Please note: The following is an AI-generated transcript that has not been spell-checked. Misspellings are not intentional but are to be expected; please excuse them. To watch a video of this session, please find the link below. Thank you.
Hello, and welcome to the Healthcare Facilities Network. I am your host Peter Martin, of Gosselin Martin associates and always I thank you for clicking on this episode and I am. I am pleased to introduce my guest today Mr. Larry Rubin coming to us from outside of Tampa, Florida. Larry. Good morning.
Good morning.
Thank you for thank you for joining. So, just a brief bit of background. Larry’s been more than 30 years in health care facilities management. He’s had a career at Cleveland Clinic, Director of FM Senior Director of FM at Cleveland Clinic, both in Florida and in Cleveland. Larry had a stint at Moffitt Cancer Center, Senior Director of Facilities Management, Larry has been a surveyor for the Joint Commission, Larry is, is well known yet a vice president role I think in Arizona for a bit Larry or can delay healthcare for a bit. No, no.
Ascension. Actually, it was in Kansas City, Kansas
City and vice president. Yeah, I should always write things down. And right now, let’s say, Larry’s independent consultant for zone Rubin, health care compliance. Larry, what do you what are you up to?
Well, certainly hospitals again, I kind of I really enjoy it. I like teaching. I’m a school teacher, I I earned my bachelor’s and master’s degree a long time ago, before I went into engineering, to be a school teacher. And I really enjoyed teaching. So when I do a survey, it’s teaching. It’s really, you’re trying to help people and I know facility so well. So when I get the opportunity to help people on a survey, it’s it’s to me, that’s the most rewarding, and I love teaching. So I make the people that are with me climb the ladders, and look up the ceiling, before I even do. And then I get up and say yep, you are 100%. Right. You saw this and saw that. And so it’s all part of training. And I think that’s what I really enjoyed doing that. Yes. When
when you ask them to climb that ladder first and look above the ceiling before you do, what’s their reaction? Typically, they
love it. Everybody goes, I can’t wait. I usually have two or three. Sometimes the women with me that have equality, they want to apply to to. Here’s what we’re looking for. And I tell him what to look for. And they do it. They’re great. Excellent.
So you you left Moffitt? Was it maybe two years or a year ago now to
have? Maybe it’s two years, almost two years? Well,
it’s amazing how, how quickly time flies, isn’t it? How have you enjoyed the transition out of the daily grind of facilities management and compliance and everything that goes with it into your own independent consultant.
You know, you’re so busy when you’re at work. If you’re a Facility Manager or facility director or vice president, whatever, our jobs are so busy, and you never know what’s gonna happen when you come into work. You never know what’s gonna happen. You could have an emergency, it could be who knows, it could be a hurricane, tornado, whatever is coming. You have to be ready, you own the physical environment. And your day is so full, especially now I’m noticing it a lot. A lot of people have a lot of openings right now for help. Facilities especially and that tough to find. We did a fantastic job of sending all our kids to college. Now we don’t have a tradesman, and that’s hurting. So plumbers, electricians, HVAC techs, that tough to find they really are so so you’re spending all your time training or teaching. So that’s kind of a big deal right now for facility folks. They’re very, very busy teaching and explaining to others what we do. We are the most compliance, crazy industry. I worked in the nuclear industry for a while and I thought that was bad. No, we’re just as bad. I’ve been on the power plant. So I know what it’s like. It’s crazy. Well, no hospitals worse. We have a lot more compliance issues to worry about. And and you’re always constantly educating. You’re always explaining to others you’ve got 100 balls in the air at once. And you’ve got to be able to capture them before they fall down. I remember I had this director, I was at Brigham Women’s Hospital. He had a director there that he was a really good job. He juggled knives and he made this presentation of these knives going up in the air and he’s making his presentation. He says, This is what life is like. You’re constantly juggling. I’m going Wow. Yes. You know, that really hit home. I said that’s great.
Knives.
He didn’t get hurt. But the emergency room wasn’t far away, but
actually the safest environment to juggle knives.
You know, it’s kind of funny. I started my career visiting a lot of emergency rooms. Unfortunately. I was I joined the police department and drove motorcycle, and well, it’s, I have scars to prove it. Well,
you know. And that’s actually where I wanted to start, Larry and Larry and I’ve been talking for a while. And, you know, the goal of this episode is, is Larry is going to discuss some of the most frequent findings that he finds when he’s out surveying hospitals, and some, some success stories and some non success stories. But Larry also has, as he’s alluded to, a very interesting type of background we have done, we’ve done two episodes on the healthcare facilities network, where I take resumes of folks who are in our databases, and I blank out the name of the people, but I show their career paths, how do they get into this field? Because especially now, you know, Larry, as you just said, it’s so difficult to find people. We need to think beyond kind of those traditional career paths that we always think and how do people arrive here. And on my last episode, two of the paths were one was a fire chief, and the other was a police detective. So you know, we hear about the military folks all the time, but we have the fire chief and a police detective, who both became directors of FM. Tell us a bit about yours. I mean, you were a teacher who became a police officer who became a director of FM. And now as your own company. Tell us a bit about your path and how you ended up here.
I don’t know. It’s just one of those things that you fall into it. But so I’m teaching school all day long.
And you’re correct. In
Chelsea, yeah, High School. Sixth grade. I did that for four years. But at the same time, I’m teaching and working nights I started way back in the Boston Police Department and will hope 1968 I graduated from the academy and 68 seems like a lot of time flooded years ago. So I did 29 years up there. And then I decided to come down to Florida to take a job in the hospital down here. It was kind of interesting. The my partner up north, had his brother in law with the Tampa Police says you need to go see him to learn the city. Tampa is a big city. So I get out and do a ride along.
So you’re still an officer up here in Boston at the time I retired. 29 years is
done. I retired in 97 came down here for that job. And it was kind of interesting. He said, You know, we’re we’re a 900 man department and 300 retiring next year. Whoa, whoa, that’s that’s a lot. He said. We’re hoping to get some of those guys back in in the reserves. Why don’t you who who was retired? Come on and join the reserves. And I gotta go back to my wife and said, What do you think of it? He wasn’t happy. But he said, No, I want you only working one job now. That didn’t work out too well. So I’m on the beginning on the reserves, and I wound up being a patrol leader for 50. Guys. I want the thronging all them that would kept me busy. And these were retired Tampa sergeants, and we had a blast. We we worked together with teams. And I always think of Tampa as the Wild West. It’s so different than up north. And because the weather’s so nice all the time, you just don’t know what’s going to happen. So but again, I was director of facilities here at one of the hospitals and I really enjoyed that all of a sudden, it became two hospitals became nine hospitals all become they kept growing at the BayCare. And I didn’t expect that. And here I am. So I just kept, kept growing.
