A typical day...

Somedays just capture the true essence of what I do better than others. Some days just have typical nursing home events in it that I feel I take for granted. Today was one of these days. I thought I would take you through a typical day of the ups and downs of my work, and working in a nursing home and hospital. The funny thing about alot of this stuff that might seem crazy to you is that it's normal in the setting I work in. Do enjoy.

8:00- Arrive at work, mearlier than I have been arriving lately. Remember the trecherousness of it being the beginning of the month. I have to close out all my current paperwork on each paperwork and start all new paperwork on all my patients.

9:00- Still going. Coworkers arrive. We gripe a little about the ridiculous finally of the Bachelorette.

9:30- Nothing exciting happened here today, but yesterday at this time exactly I was working at the nurses station when one of the residents walked up to me with a handful of feces. Not trying to gross you out, just trying to let you in on a typical day for me.

10:00- Paperwork completed at last (And they want 75% of our time to be direct billable time with the patient. Yea right) Start my first session with a little lady who has short term memory loss. (The problem with these patients is that they can NEVER remember when our therapy is and they always schedule a doctor's appointment or hair appointment or something of the like and have to reschedule therapy, therefore they receive no therapy to work on their memory which caused them to forget the session in the first place. It really is an uphill battle.)

10:45- Rope a patient into doing therapy. She is not thrilled, but obliges, as long as she doesn't have to keep her eyes open.

11:30- Evaluate the sweetest little lady who I have been seeing off and on for the past 5 months. As soon as she gets stronger, she has another stroke that takes her back down. It really is discouraging because she is just so tired and is really ready to pass on. She is really weak too, but finds the strength to laugh with me and respond to my jokes by punching my arm in a friendly way (yet really hard for an 80 year old who has weakness on that side).

12:00- Highlight of the day. I have a new patient to evaluate. I am going to see how his swallowing is going so I walk with him down to the dining room after waiting 20 minutes (no lie) for him to put his dentures in (And no, that time is not billable time that can go towards my productivity. They should factor in an extra 25% for us to make up the extra time it takes our geriatric patients to get moving.) We get to the dining room and he remembers that he has some ham and biscuts that a "friend" brought him. They have been sitting out in his room for who knows how long along with some deviled eggs. Lovely thoughts of food poisoning. My ravenous hunger for lunch is curbed. We go to the dining room. Remember that this nursing home is not your typical nursing home. It is fairly proper. Fine dining, tables set to the nine, floor staff waiting on the residents hand and foot, asparagus, shrimp, almond encrusted salmon, beef wellington.... not typical for nursing homes.

12:30- So I get to my patient's table, who is sitting down with three other gentleman, all with great personality, 3 out of 4 whom I have seen for therapy. All the men welcome me to the table and suggest I make it a norm. My patient opens his biscuts and ham and urges me to "Get in on this." I assure him that I am good. He keeps insisting I eat, and after thanking him repeatedly I insist that I am working and will eat later. He then tries to take a bite of this ham. After clamping his teeth down full force for 3 minutes (the meat has been sitting out for who knows how long and it is as tough as leather), he asks me to get the kitchen staff to "pulverize it." I asked him what he meant by that and he said, "They have a pulvarizer where they grind up the meat so I can chew it. A pulvirizer." All the other men chime in and I have never heard the word "pulverize" used as much. The kitchen staff "pulverizes" the meat and the day is saved. One of the patients at the table (the one who used to tell me that he was good until I came in his room) kept yelling out, "Why do they all get pie and I don't? Why is their dessert different then mine!" The reason is because he can't eat pie or things with crumbly crusts because it falls in his airway and he can't swallow it. I am the one who has regulated this and I am hoping no one will remind him of this or he might throw his brownie at me. No one answered him and he kept yelling. Finally one of my favorite patients who I was seeing not to long ago for problem solving and word finding deficits turned to him and said, "Yours is free. Ours isn't." Good problem solving on his part (and of course they don't have to pay for their food, although I have had residents freak out on me telling me they didn't have any money to pay for their meal).

1:00 - I excuse myself from this lovely dining experience. They really are the cutest little men. I finish up and drive to Hendersonville.

2:15- Therapy with a middle age man who just had a massive stroke. It's really sad that he can't communicate and really understands little of what is communicated to him. It's very slow progress on a daily patient and it gets really sad sometimes. I feel helpless because I get hardly any response.

2:30- We do a video swallow study in radiology with the CUTEST little black lady. She is precious. She actually was my patient a month ago in ICU and had a PEG placement (feeding tube) because she wasn't safe to eat. Well she has made a miraculous recovery. In a swallow study, I have to give my patient's food and liquids mixed with barium so it shows up on the monitor, and barium tastes like crap. So most patients glare at me the whole time. But this little lady was so thrilled to eat, that she kept thanking me. She had no teeth, so when I offered her a banana, she bit down for like a minute and couldn't gum it enough to bite down, so she just licked the barium paste off like it was marshmellow fruit dip. And then when I cup up and gave her the banana, she praised God for it several times (LAWD thank ya) and blessed me ten times over as well. After the swallow study, she thanked us for all of the food (Have I emphasized how terrible barium tastes? It's like radioactive chalk, if you will.)

3:00- After calling her doctor, I got to deliver the good knews that she could start eating again. A plus side of my job. That's always good news.

3:30- Play a solid hour of the game Guess Who with a little 6 year of patient while working on his speech. Fun times. That little rascal always beats me.

4:45- Work day complete.