Saying Goodbye

I was having a little trouble coming to terms with the fact that i would no longer be a healthcare practitioner; that helping people regain their independence and functionality was no longer my job. I still had a few days left before the end of my notice. For a few more days there would still be reason for me to put on my scrubs and tie all my ppe around my face in the pre-dawn hours of the morning. I wondered if i could really successfully do it. I wondered if i could really successfully leave. For seven years i had wiped bottoms, ran showers, assisted arms through sleeves and catheter bags through pants legs. I had taught stroke survivors to use one handed dressing and bathing techniques. I had taught people to change and clean their colostomy bags. I had taught people to wrap their wounds with plastic and tape to keep them dry in the shower to prevent infection. I had taught people to use adaptive equipment to adhere to hip precautions and refrain from bending head-first towards the ground to reach items. I had educated people on how to utilize body mechanics and energy conservation techniques to prevent injury or loss of consciousness during self care tasks. I had taught people car transfers, tub transfers, toilet transfers… and the most important aspect of my job: i had taught people how to look on the bright side, to focus on the positives through their injury or illness; to get up and take hold of life rather than just letting it happen to them passively. For 7 years i took care of people until i could motivate and teach them to care for themselves; a beautiful transition i enjoyed watching each time it was achieved. I tried my hardest to protect the sanctity of that transition though insurance companies and corporations would rather i had split my attention between two to eight patients at a time and given my focus to a computer screen throughout. The powers that be would rather i not be able to tell the names or faces of any of my patients. They would rather i had functioned as a mindless conveyor belt of maximum efficiency, no one getting individual consideration and everyone taking their share of cookie-cutter compiled rehabilitation. As i sat in my last Thursday meeting of my career in healthcare i remembered all the struggles i had been through in the past seven years. The struggle to fit self care in when the industry wanted all patients seen two at a time. The struggle to refrain from working off the clock (illegal) and yet still maintain only 22 minutes of time on the clock while not doing direct, face-to-face patient care. At one point in my career this involved running through the halls because the time spent fetching the shower chair was not considered “direct patient care” and so was being deducted from the 22 minutes of time i could spend doing activities like “peeing”, “washing my hands”, “reviewing the pt chart”, “discussing the pt’s rehab potential or medications with a superior or nursing” or “walking from the rehab gym to the patient room”. One either had to sprint like the wind or work off the clock. Each practitioner sort of made their own choice for where they sat on that spectrum. When i sprinted through the halls, peers became furious because i was constantly giving the impression that there was some emergency and they were worried someone had coded. If anyone was caught doing paperwork off the clock, peers would threaten to turn them in. There was no way to win in healthcare. Whether you sat on the left side, the right side, or the middle of the fence, you were always breaking someone’s rule. I had my own rules, given to me by God. Treat others as you would like to be treated. Extend kindness. Leave the judgment to a higher power in the next realm. Don’t be lazy. Reap what you have sown. Anything you put effort into doing is worth doing well. Help others whenever the opportunity arises. Show others the grace of God through your everyday actions. Sometimes that meant staying late to give someone a shower because they needed it even though they were only scheduled for a short amount of time on the daily sheet. Sometimes that meant buying dry-shampoo for a pt out of pocket because the facility didn’t stock that supply. Sometimes that meant sitting with a pt after i had clocked out and given the company the notion i had gone home, because they were actively passing and their family was still in the car en route 3 hours away. Sometimes i had to take note of the many different tangled networks of rules, try my hardest to follow them all, but in the end, consider God’s teachings above everything. It is not easy to be a Christian, avoid burnout, and work in healthcare, but it is important. It is important because the time people need to see God most is when they are scared, injured, and discouraged. If all i can give this field is seven years of my life, i’m glad the last seven were spent in healthcare because i know God allowed me to bring a little bit of kindness and a little bit of hope to individual human beings who were part of a vast and scary system, just hoping to regain their strength and make it back home. Nearest to my heart will always be the dementia patients i had the privilege of serving. They are not like the other patients. They don’t get to go home. The end game is not rehabilitation, but rather quality of life. Not everyone understands how to interact with the dementia patients for often times they’re in their own world and it is difficult for us as healthcare professionals to have insight into what that world looks like. As a rehab therapist, i learned early on that one has to take a different approach with the dementia patients. You cannot simply show up with a dumbbell and a shower chair and say “lets do upper body strengthening and then practice 5 shower chair transfers at the grab bar.” You have to find out who the patient was in their younger days, what their personality was like, what their role was in their family or peer groups… dementia patients were my favorite patients. For a few minutes each day i could spin a narrative that made sense to an individual that would spend the rest of their day confused and wandering with a somewhat lost expression on their face. I could watch the confidence return to their faces as they understood the one situation they were in at the moment. With the pt that spent her younger years hosting parties and get togethers for her friends, i would come for a “visit” early in the morning. I would find her in a hospital gown staring at the wall. I would hug her…which turned to a handshake during covid times, and tell her how happy i was to see her, and how long it had been since our last visit (though i saw her yesterday; she doesnt remember). I would ask her if she was so excited for the party she was throwing this afternoon and i would tell her i’d come early in the morning to help her get everything ready. She would smile and her whole face would light up as she relived the excitement of planning and executing a get together for treasured friends. She would start talking about things she was meaning to cook and the tablecloths she was laundering for the occasion. I would go through her closet and hold up suggestions for what she could wear to the party. She would pick out an outfit and we would celebrate the bright colors and how pretty we were both going to look at this get together. I would ask her how she wanted to do her hair and we would pick her out some earrings. Midway through dressing i would tell her i needed to use the little girls room. She would graciously offer her bathroom and I would disappear into it for a few minutes. I would stand there counting the seconds on my stopwatch and then flush the toilet and emerge. I would thank her for use of her facilities and then ask her if she needed to use the little girls room after all that coffee we drank while we were planning this morning. She would say, “you know, i think i had better.” I would find something to chat with her about until she was safely on the toilet seat, then pull the door between us to give her some privacy, returning when i heard the flush to assist her off the bowl. I would see her reflection in the mirror as she was washing her hands and say, “you always had the most beautiful curls. I was always jealous of your hair. Let me get your pick and we can make sure its just perfect for the party.” I would hand her the little 4 pronged comb and she would pick at her curls while standing at the sink for several minutes (thus working towards a standing balance and activity tolerance goal outlined in her plan of care). When she was dressed and her hair was just perfect she would return to her bed. I would tell her i was going to go to the laundry room and get the table cloths we had set aside. I would bring her a couple blankets and she would stand next to the bed, in her own world, folding the “table cloths” just perfect and pressing them with an invisible iron. I was in that world with her for the time being and i could see the beautiful tables she was going to cover with these wrinkle-free “table cloths” for our party. She was all smiles and her eyes had life in them again. They danced and glittered as she looked around the room. I knew she was seeing a little one story house from a different decade, and not the nursing home walls. The buzzer on my phone would ring. Time to go. I would tell her i had to make a phone call real quick and would squeeze her shoulder. She would smile at me. I would thank her for involving me in what was going to be the party of the year…then step out of the room. I would wait for a couple minutes. After about 90 seconds the ironing motion would stop and she would be seated on her chair staring at the wall once more. She had no memory of our morning party planning, but for those 50 minutes, she had fun. She was herself again. And you know what? She did dressing, toileting, grooming/hygiene tasks, transfers, and standing tolerance. All in all, not a bad therapy session. But you can’t go into the room of a dementia patient and just start barking orders. It doesnt work the same. That’s something neither the corporations nor medicare will ever understand. But it’s okay. They don’t have to. God does.

