There are many reasons I haven't taken some time to blog lately, but the one that seems to have hindered me the most is that I have felt completely exhausted lately. Physically and emotionally drained. I come home from work and sit down with the intention of never standing again. I have recently said I will never ever make fun of my dad for falling asleep on the couch every single night (sorry, Dad!) because now I get it.
Last week felt more exhausting than most. I saw more patients in a day than I ever thought was physically possible in our tiny clinic. I was here extra long hours and felt like all I was doing was working, sleeping, and eating. My boss took me out for brunch Thursday (the best boss), and confronted my fatigue head on. He said something along these lines:
"Abbey, you've let it become a grind. You see patients and just want to keep them moving and get the next one ready."
He was referring especially to a conversation he overheard between me and one of my favorite patients in which she was sharing with me some really difficult news that she had received that weekend. I was unable to engage with her, because I was so exhausted that I was barely listening. I was initially taken aback by his statement thinking. "How the heck do you expect me to engage with everyone when we see 50 people in one day??" But as I thought about it the next day at work and over the weekend, I realized how true it really was.
I'm currently reading, Tattoos on the Heart, an account of gang life in LA as told by a Jesuit priest Fr. Gregory Boyle. The chapters are full of stories of his work with current and former gang members and the neighborhoods of LA. He tells the story of one girl who had been locked up for awhile and was really difficult and gave him loads of attitude. She comes to his office one day and he recollects a certain sense of annoyance that he felt that she was there. She began to tell him a story, at this point I don't really remember what it was about, and as she is talking begins to feel shame because he had seen her as an interruption to his day.
How true is it that often times our days become a series of assembly lines and to-do lists. We grumble at the people who interrupt our routine and make us stray from this path we have created with the idea that it is the best and most productive way to get us out of work and back home to the couch. This is how we let our days become a grind. This is how we let fatigue take over and put our bodies into autopilot.
This week I have attempted to slow down and re-engage. Allow conversations with patients to last longer than I think they should. Let charts sit in a stack for 5 more minutes so I can ask someone about their day, and actually hear the response. I feel much less tired today. Part of it is that I sleep better at night, but more importantly I think it's because I spend less energy fighting off the "interruptions" in my day. My conversations feel more genuine, and for that reason, much more life-giving and energizing.
Here's to fighting the grind this week and every week. Because in reality, what's more important than building relationships and having genuine interactions? Certainly not my couch or the nap I've been dreaming about that's for sure.
Tuesday, October 15, 2013
Tuesday, October 1, 2013
An Education
Today is October 1st which means two very important things in my life. Number 1: My favorite month has just begun and the leaves are changing colors which made my walk to work this morning extremely enjoyable. The calendar is already full of fall activities and outings. Also, my house is decorated for Halloween (thanks lyss), so again, October is starting out on the right foot.
Number 2: Today, is the beginning of the new fiscal year which means many things for many people, but I'll just focus on how it affects my reality on this Tuesday. At Bread of Healing, we are starting to get our patients signed up for insurance under the Affordable Care Act. We have two full-time staff people newly trained and poised to begin this process when the clinic opens in half an hour. I entered the office today to a flurry of "Happy insurance day!" and physicians with smiles plastered on their faces. A sense of hope is palpable amongst all our staff and many of our patients. We have flyers and power points and other educational material ready to hand out as the questions come flooding in today. In light of recent events in Congress, I imagine that today will be FULL of questions, concern, confusion, hope, excitement, promise, the list goes on and on. Many of the most vulnerable in our midst will gain some form of a safety net starting today if things go as previously planned. There is much to discuss, and be excited about...but for me there is much more to learn.
As the day begins, I am stuck on a conversation that I had with a patient yesterday. It was nearing the end of the day and he was waiting to see a doctor, so I sat down in the room with him to chat for awhile. We talked about what's happening in the news as we usually do, and he started telling me about the information session he went to about the new insurance exchanges in Wisconsin. I sat and listened for awhile, before I realized that I knew VERY little about what he was telling me. His monthly income qualifies him to sign up for the exchanges with co-pays, and he was expressing some frustration about the lack of information he was given about just how much he would have to pay, and how everything would really work. I tried my best to contribute to the conversation, but I was really lost. The questions came flooding in:
"So Abbey, explain this to me, they want me to give up my free care here and buy into something that half of the government doesn't even agree with or face some kind of a tax penalty? Does that seem fair to you?"
"How much is this actually gonna cost me?"
"Is it true that my premium will cost me more because I live in Milwaukee county where there is more trauma like gun shots and gang violence? Are they really gonna tell all the poor people in this city that they should pay more than those people in the suburbs?"
