A journal of healing

Posts tagged ‘healing art’

3rd quote

c and trees

“Highly sensitive people are too often perceived as weaklings or damaged goods. To feel intensely is not a symptom of weakness, it is the trademark of the truly alive and compassionate. It is not the empath who is broken, it is society that has become dysfunctional and emotionally disabled. There is no shame in expressing your authentic feelings. Those who are at times described as being a ‘hot mess’ or having ‘too many issues’ are the very fabric of what keeps the dream alive for a more caring, humane world. Never be ashamed to let your tears shine a light in this world.”

 

― Anthon St. Maarten

2nd Quote

 

magoo 2015  In following the challenge, I add this quote. It also reflects my concern about having a mission here on Earth.

“We did not come here to be common. We did not travel this great distance to give up, give in, and lie down. We came here to wake up and be joyful; to stand up and be powerful; to open up our hearts, our minds and our eyes as we expand our knowledge and our perception. You are extraordinary and you are powerful beyond belief!”

~Heather K. O’Hara

Getting juiced

rhoda3

Over fifteen years ago, getting juiced meant sitting and drinking all night long. It was my method of numbing. I would consume a ton of crushed ice and then my chosen poison which was usually wine. I was committing slow suicide and I knew it. Now, getting juiced means a completely different thing to me.

The idea of getting juiced was brought to me by a very talented young woman who I am developing at work as a Mindfulness Instructor. She is amazing and her demeanor is one of such utter calm. I feel like a whirling dervish around her in contrast. She and I are working on our next series of instruction for clinicians on self-care. She just came back from a workshop and in conjunction with the work I am doing on Trauma Informed Care, we are putting a class together to teach compassionate care for caregivers (clinicians).

We talked about other programs I have in my head for the near future including alternative therapies in homecare. I have been promoting them since I started and was poo pooed. Last week, one of the PT managers said they are reconsidering a program I participated in as being offered for pain management. Inside my head I was doing all kinds of happy dances. One goal I have always had is to get our programs out of 1980 medicine. Maybe now with some of the old school leadership leaving and with the foreseen housecleaning coming, we can progress.

As we are talking, my young instructor was getting more excited with all the possibilities. She said to me, “this is what juices me.” I laughed as I often think buzz words, especially in the Woo Woo world, are so funny. She went on to explain that she wants to keep working with hospice patients but the idea of bringing classes in on Mindfulness Based Stress Reduction and now her work in self-care “juices her to the max.” We already include MBSR in orientation and I guess at the workshop she went to that was quite impressive.

Later at night as I sat in my garden chair, I pondered what juices me? I have been in such a negative place lately that I thought not much. But what juices me was actually demonstrated right in the conversation the young lady and I were having. It was apparent later with the PT manager.

What juices me is getting the best out of people. I love development. I can see potential in people that others may not see. I love innovation. I love creative thinking. I realized that I struggle so much where I work because they are so stuck with doing things the way they always have. It has now come to haunt them and it will be their demise. I get juiced talking about new ways of doing things. I get juiced working with creative people who have so much to offer but need the push or a hand up. I understand now that this is a threat to the survival of the people who have put up roadblocks or who are actually miserable to me. I think they are frightened. They should be. I do not feel bad for them because there are more than enough educational roadways to get up to snuff. But in their arrogance, they did nothing to stay current and now the Mothership is sailing without them.

I also realized that I get juiced up working in my garden. Later I will post pictures. Planting flowers and vegetables really brings me great pleasure. I love the various lights and statues I have collected over the years. I get juiced when I get to take pictures of the flowers, birds and animals that come to visit. For me, creating a sanctuary, even though a lot of people will never see it, juices me.

Getting juiced is great for the soul. Some people call it putting oil into your lamp. But it is the sustenance of life. What juices you?

I can’t get no satisfaction

tangels

My thoughts today are a reflection in respond to a friend’s blog who is going to be about the overkill of patient satisfaction and the impact on the cost of medical practice. I was going to use the link to an article that she used to explain where this discussion is coming from. However, the article is not substantiated and does not use cited resources or even verified statistics. It is claptrap.

Patient satisfaction in health care has become the elephant in the room. The problem is now the government has stepped in and will (and in some cases is) attaching a numerical reimbursement rate based on a scoring. The scores are based on patient’s answers from a survey. Statically, it is proven, more people will respond to a survey if they have an emotion attachment to the outcome. In other words, if you’re pissed, you are more like to answer the survey. To that, the opposite is should be true and it is to some extent. I get the survey results and tabulate them for our agency. I would say that most patients are satisfied with our services. But in order for the survey to be counted towards reaching the mark, the patient has to give a 9 or 10. I personally very rarely give a 10 for anything. But if the patient is pissed, we have to do cartwheels to resolve the issue. And that negative score is going to cost us revenue someday in a climate where the government is already trying to take back as much money as they can for reimbursement.

