Thursday, December 10, 2009

The Whole Truth

About 2 seconds ago, I silenced the alarm on my work phone. It's there to remind me to call the time system and clock in for the day. As of right this minute, I'm officially on vacation until next Wednesday, and not a moment too soon.

I want to talk about a few things here, because I'm losing the courage to do my work.

I love this specialty, I truly do. I feel I make a difference. Even during that kerfuffle last month, I may not have made a difference to the family who verbally abused me, but I saw to the needs of the struggling patient. I made a difference to him and was able to ease his suffering. Over the summer, I had an incident where the family told me they never wanted me to darken their doorstep again. That was until the next time they called and needed help at 10 PM. Recently, they sent a letter to my employer thanking the staff that helped them and though at one point they'd expressed dislike for me, in the end, they singled me out to express gratitude. I was surprised and appreciative of the recognition.

Truth be told, I feel like a RN (real nurse) doing this job. Unlike my day shift counterparts who carry a heavy workload, I usually don't. I have time, hours to spend if needed, to provide emotional and skilled support. I often get phone calls where someone has but a question and not a need for a visit, but if I sense any distress at all, I make a visit. I've kept vigils with families who are distraught or afraid to be alone. If I'm there for awhile, I'll pull out my knitting and we while away time talking with the soothing sound of needles clicking away.

In short, I love my work, but sometimes, I question what I'm doing.

Last night, as I pulled up to a home in a very dicey neighborhood (not a unique situation), I was aware of a man lurking in the shrubs and trees 2 doors down (definitely not the norm). It was late, dark and bitterly cold. I called the caregiver of the patient and told her I was there, but couldn't safely exit my car. I could see the man looking my way in my rearview mirror--you know, the mirror that says, "objects in mirror may be closer than they appear?" The caregiver came out to get me. As she opened her front door, and I stepped out of my car, two men emerged from the trees and approached me. With my heart in my throat, I started to climb the porch steps, lost my footing and fell. The men, seeing the woman on the porch, stopped, turned around and left, but believe me, both I, and this woman, had no doubt that they weren't there to help.

I was scared out of my mind. Truly. The entire time I was in that house, my heart was not in my work because I was too worried about leaving and running the gauntlet back to my car.

I'm beginning to question the sanity of what I do. Is it worth my well-being to continue? My work area includes, with the exception of two zip codes, all of the metropolitan Detroit area (around 3,900 square miles). Last night, I've never been so afraid for myself in my life. While I do earn a little more money than I did working in a hospital, it's never been about the money. It's always been because I've felt called to do this--to honor and care for the souls leaving our world. I know that may sound silly and trite to some, but there is a need for people like me. I want to be able to do it, but I can't do it well if I feel unsafe.

Obviously, more than the usual pressures of the holidays will be on my mind during this week off. I have to find a solution to this conundrum.


Anonymous said...

And that is a conundrum. I have no idea what advice to offer, but you're a very thoughtful person and will arrive at the best conclusion, I've no doubt.

sue b said...

In our area, the police are willing to escort us if we feel unsafe. Is this an option for you? Don't give up work you love if there's a way to continue.

Stephanie V said...

I don't think it sounds either silly or trite to want to share your (obvious) skills with people who need them. It's an uncommon love that puts itself in harm's way to help others.
I don't have the solution but I know that you will do what is best for you and your family. You have a wise head.

Rudee said...

sue b, we can take private security contractors, and we do to known bad situations. This has been an alright situation to the day shift for a month. Nobody has had to go out at night until now. The caregiver told us these men are from a drug house 2 doors down and they frighten and threaten everyone who visits at night. She didn't think to share that with us in the beginning. I'm so thankful I saw this man in the bushes before I got out. In short, this bad situation made itself known on my time last night. I think my heart is still beating a bit too fast.

SkippyMom said...

Rudee, I have no words.

For what you do [and I thank you - okay, those are words...but]

the danger you are in.

