot of the times their notes, like I don’t know that a lot of their– like, they have to go look for our notes because the way that their system loads, it’s not as obvious to them. And so they might go through and reread them, and get upset with me, which could damage the relationship, but the biggest risk is if this was audited for court, for example, so if there was a complication and the patient wanted to bring it to court, anyone who’s touched the chart, it keeps a log of everyone who’s logged in and clicked and opened that chart, and anyone who’s written in the chart is probably going to get subpoenaed, and possibly deposed for this court case. And so I have to, you know, show that I’ve done my job, but I also– many court issues end up getting– like if there was incorrect care or something, a lot of times in nursing you’re taught it gets pushed back down to nursing, even if it’s not really in your control, because you’re like the last line of defense, right? So you don’t want to say in your note, you have to prove that you didn’t willfully ignore something, that you gave good, fair care, but you don’t want to provide any ammunition for – this is sounding terrible [laughter] – you know, someone trying to prosecute you saying you didn’t do your job, or the physician didn’t do their job when you know you did. And most of the time, I mean most cases have great outcomes, most cases don’t go to court, but even when they do, most of the situations that are brought to court aren’t because of any negligence or you know, it’s like something crappy happened, that couldn’t be avoided, and it wasn’t in anyone’s control, but no one wants to feel that way, you know? And so you want to make sure that you’re writing these intentionally vague notes so that no one gets in trouble for doing something wrong when most of the time things aren’t being done wrong. Does that kind of make sense?

 

Q: Got it, yeah that makes a lot of sense. Yeah, that’s really clear actually. That makes a lot of sense. There’s so much nuance to this. So how did you know how to perform these types of writing?

 

A: That’s a good question [laughter], I need to think about that one. I guess we talked about it some in nursing school, but not a ton. A lot of it comes from working on the floor, and just having to practice when you’re kind of, maybe like one of the first times that you’re put into a touchy situation, where maybe there isn’t a right answer, or you don’t agree, but the person who’s giving you orders isn’t technically wrong or something, and you have to write a note about it, you probably are learning more from your more experienced coworkers. It’s like a skill that’s passed down, because your first intention is just to want to write this like, long narrative note that explains every detail and everything, and then you’re probably doing it with someone with you know, 10 or 20 years more experience looking over your shoulder saying, “Delete that, delete that, delete that, delete that! You already charted that,” [laughter]. So a lot of practice. I do remember starting as a nurse, working in like med/surg–

 

Q: What is med/surg?

 

A: Oh, it’s like a medical/surgical floor. So if you’re admitted to the hospital for something, it’s probably where you’re going to go, unless you need like a specialty floor. So if you’re having general surgery for like appendicitis, you’re going to med/surg. If you are– on our unit we did a lot more surgical than medical, but let’s say you have pneumonia and you’re really, really sick and have to go the hospital but you don’t need the ICU, you’re probably going to go to med/surg. So it’s like a general hospital floor. I feel like situations, I remember having to sit there and write notes with people, and you would always seek out like someone you felt comfortable with and saying, “Can you help me write this note? This difficult thing happened.” Like generally then, it had to do with pain management, and you couldn’t get anesthesia to get there on time, or something like that, right?. Patient’s in pain, you’re out of pain medicine, anesthesia isn’t coming, it took an hour, your patient hates you now, you know, something like that [laughter], and you have to careful not to write, “I called anesthesia a hundred million times and they didn’t want to come, because they didn’t like the page,” like, you can’t write that, right? So it’s like going back in time and someone you know, teaching you how to write, okay, write a note for the first time that you notified anesthesia. And then write another note that says, “notified anesthesia.” Write another note that says, “notified anesthesia, anesthesia now in rounds,” you know, and you write it that way. Like these little one line notes that say, “Hey, I did it. Hey, I did it. Hey, I did it.” And as someone showing you, instead of writing one long note, it shows this persistence, for example.

 

  1. I see, without having to say, “They didn’t show up, I had to follow up.” Yeah, got it.

 

A: Yeah. It’s obvious by, you don’t have to say it, because it’s obvious by how many times you had to follow up, for example. But that’s like a learned skill from your other nurses.

 

Q: Absolutely. That’s really, really interesting. Are there other things that you did besides seeking out more experienced nurses to learn how to perform these types of writing?

