Mentorship.

Mentorship can happen in the ways you least expect it, truly. I've come home feeling a little bit downtrodden about work some days over the past two months. It's been hard - my manager transitioned to a new company a week into my first day of employment, and I was sort of left to flounder a little bit with adjusting to a new work environment and learning the ropes of a SNF. I was expecting there to be another full-time PT - they left. We still don't have a dedicated manager. Part-time therapists come here and there. There were so many things that I was supposed to be formally taught but wasn't - the documentation system, that you put papers for the physician to sign in that folder, not that one, who the restorative nurses are and how I set up a program and which nurse gets the program; the fact that we never seem to have enough wheelchairs or matching footrests; that you have to print this paperwork but don't worry about this one; ARD's and OMRA's and which patients will let you treat them at this time or that.
I know, I know. Little guidance - that doesn't always make for the best environment for a new graduate. I've felt as though everything I needed to learn is an insurmountable mountain sometimes, and I feel that I've learned so much of it by error. My job has been where the qualities that made me a good homeschooler have come out a lot - I'm a very self-motivated person. I love to teach myself, to learn, and to be inquisitive in nature. And though it's been hard, I've been really blessed in the form of some absolutely incredible coworkers who have helped me. SNF's, as I've touched on in my last several blogs, can be difficult environments to work in. There are some very challenging patients. Some patients will love you, others may hate you for seemingly no reason. You change people, you're constantly on your guard and keeping an eye on people, you may get yelled at, you deal with employees who are less than thrilled to work there, the list goes on and on. Another thing I've encountered in this setting is an air of sometimes depressing complacency, in a number of places. I say this more as simply a topic of discussion rather than a blame game. I'm not laying blame on anyone. However, all too often I see employees speaking rudely to patients, or shaking their heads, saying, "Oh, them? They are where they are. They won't really get any better. They just talk a big game." Or, people treat patients rudely. "I don't have time for you. You're not my only patient, you know." Or, employees who will treat you rudely. Who you'll ask for help from and they'll just walk on by. I had a woman in the hallway pass me today who has midway though putting an oxygen tank back on a patient. She saw me and literally shoved the cord into my hand and left the patient without a tank on. "You do it," she said, stopping midway though the task, walking towards the door. "You were literally just in the middle of this. You can't just leave her," I told the lady. She shrugged. "I'm off for the day," and she walked out the door. I seethed a little as I helped the woman (a patient who I'd come to love working with) with her oxygen, unable to understand how a simple 10 second task was too much trouble for someone who gets paid to help these patients. I don't say this to paint myself as a saint, because I'm not one. I get tired and short with people just the same as any other human being. I've had to take resident's hands off me gently, shaking my hand, saying, "I'm sorry. I cannot help you right now. I am with another patient." However... working in this environment, I have learned so acutely that if you don't do something for a patient, it may not get done at all. It falls on you to be an advocate in so many ways. You don't know how bad it can get sometimes. I've come into patient's rooms and it's been far too long since they've been sitting in a soiled diaper. Or the PEG is clogged up and no one has come in to check it in far too long. Housekeeping has thrown away patient's shoes. A woman had fallen, door open, and no one had helped her. Or, all too often, even other therapists may write patients off before they've really even worked with them. I've worked with patients that other people have written off and gotten some really amazing results. You would be amazed at what some positivity does for a person. Patients need to know that you are enthusiastic and invested in their progress in a setting like this. They need to know that you care. If this means taking that extra 5 or 10 minutes to set up their room how they like it, or getting their ice water or an extra sheet, or getting them their daily coke from the staff room, working on things in therapy that they actually like doing, or jumping up and down for joy when they go from a maximum assist transfer to a minimum assist transfer over the course of a week, then do it! It's so key. I helped one of those very same patients who had been written off today stand in the parallel bars. He did 75% of the task alone today. A week and a half ago, he couldn't even stand at all. He cried tears of joy as his family came in and myself and the COTA told them glowing, at all of the progress that had been made. At how, being an engineer, he loved to hear about how joints and anatomical pulleys and muscles worked to help him stand, and how he could set himself up in the most biomechanically efficient way to stand. How teaching him these things helped it all click together for him. How he simply needed to know that he could do it, how much it benefitted him just to try. This was a man who couldn't even lift his leg to get out of bed a month ago. You wouldn't believe it now. Some patients don't get better, that's true. But you can't ever truly predict what someone's potential is until you give them the time. Never underestimate a person.