I realized, in leaving healthcare, i was leaving the patients. I would not have access to them anymore. I would not be planning parties with patient A or getting patient B up and serving him a hearty breakfast (made by facility kitchen staff) so he could get on the road driving his big rig. I would not be helping pt C get showered and dressed so she could tend to her many grandkids she raised (some represented by baby dolls which she fed, dressed, and changed the diapers of dutifully), or addressing tremors and fine motor coordination deficits in the hands of a former healthcare worker with dementia who “charted” for us daily when we brought a “new patient binder” (blank forms) for her to fill out on the patient that “just came in”. I would miss these people. I would miss my job. I would miss my career. It was a huge part of my identity. For a long time, i wasn’t sure who i was outside of scrubs. But, i knew i could stay no longer. To stay was to go down with the ship and when faced with a life raft, i wanted to live. The ultimate decision to end my career in healthcare was based on the fact that i had lost my rights as a human being. I had lost my right to decide what went in my body and what didn’t as vaccinations and testing procedures became mandatory for all healthcare employees. I also lost my ability to choose what type of test i received as the company vetoed the less invasive procedures on the market and mandated the ones that caused migraines, a burning sensation, excruciating pain, bleeding, vomiting, and scarring of tissue to be given to all healthcare employees weekly. I lost the ability to choose what i would and would not expose myself to, based on the amount and type of ppe available to us during the shift. I lost control over my body. I was a slave to the industry and i was nearing a juncture where i would have to do as i was told or quit. So i wrote my resignation letter and handed it to one of the best directors i’ve ever had. It pained me to do that because she was a good leader and a fantastic person. I did not want to leave her, my patients, or my team, but i had to leave the industry at this time.

Sitting in what was to be my last Thursday meeting i realized, if i had quit just a few days later than i had, even though i was leaving, i would still be mandated to get the vaccinations i didn’t want because of the way the days fell. I would have still belonged to the industry when the workers came to inject us. There would have been no escaping it. My liver didn’t filter out toxins as well as regular livers and i had to take synthetic liver enzymes to replace the ones my body didn’t naturally make. However, i did not need a prescription to obtain these enzymes. They could be purchased at a health food grocery or on amazon. So, it was not recognized as a condition that would exempt me from mercury-laden vaccines. I was worried that my liver would fail to do the job of filtering the mercury efficiently and it would ultimately stay in my body…something i didn’t want. But, in healthcare, i was no more an individual than any of the patients and the conveyor would roll on. Something happened to me when i realized i was not going to be a healthcare practitioner anymore. I started smiling again. I started making plans for the future. I realized in surprise that i had fully believed i would eventually die working in this field and i had resigned myself to never seeing family or friends in person again because i worked with the sick on the daily. My heart was joyful once more and i found appreciation in things i had previously ignored; the sunrise, food, crickets, toads, stars at night, rain, the dogs and chicken snuggles, sunlight filtering through the trees, zoom calls, clouds, every new day… i had no idea what the future held but sitting in that meeting i heard my director’s voice as a muffled background noise as my thoughts tried to collect themselves. I realized that i was 100 times more afraid of what my coworkers were going to have to endure in the coming months than the possibility of losing my homestead and becoming homeless; having to say goodbye to my chickens and one of my dogs. That aspect would usually be the most terrifying thing in the world to me, but at that moment, i realized, staying in healthcare and enduring the mandates coming down the pipeline was most scary of all. That morning i sat for my last weekly covid swab. It seemed an unnecessarily invasive and barbaric procedure for the 21st century, especially with such poor accuracy rates. But, no one asked me. It was the last time i would be forced to do this against my will. After this, i was free.