I found out Monday morning that my hand surgeons were going on a medical mission. This month. And it is my job to cancel and shift clinics and OR schedules. Leaving over 20 people who thought they were going to be seen for their hand pain left back in limbo. And another four people who thought they were going to have surgery, now back on the waitlist.
Most were annoyed, but patient with me. A few were angry, and I let them blow off steam at me, as I validated their frustration. Some told me they were going to report this, which I agreed was appropriate.
This is all made worse by the fact that with the holidays, we had even fewer clinics and OR days. And referrals for care in the community - outside the VA system, is very regulated and there is a big backlog. Some of the regulations were eased during the worst of Covid, but were re-instated and re-enforced in the past few months. So, to get their care covered by non-VA providers, they have to be pre-authorized to have it paid for.
Of course, a lot of people don't have insurance, or it's expensive, or will leave them with a massive bill, and insurance loves to disallow paying if they can. ACA has improved care for a lot of people, but it's still part of an insurance system that is out to make money, not provide care. And this is for those who don't have access to the VA at all.
When we got back from Gulf War I, we were covered as Vets while we were still in the national guard. Since I had no other access to medical care, and barely enough income to cover rent and ramen, that's where I went. Walked in, took a number, and waited. It always took at least 4 hours no matter how early I got there. About 2 hours to be seen, and another 2 to get a Rx or tests. Antibiotics for URIs & UTIs, steroids and an MRI for my sinuses, a lump taken off my shoulder, I paid in time that I had rather than money that I didn't. I was grateful as hell, even knowing it was not exactly ideal.
So yesterday, in the midst of a busy hand clinic, with a computer access issue that meant our MDs didn't have access to charts and x-rays, and we got behind 60-90 minutes, and two or three patients who lost their shit at us because they didn't get what they wanted, my old hand surgeon came in after the OR was done, rubbed my shoulders and apologized for the mess he had me clean up.
Well, cleaning up after surgeons has been my job for over 25 years now, so, here I am. This is what I'm paid to do. Best do it cheerfully. I managed, I dealt with the minority of crabby and mentally ill vets, I deescalated and sorted and worked the problems until it was all done. And even working 40 hours a week at this, I'm not in pain as I was working 30 hours a week in the OR. This is my last hard climb to a decent retirement.
I can do this. I can.
Dylan had a procedure this week, and got his booster, so he's feeling more than a little ragged. I got to see him a bit disinhibited with drugs, so that's my consolation prize for being his nurse as well. I'm still not getting much energy improvement from the vitamin D supplement, but that can take several months to be noticeable.
Later this weekend, I'll write about the cats and the compost and some new tea.
4 comments:
"I paid in time that I had rather than money that I didn't."
Thank you for verbalizing so well my current life situation.
Each time you write about your experiences in your new job, I remember with gratitude the nurses and VA staff who gave my R the support he needed in the last months of his life in a VA hospital. It does my heart good to know you are there doing what needs to be done, doing all you can do, all that you do so well.
am,
This is absolutely the best bunch of nurses, PAs and NPs I've ever had the honor to work with. And it's because of people like you, and your dear R, that we try so hard in a broken system. We wish it weren't so broken, and we are trying to make it better. But it's like paddling from the front of the canoe, while the one in back flails instead of steering.
Good to get an apology...and I bet the shoulder rub was needed.
gz,
He's very good at the shoulder rubs, and one of the very few surgeons I would accept this from. He has Good Touch. He's also the one who fixed my broken wrist, so we have a strange sort of bond.
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