So you’re a police officer and a director of FM.
That’s a way back when Yes, not now. No, no, I
know not now. But when you so you’re doing both.
And there were times that I actually worked my area work my hospital went to it, which was interesting. We had a bad accident front of the hospital. I wanted to go into the hospital, er, doing the report. And everybody know me said hey, wait a minute. So well, it’s you know, it is what it is. Yeah. How do you how’d you do that? I’m not really sure because there’s a 12 hour shift. Yeah. So I was like, say five to five and then wound up working at six o’clock till till five. That’s a long day. Did that a lot, but my body was used to it. I’ve worked two jobs all my life. So I’m so used to it. I just did not now it’s getting more difficult now that I’m older, a lot older, it gets more difficult.
That’s great. So when you were when you were a teacher in Chelsea, so you were teaching and going the academy at same time. Actually,
I was already out of the academy. I was I was teaching full time and, and working full time. So I was kind of interesting story at top of sixth grade and a very large school in Chelsea. And I’m the only classroom out of I think was 48 classrooms. The only classroom had also windows because the kids would throw rocks through the windows. It was a very tough area. And they knew that I was a police officer so they didn’t break my windows. And every morning I had to shake my kids down. I had a box full of knives that were just in one gun. Really that’s what it was like it was a different world. So being a police officer helped me there but I really enjoy teaching. I really love the kids. The kids are anywhere from 11th to see Explain in my class. So you just, and I had 30 to 35 kids all the time, it was just a typical urban area. Yeah,
yeah. So did the How did the How did the FM world I didn’t see your teaching? You’re a police officer. Now you’re not? How did that arise? How did you get hooked in to facilities management?
You know, it was one of those things where a friend of mine grabbed me to see if I would come in and take over a construction project he had going. And I said, I’m glad to work with you. And he’s a good friend of mine. So he helped me. And I worked for one of the largest construction companies in Boston. And one. Boy, yeah, that’s that question. names have left me. Yeah, I
spent a long time since you’ve been up here. Yes. As you say, I mean, you have Suffolk is, is one of the big ones now. But you go back to 90 say, you know, when you were here, you left in 97. They weren’t
the the the owner of the company was that a lot for Harvard University. And I’m just trying to think of his name, it’ll come to me. And that’s the boss, the president of the company was approached by the President of Brigham Women’s Hospital and said, Look, my director of facilities is going for heart surgery. I need somebody in there now, because Joint Commission is going to be coming in December. And this is like September, and I go in. So my boss comes in. He’s, look, I need you to go over to Brigham Women’s Hospital. Don’t say who you are. Don’t say, well, you’re working. But you’re going to be filling in for the director of engineering. And I said, Okay, I got a good engineering background and know what to how to do. So. Off I went, and by the way I was teaching not only was I forgot to put all this in there, because when I left teaching school, I decided to teach engineering. So I did the physics and thermodynamics. So I knew this well, I knew what I was getting myself into in engineering. So I get in there. And that’s what what happened was that I was the that made me a temporary employee. I was the director of engineering and really enjoyed that for a couple of years. And that’s when 1990 a guy to figure out what year was, but in 97, I got a job down in Florida. And off I went, that’s how I started the business at Brigham Women’s Hospital and Partners Healthcare. Wow, a lot of fun.
You didn’t, you decided, You know what, I’m not gonna start at a small community based hospital, I’m gonna go into some of the most prestigious academic medical centers in Boston and start there. Yeah.
But I had a great team. I mean, I had an assistant or a to system directors, we had a really great team, and a lot of good people. So that’s what made it nice to. So when I left there, and to go to Florida. And I actually, when I got the job offer, I actually talked to one of my assistant directors, hey, do you want to get on there? Because your daughter’s going to school there? Why don’t you take the job? And he said, I don’t want to go, that’ll pay any money down there. So I said, to the headhunter, that’ll pay down there. So he’s not interested? No, here’s what we’re paying. So wait a minute. I’m interested. So So that’s what’s that’s decided I didn’t you know, to leave Washington was difficult, but it just made sense. And my wife was excited because I was just going to work one Job said, you’re going to work one job, Monday through Friday, much better. That lasted a couple of months.
How would you? How do you describe yourself?
Crazy? Yeah. I really enjoy teaching. And I enjoy humor. Because you know, you don’t know what’s gonna happen in life. And don’t take life too serious. You got to enjoy it while you can. And I’ve seen so many horrible things that you can explain to anybody what you’ve been involved in. And I got the scars to prove it. I mean, I’ve got holes off my body. I mean, I’ve lost half my face. But here’s my cut off. So I’ve had a lot of issues, and you go through some of the stuff and you just can’t take it serious, you got to start enjoying life, because you don’t know when it’s going to end. So what you can do to help other people. And that’s what I really enjoy. That’s why I enjoy teaching, because you’re helping others. And that’s what, that’s what you’re put on this earth for really to help others. And I’ve always felt in the facilities world. We’re one team, I help every director wherever I go, I leave him. He said, Look, I’m on LinkedIn. Look me up because my email address your question, let me know. And I always tell people all the time, my phone is always going off. And all the surveys, we were good friends, when I left, we kept in contact, we still keep in contact, because they’re all good people. I got a great boss, my field director was two microphones, great guy. All the surveys were phenomenal. So I mean, they’re all good people. And they’re all trying to do the right thing. So man I always try to again as I do the right thing of teaching and that’s what I really enjoy now consulting because now I’m helping. And I’m actually I’m still helping with energy stuff that we do have my background is energy and power plants, things like that. So I’ve got the craziest background. I ran a power station for 10 years. And I can go on forever but my background is on the on LinkedIn. So you can certainly look me up in a psychiatric hospital on up the
the I didn’t realize the the engineering part of it, you know going back to school are you? Are you mechanically inclined? Like you’ve got a lot of different? Like I’m not very good mathematics engineering, I think I’m stronger on the kind of that soft skill but communication part of you seem to have both of those areas combined. Most people don’t get both you get one or the other. But it seems like you got both. It
was kind of crazy. My oldest brother is an electrical engineer. So when I told him, I just look, I’m going to Northeastern, I want to be lucky. He says, no, no, you’re not going to be electrical engineer, you’re gonna be the only one in the family, you go from mechanical, and my background, and I really enjoy I’m ham radio operator. So I really know electronics well. And I really wanted to be an electrical engineer. But so for some reason I became I got more involved in mechanical. And then when I went into a power plant, I really learned the electrical side of it, because we were generating power, so is a real big station. So we have a lot of fun and no boilers, well, no pumps, no equipment. So that’s helped me a lot, especially in this field. So I really know, the small boilers that are in the hospital, so much different than the, you know, the 1500 pound 1000 degree Fahrenheit generating boilers that we had. So it’s different, but a lot, but still very interesting. I understand it, and you certainly know how to take care of not a PM. And the same thing with electrical equipment, because electrical engineer does a lot of electrical work, or we generated 13,800 volts and how we took care of all the breakers and the problems we had. So we learned a lot. And that’s helped me in my field.
