Tuesday, July 27, 2010

Busy

Today was a magical day. After morning rounds, I had Sickle Cell clinic and a few in-patients. I was running around clinic, starting with one patient and then getting tagged to see the next, in the meantime fielding calls from the in-patient side. By afternoon, I hadn't eaten lunch and I could hardly remember who I'd charted on or what I'd done that morning. I didn't care. It felt amazing to be listening, helping, and learning about the families I'll be working with for however long. I still have so much to learn but I've got the basics down. I can honestly say I love my job!

I know in a few weeks, I'll be irritable about not having time to eat or chart. Right now, it feels good to be used by staff. I think I'm a bit more proactive than my predecessor but I realize I'm still figuring out the ebb and flow of my service so perhaps I have the time to be more proactive. In any case, I've been getting good feedback from everyone. The next few days promise to be equally busy. And you know? I'm looking forward to it.

Monday, July 26, 2010

Specialty

There have been a couple of cases of consanguinity today. Yes, I'm talking about patient's parents being related to each other. When I read the history of a second case and saw the parents were first cousins, I couldn't help but wonder about the odds. Then my officemate said maybe consanguinity would be my specialty, the way she's the go-to person for transportation and the other social worker in our division is the go-to for sperm-banking. I told her it would be nice to have a specialty but I would prefer not to be known as the consanguinity expert. But seriously, what are the odds of having two cases so close together?

Tuesday, July 20, 2010

A Different Kind of Bucket List

Kristen D'Antonio was diagnosed with a rare genetic illness called Neurofibromatosis type 2 three years ago, a disorder of the central nervous system that forms tumors on the nerves that will eventually lead to deafness. Music is her life and so she has put together a Bucket List of artists she would like to see in concert before she loses her hearing. You can read more here and watch the video below for the whole story. I first learned of Kristen via newspaper article and was impressed by her effort to make the most of her hearing while she has it. It also makes me wonder if there are other similar Bucket Lists out there, related to the loss of an organ or a chronic illness.








Thursday, July 15, 2010

More than Mom and Dad

My division started doing walking rounds about a week after I started working. Also known as family-centered rounds, goals include improving communication, allowing opportunities for education, involving family in decision-making, and improving satisfaction. Although some days take longer depending on who's the attending physician, I feel it's of great benefit to both staff and families. There are 3 of us social workers on the division and this increases our profile among the residents, fellow, and attending. It also helps us get involved with families more quickly, as well as easily check in with them once a relationship has been established. Some staff are still getting used to the process but everyone seems to be on board, which once again highlight's my organization's commitment to taking the best care of patients that we can.

One thing I've noticed during rounds is that patient's parents are often referred to by the residents as Mom, Dad, Grandma. Not by their name. Sometimes patients and parents don't participate in walking rounds, in which case, it doesn't seem like a big deal to identify people by their roles. But when we're in the room or the parent is in the hallway, it seems strange to say, "Mom, have you noticed any changes?" vs. "Mary, have you noticed any changes?" This is disconcerting to me.

Time on a children's cancer wing is not time that parents ever imagined spending. So much changes for them so quickly. Concerns about finances, work, other children must all be addressed. The cancer wing may become a temporary new home. To only identify someone by their role seems to strip them of their identity. Parents are still people. In spite of the serious nature that brings them into walking rounds, they deserve to be recognized as the whole of who they are. I don't expect everyone to get to know each other intimately. Our roles and disease process/treatment don't always allow that. But remembering a name seems doable. And I'm going to intentionally do so.

(I realize that parents themselves might not mind or even notice this distinction. I also remember reading a Dear Abby column in which someone complained that the doctor's office or school secretary referred to her only as Mom, instead of Mrs. X or Mary. She wanted to note she was more than a mom.)

Tuesday, July 13, 2010

Clinic

I shadowed a nurse during one of my clinics today. I can't tell you how great it felt! I was bone tired by the time I left, a good sign in my book. I was able to help a few patients and/or their families with concrete needs and emotional support. I was able to meet a lot of the patients that I will be working with for the next however many years. How cool to see a baby and know that I will be walking alongside him or her and watch as they manage their illness and grow! Clinic is such a different routine from the hospice world. I hope to be more present in my clinics than the person I replaced was able to do. The good news is that both services I cover want to grow enough in order to have their own full-time social worker. It is exciting to be a part of that journey and to shape these programs. I have to figure out my routine and how I will divide my time between clinic and in-patient. It's starting to come along.

Wednesday, July 07, 2010

Palliative Care Grand Rounds 2.7

PCGR are up at GeriPal and listed in a most unique way. Don't miss out on these clever descriptions! And then check back here the first Wednesday in August when I play hostess. Feel free to comment or email with any posts you think are worth including in the next installment.

Tuesday, July 06, 2010

Listening

I saw my first pediatric patient today. She's in her late teens and is currently in-patient for hematology. She actually requested to see the social worker! My officemate offered to go down there with me, in case the patient had any questions. Which of course she did. The beauty is that now I know what the answers are! And I think it will stick. When I brought a few forms back to her room, we started to chat. She was so lonely. She was frustrated to be back in the hospital. She's had a humdinger of a life already but this illness was wreaking havoc on her future plans. So I sat with her and listened. And let her spill it all out. By the end of our time, she said she felt better having someone to just listen to her. I told her I'd stop back tomorrow to check on her. It felt good.

Thursday, July 01, 2010

Tomorrow

Tomorrow I have to really start working. Or something like that. Two weeks of orientation have almost come to an end. Tomorrow morning I turn on my pager for the first time. I will no longer be "incognito!" Next week I'll start receiving referrals. I'm hoping I can spend time shadowing the nurse practitioners in my clinics and handle the referrals on the side. I have so much to learn, from disease process to TN resources to my employer's protocol. It's exciting and overwhelming all at once. It is so incredible to work for an organization that is pro-social work. I feel so welcome and like a vital member of the team. It's refreshing to not have to advocate that the other staff need me- they know it and they're excited for me to start. I can envision myself doing this job well...it just might be quite some time until that happens, or rather until I'm confident that I'm doing it well. All the other social workers commiserate that orientation is overwhelming and you have a million questions once you start working with patients and families. Most of them have said it took a year or two before they felt like they had a good grasp on things. They have reassured me they are available to help out, no matter what I need. And I will surely take them up on that! So while it's scary to start direct care since I feel like I know nothing, it's time to jump in with both feet. I'm a good social worker and I was hired because they believe I can do this. I need to be OK with not knowing everything and trust that I will pick it up along the way. Stay tuned...