Friday, March 19, 2010

Therapizing the Therapist

Sorry, didn't get a chance to blog about yesterday because, yet again, I fell asleep without actually going to bed. So anyway, here is what all went down yesterday...

Thursday, March 18, 2010
8:45am stand-up/morning rounds
9:00-11:15am Mock IDG meeting - the medical director from our national office came in and taught us how to properly hold our weekly team meetings.
11:30-12:18 Drove to south county for a marketing in-service
12:20-12:35 Introduced myself to the staff at the assisted living home. They had no idea who I was or the company I represent.
12:35-12:40 Drove to nearby SNF to see two patients
12:40 stop for lunch! hehe
12:52 Took first bite of sandwich
12:53 received e-mail to come play for dying patient 25 miles away
12:56-1:40pm Drove to SNF
1:45-2:45pm played guitar and sang for pt, sister, and nurses :(
3:00-3:30pm drove to SNF at a beach further north to see new admit
3:30 - 3:45pm sang Amazing Grace for new pt as she snored (but her roommate loves music, so at least she appreciated the song)
3:45-4:10pm drove to town near ALF.
4:10-4:30pm stopped at Wal-mart, bought some dinner (mmm Triscuits!)
4:45-5:10pm played music for actively dying pt at ALF
5:10-6:00pm sat in car and documented on day so far
6:00pm met with HCC back inside the ALF for a support group presentation
6:00-7:00pm Presentation about UTIs, mini-strokes, and MT!
7:10-7:45pm DROVE HOME!
8:00-9:00pm finished documenting on pts
9:00-? I don't know, it was all a blur...

The morning began as usual with our morning meeting, catching everyone up to speed on who passed, who needs supplies, etc etc. At 9am, the medical director from our national office, the team director from the new California office, and our to-be team physician, attended our "Mock IDG" meeting. For the next 2 hours, the medical director explained how our weekly team meetings should be run according to national protocol, using examples from our actual cases. I was a bit lost... but I'm sure it was helpful for the rest of our staff.

After the meeting, I got in my car and drove back down south (yuck) to an assisted living home where an in-service was scheduled. My GPS had the address set as a few 100 feet past the actual entrance, so I pulled into a church parking lot to turn around. Bad move. There was a huge line backed up to get back out of the parking lot, so "turning around" took about 10 minutes.

When I finally got out of the parking lot and into the correct parking lot, I parked the car and went inside. The secretary sitting at the desk welcomed me. I introduced myself and explained why I was there. She looked very confused, kept looking at my badge, and then repeatedly asked, "but why are you here?" She then sent me upstairs to see the director of nursing. When I got to the second floor, a staff member suspiciously asked, "Can I help you?" I told her who I was looking for, and she told me to look downstairs in the medical file room. I sighed, and just as I was about to head back towards the elevator, I heard a voice behind me say "I'm here, I'm here." I turned around and it was thankfully the director of nursing. I then proceeded to introduce myself to her, and she provided the same response as the secretary downstairs. No one knew why I was there, who our company was, why would we be doing an in-service...

I didn't know what to do. How could there not be an in-service and nobody tell me? Why would it be on my calendar if the appointment was never even set?

After some calls and emails to the MT and some other staff, I finally learned that the in-service was canceled and rescheduled for next week. Thanks guys.

Well, I thought to myself, at least I can go see our two pts at a SNF all the way down here. The SNF was conveniently located 2 mi from the ALF. I stopped at a bagel shop right down the street from the SNF for a quick bite to eat. As soon as I took a bite out of the sandwich, my phone vibrated. It was an e-mail from a nurse asking for music for an actively dying patient. She is just a year older than my mom, and has breast cancer. I never met the pt, and was nervous to meet someone so young who was actively dying.

I sat in my car and debated what to do. I asked the nurse if I had time to see my pts down here in south county, and she said yes, but do it quickly. When I asked the MT the same question, she said no and to go see the dying pt ASAP. I was torn. Do I stay here and at least see some pts since I drove all the way down here? Or do I leave to go see the other pt and make this whole trip a total waste? Then it hit me. You know how people ask you to help them, and jokingly, sometimes people say things like, "Right now? Is it an emergency?" or "Not unless you're dying!" The patient was dying! I can't believe I even thought about it for more than two seconds. Obviously the right thing to do was to go see the patient and to be there for her and her family.

