Friday, November 16, 2012

It's not always what it seems.

Fridays are crazy busy days at work.  I don't have time to spin my wheels on things that are inappropriate. So when I heard a nurse I spoke with yesterday about a patient who was inappropriate called a colleague today with the same referral I was a bit confused and annoyed.

Yesterday I had a lengthy conversation with a doctor's office about a patient they referred.  He was not appropriate.  I told them why.  Not my rules, he just didn't meet admission criteria.  Not even close.  Today they called again, spoke to a colleague and asked again for a home evaluation.  The story had changed.  His wife had apparently called tearful and upset that he needed all this help. She (my colleague) happened to call me to ask for help and to take this referral as I was geographically closer and happened to have the time where she was busy at the time, and I explained he was not appropriate and why.  I agreed to take it on to help her, especially since I was familiar with the situation and had the time.  Giving the benefit of the doubt, maybe things were different than they were described yesterday, I drove 45 minutes to their home to do an on site evaluation.

His wife was wound like a top and over the top anxious when I arrived.  She was waiting at the door pacing for me to arrive.  Practically in tears and going a zillion miles a minute she ushered me in to her husband.  The phone rang while I was talking to him and she snapped at the person on the other end and hung up.  Then she literally had her hands on her head and in her hair pacing the hallway, muttering about Israel.  She was angry.

OMG! She was worried about her family and friends in Israel with the tension in the area building!  She feels powerless to help them. And her husband had been home and in increasing pain for weeks and needing her help to get dressed and he is unable to help her around the house.  She feels powerless to help him.  She is overwhelmed.  Neither of them were sleeping or eating well.  The stress was getting to her.  He was tired, in pain and depressed.  He told me the whole story.  Quite a delightful man with a horror story of sorts of his medical woes of the past few years.  It took about 15 minutes to realize I was right, he was not appropriate.  Not that he didn't need medical care.  Our facility was just not the right place for him and he didn't meet our admission criteria.  I explained other options.  I called his doctor.  I facilitated another option.  He will get what he needs.  They both cried.

I then spent a good 40 minutes sitting and talking with them.  It occurred to me I wasn't summoned there for the purpose of spinning my wheels.  I was chosen to go there because they needed to be heard.  To have things explained to them.  Face to face.  To have their frustration acknowledged and witnessed.  They needed to vent.  They needed to be reassured.  They needed to know they were being heard.  Only then were they able to listen to what I was saying.  We talked about him, his experiences, her, her experiences with health care, what they loved, what they hated, why they wanted to come to our facility so badly and why they were so upset they didn't qualify.  We talked about their other choices and how to advocate for them.  We talked, briefly, about Israel.  We talked about the importance of his wife taking care of herself so she could be there for him now that there was a plan.  We all took a deep cleansing breath.  She cried again, this time, much calmer.  They were tears of relief and gratitude.  I damn near cried with her.  Instead, she reached for my hand and squeezed it.

I excused myself.  As I walked out, I was very aware that the energy in that home had changed significantly from when I walked in.  My energy had changed.  I knew my purpose in going there was far beyond that which the situation originally called for.  I knew why I ended up being the one to go instead of my colleague.

It was also a nice reminder.  If you need to be in a hospital for anything serious or that is not able to be 'solved' by your MD, GO TO MASS GENERAL HOSPITAL!   That was a message for me from the Universe, validating something else entirely.  But timely, nonetheless.

I am grateful.  For being able to facilitate what they needed.  For the reminder to myself to resist making a judgement.  For the validation about MGH.

It's not always what it seems, but it is always what it needs to be.  No matter what "it" is.

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