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They finally hired someone to replace our manager that was fired last September.

First they said they would replace her.

Then they said the position was dissolved.

Now they’re walking a new guy around the unit.

I’m hoping he’ll bring some positive changes to the place.

I’ve heard nothing but good things about him – and not just from administration.

I’m still looking.

There’s a new nurse orienting with us.  Maria is  young, just moved to the area, and speaks Spanish.  This means I’m not the only one the others (from any floor) come grab when they need a translator.  I’m not sure what her origins are or even how fluent she is -though, I suspect she speaks better than I do.

She’s heard Charge Nurse say things that just aren’t quite politically correct.  I was telling her my own experiences with her.  Basically, Charge Nurse is nice and not intentionally being rude or racist.  It just sounds that way.  And we tell her when it happens, so it’s not exactly a big secret that she lacks tact.

Debbie, former preceptor, and I were also sharing with Maria our own conversations and the things that even Debbie has said to me that were hysterically and unintentionally wrong.   How once Debbie asked me where Mexicans came from.  I explained about the mixing of the native Indians and Europeans, to which Debbie replied, “So a conquistadores plundered the Indians and made little Mexicans?”  And then proceeded to make a comment about how my great-great-great-great-great-great-grandfather plundered my great-great-great-great-great-great-grandmother.

Maria and I were laughing, and Charge Nurse was sitting nearby listening to the whole story.  She turned to Debbie and said, “You should know where they come from.  I took you to Laredo.”

I love Charge Nurse, but she often says things that could be construed as racist  or, at the very least, culturally obtuse.  For example, she once said she didn’t think of me as being Hispanic because she considered me an American.

The other day the nurses decided that wanted pizza for lunch, and I was designated as the one to place the order.  I was asking around to see what people liked or disliked for toppings.  Charge Nurse turned to me and said,” Just don’t get any beans on the pizza.”

I and the others nearly died laughing, and she didn’t get it.

Because Charge Nurse thought she was telling me not to get weird healthy toppings.

That is my first paycheck from West at Home.

I’ve been looking into alternative (and legal) means of income as the final leg of my nursing program approaches. The upcoming summer class and clinicals left me no choice but to take a leave for (at least) that period from my current job. My fall schedule won’t be any lighter; so, that leave may become permanent, but I’m not ready to burn any financial bridges just yet.

I’m still optimistic as I’ve been told that the work-at-home paychecks increase dramatically after a month. Also, the pay isn’t bad considering that I spent most of the time on Netflix’s Watch Now option (“Dead Like Me” Seasons 1-2, Sherrybaby, and Team America: World Police) and the rest of my “working” time either studying or surfing the internet.

No complaints here.

Next month my school schedule is going to make it impossible to work my current hours.

Mon ~ class from 8:00 to 4:30
Tues/Wed/Thurs ~ clinicals from 6:30 to 4:30

Knowing this was coming up, I started checking out a work-from-home position through http://www.workathomeagent.com/ A friend of mine has been pulling an extra $600-800 a month on top of her regular pay. I’ve completed all of the training and background checks; now I’ve begun taking shifts and trying it out. When I’ve signed onto the contractor’s website for my scheduled shift, calls are routed to my phone. All I do is take orders for a home shopping company using call-taking and order applications on my computer. It really couldn’t be easier. I’m just waiting to see how it will pay off. If I can at least match what I make now, I’ll just quit my job. My fall schedule won’t be any lighter, and it would be great because I’m already enjoying the study time this job allows. *fingers crossed*

I love Thursdays, but it’s not serious. Until May it is the one day I can sleep in because my one class doesn’t start until 12:20p. This one class doesn’t end until 4:00p, but I’m still happy because I don’t have to work. Work now officially sucks. I thought it did before, but I was wrong.

My class and clinical schedules only leave me two week days to work: Wednesday and Friday. That means I now have to pick up the rest of my clients on Saturdays. So I’m cramming 5 days worth of visits into two days and an afternoon (I have class Friday mornings). One aide quit and another isn’t back yet from medical leave for surgery. This means that I’m getting calls nearly every day telling me about a new person to add to my load. Yesterday I talked to the scheduler and told her that I can’t handle any more people on Friday afternoons (now at a total of 9). She responds by leaving me a message today telling me she’s added a new person. On Fridays. Not even a month ago my supervisor told me she really didn’t want me seeing more than 3 people on a school day. Ha.

The patient load wouldn’t be so bad if they all lived near each other. Most of mine live in two neighboring towns, but I have one random guy that lives almost an hour away from any other home. On Boondock Road. Which would be funny if I didn’t have to make that drive.

I have been looking for a new job, but no more seriously than to fill out some on-line applications to some area hospitals. Clinicals, class, and work have been distracting me from updating references, resume polishing, and cover letter writing. Frustration and stress are pushing me to make it happen. Soon.

*sigh* Our time is almost up. Until next week, Thursday….

I love Thursdays, but it’s not serious. Until May it is the one day I can sleep in because my one class doesn’t start until 12:20p. This one class doesn’t end until 4:00p, but I’m still happy because I don’t have to work. Work now officially sucks. I thought it did before, but I was wrong.