Yeah, well, you know, as you listen to you talk, everything you’ve done, you’re using now I’m gonna you’re really kind of an accumulation of all those experiences that you’ve had along the way you’re using each and every one of them. And you
learn every day, even when I was a facility person that you’re seeing, and serving, you see the good, the bad, the ugly, and you see a lot of good things. And you see a lot of things that you always say to yourself, you can’t make this stuff up, you can’t you see stuff you go, you gotta be kidding me. But that’s all that’s all part of the learning. And so if you can pass that learning off to others and help them, that’s what it’s all about.
So I would like to ask you, you know, what are some of those top findings that you’ve know that you find that are at the top? But before I do that, Larry, you had mentioned it, we know that there’s an issue bringing people into the field, as you’ve been going through your career. Now, as a consultant, are you noticing that you’re interacting with more folks who don’t have a healthcare background or hospital or healthcare background? They may be coming in from some other industry? Have you noticed kind of a demographic change?
Yeah, a big change. And I’m seeing people from the hotel industry come into, I had a hotel, Director of Facilities working in the hospital now. And interesting. He wanted to leave open all the stable exit doors. So you can’t do that. No, not in the hospital. Okay. So we’re seeing a lot of people from different industries coming in here. And I’m seeing a lot of women that are very bright. I mean, I know a number of them as now, but it’s just phenomenal. So it’s more attention to detail. Men sometimes don’t always have that attention to detail that women have. My wife tells me anyways. So
there’s some truth to that. I know my wife is more so than I am. And
I’m excited to see that happening. It’s really made a big difference. So it’s, and I’m seeing now women electricians, HVAC techs. I remember at the Cleveland Clinic, we hired a woman for our tube system. Fantastic. So you’re getting people into the industry, that’s really help. And it’s really good now. So it’s changing. It’s all types of people coming in now, which is great.
Yeah. Do you know you mentioned the hotel person are there in hotel would? I mean would certainly seem I mean, that’s a huge difference. Just even in mindset, you are giving the, you know, the door example. But are there from your experience or from your, from your experience? Do you find that folks from one industry or another may transition easier into healthcare facilities manager, maybe it’s out of the power plants, the nuclear plants, but are there certain fields where those people seem to have a better aptitude to come in and, and catch on a little bit quicker in healthcare? You
know, I’m seeing the military folks that are coming in the veterans coming in. They have been phenomenal. And I’ll tell you, they have this. It’s built into the veterans. They have the respect and dignity and they really they show that respect you don’t often see that that’s something that kind of nice all of a sudden I’m hearing Yes sir. No, sir. I’m used to that. I’ll get that done. Yes, sir. So that is in the in the discipline is phenomenal. And that’s what we really need and having the the veterans come in has been a big change. And I’ve always been a fan when I was in Tampa, we would recruit from MacDill Air Force Base and people that are retiring leaving, and they were phenomenal. The back of the training. They Have is just the airplane mechanics. Wow. Yeah. Yeah. As many as you can.
Yeah, they’ve got a lot of a leadership background, they’re disciplined. You know, they’ve had good training one of my and I don’t know if you can comment on this, but one of my frustrations occasionally in the recruiting world is you’ll get somebody who maybe they’ve gone through the Nuclear Power School in the Navy, but they might not have their degree yet. But yet they’ve got that they’ve got the nuclear background, they’ve been through their training, they’ve got the lead, and a hospital won’t look at them, because they don’t have their degree. And I’m like, this is the person you want. Do you? Have you found that
I taught the I was up to pilgrim nuclear power plant. So I thought the class the guys just just came out of the Navy. They were phenomenal, extremely bright degree and no degree, man, those are the leaders. And they are extremely bright. They, they learn fast that human sponges, those are the people who really want running your facility. Right?
Yeah. And I know, that’s one of the frustrations, especially as we’re trying to, you know, you’re trying to attract people in, not close them out. You it’s what do you have not? What don’t you have? And if you’ve got this background, then you are? You’re perfect. You really
need to agree, you know, do you really need that the great, I don’t know, what you really need is your certifications, the CHFM. So with as you know, being certified, and these guys can easily, easily, folks, veterans key is no problem. You have to CHFM chc. That’s what you really need. And when they get that under the belt, the good to go. Great. Yep. So hopefully you can convince HR over that as well.
I know, well, that’s the thing. I mean, you know, it’s not always black and white, sometimes there’s some gray, middle and and you got to be comfortable kind of working in that gray area. You can’t just say no,
that’s right, you got to start looking at all that. Right.