 

A: That like I, that I intentionally did?

 

Q: Yeah, yeah. Are there any other sort of strategies that you utilize to, you know, learn the nuances of this and improve?

 

A: I don’t know. I guess I can think of a few situations where, a lot of times the nursing managers or the units will have someone specific to call and check up on patients after they’re discharged home to see how they’re doing, and to get like a general idea of what we can do better and what we did really well, for example. And then they would, you know, give you follow up in staff meetings and stuff to talk about, “Well, this patient said that they asked for pain medicine a hundred times and were never given pain medicine,” but I can see from the charting where you called anesthesia, and gave them pain medicine, and reassessed their pain, for example. So you get feedback like that, where you learn you have to prove everything you’ve done.

 

Q: That’s really interesting, yeah.

 

A: And there’s a nursing addage of, “If it isn’t documented, it isn’t done.” So that gets beaten into your head as well [laughter].

 

Q: Got it, yeah, yeah. This is fascinating. Okay, so does anyone oversee your writing? You talked about other nurses reading these, and you talked about how you know, in a specific situation, a doctor might seek out your narrative, or your notes, but is there anyone who actually oversees your writing directly?

 

A: No.

 

  1. Okay, alright. And how long do you typically have to complete one of these narratives?

 

A: So your charting should be done– okay, so the goal is always real-time charting. So real-time charting should be done within two hours of whatever event. But real life, it doesn’t always work like that if you’re in a really, let’s say you’re in a patient’s room and something changes and you have to go have an emergency c-section, well that whole process can take four hours, between the emergency in the room, going for the c-section, recovering the patient, getting them upstairs, and sitting back down, where you haven’t stopped moving, right? So in that kind of case, it can take a little bit longer. I think most of the applications won’t let you chart things that are older than 24 hours, and if you’re writing them really delayed like that, you should start them with like a phrase that says, “late entry,” or something, to show that, you know, if you’re really writing a, like maybe you wake up at midnight, and you’re like, “Oh no! I didn’t write this note about this thing that happened!” So you show up the next morning and you go to their chart and you write, “late entry” for the time it actually happened. And then how much time you’re given to do it – I mean, I guess as long as it takes to write it, I don’t know.

 

Q: Okay. if you, let’s say, like if it is happening in real time with a typical patient, without any sort of crisis within that, how long do you usually spend you know writing your one narrative for that shift about that patient?

 

A: Oh, I don’t know, like some seconds [laughter].

 

Q: Okay, perfect. Some seconds, perfect, okay [laughter].

 

A: If it’s like a really simple day, I’m not doing anything above and beyond, everything should be captured in that flowsheet. So my note might be like, something about like, it might just be comments I’m making – like in the fields, you can right-click and make a comment about something – like for a slightly elevated temperature, “reassessed in their axillary,” or something like that, you know?. So it could be really, really simple, or you know, “Spouse to bedside”, I don’t know, like really simple stuff like that, if it’s a really simple day, yeah.

 

Q: Got it, okay. What kinds of writing do you remember being asked to create as a student?

 

A: As a student, if you go all the way back to the beginning of nursing school, a lot of your writing is in the form of care plans, which is something nursing school really focuses a lot on still, and the idea is to be able to understand and write these nursing diagnoses, which you don’t ever use in real life. But like a true nursing diagnosis goes something like, let me think, like, “malaise secondary to spoiled milk ingestion following something.” It’s like this really silly string of words and modifiers [chuckle] that you just don’t use it, it doesn’t make any sense, no one’s looking for it, but it’s one of those things that the nursing profession really wanted to have included in part of the education. And then your careplan is based on those nursing diagnoses that you’ve made in writing like what the symptoms of the malaise are in that category, and then what you’re doing for it, and what the expected outcome should be following it. And I think the idea is supposed to be like, big picture thinking, you know, like not just saying, “Oh, okay, so they have a fever, let’s just do Tylenol. The end.” You know? High level thinking, like, “Okay, so they have an elevated temperature, and an elevated heart rate, and shortness of breath. And so I’m considering that they might not be perfusing their lungs as well, and so I’m going to follow up with the MD for XYZ.” So it’s to get you thinking like big picture, what are the causes and effects of different things. That was most of nursing school, was these really crazy mind maps and venn diagrams or something, and I don’t know.