I can't imagine my lil' world without you - trying to imagine what your family would experience? Unthinkable. Does that make sense and not sound selfish?

My Mom has a hospice nurse twice a week and she is a gift. As you are to your families. But the difference is my Mom's nurse isn't in danger.

Is there some way, some how you can find the same type of work in a better environment? [Duh, Skippy if she could, she would've! Sorry]

Or as SueB said find police to help out? [excellent suggestion]

You aren't being silly about this, but you shouldn't put your life in danger for the good of someone else's.

You are on the thankful tadpole list for a reason. Please take care of yourself. My pal.

Renie Burghardt said...

Oh Rudee, what a scary situation. Please stay safe!

Hugs and Prayers!


Gail said...

The answer will come, have faith.

Quiltluver said...

It's been a while since I had to travel to certain parts of Detroit for work. I still remember that scary feeling of driving by myself through certain dilapidated neighborhoods, hoping my car didn't break down. The clients were always very aware of safety and many had security and/or locked gates so I would feel safe once I was there. You did the right thing by calling the family for help. I don't know how much planning ability you have not to go to a strange neighborhood at night for the first time? Asking the family for their help and input, watching for you to arrive, and assisting you into the house? I would think that most people who live in bad areas are very well aware of the dangers near their home and can advise you on this. Can you ask some security-related questions of the family before you go there? Trust those gut feelings and ask for security or police help if you think you need it. You seem to be pretty smart about these things, so I'm sure you'll come up with the right solution. You may want to take some time so you don't make a hasty decision while you are still in shock...Anyway, for what it's worth, that's my 2 cents. Karen

Lisa L said...

awful. just awful. are there any freestanding in-patient hospices in your area? what about a hospice unit in a hospital? what happenned last night is insane rudee. i have been chased with a knife (angry hospice patient's husband)(horrible) but managed to run outside..and thank god it was daylight. there must be other hospice options in your area. please,please take care...

Anonymous said...

Oh Rudee, I am so sorry this happened to you. You are right there is such a need out there for nurses like you. I was not a staff nurse when I worked for home health, I was the referral liaison nurse, but I made visits many times just to help out. I had troubles sometimes in in the day. Got in the wrong house and had a gun pulled on me. But I would ask for security escort no matter where it is if late at night and bad weather. True no more can ever know for sure what will happen. Good luck.

Brenda said...

I am certain that your heart will let you know when to make a change. Sounds like maybe you are really close to making that change...I sure would be after a night like that.
Your family needs you and I am sure there are many options for you, with all of your experience.
Sounds like a good week to look into it.
Hope you are not having too much bad weather. It is FREEZING here. BRrrrr..

Rose said...

I don't have any advice either; it's a tough spot to be in. The police escort sounds like a good idea; is it feasible?

Miss T said...

I have no idea how you should make that decision, except to say that your life is important, and the company you work for should make sure you're safe getting to work.

Ruth said...

This is such a sad situation. You own safety is paramount and must come above all other decisions. Perhaps all first visits at night should have a security escort - just to suss out the place you never know what the dark will hide .
Take care and if in doubt LEAVE.

Sandy said...

Oh dear, that would have freaked me out and I would be in the same position, questioning what to do in the future. I guess if it is possible to always call ahead to your clients and if someone can "see" you into the house would be the best solution other than quitting.

Jane said...

Dearest Rudee, I am so sorry that this happened on your watch, but you came through. Someone was watching over you. Maybe it happened so that you can raise awareness of the issue in this area and save someone else from having the same or worse experience? Your heart will tell you what to do. Trust your gut!

Rositta said...

Everyone has already said what I've been thinking. Two things, I was once lost in Detroit in the dark on my way to Grand Rapids and it was the scariest thing I ever lived through and secondly I if I were in your shoes would never go out to those neighborhoods without a guard at night, ever and third, maybe it's time to change jobs...ciao

distracted by shiny objects said...

