What in the world……

I haven’t been on here in a while.

Why?  You might ask……

Well, things have been rough at work.  My caseload continually started dropping, but I thought it was not too big of a deal because, after all, I was the Rehab Director and I had those director-type things I needed to do.  Make sure documentation is completed and accurate, checking daily for G-codes, reviewing every chart prior to submission to medical records, daily meetings, keeping all staff up to date on what was new with our company.

Unfortunately, the hospital didn’t see my value in that area and decided that I had a month to increase my caseload (yup, that included marketing my own services) or elimination of my position.

Our company, who contracts us to the hospital, decided that the best option was to have me start covering a local nursing home as well.

I’ve worked at that nursing home in the past and swore I would never go back.

Fortunately, a friend of mine has connections with a contract traveling company.  One day I’m emailing a recruiter, the next day, we’re talking on the phone.  By the end of the week, I had a phone interview with a school.  Yup, you heard me, a school system.  By the next week, I had a full-time job offer, guaranteed 40 hours/week, willing to work with my travel/speaking schedule and mine to start the following week.  I had the difficult job of talking to my supervisor and going part-time at the hospital, so that I could work full-time at the school.

Basically, my outpatient caseload now is 3 and the nursing home has less than 3.  My outpatient caseload equals 4 hours a week.  I think I made the right decision.

The bad thing was that in order to not give notice, I had to work at the school, cover the nursing home and the hospital for 2 weeks.  That doesn’t sound bad, but I do think I’m still recovering from working so much.

What will I miss most about my hospital job, other than the 3 outpatients I’m keeping on…………..
1.  Modified Barium Swallow Studies.  I love modifieds.  I love diagnosing dysphagia and working on that treatment plan to improve my patient’s swallowing ability.
2.  Outpatients.  I love working with adults.  I love working with them and helping to improve aspects of their lives.  I also love that moment, when they’ve attained their goals and the gratitude they show.

What will I NOT miss……….
1.  Productivity.  That’s right.  I’m not a factory.  Some patients take longer than others.  Sometimes, outpatients need 2 hours, most times an hour will do.  45 minutes is not sufficient even though that’s the magic number from a business stand point.
2.  Swallowing evaluations for EVERY patient diagnosed with CVA, whether it’s actually a CVA or not.  Sometimes they get it right.  I’d say it’s been about 20% correct diagnosis since we became a stroke certified hospital.  Not that I don’t love evaluations and swallowing evaluations.  When I know it’s not a stroke going in, the patient has passed the 3 ounce water swallow screen multiple times and nursing reports no difficulty with meals or pills, it seems like an enormous waste of tax payers money and my time.
3.  I took the job as rehab director because I wanted to learn to be a manager.  I really wanted to get into the managerial aspect of therapy.  I did NOT want a title, expectation to maintain the same productivity, however take the blame when I didn’t have time to do something.  Also, I’m not into marketing.  It’s not what I do or what I went to school to do.

So yes, I work in the school system now.  I’m adjusting.  I like the kids.  I have yet to like the artic, but I was really excited the other day when a first grader who substituted k/t and g/d actually started using t and d in words.  It’s the little victories.

Will I quit dysphagia therapy or will my passion for it waiver.  Never.   I will continue to read research on dysphagia.  I will continue to speak on the topic of dysphagia.  I know that I will soon get back into the practice of treating dysphagia full time.

Just for now, I need a change in pace in my work setting and boy did I ever find that!

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