Nancy's Story

I have been working with PCI for over ten years.  What started as a one-day per week position is now my full-time work.  I had been in private practice for over 25 years and generally loved my work, but found the paperwork and insurance requisites to be ever more onerous. I was surprised to learn how much I really enjoyed this work.  I love working with the elderly, the disenfranchised, and the dying.  I have found the residents, whether long term or there for short term rehab to be a challenging and very satisfying population to work with.  Never a dull moment!!  Each day is different and brings new situations for me to think through.  The elderly are as diverse as any group...kind, compassionate, angry, bright, ornery, often unfiltered, and most often appreciative of the attention and thoughtfulness given to them. 

There are a number of practical reasons for working with PCI which are also very appealing for me. The staff are competent, prompt in dealing with any issues I might have, and have been helpful and respectful to me.  I have especially appreciated their patience in helping me to learn how to use the electronic record.  I love being my "own boss."  I work the days I want and am free to take vacation when I want.  I know that my residents have others on the nursing home staff to care for them, so when I am gone, I feel that they have others involved in their lives on a daily basis.  They are safe.  I love working week day hours only.  I never enjoyed working evenings and weekends, and so this position affords me the opportunity to have this time available to be with my family.   For those who have children at home, it could easily be worked out to be home when they arrive home from school.  Because I am a consultant, I don't get caught up in the politics that inevitably arise in any workplace.  On the other hand, because I have been in my 2 nursing homes for many years, I know the staff and have an excellent collaborative relationship with them.  I enjoy working with the aides, nurses, rehab staff, the medical director, and  other personnel.  We are all part of the team.  Their input helps to broaden my perspective.  One of the things that was frustrating for me about private practice was the issue of people needing to cancel at the last  moment.  This sometimes left me in a position of open time slots where I had hoped to be working with someone. I have found in the nursing home setting that if someone has gone to the hospital or out for a doctor's appointment, that I am able to continue with my day and likely see that person later or fill that time slot with another resident.  My income is much more stable than when I was in private practice.  While my hourly rate is lower than I had received in private practice, I am  able to compensate for this by having residents available with only a few minutes in between appointments and virtually no cancellations.  I feel like the opportunity to build a solid group of residents to see is within my own hands.  By building strong collegial relationships with the nursing home staff, I have a steady stream of referrals from many different sources.  Because we work at the same facility, we have the ability to communicate on a frequent and easy basis regarding the expectations and progress occurring for the resident.  No need to set up a time to discuss a patient.    We see each other regularly throughout the day.  For me personally, what makes me feel good about my work is knowing that what I give makes a difference in someone's life.  There isn't a day that goes by, where I don't receive a warm welcome, words of appreciation, and reciprocal concern from many of the residents. It's a challenge to work with people who are skeptical about what you do and how you might be helpful.  They are not crazy and certainly don't need a shrink!!  I have been fired a few times minutes after I have entered a room.  (A new experience for me, and quite an interesting time for reflection.)  It has taught me to honor their needs, not take things so personally, and to work at trying to help them see beyond their fears.   Working with residents in a nursing home is quite different from working in private practice.  First of all, there is NO privacy.  You may be talking with someone, and there is a bedridden resident in the next bed who may join in on your conversation.  A nurse may come in needing to give medications, and someone else may need to empty the wastebasket.  At first this was very unsettling to me.  I have since learned to incorporate these interruptions into our appointment with the obvious exception of a resident sharing an emotional and sensitive topic.  The resident knows these individuals very well and in many ways they have come to accept living in this fishbowl.  Another big difference can be the lack of specific goals to reach.  In private practice, with a younger population, it was much easier to define one or more  goals,...overcoming panic attacks, dealing with a marital issue, making a decision about one's work, etc.  In the nursing home, you are helping individuals with other issues, such as:  death of spouse, not being able to drive anymore, amputations, loss of home and independence, learning they will be living in a nursing home the rest of their lives, family dynamics, no visitors, loneliness, severe, life altering health issues,  confusion and dementia.  If it all sounds like doom and gloom, please remember that the human spirit lives on and there is courage present every day for many of them.  I learn something everyday about how I would like to be in my older years.  As I near my own retirement, I am strongly considering the option of continuing to work for 2 days instead of 4.  I realize that this flexibility provides me with several different choices, depending upon my circumstances.  I don't have to go from full time to no work if I don't want to.