I had been feeling particularly downtrodden over the last three weeks due to my company's transition to a new company. It had been hard, there had been too much paperwork, we were so understaffed. This past Monday, one of my coworkers and I were part of a particularly trying care plan meeting with a patient's family. Afterwards, just needing to get out of the building for a break, we drove to Chick fil a for lunch - the very same one I used to frequent as a student. My coworker was leaving to go to a new company because her current commute was simply far too long. I was sad about it - we had become close, we were a good team, and we were able to cotreat extremely well together, excitedly shared rehab articles and new information with each other whenever we found it; this is something I think is a really special thing to find, when you click well with someone in a different therapy discipline. She'd been in therapy for 30 years this year, and in her, I saw a lot of what drives me to work in this population - a deep-seated love for people and a willingness to meet them where they're at. I've watched her treat so many patients with an incredible depth of compassion and a desire to learn about them in ways that helped them open up and thrive in therapy. I've watched her go out of her way and treat people with such incredible kindness that it made me feel that I need to try 100 times harder to be better. Her and I share the same optimism for patients and willingness to push them past what they or perhaps even other therapists think they can accomplish, and we have seen wonderful results for it. I told her how sad I was that she was leaving, and how I wasn't sure what I felt about the new transition, or where I was supposed to be. Still being in such a phase of learning as a new grad, it has been hard, with all the seemingly extra challenges piled upon me. She looked at me from across the table. "They need you," she said earnestly, and I shook my head, saying, "I know, I'm the only full time PT right now." She shook her head. "You're not hearing me. They need you. Not just for your license. But the way you treat patients. The way you treat people. You don't write people off before you've even tried. You encourage people and make them see all they can do. That gives them the push they need." She told me about how passionate she was for what she did. "I see a lot of the same in you," she told me, "And I hope you never lose that. Trust me. It's easy to get jaded in places like this, but I'm 30 years in, and it doesn't have to be like that."
This motivated me in so many ways. It's still hard. Another PT is starting this month, and I'm excited because this means I'll hopefully be able to learn more from them and continue to learn more wisdom from other coworkers that have worked in this environment far longer than me. My coworker who is leaving and I plan to keep in touch still. Many of my other coworkers have been so understanding and helpful in teaching me new things and correcting me if I make errors and helping me learn the things that they don't teach you in school, that you acquire from years if wisdom. And this week has reminded me that it's so important to embrace your own unique gifts for what they are. For me, that means continuing to try to encourage patients and show them what they're capable of, even when it seems they are in the darkest and lowest of places. This job has shown me how important it really is to have mentorship, not even necessarily from just one person, but from multiple, if that's how it goes and you can learn something from someone more experienced than you at something. And this job has shown me how important servitude is - how we, as able human beings, are called upon to help those who are needy, even if we are tired, or they are mean to us, or we have other people to see. I feel so strongly that we have a moral obligation to do these things, and though it can be hard, I am happy that I can spend my days serving others. Being kind. Mindfulness and kindness with how we treat others is so important.

Friends, if you've never looked inside of our nursing homes in America, please do someday. I see so many people get inspired about caring for children, but so many times, I see so little inspiration when it comes to caring for the elderly - a vastly forgotten population in these forgotten places. Not everyone is called to work with these people, but I will personally say that for me, it has been one of the most rewarding and rich experiences in my 24 year old life. Sometimes I walk out of work, exhausted and over it, no positive energy left to give. But every day I pass my patients in the hallways. I laugh with them, tell jokes, we smile, we cry, we share victories and I have the honor of helping improve their quality of life - I could go on and on and end up in tears over it because I love these people so much. People whose families don't even come to visit anymore. People who may otherwise have been given up on. These are special people with so much wisdom to give and we are privileged if we ever get a chance to hear them voice their stories. Let's remember that these people are a gift, shall we?