Healthcare is more than just needles and vitals. A long time ago, I remember my first day at the clinic. I was speaking with the front desk manager, and she asked me: “Do you have thick skin?”
I had just finished a 15 year stint at Chase Bank. I assumed she meant unruly and angry customers, only in this case, patients. I had indeed gotten used to angry customers at good old Chase. You can usually tell you might have a ticking time-bomb on your hands as soon as one of these types of customers hit the front door. I became very skilled at calming them down; it’s a trait I have carried over into healthcare. Patients can be nervous or angry. I’m good, most of the time, at alleviating some of these feelings.
I have come to realize she was talking about something else. Yes, you do have to be thick-skinned, as patients are not always in the best of moods when they come to a medical clinic. That’s why they’re at a medical clinic. I’m talking about a suit of armor you must wear, maintain, and strengthen.
It’s a suit of healthcare armor that every practitioner must wear. In fact, there are two layers to it. The first layer is the blood armor. The second layer, the harder one to develop, is the emotional armor.
It’s something that they can’t really teach you in school. In our first quarter, the instructor pulled no punches when he showed us images of what we might see. And the endless education about the tragic things that can go wrong with the human body; that gives you just a slight idea of what you might see. Healthcare is not for the squeamish.
To be honest, this has never been a problem for me, blood and guts. I don’t like seeing people suffering, but gore does not bother me. It’s disgusting and unfortunate that this has become a genre in the entertainment industry, torture porn. Eli Roth can go screw himself. But in reality, in my clinic, blood and gore occurs frequently. It’s never bothered me. I remember walking into an exam room after the provider I usually work with, Susan, texted me that she needed help with a punch biopsy. I walked into the room. Apparently, the area she was working with was more infected than expected. There was a large pool of blood on the floor. Huh, I said. Dr., you’ve got the patient’s DNA all over the floor. What can I help with?
My station is right next to the lab. More that once, I have had to run over and help our lab technician, a big, good-natured fellow who works in tight quarters, help a patient to the floor after they have passed out during a blood draw. He’s very skilled at helping people lie down in a cramped area, while I grab a pillow and a blood pressure cuff. And some apple juice. Afterwards, when the patient comes to, they are usually embarrassed. I’ve written about this before. We don’t judge you for that. Metal is going into your body, and you see your blood coming out. Perfectly natural, the fight or flight reflex.
We call this vasovagal syncope; fainting at the sight of blood. It’s actually somewhat common. People hate needles. I’ve written about this as well. Perfectly natural. You will never be shamed or judged by a healthcare worker. If you feel you are, advocate for yourself, and let the clinic know.
The stronger, more important armor to develop, the thick-skin the front desk manager was referring to on day one, is the emotional armor. It is imperative in healthcare that this armor be strong. But all of us realize that we are human beings. We have emotions, and you have to feel them. Like I said, I’m still a bit of a rookie, and my emotional armor is still developing. It gets stronger every day. Last week it became even stronger.
They cannot really teach you about this in school, either, even more so. But the fact is, if you are going to work in healthcare, your emotions will be tested.
The other day, Susan had a patient who was a recent stroke survivor. As in, very recently. His friend and neighbor, Gary, had found him unconscious on his apartment floor. This patient had spent a month in the hospital, and a month in rehabilitation. In fact, he had not been home yet. Gary, at the advice of the facility, which he had left just hours beforehand, had brought him straight to a doctor. This patient had no primary physician. This patient had no one really, just his friend Gary.
Of course, it reminded me of father. My father passed away last February, just two weeks shy of birthday number 93. He had had two strokes in the last two weeks. In a way, my father was lucky, though I still miss him greatly, every day. My father was surrounded by good medical care, his wife of over 60 years, and his family. He did not suffer long. He died peacefully, in his sleep, and stepped into whatever comes next.