 

Q: That’s really interesting.

 

A: I don’t think very well like that.

 

Q: Yeah, so it was more to get you to a certain way of thinking, rather than to you have you practice writing the kind of document you’d be writing on the job.

 

A: Right, exactly.

 

Q: Got it, interesting. And so how do you feel like that did prepare you for the actual writing you do at work?

 

A: I don’t remember it very well, so maybe not great [laughter]. I think it did do a good job of helping you get out of the habit of looking at medical diagnoses though, as a nurse, and get really good at describing what’s going on. Like describing someone who looks like they’re having a pulmonary embolism, instead of saying, “I think they might have a pulmonary embolism,” or, you know? So it does help you with that. But besides that, I don’t know, that kind of felt like busy work.

 

Q: Got it, okay. And are there things that you wish you had learned in school that would have set you up to be a more effective writer on the job?

 

A: Let me think for a second. So I did a lot of like educating new hires for example, and training them on the units I worked on for a long time. And I know some of the focus has really changed. When I was in school, there was definitely a focus on, you know, if you didn’t document it, you didn’t do it. And you had to learn how to write in like a paper chart, so you did do a couple examples of writing little notes in paper charts and reading your notes in paper charts, but now the focus seems to be a lot more on the immediacy of charting, because the electronic medical records are everywhere in this area, at the very least. And so for myself, I don’t, I guess maybe more of an emphasis or some more education on how language can be used in like court system, or chart reviews. Or when the hospital can get reviewed by the Joint Commission to makes sure that they’re following standards of care, for example, so you kind of have like a bigger understanding of why you’re charting what you’re charting when some stuff just seems so silly, because you’re just hitting these like charting requirements for the day that don’t have any meaning or impact on what you’re actually doing for the patient, but it’s some bigger company’s proof of what you’ve been doing. So I wish I had learned about what the Joint Commission was, and what they were looking for, so that way I wouldn’t feel so bitter when I was a new nurse about spending extra time filling in these [chuckle] silly paperwork. And I wish that, well the nursing schools it seems like from the nurses who I’ve been training, they really come out wanting to chart everything the moment it’s happening, which is great, but they are so busy charting that they will forget to actually care for their patient. So I find myself saying a lot, like, “the computer’s not your patient,” because that’s what their emphasis is in nursing school, it’s just so hardwired that you have to make sure everything is documented, you know, documentation has to be perfect, etcetera. Which, a lot of what you do is already in the chart, you don’t have to like constantly be in it, you need to be focusing on your patient first. So I wish that was a change too, I wish they really pushed patient first, rather than chart first.

 

Q: That’s wonderful. Yeah, that’s really fascinating. Um, this next question is sort of a big picture question, we touched on it earlier – but what is at stake in your writing?

 

A: Oh, I mean, I guess if I am in inappropriate with the kind of notes I write, or if I don’t write something that I’ve done that’s really important, that proves I was doing my job, that proves the provider was doing their job, that we were working as a team for example, and there is a negative outcome, and we all go to court, like I could lose my license [chuckle], yeah.

 

Q: Yeah, pretty big impact, okay.

 

A: I mean charting isn’t going to save, I mean I guess in theory charting could really impact someone’s care if you don’t chart that you’ve done something, I mean that becomes bigger with proving that you’ve passed your medications and stuff like that, but as far as narrative writing, it’s mostly going to be proof that I’ve followed up on things, and acknowledged things, and noticed changes.

 

Q: That makes perfect sense, yeah. And what is the most difficult or challenging thing about writing in that particular position?

 

A: A lot of times you’re doing so many things at one time, and you’re following up on like if you notice a change in someone’s status, and you’re following up on it, and your provider’s following up on it, and they’re getting specialists involved, and you know, you’re like trying to keep track of everything that’s happening, while also making sure you’re patient’s safe, you could definitely just forget to write something, you know? And that’s your proof that it was done.

 

Q: Right, okay, okay. You talked a little bit about seeking out more experienced nurses early on in your career – is there anyone else who’s helped you with your writing, formally or informally, since you’ve been on the job?

 

A: Like in my nursing writing?

 

Q: Yeah.

 

A: No, I guess not really. Because no one really follows up on it unless you’re not charting that you did something.

 

Q: Okay, okay. And how do you believe you’ve evolved or improved as a writer over the course of your career?