It does not matter to the government that the patient had dementia or was giving a diagnosis which has caused them to be pissed at the world. Some surveys come in with all the answers with terrible negative responses until the last two where they answer we are the best and would recommend us. Clearly, they do not understand the survey. Also, we teach that a score of ten on a pain scale if horrible, the worse pain ever. BUT the government in its stupidity makes a ten the best answer on the survey. No problem there. We are not allowed to teach using the survey to the patient so we have used a discharge checklist with similar language to remind them of what happened with our service. The survey can come at any time, but often after the patient is discharged and has forgotten how bad they were when we started working with them. The whole process is stacked against the agency, hospital or provider.

The survey does not measure things like the environment of care, the caliber of the care…or in other words was the patient a complex visit which is much more involved, or even the overall health of the patient to begin with. It does not measure the attitude of the patient in general. If the patient is not one who is taking care of themselves to begin with, medical care is just another intrusion.

Having said all that, patient satisfaction is critical to the wellness or the ability of the patient to get well. Health Care is reforming and the responsibility of care will be more on the patient. If the patient views health care systems and all the clinicians as something to fear, or they come away from a service angry or upset, be it a hospital stay or a visit to a practitioner, it impacts their wellness. It keeps people away from the care they need. Bottom line, most people will not subject themselves to something not pleasant until it is a desperate situation. And then the cost for the care is more expensive. They are not going to keep appointments, which costs the practice lost revenue. They are not going to listen to what the prescribed recovery entails and they will be non-adherent. And often that ends up in a hospital readmission which then costs the hospital more as they get dinged for those by the government. And that all drives up medical costs more so then having some person in-charge of patient satisfaction.

Locally, our Patient and Family Centered Care practices came about when the Chief Medical Officer of the largest hospital in the area had a bad fall from his bicycle. He ended up losing all senses from his neck down. He said the one thing that made his initial situation tolerable was when a nurse offered to wash his hair for him when he was in ICU. He said because it was the only place he had feelings, so her touch was critical to his healing. The power of simply touch and caring had such an impact on him that once better (he recovered much of his abilities) he made it a major initiative for the whole URMC system. The fervor died down over the years, but there still is a PFCC unit and all employees of URMC and the affiliates still train on the principals and work hard at giving the best service possible to our patients.

My point is that until you experience a personal situation of being the patient, it is very difficult to understand how necessary it is to continue to have patient satisfaction an important part of health care. I feel there are way too many caustic and omnipotent clinicians out there that do more harm than good with their arrogance and judgments. The cold impersonal care of clinicians with too much on their caseloads drives up the cost of health care. Unfortunately, it is hard to statistically prove that because they produce high volume revenue. It’s hard to find the losses if their numbers look great.

And that is the problem with health care in general. It is all numbers. It is the flaw with patient satisfaction scores. “I did not like my doctor telling me something I do not want to face so I am going to give him/her a lousy score.” This in no way measures the clinician’s ability to do good work. And yes, there is a cost for providing good customer satisfaction as the article explains, but there can be overkill on anything. I do not think that it is the general case and that we actually have a long way to go to improve the patient experience.

This is the link to the good doctor’s blog. https://doctorly.wordpress.com/2015/04/25/closed-door/

 

 

Trauma Informed Organziations

crystal light

I am currently working on a certification from the University of Buffalo on Trauma Informed Organizations.  I have been studying trauma related materials for a while. It has been fascinating and helpful  healing for me.

What is a Trauma Informed organization? It is an organization that has taught trauma informed care from the person who answers the phone to the CEO. It is the basis for policy and procedures. Trauma informed agencies and organizations are totally aware that every contact with a patient makes a difference in their reaction to the care being offered and also in their ability to get well.

For example, a person with mild PTSD is coming to see a doctor for stomach upset. The admission person snarls at them because they are lacking some information on their admission form. She tosses the clip board at the patient and says snottily, “you need to fill out all of the information!” She is line with several people behind her. (Having people behind you is a big trigger for trauma patients.) The client/patient did not fill out all the information on purpose because she is not ready to share her details yet. She will once she sees the clinician but not with everyone else. It is her right. Her stomach issues are actually a response to the stress from domestic violence, but she is not going to share that easily. A trauma informed organization treats everyone like they have a trauma. The clinician who she eventually works with should request a trauma screen once the patient is comfortable with the plan of care. By doing a root cause analysis, then, and only then, will the real healing begin.

Trust is huge along with safety for someone who is traumatized. Just walking into a new environment is bad enough, let alone in a waiting room with strangers, standing in line  and having to answering questions to someone who does not give a rats-ass about why your there.

Another perfect example of a non-informed practice is the process of getting vitals. This is me: I am sitting way too long in the waiting room. Other patients are called before me. I start to worry why I am not getting called back. Did they forget me? (Blood pressure begins to rise) Finally someone swings the door open, and even though I have been coming to this practice for years, and they all know me, they bark my name from across the room. I get my stuff and in a cadence for jogging, we go back to where all the rooms are. They stop and bark “get on the scale.” I am immediately humiliated. Blood pressure is really rising. Then we trundle off to the little room where she asks questions about meds. She pulls a cuff from the drawer and puts it on over my sweater. The pressure is high.  She sharply asks me why I am there. Of course by this point I am upset.

