Monday, February 20, 2012

White


This is a voyage I took
Two hundred years ago
              to a land 
      barren of passion.

My last vision is you
In tears waving a white glove
        waving goodbye
Yes, goodbye
And the shade of your parasol
Hides the silvery drop of
Salty tears on your face.

This journey,
This journey is empty
 Without you in it.
Without your smile
         your mood
             Your white glove

It is empty.

Now is when life ended
And existence 
                    begins.
A life 
A life without you in it
Is a voyage I took
Two hundred years ago
   to a land barren
       of passion
To a land where there is no life.
No life
There is no life without you.

And so I stay on
       to merely exist.

11:40pm 2/20/12

Friday, February 10, 2012

A Long Friday

For the first time ever, I went home and the first thing I did was open a bottle of beer and smoke a cigarette.  I have never drank a bottle of beer alone, nor smoked a cigarette straight from work here.  This day is more unique than others I think.

I told you the last couple posts that I work with the elderly.  Some are nice, some are funny, some are hopeless and some are downright nasty.  You have to deal with different people everyday, it is given, but add to that the effects of multiple medications, time of day, weather, and whatever extra credit you can think of and it makes dealing with people less than appealing to the physically, socially and emotionally unprepared.  

Today I dealt with a patient who gives me a hard time.  He is in his 90's, with multiple pathology, multiple attachments, easily angered and basically deaf due to presbycusis.  This is a patient I have to talk to through sign language and a communication board or paper.  You can imagine how hard it is to educate, instruct or simply do small talk with that man.  And since he is very impatient, he just screams when you do something that does not please him or whatever. He is also dysphagic so speaking is difficult for him which makes it worse. It's a guessing game what he wants and you just have to grin and bear the sh*t you do to make him go to or/and do therapy.  

Today, I asked a certified nursing assistant (CNA), a euphemism for a caregiver, to get him up, dressed and ready for therapy by 11.  She complied.  By 11 I came to pick him up and the nurse told me he has to get back into bed so the wound physician can see his sores on the buttocks.  I asked the CNA to get him back into bed and she told me why do you need my help? And I said well I need help to get him back into bed.  She said I don't know why I can get him in and out of bed on my own, and I'm a woman and why you would need help doing so.  In my mind, errrr cause that's your job? Well anyway to make the long story somewhat shorter she did it herself and stomped out the door making me feel stupid and worthless.  I had to take it though it did pinch my ego.  Anyway, I scribbled on the board that I gotta leave and see some other patient while the he waits for his doctor.  Frantically, the patient scribbled back: Please don't go.  I wrote back: Well I can't stay here I have a schedule to keep.  He replied: Please stay. I want you to be here when the doctor comes.  I need you to interpret for me. U understand me.

It broke my heart.  This man, this man from hell, made me feel special, needed.  He didn't ask for his nurse, or his nursing assistant.  He wanted me to be there cause he trusts me I guess.  Cause maybe I did something that others who are involved in his care plan didn't.  It did make me proud despite the fact that afterwhich he screamed again at me when I didn't get his foot orthosis back on in the exact way he wanted it to.  Oh well, you can't win em all.

That afternoon, around 3 o'clock, I was scrambling to get more patients.  I still had three patients to see, the clouds outside didn't look friendly and talk of snow during the weekends abounded.  I had to get the three of them done so I can go home by 530 which around here is dusk.  On my way to my new patient's room (let's call the patient "A", patient "B" called me from across his room.  B is a Parkinson's patient who almost made me cry on my first day on the job.  I worked with him a couple more times and now we are somewhat good friends.  He called me in, and although my precious time is being consumed, I obliged.  He wanted to change cause he 'wet' himself.  I told him I will tell the nurse to get the assistance he needs.  The nurse pointed me to a CNA incharge of B.  I told her he needs help and she just told me: Oh I'm sorry but I'm just about to go home. Just wait until the next shift comes and she'll help him out.  Wow! I was mortified! I just couldn't understand why you couldn't help the man while you're still at it.  Anyhow, I saw the man, standing, trying to get his pants off to change himself.  He is a PD patient my God he could fall anytime! So i did what I think I had to do.  I told my patient on the opposite end of the room that I'll come back for her and went on to help B who wasn't my patient at all! I helped him change, wiped him clean, threw out the soiled clothes, etc.  I know I didn't do everything right and sanitized everything perfect, damn I din't even have gloves on.  But I did what I have to do eventhough it wasn't my job at all.  I mean, I am far from patting myself of the back and calling me hero, but at that time, it was the right thing to do.  As a consequence though, I lost 30 mins of precious time.  I had to cramp the schedule of the other three patients so I can go home by 530.  I did get their complete minutes but some minutes were overlapped which shouldn't happen cause it should be a 1:1 patient-therapist ratio.

