Meet our Staff

Rich Miller

A Path Not Often Traveled: From Tool and Die Maker to Hospice Nurse

Compassionate and caring. Comforting and knowledgeable, Proficient and efficient. These are the skills and behaviors that are highly valued in any nurse today.

Rich Miller, hospice nurse for Family Centered Hospice, is not --- by any stretch of the imagination -- just “any nurse”. Not only does he have the skills that make for an exemplary nurse. Rich also is uniquely “hard-wired” to provide outstanding patient care.

Three years ago, Family Home Health and its sister agency, Family Centered Hospice, became one of the first in the country to install innovative software specifically designed for patients in home health and hospice settings.. The technology, known as Healthwyse, allows the patient record to be stored and updated electronically. The data is shared with members of the health care team in order to enhance clinician-to-clinician communications about the patient’s health status, as well as to improve overall patient care delivery, satisfaction and outcomes.

The first generation technology, according to Rich, while a vast improvement from traditional paper charts, had some significant limitations. “The handheld device we used to record our visit and notes about the patient’s condition processed the information very slowly. The text on the screen was very small, creating a lot of eye fatigue for the nurse. At the end of the day, all who used the device to record their visit activities had to connect in to the central database and “synchronize” or update the latest information about the patient into the centralized chart.”

This activity was time consuming, taking in some cases hours to complete. If “syncing” was not successful, sometimes clinicians scheduled to visit the patient the subsequent day had less than comprehensive detail on the patient’s status. “If one of the team members had difficulty syncing the night before, then those who were visiting the next day had incomplete information. This created the need to make multiple phone calls to other team members, and disrupted the actual face to face care time spent with each patient,” stated Rich.. “But, even this approach was more reliable and timely than the paper based charts that many agencies still use.”

Recently, the agency transitioned all clinicians from the small handheld device to wireless laptop technology. According to Rich, “The hardware we are now using is outstanding. It processes our updates quickly in real time and fully captures our observations about the patient and his or her condition.”

The speed of the technology has resulted in one hoped-for benefit: it allows nurses to work more efficiently and productively, thereby allowing them to better manage their work/life balance.

Another unexpected but welcome benefit has also emerged: the technology is helping nurses to more quickly build trust and gain the respect of patients and their families. “After visiting with and assessing a patient in the home, many families will allow me to update in my laptop the patient’s record while sitting at their kitchen table. What I am doing can be a curiosity to them, so I use the time to teach them how the interconnectivity of the wireless laptop helps me ensure that the next team member to visit will have the latest and most up to date information about their loved one.”

Families often ask a hospice nurse when an aide is scheduled to visit or the chaplain or a social worker. “The information is right there, at my fingertips – no need to call in to the office to find out the answers. When families realize that I have provided the whole hospice team with real time information on things such as medications, the patient’s vital signs, how the patient has eaten on that day, the patient’s mood, and much more, they become ever more confident in the fact that we are providing the optimum level of care.”

The use of this type of technology comes naturally to Rich. While he professes that the technology is intuitive and very user friendly, maybe his “pro” status is in part due to the somewhat unusual trajectory his work career has taken.

For many years, this self-effacing nurse worked as a tool and die designer for well-known companies such as Motorola and Zenith, and for some in the automotive industry. Computerization was part and parcel of tool and die manufacturing, as was a mandate on safety, detail and preciseness – often called a “zero defects” culture.

According to Rich, “The only two things -- although they were big ones -- missing in my line of work were interaction with people and true job security. From the people perspective, I tinkered with software programs 8 – 10 hours a day, five days a week, from a cubical, hardly ever talking to the person on the other side. From the job security perspective, the handwriting was on the wall: there was a rapidly shrinking need for tool and die makers in the U.S.”

“I would come home at night, nervous and concerned about my future, and wondering about my ability to financially support my wife and two children for the long haul. Over the years, I did a lot of self analysis, and while doing so, observed how fulfilled in her career my wife was as a nurse working in private duty. The elderly people she worked for cherished her and recaptured a good quality of life due to all the good care she gave them.”

Then, the light bulb went on for Rich: he had to transition his career track from the product focused, dispassionate industry of manufacturing to the patient centered and service focused industry of nursing.

Rich started slowly, by taking night classes, but continued to work during the day in tool and die design. It was a grueling schedule, but the more classes he took, the more convinced he was that this was the right profession for him..

Eventually, he began his clinical rotations, which have to be completed on a full time basis. He took the major leap of faith, quitting his job of 20 years. He secured an equity loan on his house, in order to pay for his schooling and other family expenses. “Without the unwavering support of my wife and kids, I would not have been able to make this career change. They were first line cheerleaders and my motivational force.”

Once he graduated, the career fit was immediate for Rich, because nursing provided Rich with the opportunity to work with people, apply his strong detail orientation skills, recapture a sense of job security, and utilize his technological strengths.

After working in a few nursing settings, Rich realized that hospice was the unequivocal right place for him to practice. :Hospice nursing care is unique in that it fundamentally allows you as a nurse to take the time to address the care needs of not only the patient, but also the family and nursing home staff, when a patient resides in a nursing home facility.”

“While I have only been a nurse for six years, I feel the technology our company has invested in allows me to utilize best practices each time I visit with my patients. It is so very rewarding to know at the end of the day I have done the absolute best I can for all patients I am honored to know and serve.”