But this patient had no one, except for his friend Gary. He had no next of kin; indeed, he had no close family. No other close friends. He was old, but getting along fine. Gary wheeled him into the exam room. During my rooming process, I asked Gary, as the patient was having difficulty speaking, how long he had used the wheelchair. Gary told me he was walking the day before the stroke. It was clear, as I took his vitals, that this patient had suffered badly.
After Susan had spent some time with him, we were wrapping up the visit, going over the next steps for him. Susan remarked how sad it was that this man was nearly alone, except for Gary. It had been a stressful day (not all of them are in healthcare, honestly), and I began to well up. Susan knew I had lost my father a few months ago. She apologized as I excused myself.
It was heartbreaking. To have this man go down so quickly, and so nearly alone. He had been walking two months ago. He did not have the care or the support my father had. It seemed cruel. Whatever your beliefs, God may be merciful, but Mother Nature is not.
I was cleaning up the exam room after the visit. Susan came in to talk to me, to see how I was doing. I tried to explain how sad that was, through a broken voice. Susan said that we are all human. She told me that I am still new, and that this is part of my education process. And she mentioned the cliché that happens to be very true: it never gets any easier. Your armor just gets stronger.
We’ve all seen interviews with the burned out nurses and MD’s, after working 4 or 5 days straight in the Covid ward. They are broken. Our armor is strong, but the hardships of life we encounter can be stronger. We are only human.
To a degree, you have to laugh about it, as a means of coping. We never mock a patient, but we do have to make each other laugh. I told Susan that if this were TV, we’d be sitting out on the loading dock, chain smoking, tears running down my face as Susan, with the thousand-yard stare, said: “I remember when I lost my first patient. It never gets any easier. Hang in there, rookie.” Of course, using her best Sam Elliot voice.
That’s my biggest challenge, going forward. Not a technical skill, not a memorization of what type of needle you use for what, but my emotional armor. I knew things like this would happen. You’re just never ready for it when you start.
The next day, Gary called us to let us know that the patient had died overnight, in his sleep.
“Patience is not the ability to wait, but the ability to keep a good attitude while waiting.”- Anonymous
Well, I THOUGHT I was in the final stretch of my preparation for employment as a Medical Assistant, but there is one more hurdle to jump through, one that I did not adequately see coming.
I have completed all of my academic requirements, with pretty darned good grades. I successfully completed my externship. I passed the National Healthcareer Association’s federal exam. I have been granted the certification of Certified Clinical Medical Assistant.
However, the merciless machine of political bureaucracy, that impacts us all on some level, is the last flaming hoop I have to jump through. And it’s being mighty obstinate.
Every healthcare practitioner in Washington State, from CNA up to MD, needs to be granted a license to practice medicine from the Department of Health, after they have completed their training. Fair enough. I suppose it’s a good thing that the government checks you out before you start treating people. However, Olympia does like to license things. I think we need a license to flush our toilets now. But I digress…
I finished all of my academic requirements, and was granted my credential, in the last week of December, 2020. I filled out the application and sent it off, with a money order for a paltry $145, on December 2nd. I paid for the application to arrive in Olympia on January 4th. My instructor had advised me to send it certified mail. Now, I hate to knock an agency that’s trying it’s best, and has been under political attack for some time now, but I’m not entirely certain that the USPS has their heart in it. I don’t know, maybe book a Tony Robbins seminar with the New York Jets or something.
My application arrived on January 6th. Good golly, Miss Molly. Olympia is about an hour drive from Seattle. If I had known that this was going to be the case, I would have just driven the application down myself. Scenic drive, too, once you get to the Nisqually Delta.
I called the Department of Health later that week, to see if they had gotten the application. They couldn’t find it. Well, alright! Things are going great!
Well, the wheels spun for a little bit, and I called Olympia on January 22nd. Bear in mind, I knew that the licensing was going to be a requirement, but I had figured about a week, at most. Wha-wha! Anyway, the courteous representative I spoke with said that they indeed had received my application, but had only started work on it 2 days earlier.
The representative told me that they were running very far behind, and that it will take some time. I asked him if it would take longer than 2 or 3 weeks. He did not hesitate when he said: Definitely.
