Giving Thanks

A few family members surveying the food before Thanksgiving dinner in 2015

Every year it gets harder to write about  why we should be grateful.  When I want to throw in the towel or worse; do something that will land me on an FBI watch list, I remember why I do what I do.

You are the reason.  Whether you are an administrator, biller, clinician or aide, you have the most important job in the world.  It is not always glamorous.  It certainly won’t afford you the luxury of driving a Lambo or make you famous so that you rise from the dust of an mundane life like a phoenix from the flames.  But, you are important in ways that cannot measured.

If you are a clinician and good at your job, you spend your days listening to elderly people complain about symptoms or walking at a painfully slow pace with a patient who had a knee replacement.  You try to remain calm as your aphasic patient tries to articulate something knowing that their frustration is ten times worse than your own.  You try not to notice the paint peeling from the wall or cracks in the vinyl sofa while you teach family members how to wash their hands.  You listen to your patient and between the garbled speech of the stroke victim and the repetitive stories of a elderly patient living alone, you learn stuff.  You empathize.  You don’t multi-task.  You are present.  And the patient gets better or dies peacefully in their homes surrounded by their family because that’s what they wanted.

If you are a biller or work with the billing department, you realize that mistakes can be lethal.  Not only do they hurt the agency financially but taking shortcuts can result in charges of fraud.  You work deliberately and do not bill without all the pieces and parts of a chart that must be present prior to dropping a claim.  You know you are protecting the field staff when you call them or send messages to complete their paperwork and realize that when you are met with resistance, you are the metaphorical dog getting kicked.  Still, you won’t let them do anything that will jeopardize themselves or the agency no matter how often you are kicked because nobody looks good in orange.  Most importantly, you know that the agency takes care of sick people in their homes surrounded by their family and that is a noble profession regardless of your role.

If you are a case manager, you know you see a bigger patient than the nurse focused on patients in the home.  You probably see the lab first and get orders while they are changing dressings.  You manage the care plan in such a way that everyone does their respective part.  You are a hybrid nanny/bodyguard to your team members and occasionally a drill sergeant.  You watch after your team and represent their position to the Directors and Administrators who may take issue with the team’s performance. You fight for the time and resources they need to take care of sick people in their homes surrounded by their family and that’s important.

The Administrators and Directors of good agencies work tirelessly to ensure that their staff has the tools to do their jobs well.  The best ones know how to listen because they know that the information required to make the best decisions come from the people working for them.  They give their employees ownership of their jobs and do not interfere unless it is necessary.  They understand what a healthy profit margin is and do not try to make money at the expense of patient care.  They know good money can be made when the agency provides excellent care to patients and excellent care is not cheap.  They pay their employees generously because they take care of sick people in their homes surrounded by their family and nothing is more important.

If the rest of the agency is performing well, there is no job easier than that of a marketer.  They understand that every business sells something and home health and hospice providers sell nursing care and therapy.  They know that ‘the numbers’ will speak for themselves and their job is to ensure that their star ratings and other published numbers are put in the position to be seen by referral sources.  They are proud to represent their nurses and therapists to physicians and they even more proud to be part of an organization that takes care of sick people in their homes surrounded by their family.

Someday it will be our parents needing care.  Later, it will be us.  So let’s hold the hands of our patients instead of grudges against stupid regulations.  Look closely and you can see the future in the eyes of patients looking to the past and in an instant, everything is put into perspective.  We can and will comply with all that Medicare is throwing our way so that we can get back to the business of taking care of sick people in their homes surrounded by family.

And for that, I am grateful.

What makes you grateful?  And since I shared a picture of my family above, send me a photo of your family’s celebration or that if your agency’s.