Amy’s Life in Brief

July 29, 2008, 2:34 am
Filed under: boundaries, job, MSW, social work | Tags: ,

So, I worked today and I’m sitting here wondering if I made a mistake in not asking a question. Part of my job entails meeting with patients from the health system’s outpatient clinics (like the physician’s offices, diabetes education clinic, wound care clinic, anticoagulation clinic, ambulatory infusion among others). As an outpatient social worker I’m supposed to provide brief therapy, help locating resources and other problem solving assistance. So, I was meeting with a woman who has no insurance and has a couple of serious and chronic medical conditions. I was helping her complete the forms for our health system’s financial and prescription assistance programs. We were discussing her condition and she mentioned she wasn’t taking birth control because of the possibility that doing so would aggravate one of her medical problems.

Now, I’m wondering if I should have asked her what exactly she was doing for birth control. Certainly given her financial situation, having a baby would not be the past course of action. And I can’t even imagine how complicated her pregnancy would be given her medical situation. I’m wondering if I missed an opportunity at education (I did safe sex education in a former job) or if it was best that I didn’t delve into that subject since the client didn’t seem to be too concerned. I could always call her and follow up, but don’t want her to be offended. Hmmmm…what’s the right way to approach it???


Recently received postcards!
July 28, 2008, 2:38 am
Filed under: Germany, Italy, postcards, postcrossing | Tags: , ,

I absolutely love

I had taken a long break from sending official cards but have recently decided to send a few a month. So, now I’ve received an official card myself. It came from Germany and it’s an odd little card with a chicken on it. I love odd cards, though. I wish I knew was the little saying was on the front, but alas I don’t speak German.

Official Postcrossing Card from Germany

Official Postcrossing Card from Germany

I’ve also received a card from a woman in France. Isabelle and I trade postcards one at a time and I get some really nice ones from her. She and her family just returned from a vacation in Verona, Italy.

From Isabelle

From Isabelle

Bad decisions…
July 26, 2008, 11:24 pm
Filed under: counter-transference, medical ethics, MSW, social work, social work ethics | Tags: ,

I think all social workers have to learn to come to terms with their clients making bad decisions. I work hard and remembering we all have the freedom to make bad decisions. And of course I think for anyone, realizing a bad decision making only comes from hindsight. In the medical field, I see poor decisions being made all of the time. People who drink too much and end up with liver disease, diabetics who fail to seek treatment and end up with a myriad of consequences from that. Heck, in my short time at my current job, I’ve had at least once very, very ill client who left the hospital against medical advice. And I struggle with these things…knowing how much to challenge a client without making them feel alienated.

The other problem I struggle with is that sometimes clients make bad decisions because they don’t get enough information from the medical provider. Sometimes I think the occurs because they are too intimidated by said medical provider or have been taught that they should trust doctors. Then, they fail to ask questions or let the medical provider know that they just don’t understand a word the doctor has just said and, as a result, don’t even know which questions to ask. But, sometimes, I think that maybe the medical provider just doesn’t truly convey the client’s medical situation.

I think this is the case with one of the clients I saw this past week and have seen several times over the past few weeks. Looking over their records I just can’t believe that the doctor would have recommended the aggressive treatment that this client is undergoing. Granted, I’m not a doctor or even a nurse, but given the extent of this patient’s disease process I just don’t understand why they weren’t offered hospice as an option. And, maybe it was. I wasn’t there when the patient was told of their diagnosis and prognosis. Maybe this was fully the patient’s decision to pursue such aggressive treatment.

Maybe I’m just experiencing some good, old-fashioned counter-transference. It is painful for me to see this patient deteriorate. They have been unable to go home. They have been able to be around their family because of the treatment they are receiving.

The other problem I have in this situation is that the MD handling the case is well known for providing many patients with a rosier-than-real prognosis. And this MD is known for being highly resistant to making hospice referrals. Often, the hospice referrals made by this MD are done at the point where the patient has days to live.

So…I just don’t know where to go with situations like this…where is it the patient making what I feel is a bad decision based on personal choice and where is the patient making a bad decision based on a lack of information?

Death and the 5 year old…
July 24, 2008, 3:27 pm
Filed under: birthday, death, fish, mom, worries | Tags: , ,

Orange Fish and White Fish at home

Orange Fish and White Fish at home

So, for the G’s 5th birthday he got a fish tank and two fancy goldfish. The fish have done surprisingly well. We are starting to have problem with “Orange Fish.” (I know “Orange Fish” and “White Fish” aren’t the most original names, but that’s what the G wanted to name them) Anyway, Orange Fish has been having some trouble with his swim bladder. So far, I’ve been able to get him almost back to normal every time by feeding him extra sea weed or worms, but I think he’s getting ready to hit the end of his rope. We’re on a bit of a death watch right now.

