Hello residents

Well, I am employed.

This is good, and I am grateful.

But....

I am working as a Director of Social Services in a nursing home. It is the first "for profit" kind of organization I have done social work for.....ever....

It is a bit different than the non-profit sector in terms of goals and philosophies. It is an organization in the health service industry, and yet they do not provide medical coverage for their employees. I am a department head, and yet I do not have a computer provided for me. I write correspondence to families, to other agencies, and I am constantly writing social/psychological histories, reports, and summaries...and yet I do not have a word processor or printer. Employees provide their own, and then apparently pay for the ink cartridges to print out work related correspondence and reports.

The job also involves working directly with people who are completely dependent, often in pain, suffering from dementia, fear, hopelessness, and depression. A typical day will involve helping residents cope with loss (of family, friends, mobility, function), and also dealing with family members who are understandably overwhelmed and distressed. I do intakes, assessments, administer mental evaluations and depression scales, do social histories, set up care conferences, set appointments for residents, deal with all issues related to behavioral problems (anger, wandering, exit seeking, smoking, striking at staff or other residents, sexually inappropriate behavior, terrors, delusions)...and this is all done with the assistance of a single part-time social worker who will not be available in the summer. The biggest single time consuming task is charting and doing these things called "MDS's" for Medicare, which involve filling out a form evaluation and then writing a summary of varying detail at 5, 14, 30, and 60 days, as well as quarterly and annually, creating behavior/mood treatment plans, and charting (narrative form) each and every interaction with each and every resident.

In previous jobs, I would have 45 minutes to spend with a client, and 15 minutes of accompanying paperwork. In this job, it is exactly reversed. This is hard for me, as what I really want to be doing is spending my time with the residents-and finding ways to make them smile. It does not require much to brighten an otherwise gloomy day, but in order to be involved in that, I need the time to go to them.

Still, there are some wonderful things.

There is the developmentally delayed little old lady who rolls around in her wheelchair all day. She rolls by my office, and in her little tiny voice yells "Hi Jo Jo!" Back and forth, all day long. She comes into my office for pretzels and hearing aid batteries. I have to make sure she eats the pretzels, and not the batteries.

There is the WWII veteran with no legs who likes M and M's. I keep them in my office, so he searches me out daily for his allotment. As I am dispensing the candy, he tells me the EXACT dates of his military service, and all major events related to it.

There is Tenacious J. She is suffering from an assortment of mental conditions. She is adjusting to the loss of the previous Director of Social Services, and testing me out a bit. She will roll to my office 7-8 times a day, and make a variety of demands. "Go see if my laundry is done." "Find my bracelet." "Run to the store and get me some teddy bears of assorted colors." She is usually grouchy, but I have managed to make her smile every single time she comes to see me. Humor works with her. It is truly amazing how if I have my heavy pine door closed (trying to do paperwork), she manages to open it and roll right on in. She makes me smile too, although sometimes through gritted teeth.

There is the wonderful woman who has had five strokes, and has lost her ability to walk. Our physical therapist (who has the bedside manner of a bull in a china shop) has informed her she will not walk again. This woman will not hear of it, and has been dealing with this news with anger (at him) and denial. Her husband is with her every single day, and rubs her feet, feeds her, holds her hand, and generally fusses over her in a touching and tender way. It warms my heart, and pains it at the same time.

There is the 72 year old man who was an active and vital manual laborer before having a stroke 2 months ago. He is Mr. Macho, and dealing with the loss of function and resulting dependency is terribly difficult for him. He gets so frustrated because he can't recall words, and has lost function on his dominant side. He has to speak slowly, and can be difficult to understand...and deals with his frustration by exercising the emotional option left open for men of his generation...ANGER. For someone with speech difficulties, he manages a pretty crisp and clear "F^#K OFF"...

There is the guy that reminds me of Paul Newman. He was obviously movie star handsome as a young man. He still has the thick snow white hair, and piercing blue eyes. He is always smiling, and those blue eyes are completely full of mischief. The nurses have to watch out. He has a bit of dementia, but could still convince you that the sun goes around the moon...

Mr. Negativity is recovering from several surgeries. He has post-traumatic stress from being trapped in a structure fire as a young man. Our facility has recently undergone inspection with the fire-marshall. We conducted a number of fire drills and system tests (alarms going off a lot)...when the alarms sound, the magnets holding our THICK solid wood doors release, and they all slam shut...he is normally bed bound-but in those instances we have to get him down from the ceiling...

Anyway...

It is a colorful place to work. I am learning a whole new skill set, and I am hoping I will be able to make a positive difference for these people and their families. I can see that it will be challenging to navigate the organization itself-and I am not working with the tools or resources necessary to do the job as it really needs to be done-but I think I will find a way. It will be good for me. The lack of medical coverage alone assures that I will be moving on at some point (probably after Coley finishes at WSU), but I think I will be better for the experience...

Thank God spring is almost here.