This is how I dealt with this. I sit near the door so they do not have to yell across the room. I refuse the scale….which used to be a fight. But it is your right and the trauma issues getting weighed causes me…well, they know now not to ask. I tell the doctor because I weigh myself every day. In winter, the clothes you have on can add many pounds.  I make them use the right sized cuff and on my skin. It bothers me that they don’t wipe it down afterwards. Surprisingly since I started doing this my blood pressure readings have been wonderful. When they ask why I am there to see the doctor, I simply and nicely say, “I will tell the doctor” or I say “follow-up.” They have no reason to know. If I need a shot, the doctor has to order it and he will tell them.

Being a trauma informed organization can only improve healthcare across the board. Non-adherence and non-compliance are huge issues. Patients need to want to take their medicine and follow their plan of care to improve their health. Our medical system in the USA is totally reactive. We spend millions on after-the-crisis care. Being trauma informed and using methods such as trauma screenings and motivational interviewing can only improve patient care.

Being trauma informed is for all health organizations. The scenario I described about myself is my GP at a family practice. Even though I work in homecare, being trauma informed can be practiced there as well. It can be used in every environment where there is a community. When we see people who seem out of it, or stand-offish or short tempered, it would be mindful to remember: You do not know the whole story.

 

 

 

Judgment

Goddess of the garden

Yesterday, The Good Doc, Victo Delore posted a great post on the vulnerability we all have to react to stimulus without the complete picture. Here’s her post: The Bigger Picture With shame attached, I would have reacted the same to the original situation and thought, “who dares to park in a handicap spot without the credentialing”?  I have a placard to hang from the mirror which is totally out of date. I lack the desire to be labeled handicapped but there are times when it sure makes my life easier to have less of a walk into the store. I honestly have also parked when I am in my car without the mirror handicap sign but only on really bad days and in a rush. One day I was feeling particularly cheeky and parked in the “for expectant mothers” spot. One of the few perks for being fat is you can look pregnant and people won’t ask, “hey, you preggers or just fat?”

Being judgmental is normal. We are taught it at an early age because we are judged. We are criticize and directed for correction as soon as we can voice a decision. When a baby first says, “NO”, the parent thinks, who the heck do they think they are? This is not a bad thing  because we need to learn parameters and boundaries. We also need to test the waters.  Learning what is acceptable is part of being assimilated into a culture.

I was raised by two incredibly judgmental parents who were raised by even more harshly judgmental parents. There was a code instilled in my family of needing to be perfect and that has completely messed with me and all of my siblings. This voice has been a deterrent for me at times because I do not want to face criticism and judgment. But the question begs, who is doing the judging?  When I take the time to really feel what I am thinking, I realize it is often not me; it is the old voice of my parents. It is the illogically comments from a time gone by. It was a mindset that I needed to be aware of so I could protect myself. But I also needed to play along in order to survive in the clan. I rebelled early on when I disagreed with their bigotry and hatred. I still hear their reaction to things and people that are not my real feelings.

I have a huge quantity of personal triggers that set me off. People who have PTSD react to stimulus that others cannot fathom. I have worked very hard to become aware of my triggers and try to deal with them. I am so sensitive to things that no one else can comprehend what they do to me because it is “nonsense” to them. For example, a certain color of light or a shadow on a wall used to completely upset me and bring on a sense of fear and despair. I now can explain that it is the color of light that happens at sunset and the low shadow is a marker of that same time frame. Why does this set me off? Because they are indicators of the time when my parents would begin their drinking.

People with PTSD have a bag of “stuff” to deal with that is so individualized that no one can comprehend what they are dealing with. It is that personal. Yet we hear people all the time say, get over it. We hear and feel the judgment. No one can really comprehend the pain and total suffering of others, ever. We do not have the ability to understand their triggers either. We need to have compassion. And it starts with not judging.

One challenge I am working on for myself is the “pause.” I try to take a moment and step away from the visceral reaction to something and breathe. In the second of calming I often can see a different story than the original view. Much like the good Doc says in her post about seeing the old couple and realizing the real story takes a moment of reflection. This process is hard and I often fail. But for the times when I do, it makes for a sweeter time of it. Unless it is a real jerk….and they do exist.  Ok, that was just to make you smile.

 

Musings on a dark Sunday Morning

snow 2014

This last week was a very interesting week. It had a mixture of joy and also a reality check. I am two months away from my favorite time of the year. The anticipation is almost as good as a young child waiting for their birthday. But today, I am up early sitting at my table with my cat purring to my left and a hot cup of coffee to my right. The doggies are snuggled up in their couch beds and hubby is asleep. There is an ominous bank of dark clouds to the west and the light is filled with that gloom the proceeds a snow storm. The forecast is calling for over a foot today and into tonight with more tomorrow. I do not have to go anywhere until tomorrow morning and I am not going to start to worry until tonight.  For now, my bliss is radiating and warming my heart.

I am trying to enjoy the simple good things in my life. I had a kick in the head this week which prompted me to revisit things. My mother-in-law (MIL) has Alzheimer’s. She has gotten very bad since Christmas or maybe she was then but there was so much going on I did not noticing. This week, my Father-in-law (FIL) went to emergency for chest pains. Turned out to be GERD and was fine, but they kept him overnight. Someone had to stay with MIL. My hubby and I were elected. I want to spend about an hour on the selfishness of my sister-in-law, but that will change my mood and so I am not going there.

