Filed under: family life, hospital, mom, surgery, worries | Tags: dehyrdation, drama, fainting
It went great! They were able to take care of everything with just 4 bypass grafts, rather than 5 or 6. She was already starting to wake up when we saw her shortly after surgery.
But, the day has not been without drama. After we saw my mom, we went out for dinner (my dad, my 2 sisters and I). From there, I came home to get the extra bed ready for my older sister while everyone else went back to the hospital to see my mom. I got home and sent The Husband off to the grocery store. Then, I get a call from my dad. Of course I think something is wrong with my mom.
Well, my mom is still doing really well. It’s just that my younger sister passed out. She went from standing and talking to the RN and everyone else to face planting into a chair. So, right now she and my older sister are in the Emergency Department making sure she’s fine. I’m thinking it’s probably stress and dehydration.
Filed under: death, family conflict, family life, hospital, husbands, mom, surgery, worries | Tags: bypass surgery, CABG, children, parents
It’s been awhile since I’ve posted…I’ve been very remiss about getting my blog updated. I’ve had a lot of stress these days, getting to see the hospital from the other side.
My younger son has developed some new medical problems. Stressful simply on the face of it, of course. It’s also stressful because The Husband and I are not at all in agreement about how to address it. I would like nothing more than to take him up to a specialist in the major metropolitan area north of us. My husband is advocating for a watch and wait and see approach. I’m giving it another few days.
My mother is also facing a challenge. She has risk factors for heart disease, primarily genetic ones. Her cardiologist really felt that they would be relatively minor at this stage. She had a slightly abnormal stress test. She needed a surgery and so they opted to wait to do an angiogram. She had very few symptoms, some minor shortness of breath and a “heaviness.” The cardiologist was very confident that she would possibly need a stent, at the most.
Unfortunately, he was wrong. She has severe, multi-vessel disease in her heart. She will be having a 5 vessel, possibly a 6 vessel, bypass on Monday. The good news is that she has somehow managed never to have a heart attack, so there is no damage to her heart muscle. She also has good kidneys and no ongoing wound issues from her diabetes. But, obviously this is a surgery that is not without some serious risk.
I’m obviously more aware of the serious risks since I work a lot in our ICU and I’m often called in when there are serious complications for patients undergoing open heart. The only issue I’ve had is having to explain to a sibling that, while she’s likely to do quite well after the surgery, there is a possibility she could die as a result of the surgery. It’s not likely but still a very real possibility.
So, I am attempting to relax this weekend. I’m going to my 20 year class reunion (God! Am I that old?) and also spending Sunday with my mother. Monday will be here sooner than I would like.
Filed under: epidemic, hospital, hospital social work, MSW, social work, social work ethics, social work practice, Uncategorized | Tags: crank, ice, meth, methamphetamines
So, 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??
Filed under: hospital, hospital social work, social work, social work practice, Uncategorized | Tags: 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!
Filed under: burn out, hospital, hospital social work, job, MSW, social work, social work practice, Uncategorized | Tags: burn out, overwhelming job
Sometimes 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!
Filed under: hospital, hospital social work, learning curve, Uncategorized | Tags: hospice
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…
Filed under: hospital, hospital social work, job, MSW, social work, social work practice, Uncategorized | Tags: insurance companies, perspective, rehab
So, 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.
Filed under: hospital, hospital social work, MSW, psych eval, social work, social work practice | Tags: diagnostics, weirdness
I just had a very weird case at work. I’m not going to go into ANY details, but I will say it was weird. It also involved a mental health diagnosis that I was told in graduate school that I would likely never see in my career. Actually, I’ve seen this diagnosis twice now.
Anyway…I’m wondering what is the weirdest mental health diagnosis you’ve ever seen given? What’s the most rare diagnosis? I’d be interested to hear from you!
Filed under: family life, home life, hospital, mom, surgery, worries | Tags: other side, surgery
Tomorrow, I’ll get a view from the other side. My mom is going in for surgery in the hospital where I work. I am taking the day off, for the actual surgery. But, I’ll be working the other days that she’ll be a patient. Hopefully she’ll be able to be discharged on time on Saturday.
The surgery itself is rather routine…let’s just say it’s a typical surgery for a postmenopausal woman in her 60’s. Unfortunately, things are a little higher risk for my mom.
In the process of getting cleared for this surgery, she had an abnormal stress test. Cardiac issues run rampant in her side of the family, so this was of no great surprise to anyone. She saw the cardiologist on Monday and basically was told, while she runs a bit of a higher risk than an average person for having an MI after surgery, she should go ahead and have the surgery.
You see, if she were to have an angiogram prior to the surgery and they placed a stent into the potentially blocked artery, it would be at least a year before she could have the surgery she’s having tomorrow. If, God forbid, they found she had something more serious and needed by-pass surgery, it would likely be 18 months to 2 years before she would be cleared to have the surgery she’s having tomorrow. Given the uncomfortable nature of what she’s going through, she’s willing to chance it and have the surgery tomorrow. She’ll go in for all the other cardiac diagnostic stuff once she’s a bit healed up from this surgery.
So, she’ll be a patient being taken care of by nurses that I know. Some, I know, are wonderful and kind and some, I also know, are not. Because of her cardiac issues she’ll be on a floor where they aren’t used to caring for people who are having the kind of surgery my mother is having, and that’s concerning. But, I’m hopeful everything will go off without a hitch. I’ll have my fingers crossed and I hope you will too.
Filed under: hospital, hospital social work, MSW, social work, social work practice | Tags: homelessness
For my to-do list for tomorrow….
Figure out how to solve someone’s complex and long-term issues that are causing them to face chronic homelessness in 20 minutes or less.