Just another week at NFC

While Lauren is away on spring break I have double the work around here. I have been seeing one of Laurens patients the last two weeks. I have been seeing this patient for case management. We were scheduled to meet once a week until Lauren gets back. So last Monday after meeting with this patient he wanted to schedule another appointment with me that same week. I said it was okay and we met again on Thursday. After our Thursday appointment we were scheduled to meet again on Monday. So we met again on Monday and discussed his housing needs. Before the appointment ended he wanted to schedule another appointment that same week. I told the patient that it is not necesarry for us to meet two times a week (I felt horrrible because he is such a sweet man). The patient kept on coming up with excuses for us to meet. During our last session I informed the patient that Lauren is coming back next week and that they will continue to do counseling and case management. The patient expressed his need to meet with both Lauren and I. He wanted to continue his counseling sessions with Lauren and meet with me for case management. I do not have a problem meeting with this patient for case management but the only problem is that he meets with his doctor once a week and meets with Lauren once a week. He is getting a lot of care. I informed the patient that meeting with Lauren would be best for him because she knows what he wants and needs. They also talk about things in their counseling sessions that we don't. This patient has not disclosed that he is dependent on alcohol and is seeking sobriety. I told the patient that I would attend his Monday session with Lauren and talk about further care. I felt horrible because it seemed like I didn't want to work with him anymore. After speaking to Maggie I learned that he could only meet with one of us once a week. I'm very nervous about Monday, I don't like breaking up with people.

Break up

Break up's can be tough, but you can also learn a lot from them. So I have been meeting with a patient for smoking cessation sessions. I was scheduled to meet with my patient for our bimonthly session. The patient showed up on time but appeared to be a little anxious. We stepped into the room and started our session. Two minutes into the session the patient tells me that she no longer needs to meet with me. She is smoking only 1 cigarette a day and is able to quit by herself. I was in shock! She thanked me and wished me luck and left the room. Our session lasted no more than 5 minutes. We spoke about this during supervision. Jose asked me how I felt about this situation. I felt like I wasn't doing my best to help this patient and she felt like she was wasting her time. Jose explained that it happens to them all the time. Patient's terminate relationships (mainly by not showing up). It meant a lot to me that she took the time to show up and tell me that she no longer needs my help. To me the patient appears to be negotiating stages of preparation and action with resistance to move forward, which can be interpreted as a form of relapse or potential for relapse. This is normal when it comes to working with patients with addictions.

Who's the patient?

So this week I came across a situation that got me thinking. I was scheduled to see a patient to aid them in filling out paperwork. When I went to get the patient the mother and his older brother were waiting with him. They all followed me into the room and sat down. The mother started complaining about the her son in polish. She said that she wanted him out of the house because he does not listen or do anything around the house. Oh, I forgot to mention, the patient who is 60years old has schizophrenia and major depression. So the mother and the brother start talking about a facility in the area that they were interested in sending the son. I sat there and listened and then realized that they were not my patients. I asked the patient if he is interested in moving out of the house and he said no. I explained to the mother that he is my patient and I can't look for supportive living communities if he is not interested. I then talked to the mother and son about things that the son can do to help her out. I explained to the son that his mother needs help. I asked him if he would be willing to do some chores around the house to help his mother. He agreed to help his mother to avoid moving out of the house.

I was not prepared for this session at all. I walked in thinking that I would be helping a patient out with paperwork, instead I was put into this very uncomfortable situation. One think that would have helped me is communication. If the resident who referred this patient to me would have messaged me before I would have been more prepared. I spoke to Lauren about this situation and she said that this certain resident is not clear when he refers patients to us. It is nice to be prepared and know the reason for the session.

Week4

Wow!! More than one forth of the way behind me!. It feels like I just started. This week in filled out my first AllKids application. After reading the application over and over again I collected the materials and faxed it over to be processed. This week Maggie and I met with the financial advisors to talk about Medicaid. At this conference/ meeting I met a lot of hospital social workers. One thing that surprised me were the questions some of these social workers had. For example, "what's the difference between an undocumented immigrant and a legal resident?" I couldn't believe my ears. This is something that a social worker should know especially when you're referring your patients to different programs which have different residency requirements. Another question that was asked was, "what's the difference between Medicaid and Medicare?" 😆 Anyway, I leaned a lot about the Medicaid expansion and who and what this insurance covers. But I also felt like I knew a lot of the information that was being covered. This week Maggie, Lauren, Jose and I went out to lunch. It was nice to spend time outside the clinic and chat. I feel like we are a team, we stick together, just like the residents, nurses, etc.

Week 3

I can't believe tins already been 3 weeks since I started. As time goes on I am becoming more and more comfortable interning here. One thing I have learned about this place is that we are a team. Everyone at this clinic needs to communicate in order to get things done. This week I met with my patient whom I work with every week. This patient is becoming very comfortable with me, she loves sharing stories about her family. During our session I felt like she was avoiding the smoking conversation. Every time I would bring it up she would change the conversation and start talking about something else. I had a hard time trying to redirect the conversation. I explained to this patient that she has to want to change and that I cannot do it for her. She has agreed to smoke no more than 5 cigarettes a day, which I thought was a great step considering she smoked 5-10 cigarettes a day. Overall it was a good week.