So let’s talk. Laurie, let’s, let’s talk about some of your, your top 10 findings. Before I do
that, let me tell you about some of the good things and bad things that I’ve seen. So many surveys, see a lot of things. And I have seen a lot of good things. One of the good things that I really enjoyed, you know, I was doing a hospital in Texas surveying them. And normally, when a survey goes into the oars, the doctors leave, because we’re going to talk about oh are fighters, they just see it, I’m gone. So into this hospital in Texas, and the doctors couldn’t wait for me to get in there. And this that was the first time that ever happened to me. That’s that makes sense. But they were waiting for me. And they just they were so well prepared, and really knew their stuff. The anesthesiologist, the surgeon, they just hope we saw the AR and video, we know exactly what here’s what we did here. And here’s the bowl, here’s the material is Whoa, and and when we’re done on this person’s injured, we take right down to the we go to the next space down, which is the kind of recovery room and I said to you, why don’t you take him to the ER and they said, the ER we’re on the third floor, the ER is on the other side of the building, but a time they get there could be more damage, we’re going to treat right away. And this is where we get more help. And it’s Oh, that makes sense. They were great. I really, normally I get the old nurse stays there and sort of gives me all the answers what I need. These are the doctors that’s the first time that ever happened. And now what’s required annually to do the fire drill separate from all the quarterly drills and a lot of hospitals are actually filming it and using it so hopefully those YouTube videos will be out there for everybody to see, like the Eon video, which was very good. So who knows? That was one good thing that second thing I saw was really did did a hospital recently that has probably the best med gas Oh to setup. And what’s one of the biggest problems we’re seeing on findings is that commingling you see the the empty with the partials with a full you can’t do that. So this one hospital had six cylinders, a full six cylinders of partial and six empty and they had on the front there was a sign saying the exact pressures and this is full. Here’s the partials, the pressure ranges. And then the empty is, you know, a great policy and it was so good. I sent the pictures that everything to the Joint Commission to use as best practices. So it was really a great hospital. The other thing I saw that I really liked, I wish I had done this. This director and I think it was worth West Virginia that every new employee that was hired in maintenance, he put on a stretcher he was lay them down and put them on a stretcher and wheel them around the hospital. But before he did they said look, I want you to look around you’re you’re brand new you don’t know where you’re going but I’m gonna take you around the hospital. Let me know what you see. If you see anything wrong with bothers you just let me know. So they go to the hospital and he was telling me the story of one guy they said we got to have big bump. It was the expansion joint and lawyers as best I can fix that. Oh, okay. And then he said that, you know, he got some stained ceiling tiles here. Oh, you got some lights out. Oh, you got the next sign out. And so the the drug said, that’s when I knew I had a really good employee. That’s I said he did that to everybody. I said, Really? That is a great idea. Why don’t you
think of that? Right. Great idea. Yeah. So
those are some of the good things I’ve seen. Now, on the bad side. Though, you know, we have firestopping material, that you have to be trained on how to put it on, how are you all assembly actually was put together and hold it. And this training, I don’t care if it’s three M STI or Hilty. They train you and they do great training. But I’ve seen some hospital, I’ve gotten it and somebody is taking a paintbrush and painted this red stuff everywhere. And I said that’s not what it’s for. But the whole wall was painted red. No, you can’t do that. Then I sorry. I was doing a fire door right above the fire barrier. And the fire damper was there. And the fire dam has to expand inside its opening and it has a flange around it to allow it to expand. It floats, if you will. Well, they must have used three, four or five tubes of cocking to caulk that fire damper there. And I said, I don’t know why you did that. But that fire damper. And that will never work because it can’t expand. It has to float. Now you’ve locked it in position, it will not function. And they they did them all that way the whole hospital is done that way. I’m going whoa, that was one of the bad things that I’ve seen yellow, bad thing.
Question. Are you going to next when you are so you worked at some big organizations? You worked at the clinic and Moffitt Cancer Center, big footprint? How did you deal with the ongoing issue of penetration, fire penetrations and staffing? How did you control that in your hospitals through
a work permit process and that is a big deal. There should be no work going on in your facility that you don’t know about. So anybody doing any work, I don’t care for IT security anybody’s coming in to do any wires running whatever, you need to come in and get a work permit. And the work permit for me is this three pieces to it. There’s one always hanging on the wall and one has to be hanging on the construction area wherever they’re working. So when they’re all done, they come down to the facility say look, I want to here’s the work permit, it’s closed. And I say Okay, now I’ll make a work order out to the one of my maintenance was the zone mechanic or one of the floaters and say, Hey, go and check it. Was it really done correctly? My guys are all trained. And then what are you all assembly looks like sealing it. And they come back and say, not done. And I won’t pay them. I will not pay the company. So look, I’m holding back 20% You’re gonna come back here and fix those penetrations. Or if they came back and the record was closed, I signed the PIO and they were done. That’s how we control that’s the only way you can control otherwise, you’re out of control. Yeah.
So you’re you’re you’re checking it while you’re having them sign in. And then you’re checking it in the moment. So there’s no lag between, oh, he was here four months ago. We never checked on it. You’re checking it that? Did you
put a sticker on it? So we know exactly who made that? Who sealed that penetration, the name and the date and all that. So it was done correctly. So we knew we watch that carefully.
Did you do the same for like above? Certainly. Did you do those permits for your for any contractor no matter what they were doing coming into your buildings? Yeah.
You have to? Yeah. Yeah. And you got lucky. And believe me, there was some security. Didn’t want to you didn’t know anything. Especially if they were setting a camera up somewhere. They were very quiet about it. And they were at night they would run the cables. Really? Trouble?
Yeah. Yeah. Did it was it similar? Oh,
it was horrible. Absolutely horrible. Everywhere. I don’t care if it’s cat five, cat six blue wires everywhere. We’ll talk more about this. Those are my top findings. So it’s, you gotta be kidding me. Yep, yeah. Well, I
don’t want to I don’t want to jump ahead to the findings. So now it’s fine. I guess I want to ask that because you work big organizations. How did you control that? So that’s a bad thing. What other types of banks do do you encounter? Well,
it’s kind of funny. wedges. I have never seen so many wedges holding doors open in my life. And we go around and there’s a quick story that I did want hospital and we picked up I’m always with the chief engineer or the director of facilities and he picked up all the wedges whether the plastic or wood and he puts them in a little pouch and we walk with this pouch. There was about maybe nine or 10 wedges in there and we walked through this card and we went to lunch afterwards. So we’re gone maybe an hour to an hour and a half. Now we took all these, even the Safety Office had had a wedge. So we went back we had a walk the same way to get back to our office we were in and the same doors were held open with wooden wedges and going. So I walked into the Safety Office. That’s it. How did you get that so fast? He said, Well, we put a work order into the cabin to shop knowing that drink mission was here. They made these things quick for us and what? You’re not supposed to have these doors were open. Well, I didn’t know that. So that’s what happens if wherever we go, Well, you know, it got hot in here, we need fresh air. Oh, no at all. So well, what’s
interesting about that story is, you know, the gentleman says to you, we knew Joint Commission was here. So just like reversed. You know, and
everybody knows that the minute the Joint Commission shows up surgeon at the hospital, they announced that over the PA, welcome to the Joint Commission. And that’s a sign to everybody, start moving stuff out of the way, clear up the corridors, do all the right things, send your construction people home, whatever it takes. So I had I had one floor that I saw a boy who had a lot of clutter here. I say what, let’s go up to the next floor. And you’re saying some of that stuff has to be there for 30 minutes. Okay, I’ll come back for 30 minutes, I waited an hour, went back to the same floor, nothing was moved. So we wrote it. I mean, you try to be a nice guy, but really come on, that’s colada, you know,
with your background as a teacher, so you’re reading, you know, you’re reading your your kids and their body language. And then as a police officer, and certainly you’re encountering everything in the world, and you’re reading people and their body languages and their nonverbals and your director of FM and as a surveyor, do you when you walk into a hospital? In your survey mode, or now in your consulting mode? Can you quickly pick up based on kind of nonverbals? And how people interact with you? Are you formulating something in your mind really quickly? And how often does that hold that you’re actually accurate? You find that what you thought is what you experience
100% of the time, it’s amazing. The minute I walk into a hospital, as I’m walking towards them, I see cigarette butts, or if I go through the front door, and I feel them being sucked into the building, I know this is gonna be a bad survey. And usually when you meet the people, and especially the team that you’re sitting down with, that’s the hospital CEO or the CEO or whatever. You can tell if it’s gonna be a good survey or bad survey. Yeah. I tried to find out how nervous everybody is. If the if the director of facilities is very nervous. Okay, calm down. It’s not that bad. Yeah, yeah, that can be pretty interesting.