My MIL is a sweet little French woman. When I met her six years ago, she was sharp, funny and impeccable about her looks. She went to the hairdresser every week, had her nails done, and dressed with simplicity and elegance. She and FIL lived in Florida and we could not afford to come down and visit. They moved up here after she had surgery for breast cancer. It changed her.

Now she cannot remember her own children. Funny, she knows who I am completely. I make her laugh. She does not do much of that. I also listen to her. Her family does not deal with her well. She does not take care of herself at all anymore. She smells and her hair is a mess. She does not remember she is hungry or when she has eaten or had something to drink. She constantly repeats the same five questions over and over. It is hell for my FIL who is 94.His guilt runs so deep that he will not put her in a memory care unit where she really needs to go. My brother-in-law had it all set up but again, my SIL stopped it. She won’t do anything to help and does not want her inheritance to be spent on more expensive care. Again, I am not going there right now. So they two of them watch TV at full blast because they cannot hear, eat the over-salted crappy food served in the dining room or delivered and sleeping. They do not go out as it is too much for my MIL.

My wake-up call is that this is my future: Living in a tiny apartment with no future but death. It could make anyone crazy. So with whatever I have left, I want to make it good. I do not think I will live as long as they are either. They were very healthy until the last five years. They had a good life. My FIL retired at 55 from the post office with a healthy pension from there. They traveled and participated in life with all the gusto they had. This disease has robbed them of those pleasures.

My MIL does not do well with a lot of people in the room, and yet, every holiday we pack fifteen or more people in the tiny apartment. My husband is the worst for spending time with them. He never goes over. There is a lot of painful history for him which he will not share. But when the chips are down, his parents call him. He spent 24 hours with his Mom this week and it was very difficult, but he came home also a lot more appreciative of what he has.

Another event this week was the situation with my shot. After haggling with the pharmacy every night for two weeks for hours, they said they were going to ship on Saturday. Saturday came and went and no shipment. I called my doctor’s office on Monday, who called them and they said they did ship. And they did…but the delivery was left upstairs by the door we do not use tucked away where we did not see it. So it sat outside in subfreezing temperatures for two days. It was ruined. I thought they had lied to me as they had been doing for two weeks, so I did not look for it when it was not where they always put it. I have been receiving shipments at the lower front door for 15 years. They will not ship another. This shot costs over $1800.00 so I am SOL. My pain level has steadily increased to the point I cannot sleep for more than four-hour blocks. My ankles and knees are giving out and my neck feels like it has two screws that are being turned daily. I am grateful that there is something out there that will help to lower this pain. If this was thirty years ago, I would not have much choice but to suffer. No wonder people drank rheumatism medicine. I have a stash of my old prescription shot in the refrigerator which is good for two years and I am going to take one of those for now. It does not work as well as the new shot, but it is something.

The bright spot of the week is I have a new office at work. My old office was in the upstairs center of the building. I had no natural light at all. I had three incandescent lamps on to create the feeling of natural light. My new office is huge and has a window. I do not have a door, but I did not before either. It is walled off with cabinets that face the hall for another department. It was a large space where the Meals on Wheels volunteers had but they have been moved to a new area. We are growing so big that the whole building is be rearranged. When I was approached about the move, I asked about the space and they were thrilled to put me there. They built it exactly to my specification which was wonderful.  I was the first office and now it will create a change of movement. They move someone in on Monday to “the hole”, my old office. My new place is twice the size and I have a window. The roof of the building is the ceiling so I can hear it rain and storm. We can hear the geese honking as they fly over. But I could not see anything. I would have to find a spot to go to if I wanted to see what was happening outside. This was the window I would go to. It was meant to be mine. I left the new place a mess on Friday with all the boxes still packed. I was too sore to unpack after moving in. It will be my project this week. It will really make a difference for me at work. Where I was before, everyone can hear you breathe as I was surrounded by other cubbies. I could not make a phone call, or listen to music or forest sounds, which I like. No plants would grow in the lack of light. Even the overhead fluorescent lights were turned off because the girl behind me got headaches. It was so dark with dull grey cloth panels for walls. My new office is pale green and one wall is very pale blue and looks white. I have more cabinets and space. I have places for my photography. Did I say it has a window?

I had my first meeting with our CEO also this week. She is a sharp lady. She was very pleased as I came prepared with my 2015 year work plan. I was right in line with her thoughts so we hit it off great. She is a no-nonsense nurse who wants to be involved directly with her agency. I like her. Things are going to get shaken up pretty quickly and the Crone Mafia better be prepared. One QA nurse who had 43 years there was offer the opportunity to retire and leaves this week. The CEO, named Jane, also shared her amazing weight loss of over 150 pounds. She was very encouraging. She knows how hard it is. She said I can come for encouragement anytime.

