Monday, May 04, 2015

Some Ponderings

100 More Aprons?

Awhile ago I ran out of disposable one time use aprons for my foot care job I have been doing for over a year, extremely part-time. I wondered if I should order any more. Proper nursing standards would indicate you should have a fresh one for each client. I had ordered them more than a year ago online from a place that sold them for food industry purposes and they weren't individually packed like the ones I had split with the two other nurses who were doing the course of studies with me back in the summer of 2013. I think there were probably a hundred of them, but I couldn't be sure, as I had never counted them. So when they were all gone I wondered if that meant I had done over one hundred visits.

I really didn't want to order any more somehow. Maybe it was realizing how little I had made there in black and white on my T4 and how much energy I had poured into the job. It could have been the fact I was paying half what I made on gas and other car expenses, and spending twice what I made in tools and supplies, or so it seemed. There was so much prep time preparing documents and tools, phoning clients, rescheduling appointments, and then there was the half hour or more it took to clean your tools at the end of the day, all that travel time, the extra documentation you did at home for no pay, the insurance you had to fork out due to the high risk of something going terribly wrong. The inconvenient truth was I could make twice as much with my other home care job for six hour shift that involved far less driving and ended when the visit was over and you signed off on your phone, instead of so much later in the day. One day seeing three clients in one day as well as attending a CPR class kept me busy until
11 pm before all the work was done.  Far more than I would like I have had to decline last minute shift opportunities for my other job in order to keep my foot care appointments I was committed to completing.

 Foot care in the home is not a very profitable business, for any one, and you have to be willing to take a loss in order to build up any kind of business. Unfortunately it felt like I was taking the brunt of the losses while my company struggled to collect the bills and clients came and went. Sometimes I have had to wrestle for over an hour to get a client's neglected feet into some semblance of proper order. At times I haven't known if my clients even have a firm grasp on their personal history, let alone their health conditions. Sometimes as I am wearing my mask, knowing they probably can't hear a word I am saying, struggling to give them some advice about caring for their feet they can't even manage to rub cream on by themselves any more, I wonder if I am really helping them as much as I would like to. Somehow the sensation test seems a little pointless when you are not sure they even understand your instructions.  And there are the feet that haunt you a little, because you know something is a little off, but you can't diagnose what exactly is wrong... As a nurse it is not really your job to diagnose, but when should you tell them to see a doctor?

 So I had kind of decided to quit. I could get into something like palliative care or some other area. Some other nurse could take over my clients. Then a nagging thought came to me that there were very few nurses who were sticking with this rather demanding, financially unrewarding work. Sure I did joke with one client I should be paying him as he patiently showed me some helpful tips for dealing with his chronic ingrown toenail. But I felt a little taken advantage of, a lowly foot care nurse, making a different rate than the other nurses, and seeing my bank account slowly descend rather than grow.

But a couple of days I ago I had a realization. I actually would do this job without any remuneration. Please don't tell my company. I love it! I love the clients I have gradually gotten to know, being a visitor in their homes whether in a cluttered dingy place smelling of cigarette smoke or a beautiful well appointed apartment.  I even love the satisfaction of cutting really really long toenails and realizing you have just made a difference to your client's mobility and health. Some of my clients have been palliative; I get to care for their feet and maybe help a little by my kindness as they are facing death. I have grown so much in my confidence that I no longer even dread the first visit, the unknowns of what I will face. One client in
Oakville I often complained lived too far away for me to be earning anything at all with the one hour visit, I miss the most, and wonder whether she is okay after her fall. I know many of my clients have few other options when they are housebound, rejected by other companies due to liability issues since they are diabetic or on blood thinners, and completely unable to care for their own feet any longer, ashamed at how long their toe nails have grown.

Yesterday, I came to a definite decision and emailed the person who had hired me that I had decided to stay. That I would make a complete reversal within the same day and today be ready to write my resignation letter is another story. Thankfully a very capable administrator talked me down and made a couple of important phone calls to clarify some issues that had made continuing seem an utter impossibility. In this season of my life, it may be time to order another hundred aprons.

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