I texted my boss about the incident and she told me I did the right thing and she will report the said CNA to whoever she called them.  I told her I don't want any trouble with anybody and I just want to do my work as peacefully as possible without any strife with anybody.  I'm sure if she finds out I complained on it, the CNAs will gossip amongst themselves how horrible, inefficient and stupid a PT I am, which I do not contest entirely. Bur argh the drama of this day makes it so unbearable.  And so...

For the first time ever, I went home and the first thing I did was open a bottle of beer and smoke a cigarette.  I have never drank a bottle of beer alone, nor smoked a cigarette straight from work here. Damn this was a looooooong day.

Wednesday, February 8, 2012

Old

In wine there's truth. In veno veritas. While this holds true, as we, the tanggeros, have witnessed time and time again, working here in the Land of the Free reveals a new truth to people.  Old age reveals how you lived your life.

I work in a skilled nursing facility.  This is like a halfway house between hospital and home or assisted living or hospice whichever is determined best for the patient by the family and careplan team.  In simpler terms, for example you have been hospitalized by a stroke.  You undergo treatment and acute rehab at the hospital.  When you are somewhat better they will send you to a SNF for further treatment and restoration.  It is then that it will be determined if you are capable and able to return to your home or not.  Well anyhow,  I am mostly dealing with the elderly and the first month that I am staying here so far, I am thinking that I could make this longterm.

Working with the elderly is a roller coaster ride.  It is not as easy as you imagine it to be.   Some come in as a ray of light amidst the gloomy winter sky, some come in as a blackhole of depression and hopelessness.  Overall, though, working with the ancestors of the modern world is highly fulfilling and it gives a lot of self-satsfaction.  What I want to talk about now though is that I have observed that old age unmasks the different life stories of people without them having to relate each and every experience they have.

I had a patient before who hated her husband (who takes care of her in the facility) so much she used to sob and sniffle during therapy.  She claimed she was married for 37 years, he was her second husband, and that 'that was 37 years of my life wasted'.  Sad ain't it, I later found out through chismis that during her hospitalization for multiple diseases significant of which is C-Diff, a highly infectious condition with contact precautions for all who handle the patient, as the nurses attempted to teach the husband how to take care of the wife, the husband reportedly said "No, there ain't no way I'm gonna take care of that shit".  What loving relationship that does make don't you think?

I had a patient who claims to be 102 sometimes 202, demented, slowly physically and mentally deteriorating who always laughs and make unique childish jokes during treatment.  She told me she was a nurse and worked as one for 63 years.  I didn't know if her 63 yrs was accurate, but she often told me she loved her job though it really didn't make that much.  You see, it shows.  When you love the life you had and you go on living with love and promise, it shows.  The light of your eyes reveals it all.

Old age may take away your strength, independence and state of mind.  It can never take away hope.  I resolve to myself, when I get old enough to develop Alzheimer's dementia, I won't be the brooding, angry old man who thinks the world is out to get him.  I will be the incoherent, playful and joyful demented client who has lived a life of joy and acceptance.  After all, when you're old and gray, there is no room to recount frustrations, dreams that will never happen and you will just take to the grave, or hatred for the world.  What matters is you have lived life to the fullest and believe me, when the day comes, without fail, it will show in the light in my eyes.