Time to say, ENOUGH!

I realized I have not mentioned in this blog the problems being experienced living here in California and trying to do my job. A medical social worker brings tools (in the form of resources) to patients. With the state of the state, my job is becoming more and more difficult and frustrating at times. Thanks you Arnold for the cuts you are about to make to the California budget.

There are two areas that are about to be cut (the announcement was made yesterday) that will directly effect social workers: mental health and In Home Support Services. Both are areas that already have faced budget cuts and now to cut any further will definitely affect other services in California. Has the Governor figured out the side-effects of the current cuts?

Without the dollars for mental health services, we have already seen many people suffer without help. Without mental health services, emergency services will be impacted. Also, for the severely mentally ill, jail and prison will be the "remedy". And we already know that incarceration is extremely "cost effective"! (I am just being facetious.)

In Home Support Services is a program that this social worker heavily relies on with patients. This program provides help after my team of nurses, physical therapists, occupational therapists, and myself leave the patient's home. It allows for the person with physical illness or a disability to remain in their own home and be fairly independent. Without this program, the State will have to then pay for these people to enter Skilled Nursing facilities. Again, the Governor needs to explain how this future cost is going to help the State of California's budget.

I wish politicians and the Governor could walk just one day in the shoes of one of the many people, like myself, who understand the challenges faced by our citizens, listen to the real stories, and then go back to our state capitol and figure out where to cut costs.

I have an idea. We need to clean house in Sacramento. Fire the whole lot of those that have been elected. They have failed. We need to start treating government the way we treat a business. Let's stop paying for the luxury vehicles the state is providing some officials, take a close look at expense accounts of those in office, no longer pay for elected officials to commute (fly) weekly back to Southern California, and examine other programs that impact our budget. Workers Compensation would be a good place to start. I know of cases involving city government employees who "schedule" their back injury to dovetail into retirement. We need more investigations of the Workers Compensation claims. And yes, these elected officials would feel some pain. Not being able to return home every weekend, unless they are solvent enough to pay the expense out-of-pocket, would be a definite hardship. But we have already created a great deal of pain and hardship on those without any voice, and that is unacceptable. Those with the biggest mouths (our elected officials), have yet to feel the kind of pain my clients and patients experience daily. ENOUGH!!!

TGIF

I was trying to figure out this morning why I am feeling a little tired. I realized that last week was another fundraiser and I am probably still "recovering" from that! Now to start thinking ahead to May when the next fundraiser is occurring. Monday after work I will start making the necessary contacts and get to work on the prospectus package for the event. I enjoy the organizational aspect of fundraisers...the development of the databases, the budgets, the timelines, the themes and designs of venues, and watching as the many people involved in a fundraiser bring it all together. It takes many people and many hours to create a successful event. Okay, enough about fundraising today!

I am glad it is Friday, as this has felt like a long week. I have many cases at this time, so I do feel a bit like I am juggling those glass plates on poles! I am still trying to figure out the best way to accomplish my job. Right now, I am basically doing all paperwork out of my home, and then spending Monday through Thursday on the road. I have team conferences with the case managers a couple of days a week, first thing in the morning. I check into the office once a day to pick up my referrals from my mailbox.

I was able to spend some time this week with other social workers, which really help me out. There are several medical social workers in my city, so we try to get together once a month and talk about our work and lives. Myself and another social worker each work alone at our jobs, and many times we do feel very alone out there. It is nice to have another MSW to bounce ideas off of. Most social workers are employed in a setting where there is more than one social worker on the job. There is a sense of security in having other social workers to talk over difficult cases with. I am lucky that the medical social workers from our "support group" remind me often that they are only a phone call away.

I had lunch yesterday with a colleague I went to graduate school with. I have not seen her for about three months, when she was just starting a new job. It was wonderful to hear about her job, which is a completely different aspect of social work. The best part about getting together with my friend: we make each other laugh!

I am taking time off next week to spend time with someone special. I am learning that I do need to take breaks from work to avoid becoming burned out. My last "break" was in October when I went to Disneyland. I am looking forward to this break.... a whole week!!! My office arranged to have another MSW on standby in case a social worker is needed while I am gone.

