Well the census dropped precipitously….all of a sudden we were down to 9, and only 5 of them are my patients…the rest are too low functioning for what our intervention is there. Because of multiple refusals and various reasons, I didn't get any productivity at all until 10am something! I ended up not having group because only two of my patients could come to group, at which point you might as well just do individual treatments…I did a lot of Mini Mental State Exams, a few leather lacing, a few ADM tile trivet tasks, and several ADLs.
I *REALLY* am starting to dislike the LACLS more and more…it frustrates almost all of my patients. And therefore frustrates me.
Tomorrow I have an informal meeting with the family of a patient that used to live alone pre-admission. My first! Let's hope it goes ok, they won't like what I have to say. 🙁
I got to spend some time – a lot of time – today – just hanging out in the ward, talking to techs, student nurses, patients, etc…there was literally nothing for me to do at times. Especially when rec therapy was going on. If rec therapy has just a small group and it's the only fun they get to have all day, I'm not taking them out of it.
But I felt guilty just sitting down. It was my first time in basically 7 weeks that I've just been able to SIT for a while. It was kinda nice although I'll try not to get used to it. 🙂 Actually, I ended up losing track of time, I was up in the unit until 3:45pm and then I was like OH MAN I forgot about notes. So I didn't get off work until 5pmish today. I guess 745 to 5pm is a normal day for a lot of people.
I only got EIGHT units today…I had several different sessions that were exactly 22 minutes…ie 1 minute short of two units…so I probably would have had at least 10 units if I had just one more minute on those units. I gotta say, ethically, IT IS SO HARD not to just rationalize the minute away and charge two units….like you're at 22 minutes and you think “I forgot to look at the watch until a few minutes into it, so I am sure it's okay…” but that's a slippery slope. Ugh. Luckily my OT had a very very busy day with 27 units, so she carried me through. There were days I had like 26 units and she had like 10, so I guess I don't feel too guilty just yet. I know I have at least one eval tomorrow, although several are being discharged…I may end up with like 3-4 patients only!! I'm gonna have to be creative to figure out what to do with them all.
You know what sucked today – is I had to clean up poo, multiple times, from the shower, and it wasn't even my patients or my issue. But two different times the techs left the shower with poop in it (a lot of low functioning patients poop in the shower, maybe because they are sat on a shower chair with a hole and it triggers toileting?), and I was like um….are y'all gonna clean it? They were like, housekeeping can do it. And I was like nuh huh. Housekeeping might not show up for hours and people need their showers…and I need to do them for ADLs/meeting goals. If it happens again I'll say something (it was a tech who isn't that familar with this unit which requires more um, dirty work than most)…but that's ridiculous…you take a patient in there and they make a mess, you clean it up. Don't make the next person do it. Not fair at all.
I am going to go look for some self-esteem/self-worth worksheets for a particular patient….and my groups tomorrow will be on discharge planning/leisure activities. Hmm, what else.
Oh…and cool thing…a friend sent me a box and I was like what is this…open it up and it was DECKS OF CARDS! CRAYONS! MARKERS! SQUISHY BALLS! Awesome stuff!! So I'm taking it in tomorrow as a donation…I am excited!
By the way, I forgot to share this awesome story from about a month ago, I had a black female pt who looked at the flimsy little comb the hospital provides, (no match for a black woman's hair) and said, “What am I supposed to use this for? To comb the hair on my tinklebox?” and then she burst out laughing and so did I. It was pretty awesome.