Home Health Stories #3
This story is an example of setting boundaries for myself and not trying to appease everyone. After working for multiple companies I realize, yes, be flexible but ultimately they do not care about you. They will find the next clinician who will take the job. Cynical, I know, but the real world in my experience means no one cares about you. Wu-tang said it best "Protect ya Neck!"
If you do not know the home health industry when a referral comes in from a hospital, doctors office, or family member calling we usually get a home address, phone number, or email to contact for scheduling. Home health population is mostly geriatric and don't check their cell phones, home messages, and definitely not emails on a daily basis. This initial contact and scheduling is important because you have 48 hours from when you accept the order to see the patient and more commonly another agency pouch the patient from under you leaving you high and dry. Surprising? It should not be because the business world is cut throat and shady in all industries. When an agency cannot get a hold of a patient the marketer, usually, or clinicians are asked to do a "drive-by." When a marketer goes they just knock on the door followed by introduction, getting reliable contact information for patient or family and getting them to commit to a time a clinician can perform the start of care (SOC) assessment. If a clinician goes they do the same thing but if the patient is home and has time they get started on the SOC assessment.
On to the story...
I get a call on the road from the office because a patient on my schedule called to cancel and since I have time if I could do a drive-by. They got new orders for a physical therapy SOC and they can't get a hold of the patient and its been 24 hours. I asked how far is it from me because I am in Stockton. She said 40 min. I reluctantly agreed and told them to note it for payroll because I will be billing this time and mileage. Upon arrival to the address in rural Escalon there is no cell reception, gps is spotty, and typical fear of trespassing. It was a ranch style home on a couple of acres with short gate around the whole yard. I announce myself at the gate listening for audible words from inside or movement in the windows. I slowly unlatch the gate, close it, and begin walking towards the front door. Midway between the gate and front door an army of Chihuahua's turn the corner of the house and immediately start barking and running towards me. BOOM! My fear of dogs again justified. They are descendants of wolves even though this specific breed is so small. My flight instinct kicks in when noticing their wolf/military tactic of encircling me and devouring me to the bone. I grab my backpack straps and sprint to the front door. Hoping that the patient or someone inside heard these barks and would open the door, let me in, or save me from the enemy forces. Still no answer. My back is against the front door knocking while facing the barking dogs surrounding me. Still no answer. No one is home. Drive-by battle lost, war with ferocious chihuahuas continues.
Back still against the door, no help nearby, cell phone useless. Both sides begin sizing each other up, I use my knowledge of action films and begin assessing my situation. Five dogs semi-circled around me, fifty-ish yards to the gate, can't jump the gate because pants are to tight, no treats on me to distract the enemy.. I start stepping towards them(slight lunges forward with a mean face) to find the weakness in the pack. All look aggressive and murderous, but one only has three legs. I knew that dog was not the weakest because if it can survive with four others bullying it then I am toast. So I start trying to fake them out with cuts and spins, but they were agile. Next and only other thought was just sprint through them and get to the gate latch. I try a couple more cuts, spins, fake outs, and nothing they are holding the line well. The hailmary sprint to the gate latch is the only option. So I run, jumping over one chihuahua, towards the gate with the anaerobic sprint of an out of shape swimmer. I glance back and I am putting distance between us, but they aren't retreating. I get to the gate latch, glance up and know I'm not quick enough to unlock, open, and close the gate before they catch me. I get to the latch, begin to unlock when I feel a tug on my pant leg. I shake it out of instinct, look down and one dog has my pant leg in its mouth while the other 3-legged one is coming in hot for the same leg. AHHH F*^$K, I swing my leg up in the air, the one on my pants lets go, the 3-legged monster takes a solid swipeat my ankle but not a full bite. Quickly, after they are stunned by their failed attempt of killing me, I move outside the gate,close it, and lock it safely from the otherside.
I get in my car, check my battle wound, tend to it, and begin driving to my next patient. When I drive to an area with cell reception, I call the office that the drive-by was also unsuccessful. When informing them of this they tell me that is probably because the patient hasn't been discharged from the hospital yet. They had called the hospital to see if they had another contact information then received the information the discharge was on hold.
Moral of the story: Just say no