Is there a, is there a major tell in your mind, like, for example, when we used to travel a lot on the recruiting sites prior to COVID. And you know, when you could travel everywhere, going into a hospital, I could usually tell just even interactions with hospital employees, like some hospitals, they’ll always say the employees will always greet the street. Hey, how you doing? Can I help you? Others? Don’t. They’re just walking blinders on. And you, you experience that quickly as you just walk in those main doors for you? Is there a tell a specific, you talked about about, you know, if they’re avoiding you, but is there another one that you pick up on right away?
I say I’ve been doing a couple of VA hospitals recently, and the VA hospitals, the people are very friendly. And kind of like, Whoa, we’re not used to that. And it’s always a Yes, sir. No, sir. Good morning, I’m walking with people who don’t work there. These are these people that are, you know, getting treatment. They’re saying, Good morning, I’m gonna see this guy’s a wheelchairs and whatever. And I’m going, this doesn’t happen. I’m all hospitals, the VA is the friendly places. And I you know, you don’t hear a lot of good things about them. But as I go to them, the people are nice. The patients are really respectful and nice. I think that’s the military background. Yeah. Everybody’s that way. And even the most of the people that work, there are veterans. So that just for me, it’s been a really refreshing change.
It is amazing the the small impact that friendliness can have. It’s one of those things that doesn’t cost anything, but it’s very impactful.
And when you get that you want to help more. If you stop a speeding person who in his vehicle and you pull them over and a little bit, it all depends on how they treat you. And you’ll look at it right away. If you really get some bad stuff you go, let me see if I can find more things wrong. And so when you get to a place that’s really nice to you, you sort of want to help them How can I help you? And how can I make it better for you? Yeah, I’m gonna teach you different things. That’s what it’s all about.
Yeah, yeah. I mean, you you mirror what you get. Exactly right. You reflect that back.
One of the things I really tried to do on every survey, I tried to make sure that everybody talks about it’s not just facilities. It’s really, you know, it takes a village to make this hospital work well and be ready for a survey. You know, it’s every every three years and when you think about it, it’s always the last six months before survey all of a sudden you get hundreds of Are coders, hey, can you paint this? Can you fix this? Why not do continuous compliance? Why not be ready all the time? And then not that really not. So it’s really frustrating. And you have so many great people working in the hospital, if you work as a team and become a village, if you see something, say something, you walk by drip on the ceiling, say something, if you see something, let facilities know it’s a work order system, you can certainly call somebody. They just don’t do that. So it’s kind of like frustrating to the facility folks that or they, I love them. They say to me, I’ve seen this many, many times. I’ve sent them hundreds of work orders. Really, and you go research it, you find nothing. That’s always been broken forever. Well, did you put a work order in? Oh, yeah, many, many. Yep. Now I always do that. And we research it. We can’t find a work order. And it’s just really, yeah, it was.
Right. Right. Do you think you know, as you were saying that the relative to the work order? Do you think that in some organizations, and it was kind of similar? There’s a work order for a person putting in the work order, and it could be Hey, I passed him in the hall. And I asked him, that’s a work order, or work orders a text these days? Because everybody tax they don’t? It’s going back to like, process. You know why those military people are so good, because they are used to process and that’s what they do.
Yep, exactly. Right. Yep. And I see that all the time, you know, Hey, I see Joe, the plumber, hey, you know, my sinks been leaking for a long time you take care of that. And of course, Joe will go fix it. Right and work on it. So there’s no record of anywhere. And that’s a problem. So, yeah, we always tell the guys Hey, please, if somebody tells you something, call it in, put the work order and then go and let somebody else let it get issued to you or somebody else. Do
you miss any of that day to day?
Yeah, do you do? Which is why I like serving because I get back into hospital. And if I see something, I’m always looking to save them energy. So I’m always looking at, hey, have you thought about this and haven’t thought about that? And try to change their processes?
Yeah, are they? Do you find like you as a consultant? Do you sometimes have to catch up because you just listened to you talk, kind of your natural nature is to educate, and to help? Do you find sometimes you have to just say, in your own mind, to accomplish what you need to accomplish, I kind of need to at least not back off. But like stay stay on task so that I get done what I need to get done, as opposed to trying to help them all over the place. Does that
happen? Yeah. Yeah, I haven’t just recently, I had to go back at night in the hotel. And I was doing all the writing and I’m, I’m up to 100 findings. I’m going, you know, I spent so much time talking, I didn’t hit all the areas I wanted to hit. So the next day, I said, Look, let me concentrate on this. Now let’s concentrate on all the things I did not see that you try to lead me away from? Oh, that’s what you’re doing. sighs right. Because I am. So I still want to help everybody. So yeah, so I. So all of a sudden now it’s, I missed those areas. I’d like to get them done. And this other You sure you really want to go in there? I said, Yes. That’s what it’s all about.
Right? Right.
It’s me on the way in there. It’s not the best shape. But yeah, okay. Let’s take a look at it. Right. It’s no sense hiding it. I’m here to help you. I’m not a Trade Commission surveyor to give you some help. So let’s get it fixed.
Maybe I, you know, maybe you don’t see it. But if I don’t take you there, but the Joint Commission is gonna stay. I mean, what am I paying you for? That?
And I told them, I said, Look, I know you have, they’ll give me a sheet for all this information on it, that they check the weather, it’s been a eyewash station for weekly check or whatever. But I said, you know, you need to have a different eye on this. It’s not that I don’t trust you. It’s just that I don’t trust you. And you have to stop looking at that now is it that almost looks like it’s been pencil whipped. So you really think these are being checked? You got to make sure that this is your hospital, you are held accountable for it. If something happens is hospital, the other one going to court. So is the work really being done on a pm is really an end and I show them I went down look at the five problems. This Pm is not being done. Can’t you see it? The zerk fittings are sealed. No one’s taking the cap off. They’re brand new, and the pumps been there for a long time. Nobody’s done any work on that pump in a long time. So he also asked it, and if he also asked it and the vendor didn’t do his job, you need to be looking at that and saying it’s not being done right. And that’s why you do a survey. That’s why you’re there. Right? Everything really being done right? Are you really doing all the PMs when you start looking and looking at electrical switchgear, you’re looking at all the breakers and the fall of dust is somebody really taking care of that lot of stuff. So you got to make sure that your site is really being again, if something happens, you have a fire or you have an explosion or whatever happens take everybody comes down to you, OSHA, you name it. And you wind up being in court. And you don’t want that.
