There's a huge dichotomy between the two jobs I work. It's been about a month and a half since I started working as a full time physical therapist, and it's insane how much I've learned in such a seemingly short period of time.
To be totally honest, I come home exhausted a lot. There is so much more to being an on-your-own, full-time, real-life therapist as opposed to a student. I remember my professors telling me that we would be surprised at how many "training wheels" and "safety barriers" we still had up even after clinical 3. I was prepared for that, and I wasn't. It is more tiring to me than I thought it would be to do both full time PT and parties, and I didn't think that it would be much different to work during the week and do parties on the weekend, but I am getting exhausted from it very quickly. I can't keep it up, and I know it. If I'm a cup pouring out for everyone around me, I'm getting dangerously low on what I have to pour in my own cup. I'm tired and frazzled. I'm shorter than usual, and I come home feeling drained, even though I love what I do. I just haven't given myself enough days to have a mental break and I need to have that moment to breathe so I can feel recharged. Thankfully, I'm taking this weekend off to relax, and that's going to help a lot. If anything, these past few weeks have taught me that it's so important, when you're in jobs that deal with people on a level like these do, to take time to yourself to recharge; otherwise, it's hard to have enough energy to devote to others. This is something I will continue to have to teach myself through my life, I think.
Aside from never being good at giving myself breaks, the dichotomy stems from the simple fact that I spend weekends with people at some of their best moments; and weeks with people who are facing some of their worst. For those of you that don't know, I work in a skilled nursing facility (a nursing home). I have always wanted to work in this setting since I entered PT school. I remember being a student in undergrad, and I was introduced to the setting by an old boyfriend. I'd spend afternoons walking through the halls, smelling all of the unusual smells and staring at yellow painted walls. Seeing people roll by in wheelchairs, propelling them or being pushed. Along the way, I came to the conclusion that this setting was for me. There was something about it that spoke to my heart, and I listened to that, making it my goal to work in a place like that when I graduated. So that's exactly what I did.
It's almost surreal, getting to go to work and do that every day now, and get paid for it, and to love it so dearly. The setting can be challenging in that there are a lot of demands placed on you on many ends; physically, emotionally, logistically. You help people that are and aren't your patients, as there are a dozen residents with a dozen different needs at any given time. You have to rely a lot on your rehab team members to help you with patients, whether that means getting them out of bed, or walking safely, or helping one into quadruped on the mat (hands and knees), or making sure the e-stim pads for Russian are on just right to facilitate shoulder movement in a patient with a subluxed shoulder due to arm weakness from a stroke; the list goes on and on. People stop to ask you a lot of questions. You talk to a lot of patient families and help them make difficult decisions for discharging. People will ask a lot of you, and sometimes it can be tiring; you give a lot from that cup of yours, emptying it throughout the day, and it can leave you coming home tired and drained. Sometimes, the sadness wears at you. There are people you can help and others you try to help but it never seems to quite do enough. They just don't improve like you want them to, despite all the energy poured into them. There's a lot of sadness because some people feel they've hit the bottom; others have problems with the nursing and have a long list of complaints that you also get to hear; sometimes, the solutions have to be given to others to help with, and they get lost somewhere up the chain of 7 people or so who have a small role to play in fixing the problem, and nothing ends up getting done.
Sometimes residents aren't there the next day - I've read a few obituaries on the bulletin and cried, looking at pictures from peoples lives, lives I knew for only glimpses. Sometimes you get yelled at, asked to get out of someone's room. Sometimes you'll introduce yourself and then forget to grab something like an oxygen tank and you come back in and the patient doesn't remember you and you have to introduce yourself all over again and they suddenly don't want to do therapy. Sometimes you catch glimpses of family members with sadness in their eyes. Bags being packed by family with resigned looks. Tired people. Patients who have received bad news and you're treating them and all you can do is feel with them. Exchange knowing glances but smile and try to look at the positives.
