Change

The glossy sheen of adventure has worn away, the warmth of friendship is tainted by a quickly approaching end. The comforts of home are washed away as an inevitable change floats in the air and settles into what was familiar and makes it foreign. But still I linger. How much longer will my world pause in this dusk. Like one who is sick and dying and wishes for an end of suffering, I wait for the sun to set on the life I've had here.

Repetition

Oh what insanity. Painting a picture with every detail starting at the farthest reaches and crawling slowly to the surface. Only to start over again.
Week after week, like a play. Every prop built and put into place, every actor and actress devoutly performing their roll to the point of exhaustion. Only to perform once again.
Every meticulous detail stroked on with a brush, every emotion displayed on their faces. Artist in their own way but never acknowledging their roll. So wrapped up in a painting it has become their world. So caught up in their part, it has become their lives. Only to start from the beginning once again.
Maybe the pleasure of their audience is what drives them. Maybe love of  their art. The accomplishment of a beautiful painting or to bring people into a world they couldn't imagine.
But if accomplishment is their goal why have they not accomplished and moved on? What drives them to continue in the same manner when the tides have washed away what they have spent so much time on? Why strive to chase the sun until it is gone from view, day after day?
They run in circles but all they see is a straight line. Have they not noticed the repetition of scenery or the path they've worn in the ground?

Coworker

I look in her eyes and I know. She is reveling in it. The smallest detail like fluency in only one language, paperwork done different (in her opinion wrongly), even unfamiliarity of the area. Sometimes I despise her for it. For her condescending questions and stares of disbelief. Other times I despise myself when reality crashes in on all four sides and I have to listen to the humiliating taunt and know that she is right. And then there are moments like these. Moments when I am thinking the clearest of all. No emotions of anger, shame, embarrassment, despair, flooding my mind. I look at her and I know I am right. I see her ignorance behind her mask of superiority that so thinly covers her. How has she fooled so many? Am I the only one who knows? Ask her and you’ll see. Ask her and you’ll find any intelligent answer is quickly deflected into questions of disbelief of your own ignorance. Watch as her sword immediately comes up and lashes out at you to protect the weak foundation of knowledge that has long since been dated. Then as you withdraw don’t take your eyes off her. From lowered head, peer out the side of half closed eyes and see the sparkle of satisfaction shine in her eyes. Is this what she lives for? What a sad hollow existence. The happiness in her life has been so easily discovered and can so easily be controlled by me. Someone who is supposed to inferior in knowledge and wisdom by lack of age and experience. She may find joy in the battles she has one. Of making me the fool. But now I control her fate. She will win only the battles I allow her to. And I guarantee you. She will not win the war.

Therapy

The other day someone asked me why I said I was not a fan of being a therapist and I was actually stumped. I couldn’t remember why, only that I wasn’t. So I was thinking about it and trying to decide if it was just because I am lazy or if it was actually the job and this is the explanation I came up with.

In the therapy world, nursing home jobs are normally the easiest to get and also somewhat higher paid. The reason for this is how overworked the therapists are. On my first day of work as a therapist I treated 9 patients. I was given a brief tour and then asked to start treating. No observation period or on the job training. In a nursing home they ask for a certain productivity from their therapists. The nursing home I was working at asked for at least 88% productivity. That means 88% of your time has to be spent in direct patient care which doesn’t count paperwork.

Every morning I would get to work and the first thing I would do would be to make my schedule which is a nightmare in itself. You have to plan out who you will see at what time without overlapping with the times physical and speech therapies are going to see them. You also have to work around doctors appointments, care plan meetings, and the patient’s preferences. Some patients with only give you and the other therapies about a two hour window that they will allow you to see them and then they will complain about having one therapy session after the other. Occupational therapist have a huge emphasis on ADL goals in the nursing home. ADLs are pretty much the basic things people due on a daily basis to survive like get out of bed, bath, brush hair and teeth, and get dressed. The only time you can work on these goals is in the morning. If you have a caseload of 7-9 patients the chances are that more than half of them will have ADL goals. With treatment session being from roughly 45-75 minutes long it is impossible to see more than a couple of people before breakfast. And even for that you have to start pretty early in the day which most patients will hate and grumble and possible refuse. And then you have a schedule that actually works and you approach a patient about an already agreed upon time and they will refuse and you have to change your entire schedule for the day. If a patient refuses you can’t just say oh well either. You have to approach them at least three time and document the exact time of each approach and why the patient refused.

