The nurse says

i don’t think you will get that SAM trial you asked for,

saying the patient can’t even remember he has a chair alarm…

OT charted last that the client’s cognition was intact

and when I wage in

it is clear

the cognitive decline

the faltering has been coming for some time

before

the fall

the rhabdo from being down hours

before

the delirium

the hallucinations

which has since cleared

and I ask if someone else could chart

something of the cognitive impairment they are seeing

it can’t be just me

when I finally get to a case

and realize nothing is good

and their are holes

everywhere.

The manager

who used to be an OT

asks why that matters

and I say straight up

it can’t be just me

coming out of nowhere

questioning cognition to this faltering degree

..how does this unit gloss over so much ?

Yet it is in the shallow way they look at things

or the caseload volume

unable to properly assess.

I realize for years

i did a little of everything

I took care to know a little of everything

being unable to rely on anyone else

and when

i started this job

and began to get my feet under me

i used to run discharges my way

not consult anyone else

simply gather information from their charting

and then extrapolate what what needed from there.

until

the complaints began

until

my managers questioned

what I do to assess what is needed

and of course I assess and I deep dive charts

but being

undermined

being questioned

at every juncture

regularly

at every few month intervals

has me charting more thoroughly than ever before

it has me

checking in with everyone on a team

it has me

never making the first move anymore

it has me beaten down to a follower

from the leader I once was.

it had me frustrated and angry

when they can’t see it

the larger picture

Where my job

is to think of everything

to pull the pieces all together

coordinate it…

judgement makes me reactive

criticism makes me defensive

too harshly questioned

unyieldingly

damaged by that

never good enough

thankless

unachievable perfection.

yet left alone

to turn my tricks

i know I am good at this

the finished products are the blended science and art.

I can always be better

i can always learn more

and it would help if

i was left to do my pieces

instead of pulled apart.

Gone is control

gone is certainty

when any moment

someone might submit another complaint

and

either I am placed on leave

or I take leave

or gone is the job that paid the bills.

no wonder I have sunk

to the bottom

of Maslow’s hierarchy of needs

again.

when safety has vanished

nothing is dependable

and I never know what a day will bring

or strip away from me.