My class and clinical schedules only leave me two week days to work: Wednesday and Friday. That means I now have to pick up the rest of my clients on Saturdays. So I’m cramming 5 days worth of visits into two days and an afternoon (I have class Friday mornings). One aide quit and another isn’t back yet from medical leave for surgery. This means that I’m getting calls nearly every day telling me about a new person to add to my load. Yesterday I talked to the scheduler and told her that I can’t handle any more people on Friday afternoons (now at a total of 9). She responds by leaving me a message today telling me she’s added a new person. On Fridays. Not even a month ago my supervisor told me she really didn’t want me seeing more than 3 people on a school day. Ha.

The patient load wouldn’t be so bad if they all lived near each other. Most of mine live in two neighboring towns, but I have one random guy that lives almost an hour away from any other home. On Boondock Road. Which would be funny if I didn’t have to make that drive.

I have been looking for a new job, but no more seriously than to fill out some on-line applications to some area hospitals. Clinicals, class, and work have been distracting me from updating references, resume polishing, and cover letter writing. Frustration and stress are pushing me to make it happen. Soon.

*sigh* Our time is almost up. Until next week, Thursday….

Working in home health brings me into …. well, homes. Rather than the sterilized environment of a hospital, I see the client’s natural environment and resources. I’ve known for years now that I want to work with older adults. My small window into the world of my future clients has only increased that desire now that I’ve seen the day-to-day struggles that many of my low-income elders go through. Most of the time it gives me ideas for my own practice and the much-needed senior center that I hope to eventually birth in my community, but today that view made me very angry and frustrated.

I don’t watch those animal cop shows; seeing just one of the abused/neglected animals and their stories can bring me to tears every time. I can’t grasp the mind frame of the abuser and the cruelty involved in these cases, much less that of a human being.

One of my clients is in the late stages of Alzheimer’s and has been living alone for the past month because his wife is in the hospital for CHF complications. I ran into their son once during a visit, and he assured me that he was stopping by regularly to check on Mr. C and give him his medications. Mr. C and his wife have been living in a FEMA trailer since Hurricane Rita damaged their home in 2005. Today, however, there were no signs of care. The small trailer is filthy: dishes piled in the sink and on the counters, overflowing hamper, trash on the floor, and pills spilled on the table and floor. A pungent smell met me at the entrance, and I left the door open to make my time there more bearable.

I found a pile of shit on the middle of the floor. I tried to ask Mr. C about it, but he couldn’t tell me anything. A little exploring turned up a soiled pair of pants in the bathroom. Apparently, he had soiled himself and then knew to change the pants. Unfortunately, he didn’t know to clean himself, and he had pulled on another pair of pants without cleaning himself or putting of underwear. I could see that he had been sleeping on the couch, and I asked him about that. He told me that someone was in his bed. I looked down the trailer and saw that his dark blanket was piled high and lumpy on his bed. He had mistaken the form for another person. On the cluttered table were several cans of soft drinks and a large plastic bowl. A look inside revealed a bowl filled with snack cakes. Someone was leaving this on the table for him to eat during the day.

I called work to report what I’d found to one of the nurses. I cleaned Mr. C and did my best to straighten up the trailer. I found cabinets full of food that he could not prepare and made him a quick meal before I had to leave. I called work again, and my supervisor assured me they were working on his case. Still…

Damn.

Last Friday I was assigned a new client to see three times a week. I went to his home that afternoon to introduce myself and set times for our visits. I called him on my way, and he grudgingly agreed to see me. I rang the bell several times before I heard him yell for me to go around the back. I made my way through muddy grass and a sticky screen door to meet him at a glass sliding door. He stumbled back to his recliner and fell back with a grunt. I sat across from him and explained again who I was and what I was there to do.

“You’re the third one here today, and I don’t need any of you. I told them, and I’m telling you. My wife’s probably behind all this.” He demanded that I not come again. The next time I was at the office I let my supervisor know what he said. She just laughed and said, “He’s just being a turd. He’s refusing physical therapy, too.”

I tried to call him Tuesday to let him know I was on my way, but the phone was busy. I kept going since I knew he was home. (His wife works during the day.) When I pulled into the driveway I called again, but the phone just rang and rang. He didn’t yell back when I rang the bell, and I couldn’t see him through the back door. I called again just to leave a message so his wife would know I had tried.

Later I stopped by the office and asked one of the nurses to give him a call about my coming to see him this afternoon. He agreed to the visit, and I was on my way again. This time I went straight to the back door where I could see him struggling to get out of his chair. Up and down he went, bouncing on the edge of his seat and unable to stand. He was getting frustrated, but the house was completely locked down. I sat down next to the door. We could hear each other through the glass, and after a while I asked if he wanted me to call anyone. He called out his daughter’s cell phone number, and I had just begun to dial it when he finally stood over his walker.