And lastly, "Why aren't you answering me? You don't know?"
Bingo. I don't know. I'm a well-educated healthcare professional who is struggling just as much as my patients to understand these changes. Here's a tip to all of you Seattle U nursing students- ask your professors why this is never talked about in school. We are taught how to work in a system without ever being taught how the system works. We discharge patients all the time without a thought as to where they might be getting their medications when the ones we send them home with run out. Here I was expected to know how to help someone understand their reality and I really just didn't know.
Yesterday, I was very humbled by the fact that I am not that well-equipped for today. I don't have all the answers. In fact, many of my patients have been educating me in the past few weeks. Granted I have spent loads of time reading and trying to understand everything myself, but still anticipate today will be full of: "I'm sorry (insert name here) I wish that I had a better answer for you."
As classes get going this week in Seattle, I am left to reflect on the reality of my education. What I learned in a classroom is a foundation for many things that I do during the day, but has still left me extremely unprepared for the reality in which most of my patients live and receive healthcare. I will work very hard today to teach and serve to the best of my abilities while acknowledging that constant nagging feeling that reminds me that I still have so much to learn and be taught. I sit full of hope as the clinic chatters with change today.
Happy October 1st. I hope we all learn something from the events of today and remember the people whose voices aren't heard in the decisions of many who are trusted to represent them.
Number 2: Today, is the beginning of the new fiscal year which means many things for many people, but I'll just focus on how it affects my reality on this Tuesday. At Bread of Healing, we are starting to get our patients signed up for insurance under the Affordable Care Act. We have two full-time staff people newly trained and poised to begin this process when the clinic opens in half an hour. I entered the office today to a flurry of "Happy insurance day!" and physicians with smiles plastered on their faces. A sense of hope is palpable amongst all our staff and many of our patients. We have flyers and power points and other educational material ready to hand out as the questions come flooding in today. In light of recent events in Congress, I imagine that today will be FULL of questions, concern, confusion, hope, excitement, promise, the list goes on and on. Many of the most vulnerable in our midst will gain some form of a safety net starting today if things go as previously planned. There is much to discuss, and be excited about...but for me there is much more to learn.
As the day begins, I am stuck on a conversation that I had with a patient yesterday. It was nearing the end of the day and he was waiting to see a doctor, so I sat down in the room with him to chat for awhile. We talked about what's happening in the news as we usually do, and he started telling me about the information session he went to about the new insurance exchanges in Wisconsin. I sat and listened for awhile, before I realized that I knew VERY little about what he was telling me. His monthly income qualifies him to sign up for the exchanges with co-pays, and he was expressing some frustration about the lack of information he was given about just how much he would have to pay, and how everything would really work. I tried my best to contribute to the conversation, but I was really lost. The questions came flooding in:
"So Abbey, explain this to me, they want me to give up my free care here and buy into something that half of the government doesn't even agree with or face some kind of a tax penalty? Does that seem fair to you?"
"How much is this actually gonna cost me?"
"Is it true that my premium will cost me more because I live in Milwaukee county where there is more trauma like gun shots and gang violence? Are they really gonna tell all the poor people in this city that they should pay more than those people in the suburbs?"
And lastly, "Why aren't you answering me? You don't know?"
Bingo. I don't know. I'm a well-educated healthcare professional who is struggling just as much as my patients to understand these changes. Here's a tip to all of you Seattle U nursing students- ask your professors why this is never talked about in school. We are taught how to work in a system without ever being taught how the system works. We discharge patients all the time without a thought as to where they might be getting their medications when the ones we send them home with run out. Here I was expected to know how to help someone understand their reality and I really just didn't know.
Yesterday, I was very humbled by the fact that I am not that well-equipped for today. I don't have all the answers. In fact, many of my patients have been educating me in the past few weeks. Granted I have spent loads of time reading and trying to understand everything myself, but still anticipate today will be full of: "I'm sorry (insert name here) I wish that I had a better answer for you."
As classes get going this week in Seattle, I am left to reflect on the reality of my education. What I learned in a classroom is a foundation for many things that I do during the day, but has still left me extremely unprepared for the reality in which most of my patients live and receive healthcare. I will work very hard today to teach and serve to the best of my abilities while acknowledging that constant nagging feeling that reminds me that I still have so much to learn and be taught. I sit full of hope as the clinic chatters with change today.
Happy October 1st. I hope we all learn something from the events of today and remember the people whose voices aren't heard in the decisions of many who are trusted to represent them.
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