And on that point, I have lost almost 12 pounds for my first month. WW is coming in and doing a meeting starting on Tuesday and I am signing up. I will keep my online account as well. We had a party on Thursday with two chocolate cakes. I took two pieces, ate about a third of each and wrapped them up to chew on. The next day I took two mouthfuls, and threw them out. This is significant for me because chocolate cake is my favorite food. I have discovered that a taste is often enough. Even the hubby is getting into it now at home. He is not as dedicated, but he is dropping a few pounds here and there.

My cat is  bathing herself and singing away. Magoo did not come out of her room for almost a year and when we had construction done last year, she went back to hiding. For her to spend every morning with me is a treat. It is already snowing now, so I am sure the forecast will change with more snow. I would seriously think about calling in tomorrow, but I have a new office to set up. Did I tell you it has a window?

2015 New years and dream

Goddess of the garden

Again I am amazed at the amount of stories and bloggers of people who have some form of PTSD and Trauma based issues. And the level of trauma ranges from violence and sexual abuse to anxiety and to incurring self-mutilation. When I first starting this new post, I thought I would focus more on the clinical aspects of trauma inflicted issues but then I thought “who was I to write about things like that?” After spending some time reading other posts I think I will continue to share my journey in the hopes that maybe others can relate. I find in the plethora of blogs out there on the topic there is also a difference in each one. And in my own pursuit I have come across information I did not have. I have felt compassion and understanding and I find this soothing. It is sort of a community. And since I do not see childhood abuse or sexual abuse or domestic abuse going away, I think it is important to talk about it and share.

So in that vein, I am going to share a dream I have had off and on for the last (I sat for about fifteen minutes while writing this and realized the amount of years and was shocked) over twenty-five years. But I must give a brief history for it to make sense. I met my first husband when I was 19. We got married a year and half later. There were signs then that he was violent and a liar and cheat but I did not pay attention. I want to get out of the even more abusive situation at home. I did love him, very much so. He was in a band, had long hair, was over 6 feet and large. He wrote poetry and sometime songs. He wanted to go to Canada with me and start a farm and not be in the military. He was pretty close to being drafted when Vietnam ended. I was a total hippie and the thought of raising plants and animals for a living has never gone away. I would never have raised animals to slaughter, but I love cows and sheep. I grew up on farms of my friends and was no stranger to the hard work that is farm living. But I was young and very healthy and strong back then.

From the day I met him, being unfaithful was going to be a part of my life with him and his friends. His best friend was cheating on his girlfriend and wanted to “date” my best friend, and was hitting on her. That was how he and I met. Once we became a couple, in short order, I realized we had a different meaning of being committed. I never caught him red-handed, so to speak, before we got married. But there were signs. I wanted to be married and on my own so I went onward. But there were a couple of situations where his temper flared, including taking a hammer to the windshield of his van and smashing it right where my face was. This was to be his method of attack in the future. He never hit me directly in the face, but would smash things very close to my face such as the wall or throw something. But, after the home I came out of, violence was nothing new.

What became more pervasive was the onslaught of girlfriends. I will not go into all the details of it right now. In the later years it got so bad that he would pick up women at bars in front of me and go off. Early on I knew something was up and would go through his wallet and find names and phone numbers. I had no shame about going through his wallet either. I knew what he got paid, I knew what he gave me, and I knew how much cash he blew on going out. Early in our marriage, he would explode when confronted on things, and I learned to let it go. But I did not let it go. I brought it all inward. It ate away at me all the time. What self-confidence and self-esteem I had was GONE by the time I was 25. GONE! I remember we both went on medication induced diets and I lost a ton of weight. I was gorgeous and had a body like Marilyn. I attracted a lot of attention. But my head image never changed and I had no realization of being anything but a fat, ugly, unwanted woman. The weight came back incredibly quickly and doubled. He had joined the police department, and the level of ostracization became intense. He quickly gravitated to a couple of women in his class and became too friendly with one in particular. This relation lasted for years. She made it very clear to me that he was involved with her. I was embarrassed and humiliated because everyone in our personal circle knew about it and accepted her and the relationship. She was not the only one, believe me, in the 27 years we were married. He had one affair that lasted nine months before he had to confess because she contracted a STD and he had to tell me. BUT…. I have to explain something that will make sense why I was subjected to this for so long and never got out.

After he became a cop, he changed. I believed in marriage being sacred. My mother instilled abject fear about divorce in me. She said it was the ultimate disgrace and failure on the woman. At the time, I did not know her mother was divorced. I did not find that out until several years after she died. I thought it was my duty to stay and put up with it. In hindsight, I know I was also terrified. And this is what he fed into, as most predators find the Achilles in their victims. He would also become the most violent after I confronted him. One time he got so mad he punched the wall and broke his hand. (served him right) He had to go to the hospital and get it cast.

