San Carlos Apache Healthcare Corporation

Insights into Nelson’s Professional Journey

My journey is not typical of most HTM leaders. In 1987 I earned an AAS in Electronics Technology – Biomedical. I did not immediately go into HTM because there were no open Biomed positions at the Army hospital at the time and I was in a position where I would be promoted if I stayed in my current position. Fast forward 10 years, I had been promoted and was working on the evening shift at the German Air Force Air Defense school at Ft. Bliss, Texas. One evening I was outside our shop shutting down the frequency converters and a soldier wearing exercise clothing came over, he explained that he was the Chief (Chief Warrant Officer) of Medical Maintenance at William Beaumont Army Medical Center (WBAMC). I replied that I had a degree in biomedical electronics, he replied that he was looking to hire some civilians to help reduce his contracted maintenance cost. He asked for my name and phone number, I gave him my information. Two years later, on a Sunday evening, he called me and without identifying himself asked if I was still interested in a Biomed job. I had forgotten our meeting two years prior and was suspicious it was a telemarketing call, I asked him who he was and what the he want. He stated that he was the Chief of Medical Maintenance at WBAMC. He stated that if I was interested, a position would be posted the next business day. I applied and about two weeks later, I was contacted for an interview. The position was for an in-house X-ray service engineer. During the interview, we talked about everything but Biomed for about half an hour, suddenly he pulled an X-ray tube insert from under his desk and asked, “what is this?” I explained that it was a spinning anode X-ray tube insert, I had read just it the night before. He then said, “let’s go out and meet some of the team,” we went to the area where the BMETs worked and he introduced me to a couple of people. In the middle of the work area was an anesthesia machine from the Combat Support Hospital on base, they would bring equipment up monthly to train on with some of the more experienced BMETs at the hospital. Anyway, we walk over to it and the chief says, “you did well with the X-ray tube, what’s this?” I had no idea and was starting to panic, looking down at the transport case, I noticed the data plate, in bold type “Machine, Anesthesia, 1 each. I replied, “it’s an anesthesia machine.”  That is how I got my first Biomed job. I ran into the Chief about 16 years later at an AAMI in Denver, he had retired from active duty and was a DoD civilian in charge of medical equipment maintenance for the Military Entrance and Processing Stations. We sat and caught up, I told him that story, he said “I knew you were a good hire, you didn’t know what it was, but you knew where to look.” 

I worked at WBAMC for five years and transferred to the Northern Arizona VA Health Care System in Arizona. While there, I meet a BMET named Jim that had transferred from Alaska Clinical Engineering Services (ACES). Jim encouraged me to go to Alaska if the chance ever arose. About a year and a half later, he transferred back to ACES. A few months later, he called and mentioned that he had told his manager about me and his manager wanted to meet me. The manager was schedule to attend a conference near, I arrange to meet with him one evening. We ended up having dinner and discussing the possibility of me accepting a position with ACES. At the time, I was still in the Federal Civil Service system and not eligible for retirement.

Give your team respect, technical training, soft skills and autonomy. Know your people and enable them to take over your position. If possible, promote from within

The following year, the VA announced a Voluntary Early Retirement Authority and they opened a window for eligible personnel to apply, I retired in January 2007.

I accepted a field service engineer (FSE) position with ACES, traveling to remote Native Healthcare facilities ranging from community health clinics to regional critical access hospitals. Travel was often arduous in extreme weather. I found the experience to be truly rewarding and am proud of the work we did to provide safe and effective healthcare technology to these communities.

I was promoted to Lead BMET III in 2012. My duties consisted of creating and maintaining the travel schedules, logistical support, database management and quality assurance.

In the summer of 2015 I accepted a position as a Lead BMET III on a contract with the US Army Medical Materials Agency at a Depot in Utah where I managed 25 BMETs and 6 administrative specialists.

In the summer of 2018, I accepted an offer to become the Director of Biomedical Engineering at San Carlos Apache Healthcare Corporation (SCAHC).

Challenges in the Biomedical Engineering Field within a Tribal Healthcare Context

Some of the challenges we face at SCAHC are varied, however, in my opinion is the subtle discrimination experienced vendors, suppliers and the uninformed public. Due to our distance from metropolitan areas, we face logistical challenges such as; no overnight delivery and service vendors are reluctant to travel to our location. Frequent utility outages.

Integrating Advanced Technologies into the Healthcare System

We have integrated advanced technologies into our healthcare system by upgrading bedside patient monitoring in both Emergency and Inpatient departments, modernizing our infusion pump fleet and drug library server, enhancing our nurse call server and network switches and installing an automated temperature and humidity monitoring system for clinical cold storage and other areas. Additionally, we are currently testing the integration of medical devices with a new electronic health record system

Importance of Partnerships with Technology Vendors

Partnerships with technology vendors as well as other healthcare organizations is vitally important for Tribal Healthcare Organizations, as mentioned above, many of these organizations struggle to get vendors out to our facilities because of the remote locations.

Advice to Emerging Healthcare Leaders

Give your team respect, technical training, soft skills and autonomy. Know your people and be interested in their lives outside the job. Enable them to take over your position. If possible, promote from within.