I was normally scheduled for 7 hours and 15 minutes of treatment time. That leaves 45 minutes to do paperwork, go from one patient to the other because you document to the exact minute (take 5 minutes to walk from one floor to the other and you’re screwed), clean equipment between patients, answer call lights, stop to help that person who is standing up in their room even though they are not supposed to put weight on their leg and are a huge fall risk but are not cognitively with it enough to stay sitting for more than 20 minutes and will fall and possible die or break a bone and go to the hospital where their physical status will slowly decline while they lay in a hospital bed getting too weak to even roll from one side to the other without help until they die but no CNA would stop to help them get that thing that was just out of reach or help them to the bathroom after they have been waiting an hour even though that is their job, help that sweet little old lady out who said “It will just take a minute”, and so forth. If you can’t tell it is impossible but you are not allowed to work longer than 8 hours because they don’t want to pay you for the overtime.

And then you spend the majority of your treatment time in the bathroom wiping people’s butts because you have to pick your battles and if wiping their butt means they will stay standing for 5 minutes to accomplish a standing endurance goal without knowing it while you are meticulously trying to draw out wiping someone for as long as possible. Or you are treating that patient with diarrhea so bad that every time they stand up they have an explosion in their pant but their family doesn’t care enough about them to bring them a new pair so they are stuck in their room for weeks because all they have to where is a backless hospital gown and you can’t go to breakfast in the dining room half naked.

And of course no matter how hard you try the patients don’t like therapy. Before every treatment session you have to mentally prepare yourself for a fight that may come in the form of manipulation by them always complaining of excessive pain, tiredness, headaches, nausea, and such even though you saw get up and walk around right before you came in the door. Some patients are hitters. This is more rare but it’s a good idea to always be on guard. Some will make inappropriate comments to you. Some will tell you to f*** off and how sh**-y you are and right where you can go. I had one patient turn to me and look me right in the eyes after calling me several names and say, “It must be really hard having everyone not like you.” I had trouble not laughing right then. It still makes me smile because you know what, sometimes it is hard having everyone not like you. This patient had a talent for hitting the soft spot of her physical therapist who could normally handle herself through all kinds of verbal abuse and sending her from the room crying. Sometimes the worst patients are the ones who really try but don’t have enough money to stay or a good place to go afterward so you know they are just going to go home and fall and come back anyway.

And then the lovely healthcare system that we have will somehow make sense of putting someone who is on hospice (which means they are dying) on therapy and you will have to spend an hour with a person who should be spending their last several days doing whatever they want making them do the last thing they feel like or are able to do which is exercise. And if you have ever tried to make a dying person exercise, it’s not easy. Half the time is spent keeping them awake and it’s normally a losing battle. And then you find out what a horrible person you are because you literally are wishing they would die because spending an hour with them is physically, emotionally, and mentally exhausting. And I have had patients die that were on my caseload. To be 100% honest I was always relieved at first. After a little I would go from being relieved to being excited that I got to go home a little earlier.

And if you even dare to ask a nurse a question they will simply glare at you, give you a sarcastic response, or get all defensive and tell you they are too busy. Also you have to go to care plan meetings which are supposed to involve the patient, the patient’s family, a social worker and every therapist treating the patient. The purpose of these meetings are to educate the family on what therapy has been working on and how to prepare for the patient’s return to home or recommend more help if needed. It gives each discipline of therapy a chance to explain the purpose for the exercises and activities and the family member a chance to ask questions directly to them. Occasionally if an impossible scheduling conflict came up (like you only work from 6 to 11 and the meeting is scheduled for 2) then you can have someone else report for you. Ideally this would be someone from the same discipline who has worked with the patient before. As a new grad I have had to go to care plan meetings where I am the only therapist and I have to report on physical and speech therapy as well as occupational for reasons as poor as them not wanting to rearrange an already printed out schedule.

And then there is the paperwork where you have to justify to an insurance company why therapy is helping them when you don’t even believe it just so they can bill the already financially struggling patients.

