The Life of a PRN Social Worker

Hospital social work includes so many different aspects. Generally, there is a social worker for every floor/department. Depending on the hospital, you may have two social workers for a department. Here's the thing... hospitals don't close. You never get to say "Sorry, we're closed, please come back in the morning", and people never have their emergencies at reasonable hours! So hospital coverage out here in terms of social work looks something like this: full time social workers work Monday-Friday from 9am-430pm. Yes, they are working 7.5 hours including lunch. That's pretty swell. But that's definitely not a normal schedule for them to get off at 430 because, like I said, people don't plan their emegencies ... and doctors love to discharge patients as soon as you're wrapping up your day. Now, the hospital has to be covered 24/365. So what happens during those other times. Enter the PRN social worker. The hospitals are then covered by either oncall shifts (every night and, for some hospitals, weekend days) or onsite coverage (busier hospitals on the weekends). And if any of the full time social workers call in sick or goes on vacation, PRN social workers will cover their department. We're like substitute social workers.

I love being on call but I also miss having a regular schedule. I love working in the ED (emergency department) and seeing the psych crises that come through and being able to help the patients. What I don't like is the uncertainty of my future. We schedule one month in advance and never know what the following month will bring. In December, I had four days and four nights. That's it. While I enjoy free time, I still need to be able to pay my bills. It's always a feast or famine approach. I can't deal with that. I need hours. Some of the other PRN social workers are married and have another income or they have a full time job. I'm trying to get a full time job with this hospital network so it doesn't make sense for me to get another job to just quit in a couple months. I tend to sign up for all the shifts I can just in case the next month is a repeat of December. So far I've been lucky. The only downside is that it takes up ALL my time. Currently, I'm involved in a pilot program at a newer hospital trying to determine if there is enough need to warrant the hiring of a full time social worker for the ED and perinatal services (babies!). This means that I'm getting to work full time ... however, my future is not guaranteed. They could say that there isn't enough work and then I'm back to square one.

In order to compensate for the uncertainty, I've been signing up for on call shifts just to give me a little cash cushion ... and I'm losing sleep and free time. I was on call last night and spent the majority of the night in the ED. I'm glad I was there and was able to help those patients but I'm now operating on three hours of sleep.... and working all day. Normally, I could probably deal with this but ....... I'm on call again tonight and working all day tomorrow. Yay? I'll survive, I know that much. I'll definitely sleep great tomorrow night though! What I've noticed lately is that it affects my social life and reinforces my hermit lifestyle. In anticipation of being called in, I go to bed ridiculously early. For example, tonight I will wash my hair as soon as I get home and probably be in bed by 5pm. Doesn't really leave a lot of room for social gatherings.

And it's these social gatherings that are so important to combat job fatigue and the risks of burnout. I moved out here to Podunkville on a whim and am slowly making friends which has been good. One friend that I have been hanging out a lot with is a night shift nurse. This has a tendency to affect when we can hang out. They only work, on average, three nights a week. But if I've picked up on call shifts, it limits the overlapping free time. I've started to notice how important hanging out with friends can be. I think it's taken for granted a lot of times but it's so vital for ones health. The question comes down to where is one willing to make adjustments in their life for the sake of their health? Is this why social work burnout is so high? We pour ourselves into work without taking the time to focus on ourselves? Our work can directly impact people's lives, more attention needs to be paid to our health so that we can provide the best for our clients. I'm starting to feel like something's got to give ....

Time in the ED

Today was .... chaotic, nonstop, never ending, insane. I didn't even have a chance to go to the bathroom. I was in the ED all day long but I loved it. I never thought that psych would be where I found a passion but I have. I love working on call at night because I know that if I get called in it's for that. Schizophrenia, Schizoaffective, Bipolar Disorder, Suicide Attempts, active hallucinations and delusions - these are all my usual calls. I really thought that I would detest psych and even passed on a job interview because of that but I feel like I have found a department where I fit. I love oncology but I'd be happy in the ED or a psych ward too ..... as a social worker, not a patient.

Hmm, maybe I should go back to school for psychiatry instead of PhD in social work??

Mad props

So I went out to a middle school today to lead some Start First groups. One of the things that I constantly hear from kids is how amazingly tall I am. It didn't help today that I was wearing 4 inch heels. However, I loved it when I was standing in the cafeteria looking for my kids when a 7th grade girl came up to me with one of her friends. Neither of them said a word to me the entire time. The 7th grader stood next to me and barely reached my shoulder. She straigthened up as best as she could to get every last possible centimeter and then asked her friend in all seriousness which one of us was taller. I had at least a foot on her and she was just standing there trying so hard to be as tall as I. I loved it. Things like this make my day :-)

Today was the last time ...

I registered for classes for graduate school! I have six months left until I am completely done. Wow, time is flying by. I think I've managed to get a somewhat okay hold on my stress right now. But I also have a paper due tomorrow that I have not begun to write and it's 9:32 PM. I'm not going to bother writing it tonight either. Technically, I have until midnight on Friday. I'll do it tomorrow.

I've been doing a lot of reading to prepare me for my internship next semester. Right now, I'm reading 135 days with Elena - Notes Left Behind about a 6 yr old with diffused brainstem glioma. I am constantly amazed by the strength of children and the knowledge that they possess when they are sick. It's been a tough read but really insightful. It's written by her mother and father as a journal for her little sister to remember her by. It is full of raw emotions and all the questions that no one wants to ask or thoughts that people are too afraid to voice. It's really good. I need to get around to booking my flight up to Baltimore in December for orientation. I'm getting more and more excited about it but still having trouble realizing how incredibly amazing this is. I mean, who all can say that they interned at Johns Hopkins? Really, that's some craziness right there. I've also been playing around looking at different places for rent in case I do end up with a job there after I graduate. I found a couple of cute apartments/townhomes that are for rent. I do know that I don't want a place that has the typical apartment feel to it. I want an apartment home. Preferably a townhome or rowhouse to be exact. I'm excited to have a grown up life with a grown up place. I have a great place right now but I'm still in graduate school and have some furniture that can be upgraded to grown up. I'm excited :-) I keep thinking about different goals too. I think I'm going to look into Spanish classes too so that I can work on becoming fluent. It's always helpful to be able to speak more than one language.

And in other news, I had some Start First groups today at a middle school. Start First is an in school violence prevention education program that teaches students positive coping skills to some of the negative behaviors that they might be seeing at home or in their community. Today, I was working with a group of seventh grade boys and asking them when they think of their ideal girl that they would want to go with, what does she look like? Well, I started hearing responses like, "wears glasses", "brown hair", "earrings", "brown shoes", and other very descriptive qualities that described how I look today. Ha! I was flattered and made them focus on inner qualities that they would like. They're really sweet kids. Always a joy to work with.

Thanks for nothing..

So everyone who just happened to drive past the intersection of Bosque and Valley Mills today at about noon and saw a broken down van ... thanks for nothing. 40 minutes in the hot sun and no AC later, Ashley finally saved us. I was amazed by the amount of people that, when the light was red, rolled down their windows to ask if we were having trouble. Nah, we're just airing out the engine. Of course we're having trouble. Why else would we be sitting at the light with the hood up? Out of all the people that drove by only one guy tried to help who looked a lot like the guy from Pirates of the Caribbean. I kept staring trying not to be too obvious. So thank goodness, the Chrysler 300 has the battery in the trunk. This is the second time that Ashley has saved the day ... or I guess attempted since the first one wasn't actually successful. On the plus side, I'm getting great at using jumper cables!