Monday, June 20, 2016

Decibels

Seems like best I can do lately is one post a year. This is not what blogs are supposed to be and I guess I'm wondering where I lost my enthusiasm. I do this because it helps me get perspective in my work, get better at what I do, and not get burned out. I think it was a clue that I couldn't fit this in with my life when I worked at Unnamed Big Psych Hospital north of town. It sure as hell was - driving an hour to work and an hour back, never knowing how many patients I'll be assigned, getting to know the security officer really well, geeeeez.... that couldn't go on. And it didn't. But interestingly, it wasn't for the obvious reasons just stated. It's because the new corporate suit had values that I simply couldn't live with. I tried but eventually, I feared for my own safety and left. I had a meeting with the CEO and gave my notice the next day after listening to him. I feel fortunate that my delegating physician chose to leave also, but it was me that pulled the plug. So now we're at another unnamed psych hospital, in a different part of lovely Central Texas. It's much better on all the fronts. Better commute, better management and a much lighter workload. I make a little less money but it's all OK. I rarely work past 5:00. I have time to do things that matter that I couldn't before, like call families and discuss discharge plans. It's like a new life.

Nile and Ken after the Swampfest

My sister got engaged at Whip In
And I have some new life in me. We sold our house and moved downtown. I like it. I can walk wherever I need to go, the bank, dinner, yoga. I walk to the gym every morning, dodging the homeless guys. It's a good life. Ken retires in 2 weeks and things will start to get real. Dani lives a 10 minute walk away in another high rise. Nile is still with us, going to school.



My new place is geropsych but with an Intensive Outpatient Program for all adults. IOP has been slow to develop, but in the past week the admissions have picked up. So in many ways, I have the variety of all adults, and I don't have the dangerous unstable young men in the inpatient side. I've learned a tremendous amount and I still have so much more to learn. Most of our patients have dementia and aren't doing well, have gotten combative either at their nursing home or at home. We change their medications (and usually there's quite a bit of change needed), get them stable and better and then send back to a nursing home or back to their families. We don't cure the dementia (we slow it, nominally) but we make them fit to live with. We take ages 55+  in the hospital (gulp! yes, that's what geriatric is!), so we get people in that lower age range with a wider range of problems -- mania, suicide attempts, with no dementia. It's absolutely never dull. The hospital is new, and the disorganization when we started was trying. They were thin on policy and procedures, and the staff was not experienced. Things would happen, and be handled the wrong way. Critical lab values not recognized as such and we weren't notified, orders written Friday and not done until Monday, things like that, medications not administered correctly (you can't crush some meds for the poor swallowers). It took us over 3 days to get a lithium level once and that's really dangerous. Lithium too high can kill you. We have a new director of nursing, someone we used to work with and knew was fantastic, so that's looking up. I'm happy to say that when things get difficult, the CEO has always deferred to our medical judgement. I do not get pressured to do the wrong thing. Which is really pretty impressive, because I know it's hard to make money in this business.

Dani, Trey, Nile at Whip In

A lot has happened. We had our fun annual stuff, including ACL and Carnaval and Art Erotica. ACL this year looks so tasty, I see so many bands that I'm listening to, and we can WALK to it this year. I said to Ken that's 90% of the reason I wanted to move here. Ha. We have more time for family, because seeing them doesn't require a 45 minute drive.

Kitten needs food - Dani & Nile volunteer at APA

One of the new things I'm doing is going to this spin studio called Ride. It's waaaaaay different that the RPM from Gold's that I'm used to. Here's a hint: I go there for my first class and one of the trio of cute young gals at the desk shows me the locker room - unisex. It's got dark blue lights and the locker combos are teeny tiny. It's so dark, the font is so small and I'm not wearing my glasses (who wears glasses to spin?). The place is so not designed for older people. The decibel level of the class confirmed that, but I'm got my earplugs in place. I do like it, and I don't need to use the lockers since I walk there, so hey, everyone's happy and I can dance on that bike with the young ones. Especially when they play Prince.