My quote for today: "Weekends are a bit like rainbows; they look good from a distance but disappear when you get up close to them." ~John Shirley““

A YouTube Video about an Anti-Social Worker...Ugh!

I have to tell you that I found this on YouTube and am offended by the attitude of this supposed "social worker". This is the link to the YouTube video: http://www.youtube.com/watch?v=890vLx6Qbfo .Obviously this is a case worker with a 4 year degree, not a MSW (aka professional social worker). This case manager is one of the reasons at times I come up against negative thinking in the community when first introduced as a social worker. Fortunately this person is no longer working in the field of social work. His lack of knowledge about social work and the philosophical guidelines of some of us is obvious. My graduate training involved strength-based practice which is about empowering the person. I resent the description of social workers as cops, etc. Having a undergraduate degree in sociology, my sensitivity of attempting to create dialogue not involving "power" over a person is of utmost importance in my work.

This is an example of someone with a few issues, one probably involving a mid-life crisis, who due to lack of a graduate degree in social work (and I am not sure he possesses a BSW-Bachelor of Social Work), is unable to change up the dialogue at his agency and empower the people he is working with. Obviously, just having a 4 year degree in basket-weaving is not enough to be a competent case manager.

For those reading this blog and thinking about pursuing a degree in social work, please don't let the negativity of this person change your mind about the possibility of social work as a profession. If we want to see change in our society, we have to start at our community level and give voice to those without power! I hope "slacker" is doing as he says, working as an artist, and staying away from those needing help in these difficult times!!

Hump Day... or the question: Is it Friday yet?

Wednesday morning blahs are happening here! Yesterday did not go too well. I think I needed to sleep about 4 more hours. I managed to get to work exactly on time for "case conferences". You ask.... case conferences??? Huh??? Basically, the nursing director and each case manager, who is an RN, discusses patient cases and any challenges that might be seen. I am at the conference to add any insight I have on a specific patient or to listen to any problems that the case manager has encountered. It is nice for me because the case manager will discuss the new patients and referrals that I will be receiving. I say it is nice, because having a little background about a patient before actually visiting a patient helps me. It is almost a luxury having more information other than the dry medical information and referral that I receive daily. Most of the time, during the week, I deal with the paper referral and don't have the rich history that case managers provide at the conferences. The conference lasted a little more than an hour yesterday. Approximately 3 case managers are assigned to Tuesday, Wednesday, or Thursday. And I go to two of the conferences dates each week. Why not all three? Good question. For now, I have agreed to be at the office at 8:00am two times a week. I would like to keep it that way. Patients do not want to see a social worker first thing in the morning. I don't blame them at all. So, my visits usually happen after 10:00am. I work from home, so I am doing the tons of paperwork when not on the road visiting patients. I swing by the office once a day to pick up any new referrals and check for any messages.

Yesterday became a disaster because of the weather. It was pouring, and I mean torrential downpours. I thought I was going to visit a patient who lives in a rural part of our county, but when I arrived and saw I had a long dirt road to navigate, I became concerned. I started driving down this muddy road with my car slipping and sticking. I then figured that I was going to get stuck at any moment as the road was becoming worse. I turned around and left! Driving back to town the weather conditions worsened. Water was pooling on the highways and roads, and I had one spin out. The decision was made after my spin out, that this rainy day was the perfect day to do paperwork! I guess a 4-wheel drive truck would be another good tool for this job!

Today I will be at the office at 8:00 again for case conference. After the conference, I will be hitting the road and visiting patients for the majority of the day. After work I will be driving to a neighboring city, about 30 minutes away, for a board meeting at 6:00pm. You will be reading a lot about the organizations and fundraisers I am involved in. I am on the Board of Directors for CASA, an agency that advocates for the rights of foster children in the system. We are working on the planning of an upcoming fundraiser this Spring. I like this board of directors because they are all active with planning and helping out. I can't say for with another organizaton that I co-chair a fundraiser with. So this experience has been positive for me and I don't feel like the weight of the world is on me! Raising money in this economy has been challenging at best. Fortunately, there are some generous folks in our community who always come through when asked to help out with a cause. This fundraiser will be a dinner and oral auction. We are still working on the guest speaker. Maybe tonight there will be some suggestions for our speaker! I'll be talking about more specifics of the fundraisers as time goes on here.