Probably. Right. Right. Yeah. I mean, it’s just such a, you know, number one, it’s for patients, but it’s so visible. And there’s no, you just don’t want it. You don’t want to be on the newspaper and hear the TV. Have you seen Larry, you and your years relative to compliance and surveying and now consulting? How has the process changed? Or? And I’m not asking like, how they do it. But what are some? How has it evolved? From your very early on, if it was, you know, a slap on the wrist all the time to now where you’re trying to educate and bring more? How does that whole thing change? Or has it? And if such
change? Yeah, I think originally, way back when I first got involved with the Trade Commission, we started, I think, Joint Commission survey started in 2005. And it was, again, it was, it was a learning time for everybody. And about 2010 or so everything changed a little bit, where CMS was getting more involved and saying that, you know, our surveys go out. And we find many more findings to your guys do in two days. How come? Yeah, and I remember George mill saying, wait a minute, you have five surveys going off for a week, your course they’re gonna find more than you’re only there for it’s one guy for two days, actually a day and a half, he’s not going to find them all the stuff that you find. So a lot of pressure in 2012 2013 2014, we’re always getting a lot of pressure, you got to find where you’re gonna find more you got to. So that’s where it really changed. And it became more or less teaching, and more trying to find things wrong. Yeah. And that’s kind of sad, because the whole goal was to make your hospital safer. Well, if you teach people keep it safe. That’s what they do. And to whack people on the head. Just didn’t work. Yeah, yeah.
Do you? Um, do you feel it’s going shifting back? The I mean, obviously, CMS is still that elephant in the room? And it doesn’t seem like there isn’t, you know, they’re not laying off. Don’t laying off the pressure. But are you? Are you sensing maybe a little bit of a shift towards that education model?
I think it’s coming back. There’s so many new, you gotta remember now, when there was like, way back when before COVID, we had at lifesafety surveys, and about 40% 40 of them didn’t come back. Yeah, so a lot of new faces in there a lot of new people, and they came in, gung ho, they really raring to go. And they’re very knowledgeable, and they want to teach. So they want to make sure everybody’s making the play safe. So I’m seeing teaching coming back again, which is really good.
I have a good comply. To be good at compliance. It sounds a little goofy, but like, do you need to have that education mindset at your core to be that continuous learner and kind of inquisitive?
You even think you’re an engineer, you understand that you’re always digging? I understand. Now they’ve hired some OSHA, people, which is our safety people and emergency management people. So we’ve got a wild array of what’s out there now, which is really good. So what you’re gonna get, so but they’re learning too, because as you do more and more surveys, you learn a lot, too. So I think that’s helping. And that’s
probably going to be the blueprint going forward. Because as we’ve said, You’re gonna have to attract people from other fields into it. I mean, there’s simply not enough folks. And they’re coming in. Yeah, yeah. So I kind of took you off track a little bit when you were talking about some of the negative findings or the bad things you’ve seen, did I interrupt your list at all? Well, I
got, let’s go for the top five of safety and the top five of ECE and these are, these are my things these are not in the past and 2023, the 1819 hospitals, and when I surveyed them, these are the ones that I found this being top and I’ve always and as we’re finding the findings, I’m always going to the staff, that’s I’m always surrounded by people that have usually quality safety, and of course, the manager or the or the director of facilities with me, and I’m always saying, you know, this is something that really the environment of care committee, or you have, you do more rounding or you do more traces, but it’s got to be not just facilities finding and doing the stuff but everybody it’s team effort. So I always take the opportunity. So I’m going to do that as I look at the top five life safety findings are found. We tried to share them so and I’ve done this in a couple of presentations to hospitals are number one was lifesafety to 135 EP for the wires on sprinkler pipes, man that is and we have spent a fortune to put these wire racks in the ceiling during construction so that when you run the wires put in the wire rack, that’s not where they’re going, unfortunately, and we get tons of pictures out there that the blue wire the famous IT group just puts wires on the poles. Like, we saw one as almost like a barber pole graphic all around the sprinkler pipe for quite some distances. You gotta be kidding me. Yeah, how did you do that so and nothing can be touching a sprinkler pipe, we had a conduit that was really onto the pipe and you got to move the conduit that’s it’s sitting on the payments are pretty heavy, so you’re gonna be kind of careful. So those are the things that you really that’s where the work permit process really comes in handy. Hey, let’s take a look at it just running some wise. Where did they put them? Yeah, yeah, that vendor, ACH piece of conduit? Did it right and right. Is the correct? Are
you finding that in newer construction as well? Or just in the older? Older? Older?
Yeah, the old the new one doing gets it? That’s well, because the new let some time go by? Right, right. I’m number two was the lifesafety to 135, EP 14, block fire extinguishers? Well, how can you do that, but you sing it. And I tell everybody, hey, why not paint around it. Three foot rule was some tape or something, or put on it do not block fire extinguisher. And actually, we found the block fire extinguisher with the sign there. And
so what’s the craziest thing you’ve seen blocking a fire extinguisher?
A move and cool unit? Really? You know, that was the HVAC. HVAC department did that really, they know better? They really should know better. But they didn’t. The third one is the lifesafety to 110, EP 14, firewall penetrations. And the big thing right now is a scab patches and the scab patches over the years have been everywhere, man, there’s a lot of them. And that’s something everybody is challenged with. And obviously, the you your group can’t find you because they have to go above the ceiling. But that’s where the issue is. And that’s where that work permit process again, hey, there shouldn’t be any patches used at all, do it right? Run the right one of the right wire pipe correctly, and you won’t have that problem. So that’s been a big deal. And again, train your staff on the UL assembly, how it’s done, why it’s done. And they can then notify you that hey, that company that was just there use a scab patch, they should have done it. No, that’s not allowed. That’s been allowed for a long time. So there’s a lot of hospitals a lot of scab patches
do you find and I think this is human nature, like when you go into a hospital if you don’t see penetration, so if you see that they’re doing a good job control as a surveyor, do you naturally start to not You’re not letting them off the hook. But are you? It’s kind of like reach out if you’re treated well. You want to treat other people well? does it build upon itself? If you’re seeing all these penetrations, and then you just become you’re going down a route where it’s not going to end? Well? Does that happen? Yep.
