Friday, September 04, 2009
Things are happening fast on my unit while I am not there, and not necessarily for the good. One of our charge nurses is going to be staff in the ICU. Another nurse is going to the day shift. I know at least one nurse aide is transferring to another floor. On top of that our favorite medical receptionist has found a clinic job.
Management will find out on Tuesday that I am also working on transferring to another unit. I still don't plan on telling them that that is why my doc has me out on medical leave. With my ADA paperwork finished on Thursday, I expect to get a call from that office some time next week., also.
I have looked at the available jobs at my instition. It looks like I will end up doing something in research or quality improvement. I am thinking that the ADA paperwork will help me get around the fact that I am on probation until January 15th. (No holiday bonus for me, even if they have one this year.)
Saturday, August 29, 2009
Now that I am done with day therapy, my doc extended my medical leave for another 7 weeks to give me time to "find another job." Right now we agree on that, but don't agree where I should get that job. He wants me to look outside of the medical system I am currently work in, but I want to stay within that system.
When I last saw doc on Tues., he told me to forget about the job thing and just relax this next week. Tues night-Wed. morning, I stayed up with the night shifters at work and worked on my competency folder. That morning I went home so tired that I forgot to wait a wee bit longer and pick up my prescriptions at the pharmacy. That meant another trip into town that day to pick them up, as I was out of one of the medications. I also had a political action committee (PAC) meeting, that afternoon by telephone.
Thursday, I went and talked to someone in human resources about finding out if the ADA laws could help me out. She just gave me a form to fill out and another one for doc to fill out. (I wonder how long it will take him to get this one filled out, even when I give him most of the answers.) With doing that, I accidently left my stuffed dog, Beefsteak, in the breakroom. I called the charge nurse that night about midnight to find out whether he was there or not. I ended up picking him up during a special trip into the city Friday night.
Thursday night, I went out to dinner with my girlfriend and her two children. (I had just told her that morning about doing day therapy and the drama around finding a new job.) That night I went to bed by 10, but didn't get up until noon and it wasn't cause I was sleeping well. I was anxious and sad as heck. I then went to Walmart, grabbed a bite to eat, did some reading, and picked up a few groceries. (I was planning on picking up a few supplies so I could get started on some pins I am supposed to make the PAC for our nursing convention in October. Oops, I will have to add that to the list next time.) Slept relatively well last night.
So far today, I filled out most of my form for the ADA paperwork. I just need to get a little bit more information from my medical record before I fax it over. Now, I am working on e-mail and blogs. Just going to try to play things low key today. Tomorrow, I think I will go to Sunday School and skip church. (I want to talk to my Sunday School teacher, who is also a lawyer, to see what he knows about the ADA.) Monday, I go to group therapy over at the clinics, the first time in three weeks. Tuesday, is an appointment with doc and the psychologist. I guess I will find out what they think is in my plans for at least the next week.
Sunday, August 23, 2009
Day therapy went great this week. I really think I got quite a bit out of it. I would probably get a little bit more out of it, if I wrote the journal entry about "Changing my Identity and Job." I have been putting off for at least 1/2 of the week. I got this idea from when I talked to pastor, on Monday night. He told me that he thought that the reason I was fighting the idea of changing jobs was the fact that I had placed so much of my identity on my nursing career. He encouraged me to grieve this loss of identity and changing of jobs. That just led me to a flood of tears, but they purged the system of a lot of fear regarding the changing of jobs.
My conversation with my doctor and social workers went from being defensive to accepting the possibility of changing jobs during the week. By the end of the week, I was back to being quite defensive. Initially the conversation was about finding a job within the health care system in which I work. On Wednesday, I finally got a chance to talk to the social worker at the Employee Assistance Program. She took a history and even noted that with what I have been through she is surprised that I don't have a diagnosis of post traumatic syndrome disorder. (There was no talk one way or the other regarding changing jobs.)
By Friday, she had communicated with my psychiatric hospital social worker that she would recommend me working at least a year outside of the health care system I work in and then come back. This was shared with me by doc and my psych social worker. I was floored. I know that the policies say even though I am on probation there is a chance for me to transfer within the system, but it is rare that such a transfer occurs. At least during this meeting, my doc stated that he would extend my medical leave to give me a chance to find a job. (No one seems to be taking into account that the Americans with Disabilities Act applies here. When I talk to the Employee Assistance social worker on Tuesday of this week, I plan on bringing that up, as it is specifically mentioned in one of the policies I plan on taking with me to talk to her about.)
Doc then had me come back on Saturday, not a typical day therapy day, during which doc and I debated about whether I would be able to get a job within the health care system, if I was on probation. (This was a time, I wish I had the policies on me. It would have been a good time to discuss the ADA with him.) He absolutely does not want me going back to work on the unit I was on.