He let me in and went straight to the bathroom, slamming the door behind him. I followed him down the hall and waited. After a while he said, “I suppose you want me to take a shower.” I could hear the water turn on. “Do you need any help?” I asked. “Stay out.” Okay. I sat down outside the door and began filling out the paperwork. Twenty minutes the water stopped, and I asked, “Can I help you out of the tub?” A negative grunt was soon followed by a gasp of surprise and a loud thump. That’s it. “I’m coming in.” And I found him sitting on the bottom of the tub with his legs over the edge, unable to lift himself. Luckily, his wife came home early, and together we were able to help him to a sitting position on the side of the tub where he informed me that I was not to come back. His wife walked me to the door and broke down in tears as she talked of him.

He’s been “fired” by three doctors for refusing to comply with treatment and care for his diabetes. Without attention his blood glucose is regularly above 500. He had a knee replacement last summer and went to physical therapy twice before quitting. Now, on top of diabetic complications with his feet, his left knee is practically useless. It was soon getting to the point that she wouldn’t be able to care for him. And he refused outside care. The only option she could see was to place him in a nursing home. When she talked about it, he would declare that he’d shoot himself first. “We were supposed to travel now. That was the plan,” she said angrily. “I still have a life to live, and I’ve got to find a way to do that.”

What do you do when someone refuses to help himself? What do you tell his family when they ask for help?

Update: When I last left him I told him that he had a decision to make concerning his future. A few days later I went to see him again, and he grudgingly cooperated with me. After he’s a bit more comfortable with me, I’ll be pushing physical therapy again.

For two seconds I thought she was dead.

I was getting ready to leave, and my client asked to be helped from her recliner to her wheelchair. I brought it close and turned to help her into it. I found her slumped over with eyes open and a slack jaw. I grabbed her shoulders and shook her a little, but I couldn’t elicit any kind of response. I called out to her husband while I held her. Her breaths were nearly imperceptible, and her pulse was so weak that I began to panic when I couldn’t feel it. Her husband came into the room, and she seemed to wake up to the sound of his voice.

I felt relieved for a moment, but we were worried at her sluggish responses. My first thought was that she’d had a stroke. I had her raise her arms and smile. When her husband asked if she felt bad, she responded clearly. “I feel fine.” Did she want to go to the hospital? “No.” She still wasn’t supporting herself, and her head hung forward. I asked her husband to call for help, and I called work to report the event and action being taken.

The paramedics arrived soon, and I stood back as they began to check her over. The stretcher was brought over, and I helped her husband gather some items in a bag to take to the hospital.

I watched them drive off and then got into my own car. I had more people to see.

My Happiness Project

1. Set a bedtime.
2. Make my bed every morning.
3. Always be reading something.
4. Move more.
5. Toss and organize.
6. Give proofs of love.
7. Leave the past.
8. Fight right.
9. Don't expect praise or appreciation.
10. Kiss more, hug more, touch more.
11. Aim higher.
12. Find some fun.
13. Ask for help.
14. Smile.
15. Realize it's possible.
16. Don't compare;be inspired.
17. Focus on what I have.
18. Beware of drift.
19. Take a chance.
20. Listen.
21. Be mindful.
22. Cultivate gratitude.
23. Spend out.
24. Do good, feel good.
25. Show up.
26. Have the courage to be imperfect.
27. Find joy in the ordinary.
28. Work smart.
29. Enjoy now.
30. Talk to strangers.
31. Go outside.
32. Start where I am.
33. Show up on time.
34. See art everyday.
35. Love with abandon.
36. Be colorful.
37. Dress the part.
38. Revel in accomplishments.
39. Learn something new.
40. Fear less.
41. Take pictures.
42. Speak with integrity.
43. Don't be critical about small things.
44. Manage my pain.
45. Surround myself with creative people.
46. Practice, practice, practice.
47. Don't force it.
48. Deal with something once.
49. Trust my instincts.
50. Avoid gossip.
51. Choose to see the best in people.
52. Take time to be silly.
53. Throw my own party.
54. Be a mentor.
55. Lean into my fears.
56. Find the others.
57. Do the unexpected.
58. Don't break the chain.
59. Do things others aren't.
60. Slow down.
61. Be cool with not being cool.
62. Be kinder than necessary and more generous than reasonable.
63. Pretend I'm good at it.
64. Keep in touch.
65. Row my own canoe.
66. Do what only you can do.
67. If it doesn't work out, find something that does.
68. Dream bigger.
69. Notice what's right.
70. Stop talking. Start doing.
71. When in doubt, choose laughter.
72. Don't let the perfect be the enemy of the good.
73. Respect everyone.
74. Be early.
75. Delete the unnecessary.

Three Simple Rules

1. If you do not GO after what you want, you will never have it.
2. If you do not ASK, the answer will always be no.
3. If you do not MOVE forward, you will always be in the same place.

All I Need

1. Someone to love.
2. Something to do.
3. Something to hope for.

What I’m Reading

Blood Meridian
by Cormac McCarthy
Their Eyes Were Watching God
by Zora Neale Hurston

U.S. States I’ve Visited

Alaska
Arizona
Arkansas
Colorado
Georgia
Florida
Louisiana
Maryland
New Mexico
North Carolina
Ohio
Oklahoma
Pennsylvania
Texas
Utah
Virgina

Countries I’ve Visited

Mexico
Colombia
Thailand
Vietnam
Bermuda (British territory)

I write about…