I just did a VA hospital that I couldn’t find a penetration or problem. So I am up on the top floor next door next door. Next one I’m going after five or six floors. I’m going wow, you guys, you have your act together here. Really nice job well done. I’m not finding any which is so unusual. The smoke barriers were correct. The fire situation everything was well done. So I’m going, I’m stopping. Yeah, well, on the other side. If I start seeing floor 10, nine, eight, I’m getting a lot of penetrations, I stop after three or four floors. This is why spread you have a problem. Yeah,
you’re just going to you extrapolate. I mean, if it’s that way on three floors, what’s going to be different. And
I could tell that with this hospital, this VA hospital, they had the stickers there. So I knew that they had data and everything. So this was a done deal. I wasn’t finding any it was kind of frustrating to me because I could find them because they were good. And when I see that, like they’ll send person up will look for us. And they say no, I can’t find that. And I go Yeah, it’s not that I don’t trust you. But I’ll trust you. I’m going up. And I said you did a good job. There were none. And I checked for wires and pipes to look for open junction boxes. I wasn’t finding anything. So You’re frustrating me here, we got to find something. But that’s what you have to have some fun. And that’s part of the humor. That’s part of it, but they’re great. And they all enjoy doing it. So there’s a good time. Yeah, that was kind of a we, we usually find a lot of Scout patches to find none this time was interesting. But that’s that’s good. That’s a good sign. The fourth type lifesafety thing that I found was the lifesafety to 110 EP 11. And that’s what I talked about before I wedges, wedges. We have latches that don’t work on doors. I always like to press against a patient room door. And if it goes up I go let me try that again and close it. It doesn’t hold the left. There’s a lot of latches that fail and just nobody checks them. And for the first time I’m noticing a lot of hospitals, they have those kick downs when they kick down so you see at the bottom of them kicks down and locks that door in place. And a lot of hospitals say look, I’ve had that kick down there for 20 years. No one’s ever said a word Before whether or not allowed and hospital, really, no one else caught it. You got lucky.
Right? You
just never know. The fifth thing it was kind of fun was the last thing is really were lifesafety to 135 EP five very common, missing discussions. And if you can spell it, I always ask a specialist
to spell on meeting notes. I’m gonna get it right the first time and just copy and paste. Exactly.
So I see a lot of that dirty sprinkler heads. And we always go to the loading dock, especially up north, it’s a dry system usually end up just being outside in the salt air those sprinklers get corroded. So that’s got to be replaced. And we always ask them, because look at how long have those quick response been in there? And they say, oh, a long time? Well, 20 years, you got to take a look at them? Should you replace them? You have to check 10%? Did you did you know all that? They say no. And if you’re over 50 years, which many hospitals are well over 50 years, on the on the normal response? Have you changed those order yet? And they said, Oh, I didn’t know that. Take a look at 99, you got to take a look at that, you know, in 72. You’ve got to take a look at changing auto sprinkler heads. And then they finally do it. But But I catch them on it every time. Yep. The TOC EC ones really and again, again, using other people, not just facility, folks. But What help can you get from your rounding, your EC, rounding and of course, your your village. All this EC 261 Probably the most common of everything to six one if you want, which is your stained ceiling tiles. And I like to stick around when I see a badly stained ceiling tile. And usually right behind this is the guy with a ladder. And he’s got brand new ceiling tiles ready to go in. And I always watch them how they take it out. It’s how you take that stained ceiling tile out. That’s got all kinds of good mold growing on it, whatever. How are you taking that out and protecting the people Nice? Well, the patients? Because those are the spores on that. So you start taking it out. And there’s a lot of there’s always airflow. It’s running around everywhere in the hospital? Do you bag it immediately? Or do you take it off? And every time they take it down? They put it down the base of the ladder and they put the brand new top? I said whoa, wait a minute. Now that’s an icy finding. Yeah, because the sports that just went everywhere. Thanks to you. Now if you bag it immediately, and that’s what the survey stands around, you know, I always played Mickey to dance and say, I’m just waiting to see what happens. And sure enough, he did. That’s exactly what he did every time you just you never know, you damage walls, you can see the nurse cord, you know the pull cord pulsation inside the bathrooms. It’s wrapped around the I said this is stuff that really your environment of care committee or nurses or everybody else is walking on the hospital? If you see it, let us know if it’s a damaged wall or it’s whatever it happens to be rust anywhere. We saw some ceiling tiles with black mold growing. Doesn’t somebody say something? Yeah, that’s one that the environment cat committee going around doing traces can really be a big help to you. The second one that’s that’s that’s a lot of fun, is Ec 251 EP nine that came back to life again, that is the spares being in the on position. And that’s a problem because you don’t know what the feeding, sell. So we’re also finding that the you have to label your main emergency shut offs. So if you have a natural gas line coming in, is that labeled Main gas shut off? How about water main water shut up, main power shut off. So especially on a boiler room want to know what that gas valve is to shut if there’s a crisis sometime. So everything has to be all utilities should be labeled FTCS outside Fire Department connections have to be labeled. So people know how to find them quickly. And we’re seeing a lot of people just not doing it until they go set it up.