Today, Sunday, I did get up and go to church. I didn't have the energy to go to Sunday School like I would have liked to. My teacher is a lawyer within the community, who I was wanting to pass a few ideas by. Oh well, I may just need to call or e-mail him later tonight or sometime this week.
As for other communications that I have out on this topic, I have a note out to the Employee Assistance social worker, replying to an e-mail that she wanted to talk to me on Monday if possible. It tells her of my plan on calling her and the best phone numbers to reach me by. I also have an e-mail sent to my psychologist and the psychiatrist that runs my DBT group to ask them whether doc had contacted them about talking to me. Doc asked me about this during our visit on Saturday. I told him that I had not heard from either of them. Then again, I don't know at what time on Friday he contacted them. It is the weekend you know.
I am hoping that Monday will be my last day of day therapy, as I already have commitments on Tuesday and Wednesday. As I said above, Tuesday is the day I am to get back with the Employee Assistance social worker related to a job change. (If we get a hold of each other on Monday, who knows what will transpire.) Wednesday, I am scheduled to participate in a teleconference related to the state nurses' political action committee. Who knows what doc's ideas will do to these plans.
Oh well, I have just been busy enough & lost my Saturday, so the cover letter and resume did not get made this weekend. At least, I can be happy that I am not an inpatient.
Sunday, August 16, 2009
On Tuesday, I saw my psychiatrist, who could tell that I was quite anxious. I shared with him how I was afraid I would lose my job over a medication error that happened. (I was already on a 6 month
probationary period for a couple other mistakes I had made recently.) After I explained the error, he reassured me that there were quite a few different ways that that error could have happened and that I might not be responsible for the mistake. The psychiatrist then called the psychologist working with me and explained things to him.
After that conversation ended, the psychiatrist talked to me about how he thought that my most recent stress was situational and related to work. He also spoke about how he saw that I was using working at night as an excuse for not meeting other people and accomplishing other things in psychotherapy. (Now, I am not only anxious, but angry.) He then told me that he saw several options for me to think about: taking medical leave, doing more intensive therapy either through the day program or being hospitalized, quitting my job and or looking for a different one, and or requesting
a transfer to another area of the medical center. (Okay, shock is now playing a role in all of this for me.) I told him that I would think about it and let him know what I had decided by the next afternoon. I also reassured him that I was not feeling like hurting myself, and promised I would report any such feelings/thoughts to him. He then relayed all this to my psychologist before I left.
Then, I went into work with my head spinning. I told my charge nurse that when things got quieter during the night, I needed to talk to her alone about something that my doctor said. Work was kind of a blur that night. At around 4 am, we had our conversation, explaining how my appointment went and the feelings that were associated with it. (I know she will keep this confidential and is very caring, understanding, and supportive, as her own boyfriend is bipolar.) During this conversation, I told her that I was planning on calling my doc in the morning and telling him that I would take medical leave and try the day program. (I was still quite against a job change at that time.)
At the end of my shift, I was asked to report to my manager's office for the second time related to the medication error. During this meeting, the manager and asst. manager, told me that the probation was not going to be advanced to termination, but they had come up with a plan for me to perform a double check to help prevent the error, and they wanted me to come up with another idea by this Monday. (I was now relieved that I still had my job, but frustrated in that I could not think of anything else to help improve my performance in this area.)
Okay. Then I ate breakfast and did some reading, waiting for 8:30 when I called and left a message for my doctor to call me back. He called me some time after 9:30. He was quite concern that I was calling so early. I told him about being called back into the manager's office and that I was also pretty certain that it was my work situation stressing me out right now. I told him I was ready to take medical leave. He then responded that he didn't want me sitting around the house all day by myself. I told him that I was also willing to try the day program at the hospital. He requested then that I go to the hospital's admitting department for a screening and to get some insurance stuff figured out.
I went to the hospital's admitting area. They did the screening and paperwork, and I was allowed to go home and get some sleep about 11:30 am. The nurse said she would call that afternoon related to insurance approval and what I would need to do the next day, which she did around 3:30. I was to report the next day a little before 9 am so I could be escorted up to the unit.
That night, I didn't sleep too well, but got to the hospital early. I was taken to the dual diagnoses unit, where my doc admits most of his clients. I remained nervous most of the day, even though the groups and such went well for me. I saw my doc and his med student about noon. At that point, we decided that I would come back on Friday also. He also stated that he hoped I could meet with an RN that he had asked to come talk to me and my social worker.