Anyway, hump day it is!! I can hear the wind blustering outside, so I have a feeling that driving today is going to be another interesting experience. I just ask for a little less with the typhoon rain! I need to get going, because today I will not go to my conference without first stopping at Starbucks for my caffeine! It is quite obvious that I am addicted to Starbucks (a habit fully developed in grad school), and without my jet fuel, my day quickly sputters to a stop!

Maybe one day I will actually enjoy the peace of early mornings. For now, I just know that I am awake because I still am struggling with the sleep habits (or lack of) I developed in graduate school. One thing that I am learning about social work: it is never the same thing. I like the challenges and newness that each day gives me. When asked "what does a social worker do?"; I hope this blog provides a small amount of insight into answering that question. Most of what I will write about will come from a medical social worker's perspective working for a home healthcare agency. I am on the board of directors of two organizations, so I will be writing about that experience as well. And I have spent over 6 years helping the homeless find their voice in our community, so I suppose people call me an activist. Okay, enough about my boring background! Back to trying to wake up on a rainy Monday morning and organizing my day.

I have an inservice to prepare for tomorrow. It has become clear since starting my new job, that an understanding of psychosocial topics is necessary for those I work with. I work with a team of nurses, physical therapists, and occupational therapists, who manage patients' cases. I meet weekly with the case managers (who are nurses) and discuss the progress of patients. As as social worker, part of my job is providing resources for the patients so they have tools for themselves, but also providing information for my team of nurses. The majority of the patient population in our home healthcare agency is geriatric, but we have patients of all ages except pediatric cases. I am finding that there is a lack of education and understanding about several topics that I see often in my job. Depression, suicide, Alzheimers, and dementia are the topics that I hope to educate my agency about. As I talk to our patient's physicians, along with the nurses working at the agency, they have been honest with me about their lack of knowledge in these four areas.

So tomorrow's inservice is going to talk about depression. As a sociologist and a strength-based social worker, I struggle with that label of depression. Something to know about me- in a perfect world, I would not be assigning labels to people just because their thinking is unique. Don't misunderstand me, depression is serious and needs to be addressed. But to simply slap a DSM code on a patient and then prescribe an anti-depressant if far from the answer. As a medical social worker, that is what I am currently doing though. When I was working among the homeless, counseling was the tool used to deal with depression. Most of the homeless folks did not have the luxury of insurance and therefore anti-depressants was not even an option. Only those who were suicidal, needing immediate help, threatening to harm themselves or someone else, received medical intervention- meaning the label "51/50". And unfortunately getting help meant being handcuffed, placed in the back of a police car, and driven to a behavioral center- a "psych hospital".

In working with patients in the home healthcare setting, insurance basically pays for the social worker to make 2 visits. In some cases, I do get authorizations from the physician and insurance company to make more than the 2 visits, but those cases are rare. Within that 2 visit framework, I am making assessments and then creating recommendations that are passed on to the case manager, and then given to the patients' physician. I am thinking of creating a little bumper sticker or license plate frame that best describes my job: "Medical Social Work- Pissing on a Forest Fire Everyday". And that really is how it can feel on most days.

So today, I will call some patients and schedule visits and then work on the inservice for tomorrow. Hopefully, I do not have any visits that absolutely must happen today. I need to create a PowerPoint for the inservice and print some brochures and notes for the class. The challenge of this inservice is that I have only 30 minutes.

I am also trying to figure out a good system for tracking my referrals to one county agency in particular. My predecessor did not have a "system", but her lack of a system worked for her. She was able to just fax the referrals in to the agency, but this same agency is resistant to letting me do the same thing. They want me to both call and fax the referral. That would be fine, except I make the call, and leave a message for a worker. I am on the road, and either I get the call back while on the road and without the patient information in front of me, or I never get the callback. I am now getting calls from the patient or patient's family asking if I have taken care of a referral, and have to backtrack looking for when I made a referral and follow-up. I love being organized, and this referral mess is bugging me and is going to get "fixed" this week!

Some high points for this Monday. It is raining and I absolutely love the rain! My niece now says to me, "Auntie, I love you". Both of my sons are healthy and happy with great women in their lives. And I now have someone special in my life who is supportive and puts a smile on my face when I need it! Life is good on this Monday.