Monday, April 7, 2014

Transitions of care

My goal for the year was to be good and put my own mask on first. It's a reasonable goal I think, prioritizing self care over draining myself caring for others.

Of course, it hasn't happened that way as much as I'd like to. I have suddenly taken over a huge amount of childcare and household stuff and that's life and was pretty unavoidable. On the other hand I've been decent about maintaining my sanity by getting out of the house sometimes, better than ever before. It has been really good to get out to be an adult sometimes. I honestly am happy to lose 5% of my grade in some classes to have the time to be human and not just a studying machine.

But here we are, getting ready to transition from me doing lots and lots to me being gone during the week. When I was away for school in the fall I came home to a disaster area and it really bothered me. I worry. I don't want to come home every weekend and spend all my time doing dishes and laundry, but if every week is like that one, I will have no other choice. I can't in good conscience leave for the week if every dish is dirty and none of the laundry is clean.

In the healthcare arena we talk a lot about transitions of care. Lots of bad things happen when people go from the hospital back home or to a different healthcare facility. It's easy to drop the ball when someone has been providing one level of care and it's suddenly gone. The new caregiver may have no idea what is needed to maintain adequate care. I think of the little old man with heart failure who goes to the hospital, stays a few days, then gets sent home on a few new medications whose little old life partner is bewildered by the whole thing. Which medications he took before the hospital should he still take? Did the dose of any of them change? What looks so bad that he needs to go back to the hospital and what should we call the doctor about? How much do all these new medications cost? What happens if he dies? What happens if I get sick? These guys come back to the hospital  pretty often because they haven't been taking medications properly and it's easy to get confused even if you are a very with-it caregiver. I've seen the little old caregiver in the pharmacy and they just look like they are in total shock. They nod and say they understand and sometimes can even repeat directions back but I don't think most of them have really understood a word of what is said.

Now we all in healthcare are looking at ways to smooth transitions of care for people so don't think we've given up on the little old caregivers completely. We do things like create detailed lists of medications and send home swaths of printed information about how things should go. We sometimes send home med lists that say specifically "stop taking medication x that you took before you were in the hospital" even. Discharge counseling for those leaving the hospital is far more than it used to be so hopefully the sick person and the caregiver(s) understand better how things work.

But sometimes no matter how prepared you pretend you are, you can't really fathom an experience with radical change.

I've been trying to ease the upcoming transition of care for my spouse, spelling out things that matter like that we need to do one load of laundry every day to keep up with things. I've been letting the mess pile up so hopefully my spouse recognizes it and deals with it without prompting. This means that a bowl that got smashed in the kitchen a week ago (by my spouse no less) is still in pieces on the floor.

I'm starting to panic honestly. I know that my rotations are what's best for my career and we as a family are in a place where it looks like it will be my career and not our careers. I get that it matters a lot that I do the rotations to the best of my ability. It's part of me putting on my own mask first. At the same time I can't believe I am really going to be gone for 10 weeks in a row. I have no idea how this is going to work. I'm scared to see how it works and that it really isn't going to work at all.

Next is my short to do list. Let me know what I've forgotten.

Figure out what dishes/pans I need to feed myself while I'm away and acquire them
Assemble work wardrobe and purchase anything I need to fill it out (new undergarments for sure, probably a few pairs of pants)
Get a proper pair of pajamas
Clean out the car
Get the car's body work done so it's presentable
Figure out the site requirements and get those accomplished before each rotation
Avoid panic if at all possible

Questions for you all: how many outfits/pieces are in your work wardrobe?


  1. I can absolutely understand how you would be worried about this. I don't want to make it any worse, but if I am honest, I would be freaking out!! I don't know what my house would look like each week but I don't think it would be good. Hopefully your spouse understands what needs to be done and just makes it happen for those 10 weeks. It is not fair for you to have to worry about that every weekend when you get to come home to be with your family. Could you get a cleaner to come in and help every now and then? I am sure, no matter what, even if not perfect, it will be okay. Like you said, it is the best path for your family and it has to be done. Good luck!!! Sorry no advice for work outfits. I am working today and am wearing cut off jean shorts and one of our camp t-shirts which I cut the sleeves and neck out of and barefeet. I am not a good example! ;)

    1. I really love knowing that jobs like yours exist at all. It makes me very happy to know you are enjoying the warmth while it is windy and unpleasant here. I am usually in my jeans and a scruffy old t-shirt so it will be exciting and awful to switch to work attire.

  2. Ooh, I would be freaking out too. Hopefully he'll pull it together once you're actually gone. Since I'm not back to my pre-pregnancy size and still nursing, I have a limited but functional work wardrobe: 3 pairs of black/gray pants, 6 or 7 work appropriate t-shirts and tanks, and some cardigans. It's amazing how little is actually necessary, though it gets a bit dull and I do a lot of laundry.