I call the DOH every now and then, just to make sure everything is still going okay. The assure me that it is, but it will still be awhile. Every representative I’ve talked to has been extremely courteous and friendly. I guess you can afford to be when hold the power. The big smile says: “You have to wait, jackass! Anything else I can help you with? My pleasure!”
I know the Department of Health is busy. I know they are behind. Covid, you know. That virus, I tell you… Handy excuse for delays. Can’t put a man on Mars yet? Covid.
I suppose, also, that because of the need for healthcare workers (Covid), that there may be quite a few former healthcare veterans who are reentering the field. But really, you would think that the DOH might expedite things a bit for people getting healthcare licenses. Because, you know, Covid.
The DOH, of course, needs to do a criminal background check. That makes sense. But I can’t possibly imagine what else they are investigating about me. My grooming habits? My shoe size? Whether or not I remember cursive and how to hook up a dial-up modem? (Yes on both.) Whether or not I remember to put my pants on everyday? (Most, days, yes.) Are they going to call my Mom or something?
So I sit and wait. The school did warn us that this would happen, but I wish there had been some way to engineer things a little more expeditiously. I had assumed I would be working by about mid-January. That hope collapsed like a Seahaws offensive line, and Russell Wilson is lying dead on the ground.
Even though there is a high demand right now, it’s tough for a new Medical Assistant to find work. Naturally, clinics and facilities prefer experienced people. I’ve had a few interviews, and things went well, but they always ask when I think I’ll get my license. It’s not like they can put a position on hold while they wait for the DOH to press the right buttons. Healthcare needs help now.
But, everything happens for a reason. So they say. I’m not sure I believe that, but, as it turns out, this might not be entirely bad timing.
As it turns out, I could use the time off right now.
It’s no secret, and I’m not ashamed to say it: I have an anxiety disorder. Anatomy and physiology fascinated me in school, and I’ll write a post soon on what goes on in an anxious person’s head.
Over the last month or so, I’ve had several stressors develop. One is being unemployed, and living on my dwindling savings. Another is the licensing process itself. An anxious mind tends to do what’s called catastrophising, playing out, repeatedly, the worst case scenario. I got anxious with the DOH and their delay. What if they find something? What if I filled something out wrong? What if they tell me that I belong in healthcare as much as that loony lady from Georgia belongs in Congress? What if I can’t perform as an MA once I do get a job? My externship was fascinating, but not without its problems. That’s for another post, as well.
The main stressor is my father. He is 92, and has had several strokes recently. My family found out recently that he has weeks, 2 months at most, left to live.
I tell you, there’s a lot of work that needs to be put in when someone is checking out. Calling extended family members, contacting various agencies, that sort of thing. In the meantime, you still have to find a way to experience grief.
I could feel the spiral happening again, and for the first time in a long time, I experienced a panic attack. It’s a horrible sensation. I wouldn’t wish it on anyone. The brain is like any other organ in the human body; sometimes things can go wrong with it.
But, I have a very skilled psychiatrist, Dr. Dispensapill. With a small tweak of my medications, the anxiety has largely abated. It will still be present, along with periods of depression. These are normal as you watch your father die. But there is a difference between situational anxiety and depression and clinical anxiety and depression. With some good therapy, the anxiety has lowered dramatically, and I have had no further panic attacks.
And so, life goes on. It’s really not such a bad thing that I have this time off.
I’ve been going over the healthcare basics again. It’s surprising what I’ve committed to memory, what now comes naturally without having to think about it.
I bought one of those dummy arms so that I could practice my phlebotomy. My brother Pedro says he’s willing to be my human test arm. Er……
I’ve done a ton of writing and research, and will have plenty more posts coming.
And I’ve done that usual trick people do when facing the loss of a loved one: I have cleaned the HELL out of this apartment!
My head is getting screwed back on, and I’m feeling better. But I have grief to come. It’s good then, to have a little time off.
Make every moment count. Don’t be afraid to tell someone you love them. Wash your hands!