Wednesday, November 22, 2006

I thought those Dilbert cartoons were of a juvenalian satire, not fact

Sigh. One more week, then I'm free! I'm so ready to flush my pager down the toilet. Yesterday, after our chaplain was fired on the spot (no big surprise), I was asked to come and meet with the administrator and the director of professional services (Adm and DPS, for short). The Adm started out by saying, "I know that there are times when people are leaving, they..."

"Slack off?" I offered, genially.

"Yes. Do you think that is what is happening with you?"

Honestly, I do. I have been slacking off. I slack off because I hate my job and I want to go home the second I get there.

I didn't say that though.

I did admit that I was slacking off, and told them this next week and a half will be about me transitioning my caseload, and that I wouldn't slack off anymore. Also, apparently I have to watch how I say things, since I said something to a coworker that she took the wrong way. We were trying to figure out how we were going to set up a situation involving crisis care for a patient she was case managing. There was also an admission to be done. She said that she would rather be doing crisis care, and I agreed, intending to imply that the case managers do get a lot emotionally out of caring for a person who is actively dying in a one-to-one setting. She took it to mean that, comparing the two, hers was the "easier" job. (I've never ever thought crisis care was easy, BTW). I apologized to her today (my boss never said I had to) and she said that comment really "struck" her, and thanked me. I just wished she would have come to me first. I felt kinda mean.

Anyhoo, fast forward to this morning. An orientee bounces up to me, and asks "What are we doing today?"

I was told the orientee would start with me on Friday. She was told Wednesday. During the day I got a call from ANOTHER orientee, asking if she also could ride with me today. This girl was hired by the home health side of our company, and will be performing both hospice and home health visits. Home health is responsible for her orientation, and at no time did they come to me and ask me about this person riding along with me today. I'm starting to wonder if I work with chimps.

On top of that, the DPS comes up to me, and says,

"I need you to see and admit this patient today. He's 49, and he's being followed by the home health now. He needs hospice. He was at a nursing home, but left AMA. His oldest daughter called adult protective services because she feels he's incompetent to make decisions. He has a trachiostomy, and a feeding tube. The primary caregiver is his fourteen-year-old daughter."

Fourteen-year-old daughter? APS? WHAAA?

This is what you give the nurse who comes to you and says, "Hey, I'm really burned out. I don't like this job anymore. I want to leave?"

It's final: I work with chimps. (And on a sidenote, the adm who accused me of slacking left today for her Thanksgiving holiday. She won't be back for the rest of the week. Folks, she just got back from a week in Hawaii on November 6. We slackers can smell our own, and this one stinks to high heaven!!!)

To make a long story short, I trudged through the day, dreading the admission. Hospice is simply not an appropriate place to handle situations like this. I sighed, and rang the doorbell of the small cruddy Church Hill townhouse. A petite teen answered the door. Her name was Sabrina. She was absolutely gorgeous. She had an exam glove on, as if she was just finishing helping her father perform a procedure. She showed me the upstairs, where a emaciated, short man hobbled around, his breathing loud and gargled from the tube in his throat. I launched into my schpiel about Hospice, and mentioned him staying in the home, when Sabrina interrupted,

"I'm not staying her anymore. The social worker from..." she struggled to remember, as if she was trying to remember a tricky word in a spelling bee, "Um, Child Protective Services came today. She said I needed to live somewhere else, and so my cousin's coming to get me later on this afternoon. And another social worker from Adult Services is coming now. They are saying he can't stay here by himself anymore. They say he has to go back to the nursing home. But he doesn't want to go."

I felt like I was sucker punched in the gut.

"Sweetie, the social worker needs to examine the situation, and needs to do the right thing. I'm going to go ahead and leave now, and let her do her job, okay? And when that's done, you guys can call us. I'm going to give you my number, and you can call us. Okay?"

"Okay!" She led me down the stairs. I wished her luck in her new home.

I literally smacked into the APS social worker on my way out. I told her what I told Sabrina, and then I left. I got into the car, and called the DPS to let them know the situation. The child was being removed from the home, and most likely, the patient was too. It was no situation for hospice to be involved in at this point. She responded cheerfully. I asked to speak to our social worker, Amanda, who I've really grown close to and admired. She had met the patient previously, and deemed the situation to be a safe one. She was flabbergasted when I told her the outcome.

"Jenn, I could never do CPS. They let kids stay with the parents who molested them, so long as the parent is "receiving treatment." I would have to leave kids behind in dangerous situations, and then see families get torn apart in non-dangerous situations. This situation is not ideal, and he's making the wrong choices, but he's competent and it's his choice to make. The daughter said to me 'if my dad stays, I stay with him.' She was never in any danger, in my opinion. It's a shitty system. But it would have been a real hard thing for our staff to handle this family. I'm sort of glad it happened, for our sake."

"Amanda, If I'm a heartless bitch for feeling relieved, then call me a hearless bitch."

"Happy Thanksgiving, Jenn."

"Happy Thanksgiving."

And the still can't understand why you are leaving?!?!? They aren't chimps, chimps are at least cute, funny and entertaning. But if they're chimps then they must be the cranky, old, mean ones like these guys.
Jeez Louise. I really don't know what to say!

I'm so glad you're getting out of there.
Today I fully understood what drives some police officers, fire fighters and rescue workers to commit suicide.
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