Tag: Practitioners

Nashville, TN — AP Health is proud to be Certified™ by Great Place to Work® for the 3rd year in a row. The prestigious award is based entirely on what current employees say about their experience working at AP Health. This year, 86% of employees said it’s a great place to work – 29 points higher than the average U.S. company. 

Great Place to Work® is the global authority on workplace culture, employee experience, and the leadership behaviors proven to deliver market-leading revenue, employee retention and increased innovation. 

“Great Place to Work Certification™ isn’t something that comes easily – it takes ongoing dedication to the employee experience,” said Sarah Lewis-Kulin, vice president of global recognition at Great Place to Work. “It’s the only official recognition determined by employees’ real-time reports of their company culture. Earning this designation means that AP Health is one of the best companies to work for in the country.” 

Founder & CEO, J. Toby Gray says, “We are thrilled to be Great Place to Work-Certified™.   Employee culture is a top priority for us, and we value what our employees think about the company. We owe our continued success to our team of dedicated employees at AP Health and celebrate them for all they do to earn this recognition.” 

“This is our third year as a company participating in the Great Place to Work® program and the feedback we gain each year is incredibly valuable,” says COO Greg Flanagan. “We actioned categories that had room for improvement and the results of this year show that. We continue to put employee satisfaction at the forefront of AP Health and our employees think so too.” 

According to Great Place to Work research, job seekers are 4.5 times more likely to find a great boss at a Certified great workplace. Additionally, employees at Certified workplaces are 93% more likely to look forward to coming to work, and are twice as likely to be paid fairly, earn a fair share of the company’s profits and have a fair chance at promotion. 

WE’RE HIRING! 

Looking to grow your career at a company that puts its people first? Visit our LinkedIn Career Page for more information. 

About Great Place to Work Certification™ 

Great Place to Work® Certification™ is the most definitive “employer-of-choice” recognition that companies aspire to achieve. It is the only recognition based entirely on what employees report about their workplace experience – specifically, how consistently they experience a high-trust workplace. Great Place to Work Certification is recognized worldwide by employees and employers alike and is the global benchmark for identifying and recognizing outstanding employee experience. Every year, more than 10,000 companies across 60 countries apply to get Great Place to Work-Certified.  

I started my career in cardiac surgery nearly 40 years ago. The advances that I’ve witnessed in terms of procedures, medicines and machines have transformed the nature and the effectiveness of the cardiac OR. While we still have heart and lung machines in the OR that pump and oxygenate blood, the technical sophistication of an operation has increased dramatically. The result is that more patients not only live but return to their normal lives much sooner.

In the early 1980s, the average cardiac surgical patient was intubated for 24 hours and then spent three days in the ICU. If they did well, they went home about a week later. Today, that patient is only intubated for four hours, are up and walking on day one and go home typically on day 4 or 5.

Back then if you had a complicated heart problem, the only device that was used was the intraaortic balloon pump. While we still have them, they are used much less frequently because we have so many more tools in our arsenal. We used to do frequent surgical aortic valve replacements, which requires opening up the chest; However, those have been essentially replaced by transcatheter aortic valve replacements (TAVRs), which are less invasive and offer faster recovery times.

Similarly, endoscopic procedures to harvest a vein for use in bypass surgeries have also made those procedures less invasive. We used to open up someone’s leg to get the needed blood vessel through a long incision and now it is done through a couple of small incisions. Today, we’re more aggressive about complete arterial revascularization and endoscopically remove the radial artery in your arm through a small incision by your wrist.

Advances in medicines have also improved outcomes and the quality of patients’ lives. Historically, you could count the medicines we had in our arsenal on one hand; now we have dozens, and they keep getting better. For example, it wasn’t that long ago that statins, aspirin, and Beta blockers were not a standard drug for heart disease. Now they are prescribed by your primary care physician and have helped stave off surgery for thousands of patients.

Of course, the devices and machines that enable these advanced procedures have and continue to evolve as well. Many people have heard of the ECMO (Extracorporeal Membrane Oxygenation) machine due to the pandemic because it provided oxygen to the blood of severely challenged COVID patients. Those machines are placed by the cardiac teams on staff. We also have a variety of devices such as the left atrial clip which reduces stroke risk in atrial fibrillation, as well as left and right ventricular assist devices (LVADs) (Impella) to assist the heart in pumping blood.

