There is the Work, and there is the Job. The Work is what I do at the bedside, one on one with the patient or the family, or both. The Work is what I love the most, and what stimulates, inspires, and nourishes me.
Then there is the Job. The Job is the Monday through Friday going through the day getting it done part. I love this part too, although lately it's been a bit tough. My Job, primarily, is to provide medical care to patients in an inpatient hospice house. These patients are all what's considered acute level of care, meaning that they have uncontrolled symptoms in the context of a terminal and life-limiting illness. About 50% of them leave the hospice house and either return home or go to a nursing home. The other 50% of them die there. I make rounds, examine them, get histories, write orders, and answer questions from the patients and families. Sometimes there are conflicts that need to be resolved among the family members and I help with that. Sometimes they need help figuring out what the goals of treatment should be. Of course there is loads of paperwork associated with all of this, and similar loads of government regulations that must be met.
Sometimes I go out and see hospice patients in their homes, which is a completely different experience. The focus at home is usually not on symptom management, although that is part of it, but on disease progression. You also see how people manage their illness, and being chronically ill, and having disabilities. In many ways, it's very inspiring.
The last two weeks, I've been really immersed in The Job. It's been busy, and we've been short staffed. The Work is all part of it, interwoven in all I do, but harder to think about and tease out when I'm moving from one task to the next. Have the patients been seen? Do the nurses have the orders they need to give the care? Has the documentation been completed? What about the other paperwork? and the checkout note for the on-call? Oh, this family member wanted a call back, and this one needs FMLA paperwork completed.
This is not meant to be a complaint, just the reality of what's been going on. I think this is the way Real Life works: sometimes you just have to live life, and other times you get to think about it. I like to write about what I'm thinking, and I have several upcoming posts in my head. Right now I have to be happy with where I am in the process and know that it is a process.