Love

Maybe it's just because it was just February :)
     Sunday the 16th, which was two Sundays ago, my Mom and I drove to church together.  Dad had left earlier to go to the jail and Ryan and Steven had stayed the night with Tyler.  We left early so that I could go to the prayer meeting the young group has been having before church to pray for our church and so Mom could drop off some church clothes for Ryan and Steven.  I started talking about the attempts we made to have coffee at the prayer meeting and Mom started getting quiet.  I knew this meant that she was probably thinking of some church issue that she was disagreeing with and less about what I was saying.  So since my topic of conversation wasn't that interesting I asked her what was on her mind.  She starts talking about how you have to be careful about doing showy thing like praying out loud in a group and how we all want to look good.  I wasn't expecting this.  Even though we mess up sometime I truly believe that every heart in the young group is sincerely trying to follow God.  And as far as personally I do not enjoy praying out loud in a group.  It makes me nervous and I have to remind myself that I am talking with God and not to the people in my group.
     To me it felt as if this was another good thing that I was taking joy and all Mom could do was see how it could go wrong.  I felt as if there was nothing I could do that would simply be pleasing to her.  I got angry at her and said some things I shouldn't have said.
     I barely made myself go down to the prayer meeting.  I felt defeated.  I was ashamed of myself for the way I had acted and disheartened by the way I felt I could not live up to my Mom's expectations.  I was broken and left unsure of what to do.
     I went up to first service.  Craig gave the sermon.  Toward the beginning of it he tells a story about one of the students he has been helping (he is a counselor at a school).  She is a Christian.  She came to Craig telling him about how she had an argument with her Mom that had really brought her down.  She didn't understand why.  Craig asked if she has been reading her Bible lately and she said that it had been a couple months.  He told her that it could be God's way of trying to get her to turn back toward him.  I haven't been vary consistent with my devotions either.  So I was like, Ok God, you are obviously talking to me.  I am down and insecure and ready to listen.  The foundation of hollow securities and misplaced trust had been swept from beneath my feet.
     Then Craig opens up to 1 Corinthians 13.  I have always only half read this chapter the times it has come up, writing it off for romantics or married people.  But God was talking to me.  As the chapter describes how selfless love is I realized that my love for Mom was completely selfish.  I had not been long suffering.  I had behaved myself unseemly, I was seeking my own.
     I used to walk down the halls at ICC and feel an overwhelming love for each and every person I passed.  I knew that's the person I wanted to be so I have been trying to do caring acts and kind gestures but it's all felt so hollow.  I prayed God would make me that person again but I couldn't figure out what was missing.  Verses 4-7 are all about how you can have great gifts or do kind things, but without love you are nothing and it will profit you nothing.
     So once again I think God is calling me to love.

Gabriel

     I can not believe that I haven't posted about this yet.  It's one of my favorite stories to tell.
     On October 18, 2009 we got a distressing phone call.  The Reinhards were in a serious motor cycle accident.  Our family started to gather at grandma's house.  The adults stayed upstairs praying and hoovering over the phone.  Us younger ones went into grandmas basement and talked and prayed.  Slowly, phone call by phone call,  we got more information in.  We figured out who was on the motor cycle.  It was Tim, Sarah, and Gabriel.  Next call:  Tim was out of danger with some bad road rash.  Next call:  Sarah was out of danger but had really serious knee damage.  Then we got the call that Gabriel was in really bad shape.  Praying, crying, hoping, fearing...  Then we got the call that we were all dreading.  Our loving, sweet, adorable, 5 year old cousin/nephew, Grabriel Reinhard, had passed.

     It was as if I could feel God's arms around me before I could even start crying.  I felt more comforted and peaceful at that moment than I ever had or have since.  We all grieved and I still think of what he would have been like if he was older.  But I guess I am just so thankful for having what time I did have with him.  And now I look back on that day, a day that should be seen as a dark and terrible day, with joy and exaltation.  God spoke to me in something more powerful than words.  I know He has Gabriel up in heaven with Him.  And I know that the next time I have to go through something like that, He will be right there, holding me and comforting me.  And that gives me an indescribable peace and comfort.  I can do all things through Christ who strengthens me.  I can bear any grief or loss because Christ will comfort me.  I can fight any fight because Christ will always lead.  I can take any twist in life because God has a plan.  

     "I can do all things through Christ which strengtheneth me."  Philippians 4: 13

     "The Lord is my Light and my Salvation, who shall I fear?  The Lord is the Strength of my life, Of whom shall I be afraid?"  Psalms 27: 1

     "For I know the Thoughts I have toward you, sayeth the Lord, Thoughts of Peace, and not of evil, to give you and expected end."  Jeremiah 29: 11

     "My brethren, count it all joy when ye fall into divers temptation, knowing this,  that the trying of your faith worketh patience.  But let patience have her perfect work that ye may be perfect and entire, wanting nothing."  James 1: 2-4

More About Colorado

     So here is the list of people going:  Abby Moser and her friend,  Clair Isaia, Bethany Reinhard, Janelle Grassi, possibly Jessica Sauder, and me.  If all goes well we will leave Tuesday night.  June is getting really busy though so it's hard to find a good time for everyone.
     On a different note I have decided to continue memorizing in James.  I have all of James 1 down and I am starting in James 2.  Communion is coming up.  It's something that I only like to face once a year.  It makes me feel so guilty to think of Jesus's sacrifice for me but I really should remember and be thankful for it all year round.  The young group has been praying for communion.  That we all will soberly remember what Jesus did for us and be thankful.  Also the young group committee will hopefully have a prayer meeting before church.  I love those prayers.  It has been such a blessing.