Advances Require Increasingly Sophisticated Surgical Staff

As cardiac surgery has become more advanced, the surgical staffing role has also become more challenging. The skills needed have become more complex such as vent management, intubation, chest tube insertion, central lines and vein harvesting. While school provides a foundation, there is so much more to learn and skills to be developed for cardiac surgery that schools simply don’t provide. There is ongoing CME to keep up with the latest information. The device companies frequently have small seminars to keep us refreshed in the latest information on their devices.

At AP Health, we staff the cardiac surgery programs at three hospitals in South Florida: Holy Cross Health, Jupiter Medical Center and Bethesda Hospital. These are major cardiac surgery programs on the forefront of cardiac care. To serve our customers, we have a program to develop staff.

Not every practitioner comes to us with the same skillset. They might have surgical experience but have never worked with an ECMO. Or, they have may have worked in cardiology, but never done endoscopic graft harvesting or worked in the ICU.

We give our practitioners the knowledge and experience they need to be successful in an advanced and complex cardiac surgical program. Some of this comes from training by the manufacturers of the machines and devices we use on a daily basis. Some of it is on-the-job training where I, along with other staffers, share our knowledge and help them develop the skills needed.

After 40 years, I still love working in cardiac surgery. It has been rewarding to witness the advancements made and to continue to develop my skills to improve outcomes for the patients in our care. I also enjoy working with younger practitioners so that they will not only be successful today, but in the future as new procedures, medicines and devices continue to advance the treatment of coronary disease.

“I can’t think of doing anything but cardiac surgery,” says Irina Gruboy, PA-C. “It is my true passion in life because we take people into the operating room and about three or four hours later, we change lives for the better. It is so gratifying knowing that you are part of something so monumental for them and I think it’s absolutely incredible.”

Irina developed her passion for cardiothoracic surgery while in PA school. “I originally thought I would go into OB/GYN, but I had a conversation with a senior resident that changed my mind,” she explains. “We talked about how wonderful the heart is and how incredible it is to be one who can fix it. That’s when I caught the ‘bug’ for cardiothoracic surgery as I call it and knew that’s what I would be doing.”

A native of Odesa, Ukraine, Irina emigrated to the U.S. in 1989. She earned bachelor’s degrees in chemistry and physician assistant studies. She then acquired a master’s in advanced physician assistant studies and a PhD in healthcare administration.

Irina joined AP Health in July 2021 and works in the cardiac OR at Holy Cross Hospital in Fort Lauderdale.

“I’m involved clinically in all aspects of care, from pre-op to post-op,” Irina says. “But the operating room is my happy place. I get to work with great surgeons, do a lot of coronary bypass surgeries, and valve replacements where peoples’ lives depend on us. I also love teaching and mentoring younger practitioners. I always tell them, ‘Your success is my success. And if you surpass me in your career, it will be my success once again.’”

Irina Found a Home in Florida and AP Health

In joining AP Health, Irina moved to South Florida and left behind more than 20 years working as a cardiothoracic PA for hospitals in the New York & New Jersey area.

“My primary reason for moving to Florida was to be with my daughters, who are both in the area pursuing medical degrees,” Irina says. “A friend who had recently joined AP Health told me about a position there, so I checked it out and made the move. I’ve been very happy with the team here.”

“Clinically speaking, my job is not that different from previous positions I’ve held. What is most different is that this company is led by (CEO) Toby Gray, who is a PA by trade, which I think makes a difference in how people are treated. The leadership team makes it clear that they care about every single person on an individual basis.

“For example, if there’s something I’d like to speak with my manager or even Toby about, I’d have no problem shooting him a text message and saying, ‘If you have a second, I’d like to chat.’ And in less than five to 10 minutes, I get either a text response, or more likely, a direct phone call back to me, and that is priceless. No matter how good I have been and no matter how many years I have put into other institutions where I’ve worked, I doubt that I would be able to get a CEO on the phone within a 10-minute timeframe.”

Irina says that while no company has been immune to the staffing challenges over the past year, she thinks the company has been as flexible as possible in creating a work/life balance for employees.

“By its nature, heart surgery is unpredictable, so schedules can be crazy,” she says. “But the leaders of the company have shown a great deal of appreciation for extra work and dedication. They have come through for me and my coworkers and have supported us along the way. I feel like they are on the front lines with me and the rest of the group to make things happen while working to create a balance of work and lifestyle.”

“I think it all comes down to the leadership here and the culture they have created,” she continues. “It’s fair. It’s appreciative. It’s understanding. Once again, it’s run by people of our own kind. They may not wear scrubs as much as I do anymore, but they have been in the trenches. That is a big difference, because they understand the essence of the day-to-day operations and they can better distribute both managerial aspects of the work as well as day-to-day assignments with people that work here. They have become a work family to me.”