I was able to meet with the nurse, and only after our conversation did I seriously consider the possibility of changing work areas. I left there about 4pm, grabbed a bite to eat, and spent some time reading in the break room of my unit. I waited until after the night shift got there and report was over to leave, because I wanted to make sure that I told the charge nurse who had been so supportive of me, thanks, personally. When I got home, I shot off a couple e-mails that needed to go out before I would get home Friday night.
Thursday night was also a night without much sleep. Things went smoothly that Friday for the groups and casual times. When my doc came around, I told him that I felt better while at the hospital, but at home, I was still feeling very lonely and depressed. He also gave me the name of a person at my job's Employee Assistance Program to have me call and find out what she could do to help me in transferring to another position within the medical center. When I called she was out until Monday, so I left a couple phone numbers where I could be contacted at and the best times to get a hold of me. When I asked him about whether I would be able to go to my psychology appointment on Tuesday, he just looked at me and said, "It's not Tuesday, yet." I am a planner so this day by day stuff bothers me.
My social worker came to talk to me about 3 pm. We talked about my background and the recent work issues that had lead my doctor and I to make the decisions we had made. As we explored my strengths and weaknesses, we decided that something in patient education may be right for me. About that time, doc called to find out how things were going with the Employee Assistance Program. We told him that a message was left for someone to get a hold of me on Monday.
I reassured him that I would be back on Monday and that I planned on going to church on Sunday to get myself out of the house. I told him that I hadn't came up with anything for Saturday, yet. He asked me how things were going between me and my boss, as I was missing work. I told him that I had explained to her that these days would most likely be medical leave days. That was when he asked the social worker to get that taken care of. (She ended up putting the form he needs to fill
out in the front of my chart for him.) The social worker and I talked a little more and came up with the plan that I could go to the gym on Saturday and walk the track for a while, to get me up and motivated.
I ended leaving about 4 pm, grabbed a bite to eat, and drove home. Once I got home, I worked on the computer until 10 pm, when I went to bed. I got up on Saturday morning about 6:30 and talked to Mom to get myself motivated and then got some breakfast ready. I then went upstairs to work on the computer, but as stuff was not loading fast enough for me, I shut it down and went back to bed.
My aunt called around 12:30 as she had seen that I had called several times during the week. I shared with her my situation, and she shared with me about her frustrations with the bankruptcy and her job as a private nanny. (She is another one of my major sources of support, as she has been treated for depression for more than 20 yrs. We just seem to understand each others situation better because of our own experiences with the disease.)
After talking with her for 45 minutes, I was really motivated. I got up, went out to eat, and did some shopping that needed done. I got home in the late afternoon and worked on the computer until about 10pm when I went to bed. Saturday night, I slept well until about 3:30 am, then I tossed and turned until the alarm went off at 8:30.
After the alarm went off, I knew I had to get up and get ready for church, as I had promised doc I would go. I also knew that I needed the support and prayers that my church family could offer me. I was glad that I was brave enough to ask for prayer in church and that I didn't breakdown and cry. It was pretty hard for me, as I don't like asking for help and I find this to be such a personal battle.
Rachel, a lady at church, and I talked a while, as she offered several ways to help me out. She was willing to come to my place or open her own home, if I didn't want to be alone. As a lawyer, she said that if there was ever any legal issue, with insurance or my employer, I was to contact her.
Sorry for the dissertation.
Thanks for the prayers,
Saturday, July 18, 2009
I find it kind of funny that a person who would call one of my nurse aides "a low down dirty scoundrel" would be so concerned about upseting me. That is exactly what happened at my last psychiatry appointment.
The psychiatrist was so concerned about having upset me that he had me sit back down in his office after I had started to leave. When he asked me what he had said that upset me, I wasn't able to tell him for sure at that moment, but I reassured him that talking about it would not change it and that I would just have to get over it. I was able to tell my psychologist the next day that I thought I was more upset with the psychiatrist calling the aide names than his talk about how I have to recognize the value of my own time and skills at work and delegate more work to the aides. (Trust me this will get back to the psychiatrist, as I have given the psychologist and psychiatrist full permission to talk to each other about my case. Two heads are better than one.)
There seems to have been lots of little things adding up this week and frustrating me thus leading to a worsening of my depression. Wednesday morning, I was called into my asst. mgr. office only to be told that I had missed to many days according to policy, and she would have to extend my 3 month probationary period to 6 months. She also reminded me that the next offense during that period would lead to termination. This is not a place I would want to be terminated from as the organization has received national recognition as a great place to work in general and specifically for nurses.
My other frustration has been this weekend my depression has been so bad that all I have wanted to do is sleep. I make myself get up and eat something, but haven't gotten the lawn mowed as I wanted to get started on that today. It already had been put off a week and a half because of my pink eye and work schedule. Oh well, I seem to be doing better now that I have some caffiene in my system. We will see what tomorrow brings.
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