But he also isolated me. He even admitted he did this when we were going through his divorce. He would do horribly embarrassing things when we were with my friends. And my friends could not stand him. So in short order, the only girlfriends I was allowed to be with were the wives of his friends. I was very blessed that my dearest friend forgave me for the period of time when I did not see her and we have become close again. Other friends did not hang in there. The women who I was in relationship with were very nice, but, I would not befriend them now. There were too many differences, especially with his closest guy friend and his wife. She was a simple woman whose whole world was her family. She had no children of her own, which was horrible for her. But without being condescending, she was also not the brightest woman I have ever met. I have not heard anything from them since the divorce either. The rest of the women were in the same predicament as I. One lady, Linda, had been with her man for ten years. He had another woman, Carol, who he saw every Sunday. He also spent time with her as he pleased leaving Linda crying in the house they shared. We were never sure who he would bring to a party. He cheated on Carol, when he met Linda. One gentleman died “in the saddle” of girlfriend #2. It was such a joke they called her Killer. I am sure his wife laughed all the way to the bank when none of the three girlfriends got anything and he was very rich. There was one guy who kept bringing this woman to our house and events and I made the faux pas of calling her his wife. Nope; girlfriend for over ten years and the wife knew all about it. She preferred to stay home with their children. This list goes on. They all were not cops, but many were. And this is not to say that all cops cheat, but in my permitted circle it was the norm. Most of the women were not highly educated and although some worked, none had management jobs. Some were secretaries, or hygienists or in medical offices. This sounds highly condescending, but they were not interested in anything else. None had outside activities except going to shooting matches with their men. I am serious. Some actually shot. Conversations were about house- hold cleaning products or television. I was even ostracized even within this circle because I believe in gay rights and was called a Feminazi because I was a feminist. It added to the depletion even more of my self-esteem. I had to get out of that circle to figure this out. Many of his circle of friends divorced when the cop husbands retired and they ended up with much younger wives. Very sad. But the real tragedy is what this constant degradation of the wife and the humiliation that goes with being treated that way does to the woman. It strips away every drop of self-esteem you have. Many did not leave because of children, but I found out later, many also were subject to mental and physical abuse. I joined a divorce support group and one of the members turned out to be the wife of a cop I knew only by name. What he did to her was criminal. Being married to a cop has many challenges as the Blue Code protects some and hurts many others.

Now back to my dream. I will preface this also with the facts I am married now to a man that fidelity is not an issue. My husband is the most faithful and loyal person I have ever met. The reoccurring dream is one where I am still married to the ex and he goes through a string of behaviors that flaunt his connection with another woman. The dreams started when I was still married to him. I would wake up crying and humiliated and also very angry. When we divorced, the dreams increased in frequency. I would wake up stressed and upset. Eventually, in the last two years, the dreams would change at the end to me beginning to fight back. There was a couple where I flayed on him. He was a big man so it was futile. It only added to the frustration. More recently, the dream resolves where I am starting to tell him to go f**k himself. Most times I don’t get it out as I become inarticulate and I wake up.

This morning I slept in and the dream came again. Just as I was about to have to face this woman picking up my ex-husband and I to go to some event, yes all three of us in her car carrier truck,…it’s a dream but the other woman always is more macho in activity or had children (we could spent a whole month of that) and I go WHOA…..”you’re an asshole”….and I am about to rip into him and tell him how I feel about this and my current hubby opened the bedroom door to allow our little peanut doggies to wake me up. I was so close.

I have been divorced for 13 years. I have not spoken to him since then. I wrote a letter once but of course never sent it. It helped with some of the anger. The anger I have now is not at him. He was a pathetic jerk and so were his friends. None of them deserve anymore of me. But I am angry and frustrated at myself for not being able to resolve all this in my dream world. It gets to the part where I pull up my big girl panties and I am about to invalidate him and I fail. I am sure there is a whole mess of psychoanalysts who can tell me what this all means. What is very weird is that I have not really talked about much of this period of my life to anyone except in my writing. I think I am still grappling with the humiliation and the fear of retaliation that was so pervasive for almost thirty years of my relationship with this man. He began his isolation and exclusion of me from his life almost from the moment I met him. There is consolation that I am getting closer to speaking up in the dream. In the real world, my self-esteem and self-worth is still pretty fractured. If you couple my childhood years with this period it is 47 years of pure hell. I guess I need to give myself a lot more credit for being able to even have some peace now.

Although I celebrate the New Year on October 31st, I am sending everyone a blessing for the upcoming year of 2015 to be one of great healing and recovery. I hope we all get a bit stronger and fight for help for all the people who are impacted in some manner of trauma to become the Spiritual Warrior they are meant to be. I cannot help but believe there is a reason we all are here. And those who have had some huge battle with the evil of the world, whether it is on a battlefield or in our own homes, we are here to stop it from happening in the future. I really see and feel in my deepest regions of my soul there is goodness and light in everyone and we are not meant to hurt each other. I struggle every day with the whys and what ifs. But the future is where the change can occur, so I wish for it to be a better world for us all.

In honor of the word Vagina

I have some wonderful down time these past days. The weather was warm enough to sit out on the deck, albeit next to the house instead of my usual spot. It has given me some real time to think about a few things and I thought I would share them here. The thing that has been weighing heavy on my heart and soul is what the heck am I doing with the short time I have left on this earth. This has been a growing concern which has become primary in my thinking. When I have tried to discuss this with anyone, it is dismissed usually before I can even get my thoughts out. People do not like to face mortality, even when it is not their own.