I reached the SNF just as she was being transferred into bed. (I think she was receiving in-home care, and finally decided to move to a SNF...) Her sister was by her side, holding her hand. She was a bit younger than the pt, and had bright blonde hair. She was a nurse by profession, and was able to help our nurses get her in bed and change her into a hospital gown. She seemed so strong, sitting next to her sister, holding her hand. The pt was pale, weak, and bald. The sister kept saying, "I'm right here, I'm right here." By some miracle, their brother had already booked his flight to California for yesterday. Hopefully he made it there safely.

I played for about 45 minutes for the pt. I took a lot of songs from the 60's and made them into a slow acoustic version... the sister asked if I was coming back tomorrow, and I told her I would.

After driving all around creation to south county and back for what ended up to be no reason at all, I was so completely flustered by the time I had arrived at the SNF to sing for the dying pt. I was actually tearing up in the car from so much stress and frustration. For some reason, driving around aimlessly or lost is just one of those things that pushes all my wrong buttons. When I got back in my car after playing for the pt, I felt SO much better. I think I gave myself music therapy :-)

I left to go see our new pt, an elderly woman at an ALF near the beach. When I arrived in her room, she was fast asleep, snoring even. I played Amazing Grace for her, but she still did not awake. Her roommate enjoyed the music at least, having been raised in a very musical family as she was telling me.

My last stop for the night was to a ALF/SNF where we have 5 pts. The HCC asked for an MT presentation for a support group that night, so I figured I'd go early and see some of our pts there. One of the pts is a staff favorite. Everyone at our company just loves him to pieces. I met him for the first time just last week when we enjoyed a nice little visit with him and his son outside on the patio. The nurse told us this morning that he is active, which really really bummed everyone out. I asked the nurse if I should go play music for him, and she said that she thinks he'd like that, but that he is also pretty unresponsive. Well, he totally was. When I started playing, his eyes opened a bit and he shifted them towards me while raising his eyebrows, but it wasn't long before his eyelids began to close again, and he was back in his own reality.

When the HCC came for the in-service, we set our things down in the room upstairs. She wanted to stop in to say hi to the pt since his room was right down the hall. She went right over to his bedside, leaned over to speak into his ear, and said with a firm, audible tone, "Hi James." The pt perked right up, looked up at her, and grumbled a greeting, as pleasant as ever. I guess the pt wasn't completely unresponsive! He's hard of hearing, so I bet he didn't hear one note I just played for him! Man, I should have talked and played louder for him!

We went back to the room as guests began to arrive. They were all husbands/wives and children of the residents, mostly on the memory care side. They seemed to know each other well, probably from visiting so often and seeing the other visiting family members too. The facility had asked us to come and talk to the families about UTI's and Transient Ischemic Attacks (TIA's or 'mini-stroke') since they are common conditions in the elderly population. Since our head nurse couldn't come and give the lecture, one of our HCCs who is also a nurse came and talked to the families about the two conditions. For some reason, they seemed to be on the attack. As she provided the families with helpful tips, warning signs, symptoms, etc, the family members asked things like, "Well isn't the facility supposed to know if our family member has a UTI/mini-stroke?" "How are we supposed to notice a change in behavior?? Their behavior changes all the time!" Everything they said to our poor HCC had a "well why are you telling us about this?" kind of tone to it. I think the facility just wanted to educate the families on some conditions their family members might experience in the future so they understand more about it if/when the time comes, and can also function as an extra set of eyes and ears to notice the warning signs so that their family member can get help. Unfortunately, I don't think they saw it this way. They were so tough on our poor HCC. I don't understand why they were trying to throw all the information she was giving them back in her face. She wasn't selling a product or trying to persuade them to do something. We weren't even advocating up front for our company or marketing, trying to convince them to choose us over other companies. She was just offering some free education, and they completely attacked her.

Well of course I'm sitting there scared out of my mind for when it would be my turn to talk to them about MT. I thought to myself, "If they're being like this with 'Jessica', what kinds of things are they going to say to me??" The time had come for me to speak, and there wasn't much I could do to get out of it. I grabbed my guitar and walked to the front of the group.

They loved it! They were all about MTx and thought it was a great thing for the pts! They smiled and laughed at my jokes. Thank goodness!! I was so nervous! If I learned one thing from this experience, it's that I LOVE to talk about music therapy! I could blab on forever about all the different things we can do, all the benefits, how you become a music therapist, what is it about music that makes it so effective, blah blah blah. I talked for awhile, and could tell when I said enough. But I could've kept talking for another hour about all the things I've learned and how much I love it. What a change from a few years ago when I couldn't even give a basic definition of music therapy, even after taking multiple music therapy courses. I think now that I have experience in the field actually doing music therapy day to day, I have a more complete understanding and a fuller appreciation of music therapy and all it has to offer :)

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