Here vs. There

For those of you who don't know, I recently transferred from my job at Shore Memorial Hospital to Bacharach's main campus outpatient department in Galloway. It's the same company, so nothing as far as compensation, time, benefits, etc has changed. What has changed is my location, caseload, boss and coworkers.

For anyone who wonders what the difference is between my jobs, continue reading...

Acute care is a world where patient care is centered around how well a person can move, what assistive devices and assistance they need to move themselves and deciding where a person goes once they are medically stable enough to be discharged from the hospital. For some patients, like joint replacements, spinal surgeries and pretty much anyone with rehabilitation potential, acute care is like the kindergarten of therapy. This is not to demean acute care in any aspect. But it is the place where patients learn the most basic of functional skills in a setting that is nurturing, caring and based around compassion and comfort. Acute care starts the process of teaching patients how to move their bodies the best they can, with family and friends there for support.

The next step would be sub-acute rehab which is like elementary school. It builds on what you learned in kindergarten and gets you to a point where you can safely cross a street by yourself, add, subtracts, read and perform other simple life skills with a little supervision from family/ friends as needed.

Outpatient PT is like the high school/college of PT. Its where people who are generally fully functional in society go to heal problems they have. For some people, they have gone through all three types of therapy in a sequence, and for some, they skip right to outpatient. Patients in this setting require plans of care specific to their problems. Goals for each patient are different. One person may want to be pain free, one may want to return to golf and one may just want to be able to walk around without loosing their balance.

Leaving the acute care world for a different setting was a decision I made a few months ago. If you know me at all, you know I hate change, so this was something I had to really think about. After spending 9 months or so getting to know acute care, I felt there was no room for me to grow as a entry level therapist. I knew most of the acute care answers, and if I didn't I knew who to ask and where to look them up. I knew what to expect from patients, where they needed to be and how to get them there. I felt I needed to develop my outpatient skills when I was new to the field to give myself some confidence as a therapist and the experience I feel any good clinician needs.

I won't lie, I thought leaving Shore would be easier. But like a first love, a first job is hard to forget. It becomes so routine and familiar that leaving that place feels strange and scary. Leaving a place that allowed me very flexible hours, lots of overtime and the ability to make patients instantly happy still makes me nervous. I didn't have a lunchtime gang of people who know all about my life and care about what happens in it. I don't have the same easy-going easy to approach mentors. I don't have paperwork time anymore. I can't shift my work schedule to have a day off, I have to use personal time. If I want to leave early or some in late, I have to find another home for that scheduled patient. I can't stop in the middle of my morning to type notes and regroup before returning to cranky patients.

At Bacharach, my life is very scheduled. Every hour, I have a patient or two that expects to see my game face. They expect me to know why their bodies hurt and how to fix it. They expect me to know answers and get them promptly. Their paperwork must be finished promptly so insurance will pay, but is not always done by the end of the day secondary to time constraints. I'm overwhelmed and bombarded but I love every minute of work these days. No one ever wants to get out of bed in the morning, but I don't mind going in to work. There is always a new patient to see or an old one who is so enjoyable. I get to spend more time with people now, I don't have to "speed date" and interrogate them to figure out what the real issue is. Sometimes I feel like the outpatient moves so slow. I'm used to seeing 10 - 15 people a day in 15-20 minute intervals, but now I spend an hour with each person. Did I mention I get to see kids and babies as patients too? This is just the icing on my cake.

I cannot one is better than the other, because my time in acute care was great for me, but I'm happy I was brave enough to make this move and try something new.

To baby, or not to baby

That is the question.

Don't get too excited friends, we are not having a baby in the near future and we are certainly not pregnant. But as I see Facebook blow up with news feeds about new babies and new pregnancies, underneath my extreme happiness for all of our friends enjoying this wonderful event is my jealousy.

I am the quintessential baby hog. As soon as I even hear about a baby, I want to hold it. I want to rock it and feed it. It seems so creepy, I know. And who knows what made me this way, but it seems to have been almost my whole life. I've always had a thing for baby dolls. The smaller and more lifelike, the better. I remember having a regular water baby, but she wasn't small and cute enough when I saw the mini-water baby.

I feel like since we got engaged people have been on the baby topic. When do you think you will have kids? How many? Etc. Etc. Well, since we got married it has only gotten worse. Now when people I meet find out I'm married they assume I have a kid or then ask when we are having one. (OR they say "wait a really really long time." You can always tell happily married people from unhappily married by their reactions to marriage. I guess the same is true of babies. People who are happily babied want everyone around them to procreate too.) I feel like people are always looking at me to see the telltale baby bump. I know how movie stars feel sometimes. You gain a few pounds in the wrong place and guess what, you're expecting and you didn't even know it.

So this brings me to the discussion of when in a marriage to have a baby. My research tells me the two most important factors in this decision process is....when you and your spouse have a solid marriage and are financially ready. Well, thanks Google, but unfortunately I need more to dissuade me because when it comes to those two things, we've got it under control. So what else....

• loss of husband wife 1:1 time
• loss of sleep
• loss of individual time
• addition of 30+ pounds
• additional expense
• loss of flexibility to do whatever, whenever in our free time
• Peach baby training
• figuring out raising a baby with a full-time job
• and I am sure many more....
  

So of course I WANT a baby. But are we really ready for one?

I can't wait for the to come when we can get on that band wagon, and I know that now is not the time, but I still can't help but impatiently wait for the time to be right. And so the thought process continues...to baby or not to baby...

Urge for Going

"Now the warriors of winter they gave a cold triumphant shout
And all that stays is dying, all that lives is getting out
See the geese in chevron flight flapping and a-racing on before the snow
They've got the urge for going, and they've got the wings so they can go

They get the urge for going
When the meadow grass is turning brown
Summertime is falling down and winter is closing in

I'll ply the fire with kindling now, I'll pull the blankets up to my chin
I'll lock the vagrant winter out and bolt my wandering in
I'd like to call back summertime and have her stay for just another month or so
But she's got the urge for going and I guess she'll have to go"

Joni Mitchell