Tuesday, February 26, 2008

Are we so different?

We are, after all, advanced animals that have learned to adapt the environment to suit us. Not animals that adapt to the environment.
I have thought and believed that there is a difference in people "out west" versus "back east".
But when I get down to my job, helping people recover from the worst things that have ever happened in their lives, they are still the same.
For some reason, stroke, trauma, illness, these souls are in the hospital to heal and re-enter life. They have sons and daughters, fathers and mothers that have loved them or not, dissapointed or made them proud. There is a home to go to or to never return to again. The emotions are the same, too.
Kubler-Ross put forth the 5 stages of grief. It has become apparent that it is not just grief around dying, but also in any major trauma or life altering event.
I see people in the worst moments of their lives and I see the anger, denial, bargaining, depression and acceptance.
I see it in the family members as well.
But I also wonder if environment and childhood roll models shape how one embraces the challenges these people confront.
They fight on, struggle, at least try, or just give up.
Giving up is the most frustrating. I have helped a 95 year old to learn to walk again. I have seen people no one expected to live regain so much function that they go home with little to no help.
But some give up. There are types of giving up. There is complete surrender of the will to live and they just waste away and die. There are the learned helplessness cases. These, to me, are the worst.
I can see their potential to recover, to regain independence, and they want some one else to do it all for them. It makes me mad, to be honest. I have limited time to work with a person. If you want to give up and make your family work so much harder than they need to, to burn them out on caring for you, tell me so I can move on to the next person that WANTS to get better, that dearly desires to be as independent as they can possibly be.
But I can't and do not say this. I do the best I can, crying a little inside knowing it does not have to be this way.
These people drain you so deeply.
The next time you see a health care worker drooping, dragging, looking drained, it could be this reason. Ms Smith could get up and walk to the bathroom by herself, but she has learned dependence so she lies in bed and wants help. Two to three people have to divert their time and care from others to come in, get her up, get her into the bathroom where she will probably, in a fit of hysterics, let herself fall or loose her balance, injuring the young nurse, mom of two children, so badly she can't bend overt to pick up her crying child because her back is so messed up. Then Ms smith will ring the call button every three minutes to have a pillow fluffed and her sheets straightened so a non-existent wrinkle is not under her sizable ass. Meanwhile, Ms Jones, next door, can get up with help but no one can answer her call bell because they are all wiping Ms Smith's ass and wondering whether or not to fill out an injury form and report the burning in the low lumbar area on the right side to her supervisor.
It is all the same as in Hamsterville Hospital. The people care just as much, the patients feel the same things.
Are we all that different?

Friday, February 15, 2008

The question of the day

Now that I have completed two weeks at the Hospital one, I have a growing sense of life on the east coast.
But maybe it is too generalized to call it the east coast. After all, the east coast is Florida to Maine. And I think I can fairly well guess that souther Floridians are quite different from a native of Maine.
The questions I am asked the most are:
Why did you move here?
What do you think of New York.
Followed by:
What do you think of the people out here.
and the cute smart asses that ask:
Did you have that/this/those out in Washington?

I am gathering more information daily from my patients and fellow Therapists.
I usually reply:
Because of the nephews.
It is much faster and more crowded than out west.
They are out for themselves before others.
No, we did not have that in Washington... we did have recycling bins though? Ever heard of those out here?
The answer is always no. Millions, literally millions of people in NYC and the Long Island, and no recycling bins in public, work places. Sad, really.

Hospital two wants me to orient as soon as I get time. Both are busy now with the later flu season getting up to speed. I keep seeing orthopaedic cases which are ok, but boring to me.
One of these days, I will get to work with a stroke or head injury patient. That is my place of comfort.
The Therapist that has been orienting me told me she talked me up to the Inpatient Manager, telling him they need to hire me.
Nothing against Hospital two, but I really like Hospital one.

Two days off and then I see if Hospital one needs me to work again.

Be well, friends.


Saturday, February 9, 2008

Patient care

It is what it is all about, really.
Health care workers, in any position, it is all about taking care of the human in front of you. I am back to doing what I love and what feels so good to me.
But what really creates a great work atmosphere, is when the people around you are motivated for the same reasons.
I stepped out of the stair way onto the 4th floor and looked left and right to orient myself to where the hell I am at. I had rushed to get out of the house and had forgotten my name badge. I looked up and saw someone, who is in my department, and I said "I have no idea where I am at."
Without skipping a beat, he said "You are on 4 south." I thanked him and went down the correct hall way to get to the scheduling office to get my patient list for the day.
A couple of hours later, he walked up to me and put his hand on my shoulder and said "You are now on 4 north." No disrespect, no sarcasm (ok maybe a little) but just a joke to help me feel not so overwhelmed.
I met a nurse and he asked me how it was going. I told him it was like a frog in a blender. (kids do NOT try that at home, ever)
I got to do three patients by myself and assisted with another and was just at home. The charting and charges systems are different, the charging system is horrid.
The walls are different, the outside is so different, but the needs and the diagnoses are so familiar.
It feels good to treat. It feels good to meet new people.
I am getting the information I need to see if these New Yorkers are all that different than what I grew up with out west.

