Head Banging and Health Care

This past May I quit my clinic job where I had worked for 16 years. It was a community health clinic that I had loved for 14.5 of the 16 years. The last 1.5 years of it were a downward spiral of administrative dysfunction leading to moral distress and burnout for me. Towards the end I felt as if I had a bad case of autism and was banging my head against a wall, the wall being an unresponsive, uncaring safety net system. I had the luxury of being able to afford to quit. I don’t miss the clinic, and I am unsure if I will ever work as a clinician in our health care system again. This is after almost thirty years of continuous work as a family nurse practitioner in various safety net community clinics across the US. I love patient care and do miss that.

I was reminded of the head banging metaphor this morning as I continued to try and coordinate sane home health care for my father. His family physician ordered hospice last week. The hospice and home health are within the same agency in his hometown. Hospice called home health to discontinue home health and start hospice. But before hospice could even start, my father’s cardiologist cancelled hospice. The cardiologist had ordered home health after my father’s hospital stay, but now it has been discontinued without him even knowing it. Meanwhile, my father continues to fall at home and his hand wound from an earlier fall is not healing. The home nurses have never even looked at his hand because they don’t have a doctor’s order to look at his hand—only his heart. I am back in Seattle trying to catch up on my job and with my family. The home health and hospice agency staff people call me because my father doesn’t hear well enough to answer his phone when they call him. My head hurts….