So, I’ve explained to the G that I think that Orange Fish is sick and that we may get up one morning or come back some day and he might be dead. He asked why and I explained that Orange Fish seems to be getting a bit sick. He hasn’t had anymore questions, but maybe we’ll have to have a discussion about death soon. I don’t know.

Of course I thought that was going to be the case last spring. One of his classmates couldn’t be at the school picnic because her grandmother had died and the family had to travel to New York to attend the funeral. I explained why she wasn’t going to be there. I sat on pins and needles for a few minutes waiting for a question like, “What is dead?” or something similar. I could see the little wheels turning in his head. Then, he asked, “Mommy? If Grandma Wanda or Grandma Sandy dies, am I going to have to go to New York?” I told him that no he wouldn’t have to go to New York…and laughed inwardly that I had gotten myself all anxious over nothing.

July 20, 2008, 6:00 am
Filed under: Squidoo | Tags: ,

This is something I heard about and I’m giving it a try.  I’m still trying to figure it out so if you go to this link …. it doesn’t look so great.  It seems like an interesting social networking site, but I’m not sure if I’ll be able to keep up on it…or maybe it will become addictive and I’ll end up staying up until 3am every morning working on it. LOL  We’ll see…

A fallen angel…
July 19, 2008, 1:20 am
Filed under: ChemoAngels, chemotherapy | Tags: ,

At least that’s how I’m feeling right now.  I’m involved with an organization called ChemoAngels.  The website is  Anyway, the purpose of the program is to set up people who are undergoing chemotherapy and other cancer treatments with volunteers.  Traditional angels send their patient small gifts and cards at least once a week.  Card Angels (that’s what I do) send their patient cards and letters at least once a week.  So far I’ve been a Card Angel to two patients.  I’m not sure what happened to my first patient because I was just notified by the organization that she had stopped providing updates and was no longer a part of the program.  Shortly after, I was assigned to my new patient.

Anyway….my patient informed me that she would be coming to our area for her job on a certain day that I’m already occupied.  I’m being purposefully vague because of a confidentiality agreement.  Anyway…I had originally thought that I would be able to go and see her do her job but that was before I remembered the other obligation.  Now, I feel bad because I had mentioned that I would be coming to the event in question that she is involved in.  Now, I have to tell her that I won’t…I just feel bad…

But, for anyone who is reading this…ChemoAngels is a great organization and I’ve found it very rewarding…you should check it out.  So, I guess if nothing else, me venting my disappointment is at least a way to maybe get more people to learn about it.

My dirty little secret….
July 11, 2008, 6:09 am
Filed under: balance, burn out, job, MSW, social work | Tags: ,

Tomorrow I go to work. I haven’t worked all week and I am so happy and excited to be going to work in the morning.  I feel slightly guilty about this.  I had always been adamant that I would stay home full time until both boys were in school all day. I wouldn’t say that I was ever militant about thinking all children needed to be home with their moms until they went to school…just for me personally, I thought I needed to be home full time.

So, I was a bit conflicted about going back to work. I thought I would totally miss my kids all day long, that it would be hard on them, hard on me, etc etc etc.  Well, that’s not how it turned out.  They love being able to hang out with their grandparents.  And I really like being able to have a life outside of the home.

I guess maybe I was getting burnt out being at home full-time and shouldn’t feel even a little bit guilty about wanting to go to work.  I guess maybe it’s like any job…I didn’t have any balance and needed to find something to get that balance back.  Apparently, it was going back to work.

My older sister said I would like going back to work and would like seeing that I had gotten something completed.  Well, I don’t know about seeing things getting completed, given my chosen profession.  (She’s an IT professional in the business sector…so she has a job where she can definitely see things being completed) But, I definitely feel a sense of accomplishment at the end of the day, even with all of the frustrations.

Don’t get me wrong, though. I have enjoyed my week with the kids.  I got to see G’s t-ball games and was there when he got hurt today.  (Don’t worry he’s fine…but it was nice to be the one that wiped away the tears!)  And playing with David and all of that.  But, I’ve also had to deal with the typical 3 and 5 year old hijinx.  That gets old really quick.

Anyway…shhhhh…don’t tell anybody…but I’m going back to work tomorrow and I’m totally thrilled about it!