I think especially these I mean, obviously it’s critical. But even more so with I mean, some of that built in. And again, it’s not a good excuse. But you know the person who might have known what that serve, they could be gone. I mean, you’re losing so much staff. How do you learn? I mean, you can’t learn by trial and error. Everything
has to be labeled today. If you don’t label it, you turn over so great. You have to label everything. Where’s the gas shop? Where’s the main water shut off? Where’s logic? How am I killed power? So those are all important things that we just have to get out there. Yeah,
yeah, absolutely. That’s important. The third
one was EP, EC 255 EP six. And that’s our favorite one that’s a lot underneath the bat has to be 100% of your non high risk PMS must be done. That is a struggle for every hospital right now. The high risk and infection control. They try to get them because that’s the first at the end of the month. They try to get it done. It’s the non high risk. Many hospitals have 60 or 70% to the 100% just can’t get that you don’t have the staff. You’re missing people. And let me tell you that Oh, We contracted out, but the contract is having the same problem that we’re all having. Right? Get the right people that just don’t exist. So in their training, they’re in training or they may not do the best job. When you have an in house team, they have ownership and they want to make sure that it’s done correctly. Well, somebody from the outside may not have that same ownership. Are
you finding Larry more pm slippage as we Yeah, yeah. Yeah, yeah. And that’s something you know, it’s
because they don’t have the staff. Every time you hear it over and over again, don’t have the train staff or it’s been a huge problem. And this has been this many things on this EP, six this from blocked electrical panels, freezer temperatures, your emergency lights being done egress lights. It’s a lot of things that you have to keep doing all the time, and you may not have to staffer, and that’s what hurts everybody. Yeah. Yeah. So as far as a common finding, EC two to one, EP five is probably an element of so common, that’s your I wash us in showers? Are you really? Do you really need the eyewash? First of all, do you have a risk assessment on it. And again, that’s part of your team needs to do a risk assessment together, make sure you get the 10 seconds, make sure that I always like hearing that the staff that’s that wanted the eyewash there, actually every week, checks it and actually does the PM, so they they got a chance to throw the lever down, it runs it, you get a chance to see the caps blow off, you keep it clean, of course, and make sure that it’s tepid water from 60 to 100 degrees, all the right things. And then once a year, I want to see the annual PM, done by facilities to make sure that it’s the right flow or the point four gallons per minute the whole bit. So those are a common finding. And you would think, you know, by now we learned all this No. And there Eyewashes everywhere people have gone out of control you putting for every reason? No. What are you doing? Well, I could get blood muck? Well, that’s not what it’s for, has been caustic or corrosive. So is the risk assessment? And yes, you can have it if the risk assessment, and you all agree. And usually I use the EC committee, because it’s a multidisciplinary group that has in its in the room says yes, they do need it, or they don’t need it. So don’t waste the money. So a lot of time and effort and maintenance. And the last one that’s kind of a seen a lot of is Ec 259 EP 12, the O two cylinders. It’s not just the commingling and the unsecured, they got to make sure that if it’s if you have them outside, they gotta be on. You don’t want to sitting on the ground. You don’t want them running away. You want to make sure everything is done correctly. And boy, we see a lot of I’ve seen Oh, two cylinders, on on heaters in the room. I’ve seen them on stretchers on the top on beds, you see, holding open doors. Really? Oh, yeah. Craziest thing is it wouldn’t find a wedge, that’s a wedge. For that those are really the top 10 that I see the most out there. And I think that’s something that we, again, people can help you with that if they see something like that call, you see somebody putting a bottle on top of a stretcher, shouldn’t just say something to somebody and say, Can I help you? Yeah, okay, move it down to something. And the bottom was stretcher, it’s got to actually hold it for the boat to cylinder. So it’s a nice cylinder, put it in the holder. Now,
have you have you found a full cylinder holding a door open? Yes. Really?
More than once? Wow. Yeah. To him. So you would be surprised at some of the stuff you almost say this up, I can’t make this up. And the people that are with me and taking pictures. And if it’s you can’t get a copy of that picture. That’s really good. Because this you don’t always see that it’s craziness. But people are in a rush. And you have so many the clinical staff is really has changed a lot that constantly leaving and coming back. We’d lost a lot after COVID. So you have a lot of new people and they’re all learning. So mistakes.
Yeah, and it sounds you know, as you just listen to your talk, and I’m sure you think this is your you know, as you’re out there. It’s not like you can’t solve for one issue. It’s multiple issues that all play a role in this right everything from education to turn over to time and it’s a it’s a tough one.
And it’s not just these findings, it’s so much else it’s going on. It’s workplace violence. It’s the active shooter and all that training it’s there’s so many things going on in Oslo at all times that you and now you got all the world’s situations that are going on, that has people upset so you got so much going on.
Time so crazy. And the hospital really is it’s the epicenter of the community because everything that happens in society if it’s if it’s a negative, it’s going through that hospital.
Exactly right.
Yeah. Do you find Larry and last question and Larry, how would if somebody wanted I know you’re have a great presence on LinkedIn, but if somebody wanted to reach out to your LinkedIn the best way to do it.
Yeah, my emails there, it’s LF Ruben on hotmail.com. I can always get a hold of me that way. But it’s all in there. And if I can help somebody is what it’s all about. It’s what’s the name of the game here? Yeah. And
when when you’re not, when do you sleep? But last question, and you touched on it a bit. We had done a survey. Just we do one every fall, just healthcare facilities management surveillance among our network. But one of the one of the comments that I read was, and I’m interested in your opinion on it, is that there is so much on our plates now. It’s really, they’re worried about compliance, specifically, you and they’ve mentioned compliance, specifically that there’s so much relative to sustainability, sustainability, active shooter, everything you’ve just talked about. Do you worry about that, too, that there’s so much on the plates of these folks, that it’s becoming even more? I’m just going to use the word burden. Some of you did, but even more difficult to stay on top of things.
I’m seeing burnout. Yeah, I did a survey not long ago with a facility manager who is really I could tell this guy’s gonna burn out. He’s so good. He’s, he’s really, it’s a 24 by seven job. So what it means is, you get calls one, two o’clock, three o’clock in the morning, I’ve got many of them. My father’s used to kid me, how do you go back to sleep after that? She hears me at one o’clock in the morning. Yeah, make sure you turn this thing on, turn that on, do this, do that, then they go back to bed? How do you do that? It’s years of doing it. It’s so but you got to be careful. Don’t burn yourself out. Because there’s so much going on. You can’t do it all you need help, and trying to find the right people, hire them for a while, hire a consultant for a while to help you. And then if then you gotta convince leadership. You need somebody here. I can save this money from the consultant by hiring somebody in house. Does that make sense? And most of the time, it actually works. I’ve done that a lot. Yeah, yeah. It’s a tough job. This is not an easy job. There’s a lot on your plate. And if you make a mistake, I mean, you can get fired. Right?
Right. Yeah. And and you could potentially cost somebody their life even more drastically. So Larry, anything else we can get? This has been a fantastic, fantastic session, anything I know you, you had taken some items that you want to get anything we didn’t touch on that you want to close with.
I think you hit them all. And I can remember the pressure on even the facility directors that I had a nurse manager come down to me way back when when it’s in Boston, saying that you just killed his patient. And I mean, that really puts a lot on you. But that’s our job is to keep people safe. This was a BMT patient, the ceiling got wet from a leak. And obviously, this is a BMT bone marrow transplant patient that’s very sensitive to that. So that really makes you really do your job. And to me in my brain, it’s always been the patient’s number one. That’s what it’s that’s why we’re there. So are we really keeping everybody safe? So when I do a survey, I don’t if I don’t feel comfortable, I will tell the manager director, look, I I’m not feeling comfortable. Your patients are not safe here. And you’re doing all the right things. What can I do to help you? That’s kind of the biggest thing. That’s what it’s all about. That’s what every manager has to deal with all the time. Yeah.
Do you ever get it last? Do you ever get or have you ever said that to a manager and has like, Have you ever received a reply that kind of flew to Florida or made you take a step back and think, oh, boy, Has that ever happened to you? No,
not really. No, I’ve been pretty lucky. I was really floored when this nurse manager said that to me, and I think that really changed my focus a lot. That was like a 9090. And I think I remember that so well. That it always keeps me focused that I will never let that ever happen again.
Yeah, yeah. Wow. Well, Larry Rubin thank you for your time today. I really, I pleasure.
Okay, thank you so much.