I am in-charge of all the educational needs of the all the staff including clinicians for two agencies. I was also hired to create a leadership program and a career succession program. I manage a nurse who does the actual clinical training and PT who does the body mechanic training. Within a year, I was in charge of the Patient-Family Centered Care initiative. What I was not prepared for in any manner was the ostracization I received.

Things were fine until I started looking under rocks. And what slithered out was pointing directly at people who unfortunately had a lot of power and time there. It was all they had ever done. They did not want change and especially from someone who they deemed not qualified because I did not have a RN after my name. No one understands that an administrator in a school system does not know every subject, but they know good education when it happens.

I am beating my head against a wall. Close friends say “just get out.” It is not that easy and what I am going to say is going to make me sound like a sap. I am bolstered to talk about this after reading a post from fellow blogger, and a physician, Victo Dolore in her blog Bridging the Gap With Silk Draperies.

I really care about improving health care. However, I will never be a clinician. This has haunted me for the past three years. I have felt there was something wrong with me because I am so passionate about a situation I am never going to be accepted in. The good Doc mentioned above wrote another post entitled Yes, Vagina, there is a Santa Clause… (let’s see if I get more hits for the word, ha!) It is hysterical and I fell in love with her writing. But she said one thing and it went right through me like an electric charge. And I quote: “For instance, if you are worried about spreading your legs for me because you did not shave your hoohah that morning, I can reassure you that I DO NOT CARE. Not one iota. If you think your doctor does care, you should run away. You should run very far away very, very fast. When we look at your vagina, we are looking at it clinically”

https://doctorly.wordpress.com/2014/11/13/yes-vagina-there-is-a-santa-clause/

This is a truly hysterical post and you should read it in its entirety because it has a strong message. But the words “looking at it clinically” hit me hard. I get it. To be successful as a clinician there has to be some disconnect from human to human. You have to be able to look at the body as the biological miracle it is but also completely disengaged. It is pure science. And it hit me. I cannot do that.

The classes I teach in orientation are the touchy-feely stuff like customer service and diversity. I feel I do a good job of motivating people to see others for who they are. Many of our new clinicians come from a hospital floor where they never see the personal side of their patients. They do not start the healing and most often, they do not finish with them either. In home care, you are there to the end, whether it is recuperation or hospice. You are immersed in the family. You are the stranger in their environment. It is a big change for many. You do not have the same control as you do in a facility or clinic. Home Care is hard work and it takes a special type of clinician.

One of the new classes I am teaching is working with them to understand motivational interviewing, which is another new buzz name for coaching. We are trying to get them to incorporate the patient and family in building the care plan. I am trying to undo some of the disengaged clinical aspect of care and omnipotent thinking that is so engrained in their training and more easily facilitated in a clinical facility than in a patient’s home.

I took hospice training last year and then completely chickened out when it came time to volunteer. I have been asked many times by one of the clergy on staff to come up to our hospice facility and volunteer. He feels I would be a natural. The Volunteer Coordinator got me in my office last week. She pleaded with me to come up with her. I was honest and told her I was afraid. I said I do not handle death well. She said, “no one does. We all cry.” She wants me to work on a project called “Loving Hands.” I would be taking pictures at the request of the family of the hands of the soon-to-be parted with their loved ones. It is a beautiful concept and I would like to do it. But I am afraid. I know I will be thinking no one held my mother’s hand thirty-six years ago. I still feel the remorse that she died alone in a hospital bed. Will I be able to disconnect and just shoot the photo? I am pretty sure I cannot do hands on care. I KNOW I cannot change anyone nor actually deal with the many bodily functions that become disabled.

So to round back to the beginning of this post about what am I doing with my life… Just writing this very long post helped me round back and focus on what is really important. I will not ever be accepted there because I am not a clinician. That is not what is important. I am a change agent and that is important. But do I have the strength anymore?

I have done some really good things there. My Core team fought for two years to get update electronics and air cards for clinicians in the field. They used to have to go to a Starbucks or similar to get Wi-FI to download new case information and documentation. Ridiculous! We had to gather data and do report after report to the point there was no argument left. We now have a standard nursing bag we had field staff design. We have skills competencies yearly that receive great reviews. The annual mandatories I write are completed with much less complaints and staff actually learn something from them. I instituted New Managers Operational training which has created opportunities for staff to be promoted successfully from within the agency. This year we are incorporating more Leadership classes. I reinstated a Clinical Ladder program for all clinicians that had forty-eight staff members complete this year and is growing. What was once a favoritism reward for a select few popular nurses now is available for all clinicians from LPNs to OT and Social Workers. The Ladder has now has an air of accountability and the significance of being a member of an elite group. I brought in nursing schools for a day for a college fair and had many staff sign up including five nurse managers to return to school and get a higher degree. I brought in Nurse Leadership classes which were jammed with participants. The grant provider who offers the classes said it was the biggest turn out of any agency they have in the state. It cost us nothing. I brought an organization in that does culture change for hospitals. I simply wrote them and began a dialogue and ended up having them create a unique survey for the agency on accountability and patient safety. They issued the survey and have created a summary which will be presented to the Administration team next month. This process usually cost about $50,000. I got it for FREE. This was almost not to be as one of the people I spoke of previously tried to put a stop to it. What will happen with this, I do not know. I am hoping it will reinforce a Patient Safe Handling Committee, which I have on the drawing board. One of my new projects this year is to bring an on-line training system up and get it running. Once up it will save hours and money in training costs. This has been a three year struggle for them to see the value. I am also revamping the content of much of the existing training. It is many years old. I was so shut down and afraid to do this because  the ramifications from the old birds who wrote the stuff had me intimidated. Even though the Core team is disbanded, our study and report is shaping the possibility of a new pay structure. There is more. But my point is made.

