Spring has SPRUNG

What a whirlwind spring has been for us!
I want to start by sharing about my weekend in Michigan with Joy! We set off for a seven hour drive Thursday after work. The time flew as we chatted and laughed the miles away into the night. For some reason, the drive back to Pittsburgh during the day was not nearly as stimulating, probably from a combination of tiredness and the reality that we had to go back to work the next day.
Joy has a small farm in rural Michigan and her parents are both veterinarians in the community. They have seven horses, many goats, pigs, chickens, a calf and a few cats and dogs. The baby goats were the cutest addition to the family. I was surprised by their temperaments, very relaxed and sociable, literally willing to fall asleep in your arms! We took advantage of some great weather to go for a ride with her brother, sister, mother and dogs! The ride lasted over an hour as we ventured though the windmills, sand pits and farm land nearby. I rode a charmingly grumpy appaloosa named Boyd as well as all the other horses! We all switched around throughout the ride! We also got to go check out her apartments for medical school in Grand Rapids on our way back to Pittsburgh! The farm land was absolutely gorgeous and all the green space was refreshing coming from the city life in Bloomfield. In between helping with chores, cooking and playing with the animals, we relaxed by the wood  burning fire, knitting, reading, chatting and playing the piano. This weekend was one of my favorite this year, surrounded by incredible nature, great people and relaxation!
Memorial Day Weekend was also a big one for us here in Pittsburgh. Our friends from Franciscorps, a sister program of ours based in Syracuse came to visit! They arrived late Friday night but spent Saturday with us seeing the classic spots like the Strip District (indoor/outdoor market), trying Primanti Brothers classic cheese steaks and walking around downtown to the Point State Park. The weather was perfect and we stopped at Dream Cream, an unconventional ice cream shop that helps fund Dreamers to achieve their ‘dreams’ or goals through fundraising with their own flavor of ice cream. The dreamers get a portion of profit and tips for their designated flavor in exchange for working a few shifts at the ice cream shop each week. Change A Heart will be participating with the flavor Fools Gold in June! We are all excited to start and figured we’d give them some business with our Syracuse friends. After a quick break, we all cooked out and hung out on the porch together and some went off to the local bar to dance later that night. Sunday we shared a massive brunch before Franciscorps set off back to Syracuse! I feel blessed to have shared a little of our life here with them, especially because they understand the experiences we are going through as full time post grad volunteers. They are an awesome group of people and we laughed a lot throughout the weekend!
Service has been consistent but never without its challenges! Working with people who are housing and treatment resistant on connecting them to their much needed medical care is an endless challenge. Finding access to an appropriate level of care for our clients is always an obstacle because they do not fit any specific category. They are often too sick for traditional mental health care, too mentally unstable for traditional medical care, not to mention the fact that our guys have failed physically and mentally in almost every other program, system or treatment plan they have experienced. In our housing model, we create flexible rules, we make compromises and we meet people where they are. Unfortunately, healthcare is not modeled after such a patient centered approach. In order for someone who is mentally and or physical decompensating to receive care, the decompensation needs to be literally emergent. They need to be having suicidal/homicidal tendency or experiencing a true medical emergency. There are significant barriers to being able to catch someone before they fall completely. Even with our excellent resource of primary care for our clients, there are many barriers to getting someone the attention they need when they are in our unique and vulnerable population. last week I had a client who was passed through the psych ER to the general crisis unit to the psychiatric crisis unit only to end up back home, without treatment and presenting with an inability to care for himself and significant cognitive deficit. He was not sick enough for one, too sick enough for another and the wrong kind of sick for another. Eventually we got him placed in a rehabilitation hospital, but not without leaping through numerous hoops, endless phone calls and unabashed pleading (mostly on my part) to take him in and give him the help he needs.
Another one of our guys who is untreated but presents with multiple active psychiatric issues had to go to the hospital for respiratory distress. After over a week in the hospital he was finally discharged yesterday, but the process of discharge was literally a drag. He was ‘supposed’ to be discharged the day before, but it was almost 4 and they still needed to run more tests. I talked the social worker into keeping him another night, worried that he’d be coming home with non of us case managers there to see him or help plan his discharge stuff. Thank GOD she agreed. I did not end up getting him until the next afternoon and subsequently spent the rest of my day finding doctors, making appointments and arranging medications with pharmacies. I left work feeling brain fried, wondering how anyone is able to deal with medical issues on their own. The fact that anyone would expect the chronically street homeless, addicted or mentally ill to be able to make sound health care decisions and maintain their own care is preposterous to me. I am a licensed nurse and still face barriers and confusion dealing with people’s discharge instructions. Between the numerous medical appointments, medication changes from inpatient as well as lifestyle changes like diet, limitation in physical activity and curbing their addictions, people are literally inundated with process and hoops to jump. To me, the biggest problem is that there is not enough time or funding allotted in legitimate discharge planning. Not everyone has income, steady food, a sound mind or loved ones to lean on when they face medical challenges or chronic disease management. Hospital care is focused on the present, on reactionary and defensive care. Even with its best efforts, the hospital care is focused on putting out fires, patching the here and now wounds with bandaids while the real issues fester below the surface. This is not a flaw of the skilled healthcare providers, nurses or anyone in particular but a plague of a health care system that is not focused on the patient, on sustainable wellness or prevention. I deeply admire the care that is provided by those in hospitals and I have no malice towards that crucial aspect of healthcare. What I dream for rather is a better system for their talents. More realistic staffing and increased integration of care and communication from inpatient to outpatient in order to curb the stagnancy of healthcare today.

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