Been thinking about you and trying to find a remedy--unfortunately I don't have a quick'n easy one either.
Hospitals aren't much better. The violence there is under reported. In the 3 years I've worked in my present unit I have 3 times seriously feared for my life. Once I texted my kids to say I loved them. We do generally have more people around and we are on our own "home turf" which gives some psychological advantage, but a gun is still a gun, and when we all jam the 911 line with our calls at the same time there is no back-up coming.
Having said that, you may feel safer doing the job that you love if you have more protection. The more options the better for you. So, one is the security escort when needed. Maybe self defense classes? Do you carry anything that can be used as a weapon?
This is a bad time of year for crime--the holidays are coming and people want money, drug addicts want their drugs--and money--and it's dark way early and most people are bundled up. It's hard to see and hard to manuever.
I hope you find a resolution to this so you can enjoy your time away from work without thinking about work. I'll still have my brain percolate on a solution:>)

Winifred said...

Crikey that's horrendous.

Do they do an initial risk assessment about the patient, family and their environment when they take the patient on. I know we are obsessed with health and safety in the UK but it's essential you are not put at unnecessary risk.

You can't eliminate all risks but you can minimise them. Your employer has to do more. Are you in a union? If so, what do they say about this situation?

It's sad that people doing such a valuable job are put at risk. You shouldn't have to worry about this kind of thing you have enough on your plate with the patient.

I can't give advice as only you can decide. However your safety and your family have to take priority.

Anonymous said...

Can you get a police escort, if you are feeing unsafe? I would try to do that because you were indeed in a very unsafe situation and you were lucky it ended up okay. Some of the neighborhoods where I have to do home visits, I get very afraid and I can always go back to school. With a sick person, waiting for you, you can't do that. I think this is something you should seriously check into, nothing is worse getting robbed or beat up or worse your own life.

Yet you give such good care to the patients, and they do need you. It would be a shame to give that up.

In the end you have such a difficult choice to make, but only you know what is right for you. I would say that your safety comes before anything else. That should be a given.

I know you will work this out. Just my two cents.

For now, enjoy your vacation, spin away, knit and just relax.


Devon said...

How very frightening! I work home health in California and have never felt afraid in neighborhoods, but one time I was in a home where I think they sold drugs. It only happened once. I guess there are risks with any job and we just have to be aware and trust our instincts.

jeannette stgermain said...

I agree with sue b. -get some support if you feel unsafe. You are right, you can't do your work, if you are too worried about your safety (and don't silence that inner voice either!)
On the other hand, don't let this incident scare you away. Get pepper spray! and the support of another person in particular neighborhoods.
Take care!

laurie said...

oh lord that is scary. i'd never thought about that aspect of the job. is personal safety the biggest issue? or are there others? do you feel it's time for a change? because being a nurse, you will make a difference no matter which area of nursing you choose.

Catherine said...

This post really moved me - I work as a public health nurse in a geographical area of about 50 sq. miles with a pop. base of about 3,000. That's me alone with responsibility for the public health of the patients in my area - mostly older, chronic sick, terminal (with the hospice home care team nurses) and all under-fives and postnatal mothers. Sort of like the WHO concept of the Family Nurse. But the area you cover is incredible and the danger and risks are too much. Do you have protocols for joint visits in such dangerous dodgy areas? I had an attack on my car when I was in bathing a lady with a CVA and her husband was paranoid and threw paint over my windscreen - I was so scared as it hit me afterwards how unstable he was. But that and the odd dog preventing me exiting my car is the worst - never had a situation like yours. Your double shifts sound dangerous. Are you alone on your shift? Our hospice nurses work alone but don't do night duty in the district. There is a separate night nursing service (free) for terminal patients - they're called the Daffodil nurses as they are funded from the money raised each spring on Daffodil Day, one of Ireland's biggest fundraising activities.They can be up to 12 nights free with the patient at the end of life. It is a great service. We work very closely with them - sharing care of syringe drivers and visiting jointly when necessary.
Good luck and don't overdo it in future. Stay safe.