But every single thing mentioned was with massive struggle and conflict. People are taking credit for things I did, and although it not the accolades that make me fight for things, it does discount my work. There is more discord and misery in any job I have been in and it permeates the building. The week of Christmas, people were dropping like flies from exhaustion and fatigue.

My New Year promise this year and in the past years is to work on not being so afraid of things. I tried Indian food for the first time yesterday. I liked it and it got rid of some incorrect beliefs. I have some other things in the fire too. But looking towards the future….am I to continue fighting the fight at work which leaves me drained, stressed and fatigued? Some nights I come home and I am so worn down I sit in my car and cry. It takes a toll on my body as I am so physically tied up in knots from the fear and stress that when I sleep and relax, I spasm into Charlie Horses that Roy Rodgers could ride on. Because of the physical issues going on I have only so much energy. Is this me and will I be the same elsewhere? That is a big possibility. At the age I am at, I really do not want to start over.

I really have something in mind that I would like to do but it is not panning out. I am going to hang on for a while as there are proposed changes that are coming, including a complete redirect of Clinical Operations. I am really hoping that this will make a difference.

Sorry for the rant, but that is what this blogging thing is about.

 

 

 

 

The Magick of Christmas

Mrs claus      Children are such amazing creatures. I was not blessed with my own. I am not going to write a depressing saga about that today. I want to share my experience with a tradition of three years and an honor I walked into to. I get to play Mrs. Santa Claus. I was part of the event committee that puts on the event for all the employees and their families. It is a lot of fun. Every year it reminds me to be hopeful and joyful. Children are so naturally pessimistic until it becomes dashed at the hands of evil. Some would say that it is called growing up. I think, somewhere in all of us, is the child who is still hopeful.
Christmas to me was never about getting gifts. There were five of us and I came at the end of the line at a time where my parent’s wealth was gone. My father and mother had begun their fall into their first bankruptcy soon after I came on the scene. I can remember my mother sharing that she allotted only $25.00 to each child. Back then, it bought a lot more. I remember two gifts the most. One was a little plastic organ, call Enenee table top organ. This was the introduction to my love of music. I was reading music in kindergarten. The other gift was a wooden bucket with my name stenciled on it. Inside was a brand new box of 64 crayons. They were all mine. I had that bucket for years. Neither was expensive but offered the world of creativity to me.
This season is a melting pot of emotions and memories. It is about the beauty of the lights and decorations. It is about the sounds of music, chorales and bells. It is about history and shared moments. It is about forbidden foods and treats. But mostly, it is about the magick. It is about the hope that things will be safe and full of love. It is a time of forgiveness and charity. I learned at a very early age that this is the time of the year where everyone can be kind and vulnerable and it is ok. I think I treasure this the most. To me, that is the magick. In the spectacular of the façade of glitter, deep down, human kindness surfaces, even if for only a short time. It is the time of the child, for all ages. We hope and pray for goodness and joy to be part of our daily lives, and I think that this time allows for healing.
My role as Mrs. Claus is to ask the parents the name of the children and then if there is a special gift they want. I then go up to Mr. Claus and whisper the information before the child approaches. Some parents do not have a clue what their child wants. That is sad. Some children are precocious and come with a list. I know that some will say this fosters greed. But it is not the child’s fault. I do not feel the need to explain how we have created this Christmas monster.
The children react to Santa with mixed emotions. We have the ones that cry and then we have the ones who keep going back for a repeat visit. One little girl who was very nervous had her back to Santa. I had already told him her name and wish, but she was reluctant to approach. Instead, she was eyeballing the cookies and milk we were serving. I was facing her. Santa called her name from across the room and her eyes turned to saucers. It was fantastic. He then said something about her wish and I thought she would swoon. She went over, not afraid anymore, but filled with wonder and delight.
There are a couple of kids who have said to their parents they know this is the real Santa. They are bombarded with imposters at the malls and other places. What validates this Santa is that Mrs. Claus is there and that he knows them. There is one very sweet little doll who insists on having her picture with me. The day ends with the last family of five. There are twins, a boy and a girl, who are now about seven. She is in love with Mrs. Claus and needs some serious time with me in an embrace. It makes my whole day.
There are many components to this holiday season. I do not care what religion you practice because I think that it is only a piece of it. I also understand that this season can make people very depressed and I have spent some pretty bleak ones myself. But I am choosing to find magick in my life and it is so easy if you look. Find the child still in you and enjoy.