Caring Isn't for Sissies

Today we sat in a small room off the Social Work office at the Nursing Home where my mother now lives. In that room we listened as the Therapists, Nurse and Social Worker talked about the woman our mother is. The woman who asks us every day when she is going home. The woman who easily asks for help from the staff, who greets everyone in the hallways, day room or lobby with a smile. The woman who participates in activities and leaves them without hesitation when a friend stops by for a visit. The woman who will not return to her home.

At another meeting, this one at the hospital, I led the discussion of what to do with patients who have no resources. Patients who have no home. Patients who no longer require acute health care but to return to the street places a burden on our community resources. Resources that are already strained beyond capacity. For my staff, those who receive the calls, hear the pleas of the case workers who beg us to keep a patient just one more day, one more day to gain strength, one more day to find resources, one more day to not be on the street, the gap between what we can provide and what is needed widens daily and they carry that burden with them and try to explain it.

We have this discussion regularly but today, in this economy with winter approaching, the reality of having to say no, of sending patients with health care needs out of the warmth of our hospital to stand in line at the soup kitchen, to sleep on a mattress on the floor of a shelter, to have their health care needs met at the Homeless Health Clinic, this reality hit my staff hard. It sat on their shoulders and weighed them down and they turned to me and asked what they are supposed to do. What we are supposed to do. What our community is supposed to do. The question is so much bigger than us.

Today I faced my mother who cannot go home and patients who have no home to go to and I was struck by the compassion and depth of caring people in healthcare have. The looks on the faces of the Nursing Home staff as they gently guided us to the realization that we were right, my mother will live the rest of her life in the Nursing Home, matched the looks on the faces of my staff as they accepted the fact that we have no alternative but to send patients who no longer need our level of care back to very difficult lives that rely on soup kitchens and shelters.

What we have to do is not always what we want to do and we may not have the capacity to change that. What we can change is how we do it, how we treat the people who need us, the people we care for. Whether we care for them personally or professionally, what matters is that first and foremost...we care.