8:32am, in a hotel room, Valencia, CA, Sunday morning, December 26, 2021. Last night ended up being longer than expected. The patient who fell was transported to the hospital before our nurse arrived. The community did not have an update to share this morning so I slept until 6 before taking the dog on my favorite walk. After that, my daughter and I ate breakfast in the lobby with grandma before my wife got dressed and joined us.
8:19pm Pacific, Valencia, CA, at relatives, Saturday night, Christmas, December 25, 2021. We traveled north today and arrived shortly after 2pm. Dinner was Prime Rib with pie for dessert. I took mom to the hotel an hour ago then came back to watch a movie. Work called at 7:30pm (8:30pm Arizona time). A patient had a fall. The nurse who covers area is not answering her phone. I tried the clinical director but she didn’t answer. Finally the traveling nurse picked up. She is calling the community. I have not heard back from her on next steps.
12:06am, in my apartment in Chandler, Arizona, lying in bed, early morning December 24, 2021, Christmas Eve. The nurse working on call tonight had her car breakdown this morning. I offered to drive if she needed to go out. At 8:30pm two calls came in, a visit and a death call, both in the west valley. I just got back home. My mom and I will soon leave for Christmas in California, though a big storm is in Orange County and headed this way.
2:50pm in my office, Phoenix Arizona, Friday afternoon, December 10, 2021. The windshield repair guy I referenced this morning no showed for the 11am appointment. I will find somewhere else to take my car next week, hopefully the window doesn’t crack on the way to California. Also, the triage nurse that I referenced last week as surly and lacking compassion quit without notice two hours before her shift was supposed to start. It has been one of those days.
4:58pm, in my apartment, Chandler, Arizona, Sunday afternoon, December 05, 2021. My phone pinged when I got back from an afternoon walk. The on-call nurse asked me to give her a call. A patient’s family requested a chaplain visit and she couldn’t get a hold of anyone. I told her to give the chaplains time to respond and if neither did I would see the patient. One of them called back just as I was heading out. I was almost a hospice chaplain again.
5:39am What did I do? I use this blog to share how I felt. It is a journal then. But what did I do? Who did I interact with? Yesterday I got to work a little late. The two girls who work down the hall were laughing. I made a cup of coffee and went through my emails. There was no call in the morning because we had our bi-weekly meeting where the staff come in to go over patients. The meeting started at 9am and got over with around 10am. After the meeting I met with the nurses to go over new assignments and update on our hiring process. At 10:30am I got on a group call for the communities on the west side then had my call with the supervisor. The call went well. Afterwards we got two referrals. I felt better. Getting referrals and admitting patients is how we stay in business. Around ten pm last night the admitting nurse sent me a text saying she did not admit the patient. I am frustrated. We are not a good hospice. We are not helpful or easy to work with. We do not provide value. We are like the beggars on the freeway exit, asking for consideration out of pity. I talked with my lead clinical nurse. She is always apprehensive to admit patients. Our approach does not work and our business is failing. I am not proud that this site is a reflection of me as a leader.
5:42am you went for a walk this morning. A little bit later than usual. You got a phone call on your work phone at 2:19am. It was the triage nurse. She went to see a patient who was complaining of discomfort. The nurse could not get a hold of the on call doctor to obtain orders for stronger pain medication. She had tried two other doctors. No one had called her back. It had only been twenty minutes. She wanted to leave the community. She explained there was not much she could do without a doctors order. I told her that was fine and to please explain the situation to the staff and to assure them a nurse would follow up later in the morning. I doubt she told them. She is not a very good nurse. She only does the bare minimum and complains the whole time. The doctor is a good doctor but only takes call to make the monthly paycheck. He has too many other interests to effectively take call. This whole site is filled with people just doing the bare minimum, getting by, here for the money. I am ashamed I am the director. Not because I created the situation but because I have failed to change it.
12:10pm in my office. Writing another post about work. Of course. The meeting at the coffee shop went alright. I appreciate the nurse sharing her perceptions. I made some changes in the reporting structure to mitigate the issues. The changes will be beneficial but they will hurt the pride of some other employees. I did what had to be done. I need to control the situation. I have felt a sense of peace since I looked for jobs this morning. In a way it made this job feel brand new. Which revitalized me. Four hours later I am drained. But it was nice to have reprieve. I have felt peace a couple of times in the last two days. I don’t get to feel that tension release often.
6:55am I am tired of thinking about and writing about work. I looked at other jobs and even applied for one today. I had another nurse call off. That means Three of four triage nurses are out. My clinical director is out. Another nurse turned in her resignation yesterday. I have never seen a program meltdown like this.
10:52pm I’m in chandler. Sleeping in the couch. Girls are in my daughters bedroom. Wife and dog are in the master bedroom. I am administrator on call for work. We got a call around 8pm from a nurse practitioner for a STAT hospice admission. I spent the last two hours talking with my triage nurse and clinical director trying to get everything in place to take care of the patient. now the family wants to wait until morning. Frustrating from a care team perspective. Worrisome for the need of the patient. Luckily The patient appears to be comfortable and managed. We will do the admission in the morning. I appreciate the experience. I have to learn how to enter new referrals in the system and run eligibility. Skills I haven’t developed yet. This is a good life lesson. It is only when I am put in a moment of urgency do I realize what I don’t know but need to know. I will grow personally and professionally from this.
mikemeyer949 