Looking a little “meth-y”
May 27, 2010, 8:07 pm
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epidemic,
hospital,
hospital social work,
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crank,
ice,
meth,
methamphetaminesSo, I saw a patient today that could only be described as “a little meth-y.” For the uninitiated, I’m talking about a person who likely has used methamphetamines in the last couple of weeks or maybe had been using very heavily within the last year.
The person didn’t have any of the behavioral characteristics of meth use, but just had that look that I’ve come to know. The person may only be in their early 30’s but can look closer to 50, their skin has an appearance that can only be described as “rough.”
Anyway, anyone who has much exposure to people who abuse methamphetamines knows what I’m talking about. My struggle today was how to document clearly what I am talking about. It is easy to just say, “The patient had the appearance of somewhat who uses methamphetamines.” But, is that enough? Would anyone know what I’m talking about??
Thoughts from any one of my 6 readers??
Social Work Fail…
I may start a new series here, much like The Trench Warrior’s “Stupid Social Worker Tricks”. Mine will be Social Work Fail.
Today I had a social work FAIL. It wasn’t horrible but it was one of those situations where I was like, “How did that come out of my mouth?”
So, I met with a female patient where I work. It wasn’t entirely clear why they wrote the order for me to come see her, so I was doing my little song and dance of “What Social Work Can Do For You!” So, she looks at me and says, “Oh, so if I have something I want to bitch about I can come to you?”
My response was, “Yes, that’s one of the things I do here, listen to bitches.”
Social Work Fail!
The Cumulative Effect
May 20, 2010, 7:45 pm
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burn out,
hospital,
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burn out,
overwhelming jobSometimes there is a cumulative effect with all the shit I see on a daily basis in my job. Most days, I feel like I am able to, not necessarily brush it all off at the end of the day, feel like things went OK. But, every once in awhile, I hit the wall.
It’s been like that the past couple of weeks, I’ve hit the wall. I’m sick to death of people dying because they don’t have health insurance. I’m sick of having the same alcoholics come in again and again with a GI bleed, telling the doctors that, “Oh yes, I want to do whatever it takes to get better” and then telling me to get the f**k out. I’m sick of seeing people being essentially struck by lightening. Going on about your business and then getting hit by a drunk driver and being horribly injured is about the same as being struck by lightening.
The Husband has a hard time understanding why I go back every day. Frankly, I don’t know what I would do if I wasn’t doing this job I do now. In some ways, it’s a job that is perfectly suited to my personality. And like I said, most days and weeks, I really feel like I’m absolutely where I’m supposed to be and serving my purpose in life.
But, I’ve hit the wall and need to find some ways to have some down time. At this point, I’m wondering if my purpose in life really is to get cussed out by alcoholics. Or if I’m really doing anything more than putting a metaphorical band-aid on a severed artery when I go in to talk with a family who has just experienced an enormous tragedy.
Sometimes it is all just too much!
I may have to put my money where my mouth is…
There is a certain group of physicians in my community that do not take Medicaid patients and only take a certain number of Medicare patients. If you don’t have insurance, well, let’s just say you’d better have your credit card and/or check book ready.
My family actually uses this group. It’s a large group with a number of specialities. My family has gotten all over care there. The Husband’s diabetes is well managed there. My two difficult and high-risk pregnancies were managed there. The pediatrician for The G and The D are there. The D’s asthma specialist is there. We have always gotten good care there, but I am thinking we are going to have to switch providers.
The thing is, I think that they are immoral assholes. I know a person who very likely has colon cancer. She has been seeing a GI doctor at this group and had been able to scrape the money together to see him because “he’s the best.” But, here’s the thing. This supposed health care provider won’t do her colonoscopy to give her a definitive diagnosis and determine an appropriate course of treatment until she is able to come up with $2500. I realize he’s probably not made that decision on his own, that this has come from the business office, but to me it might as well be the same thing.
So, she was approved for financial assistance through the organization I work for….after two and a half months. Now he’s going to “help” her by getting in to see one of our GI specialists.
I am disgusted and appalled by this situation. And frankly I’m a little horrified that we have supported this group financially over so many years. So, I’m starting the process to get our care transferred to other providers. I’m a little loath to transfer The D’s care due to all of his issues, but I may just have to. We’ll probably have to at least stick with the asthma specialist, but a mom’s gotta do what a mom’s gotta do.
And this is also why I am continuing to advocate for health care reform. In case you weren’t aware, people really, truly are dying because they don’t have insurance. It’s not as dramatic to watch as a car wreck or plane crash, but sometimes it’s many times more tragic.
Enough with the hospice talk already!
There is a person I and my colleagues work with on a fairly regular basis. The one thing I have to say about her is that she is very thorough and conscientious and truly wants the best for patients once they leave our facility. The problem comes when she can’t seem to come up with what she considers to be an adequate plan.
So, what is her fall back options for these people?? You guessed already? She thinks that a hospice referral would be just the ticket? How did you know??Oh yeah…the title of my post probably gave it away.
So, at least a handful of times a month she’ll give us a call and say, “Well, so-in-so could really use some help at home. They are 94 (or 82 or 77 or 55) and I’m going to be sending you guys a hospice referral.” We’ll also get this call if the family doesn’t think they can pay for things like a hospital bed or a commode.
So, we’ll say, “Well, only a doctor can write a hospice order and, by the way, what’s the hospice qualifying diagnosis?” Sometimes the hospice qualifying is the fact that the person is rather aged. Recently it was that they were blind and aged.
The thing is that hospice IS a wonderful resource for people and their families. Hospice provides care for people in the last part of their lives. They provide the family with necessary medical equipment such as hospital beds and medicines needed to make their loved ones comfortable in their last days. They receive nursing care and other supports. They get visits from social workers and chaplains. I feel that hospice care is some of the best medical care provided here in the US and around the world.
But, the thing is, hospice can’t provide round the clock, hands on care. And they can’t provide care to people who are expected to live longer than 6 months. And some times, people aren’t ready for hospice care even if they aren’t expected to live longer than 6 months.
So, we’re still trying to explain to her that hospice isn’t for everyone…
Maybe it’s all a matter of perspective??
May 3, 2010, 7:36 pm
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hospital,
hospital social work,
job,
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insurance companies,
perspective,
rehabSo, as I may have mentioned before, I am a social worker in a medical setting. My role in my current work place isn’t in the typical model you’ll find for a medical social worker. I will often say, “Thank God I don’t have to order oxygen and find beds for little old ladies in nursing homes. I did not spend all that money and time in graduate school to do that!”
But, today, I got to thinking about these self-righteous statements of mine. This is after I spent a good deal of time assessing a chronic alcoholic. And then, I spent the majority of my day rounding up a treatment bed for him…and getting authorizations from his insurance company…and ordering oxygen for him. No, just kidding…he didn’t need oxygen…
But, my point is that maybe my job isn’t always so far removed from that of a social worker who does discharge planning…how different is it to get authorization for the little old lady with a broken hip to go to a skilled nursing facility than it is to get them to authorize a stay at inpatient alcohol rehab? It’s pretty time intensive and they didn’t give us training in graduate school of how to talk some insurance company peon into having some compassion (I bet you can guess where I stand on health care reform). So, maybe my job isn’t all that far removed from a discharge planner, at least sometimes.
Amy's Life in Brief 