 

A: I’ve gotten a lot more efficient [chuckle]. I am really good at saying as little as possible to get my point across [laughter].

 

Q: And to what extent do you think that writing is valued in that position?

 

A: I would say among other nurses, you know, you definitely have opinions about how people chart, and there’s definitely lazy charters, which isn’t so much a big deal, unless they’re not really saying things like, that they’ve called case management, or whatever, and it’s making your day extra busy because you’re doing stuff they already did, so. I think it makes a big difference between the other nurses that you’re working with, to know what’s going on.

 

Q: Got it, got it. So sort of your reputation as a nurse also has to do with it?

 

A: Yeah, your like reputation as a nurse, and also the, how– how do I say it? Like how easy it is to care for the patient can be impacted by how willing someone was to sit down and type something out.

 

Q: Got it, got it. Okay. And this is my last couple of questions here. So how would you have defined successful writing when you were a student, versus how do you define successful writing in this job that you’ve recently left?

 

A: So especially working on my bachelor’s after I had my associate’s, the focus what a lot more on paper writing, and writing, I don’t know, a bunch of, I felt like the same essay again and again. So doing well on the essay, right, was really important, and what really became hard, because I was already working as a nurse, was when you had a word count that you had to hit; you’re getting really really good at mincing your words and being really succinct, and then you’re given a word count that’s longer, like hitting a word count becomes really hard [chuckle]. So the big difference is that, is in nursing you’re– wait, is that what you asked, I’m sorry?

 

Q: It is. How did you define successful writing then versus now, yeah.

 

A: Okay, yeah. So then, it was a lot more about hitting word counts, and saying you know, what they wanted to hear, and sometimes just being more verbose. And then now it has a lot more to do with how quickly and efficiently can I say the bare minimum to show that I did my job?

 

Q: That makes perfect sense. That’s so interesting. And I’m sure that’s– I don’t know how typical that path is for other nurses, but it seems especially tricky, because I guess most nursing in doing a bachelor of nursing have not worked as a nurse in the past? Is that a fair statement, or no?

 

A: At least in this area, that’s probably true. It depends on where you are in the country. Associates-prepared nurses, I mean this area still has associates programs, and throughout the program some places really rely heavily on associates prepared nurses.

 

Q: Gotcha, okay.

 

A: Yeah.

 

Q: And my final question – would you say that you are a successful workplace writer?

 

A: Yeah, I think I’m a good note writer. People come to me for help with their notes.

 

Q: Excellent.

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Interview Questionnaire

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  1. Would you please state your job title, where you currently work, and how long it’s been since you graduated from college?  (Note: If you’d rather not name your employer, you are welcome to simply offer a broad description of the organization.)
  2. Can you provide a very brief description of your primary job functions?
  3. How frequently are you required to write? Can you please estimate, in an average week, what percentage of your job requires writing?
  4. What forms or types of writing or kinds of documents do you most often complete? (If the participant requires clarification: “For example, memos, emails, reports…”) Who are the primary audiences? What are the primary purposes of these communications?
  5. Can you describe a time in your career that you felt unprepared as a writer at work? How did you handle that situation?
  6. What kinds of writing were you asked to create as a student? In what ways do you think your academic background prepared or did not prepare you to write in the workplace?
  7. Please describe your writing process, including how writing “assignments” or tasks are given to you, preparation, and the steps you take from the start of the project to completion. If useful, you might walk us through the process for one specific recent project or type of project.
  8. If your documents go through revisions or multiple drafts, how do you approach making these changes or improving your writing from one draft to the next?
  9. How long you do typically have to complete a writing project?
  10. What is at stake in your writing?
  11. How do you believe you have evolved or improved as a writer, if at all, over your career so far?
  12. Who oversees your writing? Could you give us a brief description of their title and role in the organization? How would you say they judge the success/quality of your writing?
  13. What practical steps did you take in the office to overcome early writing challenges? (If they hesitate, suggest: “For example, looking at documents by other writers in the office, asking questions of more senior writers, or seeking out professional training.”).
  14. Have you had any writing training or education since graduating from college?
  15. What is the most difficult thing about writing in your field and/or your specific position?
  16. Would you say that you’re a successful workplace writer? Why or why not?
  17. What skills do you think are most central to writing in your specific role, organization, and industry/field?