There are some very beautiful moments you can share with people, though. There's grit and sweat as you work with someone on something and you're hoping they can do it so greatly...and they succeed, and you're just as happy as they are in those moments. There's smiles and triumph in little victories, whether that's transferring from the bed to the wheelchair more easily or climbing the stairs or walking with 3 people helping your patient alongside you. Cheering in the therapy room and the first time standing in weeks and hugs before patients discharge. I had a patient transfer from the mat to the wheelchair using a sliding board entirely alone today and I wanted to dance around the room for joy, because when I met him, he couldn't even sit up out of bed by himself. I can't help but feel right alongside my patients and put my all into it, even if it's tiring sometimes. Even if I'm tired and just want to go home and sleep, when I'm with a patient, they've got my attention and my time fully. I love these human moments and human people. I love working with people who have had these beautiful and colorful lives and hearing their stories and feeling their emotions with them. I love treating them with the dignity they so deserve and working alongside them to help better their quality of life and saying hello each morning or afternoon. I love trying to be a small bright spot in their day and offering kindness and patience and a listening ear where I can. I love to empower people and show them that they can be strong and they can do things they didn't think they could before I started working with them. I love building rapport with these people and learning about why they are the way they are and growing as a clinician through working with these people to try and get better each day. Am I perfect at it? No. But my residents teach me these things, too, just as I teach them.
It's only been 7 weeks, and I've learned so much. There's a patient who doesn't always want to do therapy but one day I was helping her to her chair and asked about a photo on her nightstand. A woman looked about 16 and was leaning against a car in a chiffon layered dress with little lace gloves and white patent shoes. She must have spent 10 minutes talking about that photo and where she was when it was taken and all the while I stared at it adoringly, and also in awe; that beautiful woman was still right in front of me. She'd lived a whole life and now here she was, telling me about it. She told me about the Sears Roebuck building, now Ponce City Market, back when it was a place young girls could work over the summer as secretaries. She told me about the depression. She laughed and said that a guy might look at that photo and think nothing of her but "drool over that vintage car I was leaning on". I told her about my old apartment with the sunroom and the wooden floors and plaster walls and old clawfoot tub and she gushed over it. One sunny day recently, it was warm outside; I had my patient out there as she loved going out and did more therapy that way. We were taking a break and sweat was trickling down my back underneath my scratchy white coat as I walked, pushing her chair in the sunshine. Roses were blooming in the center of the courtyard and some of the residents were smelling them. One of the residents was trying to pick one but the thorns were prickly. I stopped her and told her I'd do it. I thought of how I regretted this as I was doing it, as the thorns were cutting through my white latex-free gloves and pricking me in the fingers, but then I'd also told the patient I was with that I'd get her a rose and she was behind me, urging me to do so. I cut one with the clip of my pen, and another for the other resident, handing it to her. "Are you a therapist?" She asked, as I handed her a rose.
"Yes. I worked with you this morning in the gym."
"Oh, how nice. Maybe I'll work with you again sometime."
I was worried she would prick her fingers on a thorn, so I picked a few thick leaves from one of the plants lining the sidewalk and wrapped both roses in the thick leaves, handing them back to my patients.
I was getting ready to leave that evening and I watched my patient from earlier hand the rose to another resident to let her smell. It was a pretty moment. Sometimes this patient yelled. Sometimes she got angry and wouldn't do therapy. But that evening, she remembered that rose, and 3 or so other residents were around her, taking turns sniffing the pink flower. The next day she told me she liked me because I didn't treat her like she was crazy for forgetting things. Yesterday, I worked with the same woman. "You look familiar," she told me. "I've worked with you all week," I said in reply.
"Is that so?" She didn't remember me at all anymore, but I hope that I've made some small difference.
I love this setting. One of the therapists I interned under once told me that if you can better someone's quality of life, even by a little bit; even if it helps them go to the bathroom on their own or get out of bed; it matters. Working in a place like where I work reminds me of this every day. Little things make a difference and little moments like roses in the sunshine make a difference. Sometimes you build rapport with patients and they don't remember it at all the next day. Again, sometimes you get yelled at, or you bear the brunt of all the emotions that may come from being in a difficult time in your life. Nursing homes are little worlds all of their own. They house so many people with long and colorful lives and beautiful, sad, tragic, and funny stories to tell. And they're important. It's important to me that these people know they are loved and cared for. It's important to me that we as healthcare providers care for these individuals just as I would children or adults out in society. It's important to me that they are treated with the same level of dignity, kindness and respect. And it's important to me to strive to better their quality of life in those small ways, as I dreamed of doing years ago when I was just an undergraduate student who knew practically nothing. People and the moments you spend with them are the most important thing we have in these lives, and there are so many stories that should be heard and so many opportunities to lend a listening ear. Whatever it is that you do in your life, for work or when you're around the people you love, I hope that this reminds you of how important it is to know that. One day, if I am lucky, I'll be older; I'll have lived a long life full of stories and funny moments and glorious successes and tragic heartbreaks; and I'll hope that someone treats me with kindness and a listening ear, too. We don't become less important as we grow older. Not at all. I want to spend my days reminding people of this fact.
No comments:
Post a Comment