There is such a seesaw pattern in much of life, but in this job in particular. We have busy days, slow days, few kids, many kids. Ups and downs and all arounds.

We have a speech therapist now, which is excellent. I look forward to not being responsible for all the communication boards needed in the hospital, and to getting my kiddos the treatment they have been waiting for.

The insanely busy SNF floor and acute care floors have calmed down a bit, at least for a few days. Nice to have less on my plate for the mornings since they are short and the evenings are long with kids. The elderly lady w/ thalamic stroke from this post has now landed down my hallway... she is doing considerably worse since acute care, sadly. We played cards today and I was happy that she had moments of understanding and initiating action on her own.

Laid down a VERY hard line with a pt. the other day... he has been quite uncooperative since his arrival and keeps insisting that he's independent or will be independent soon without assist. 2 weeks ago I needed to reevaluate how close he was to meeting his goals and needed to see him don shirt and pants on a Friday afternoon. "I don't need to do that, I'll do that when I go home." I basically said, "prove it." We stood w/ MAX Ax2 for 3 seconds, which was not enough time for him to pull his pants up, but was (I thought), enough time for him to realize that he needed to work on ADL tasks. Gave him a brief talk about how he needed to keep working... it didn't take. He made the COTA cry when she was trying to work with him. So, when I came back to that little mess, I said, "Mr. B, you made the other girl very upset, and I have to tell you that she's the nicest person on staff. Now you're stuck with me. You can pick which chair you sit in and where it is in the room, you can pick out which pair of pants you're wearing, but you will sit up and get dressed, and you will not get rid of me until that is done." His son was skeptical, but proud that his dad was able to do so much for himself. Saw him again today and he had a much better attitude about the whole thing, and is now a CGA w/ LE dressing.

New kid eval tomorrow... tried to do a Peabody on my fresh eval from last week and he was a total terror today. His mom about cried when I gave her the report on his behavior. She has some majorly off-base assumptions about his development as well, thought that his FMC was at normal developing range and reported that he "graduated" from speech therapy. I suspect that he "graduated" because he ran out of visits under medicaid, b/c his main statements of "I tell mom" and "you not my friend no more" were not age appropriate. He has sensory and behavioral issues (always a combo) and he will be a considerable challenge.

Get to go w/ my PT coworker to a Civitan Club meeting to explain our grant request for some new equipment and supplies. Fingers crossed for support in an expedited fashion!

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