On a painful note, I have a bitch of an infected ingrown toe nail and I had a 5 lb cuff weight fall on it. I hate limping at work. It looks bad when the pulmonologist smokes, the dietician is obese and the Physical Therapists limp.

Be well.

Thursday, February 7, 2008

Hi ho, hi ho, it is off to work....

Monday I reported at 9:00 am for Orientation at the first hospital. Wow. We covered a lot. the health care alliances out here, the Hospital history, policy and procedure. HIPAA and how it can ruin your career...
In one activity, we were to summarize, in a small group, a section of the employee propaganda and present it to the room. We were told to use "neumonics" in this exercise. How is that again? Mnemonics, maybe?
In discussing artificial nails, the video strongly stated that "Anything not natural is artificial." Thanks for the heads up on that one.
Another fire education video we were informed that "In a fire, exits are your only means of escape." And by definition, a lousy statement.
One presenter said "We encourage yous."
OK , the stage is being set.

The Rehab portion of this hospital is 10 times larger than my last hospital. It covers several floors. It is big. I think I might have lost two pounds my first day alone. Once I get into a groove, I will start relying on the stairs to burn a few more calories and try to regain my figure.
Day two I was oriented to the Hospital. The facility its self is so much bigger that I am at a loss to locations as of yet. I was informed that North hall and South hall and East hall have no relation to actual compass points. That messed me up.
OK, ok, I still can't tell you north unless I can see the sun or the water, but it does not help that the halls are randomly named.
Day three, I helped with some treatments and continued to shadow another therapist, learning all I could and getting hopelessly overloaded with information.
Today was day four and I actually did some treatments by myself, did some charting myself, did some charges under the watchful eye of a supervisor.
Tomorrow, more of the same.
I got told I will orient all of next week, to make sure I know the systems and procedures. And then it is a February break week from school and if census stays high, I will be working steadily.
Once things slow at Hospital one, I will orient at Hospital two.
I like the therapists at Hospital one. There are a lot of them and I know about 6 of 25 by name and by sight. More learning is needed.
I keep thinking the day room is on the 2nd floor when it is really on the 4th. Second floor has its own gym but I got lost and had to ask directions to get there today.
My brother told me to enjoy this time, like he told me to enjoy the exam. It is not often in life you get to experience these situations.
More experiences tomorrow, then I can come home and fall over.
But not too hard, I do not want to be on my own unit.

Be well.

Saturday, February 2, 2008


Precipitation is vital to life. We all need water, that is simple. It can rain, sleet, hail, snow, monsoon and hurricane. Water falls and flows downhill, basic physics, gravity and all, you know.
Growing up in an arid high plain technically classified as a desert, and then living in a coastal town, I thought I had seen rain.
It has rained on us here, too, before yesterday.
But, in Hamsterville, it would take all day long to drop up to an inch of rain. In the high dry place it would rarely rain long and or hard.
I saw east coast weather in its glory.
It rained. Oh boy did it rain.
I can't find a good total from a web source, but a quick look at an hour by hour rain gauge looks like better than three inches in a 24 hour period. It came down.
Poni held it in all day. There was no way she wold do anything. I happened to take her out between systems and she RAN to perform her necessaries. And again this AM she RAN do take care of her business.
K and I went out to eat and then shopping for a bit. Walking into the store it was notraining. After about 5 minutes in the store and gentle roaring sound started to compete with the ever present '70s muzak all stores play here. The muzak stopped and the pounding of the rain on the roof was impossible to ignore. Even the store clerk who took our cash for goods thought we were nuts for being out in this weather. She voiced a longing for home and warm soup and a comfy couch.

Whilst out and about accomplishing errands long overdue, I was driving along a street where the rain water system had been hopelessly overwhelmed.
In my youth, as a passenger, I was thought that driving through a puddle of standing water could be fun, look at that rooster tail from the Maverick as it flies down the road. But I was also introduced to hydroplaning and wet brake pads.
I witnessed some nice hydroplaning from young men, mostly, who thought that rooster tail was the sign of high verility in the ever nauseating mating ritual of the testosterone hyper. It is interesting to see a big 4x4 pickup slide sideways in a deep puddle of water.
Then I hit a puddle that was deeper than it looked. I went to hit my brakes and got nothing.
I have never experienced wet brakes before. It gave my heart that little shot of adrenaline and I calmly pumped the brakes, like your driver's ed teacher told you, and got stopping power.
The tide was out as I got closer to home, otherwise I am sure the road would have been impassable and I would have had to go around and take the higher road approach.
This morning, you can see the grass is bent in the direction of the run off from the yard. Can you say erosion?
I love weather, I always have, always will, I hope. But K had warned me of the east coast rain. I thought I had seen it. K told me that this particular weather system was about typical for NY. Oh boy!

On another note.
It became more of a reality yesterday as well. I opened an east coast bank account, licensed my truck and got insurance. I start work next week. I am here, it is real and happening in a big way.
The adventure continues...