A Tough Decision

Recently I’ve been going to my consulting job at the nursing home in the early evenings after most of the staff has left for the night. Although a few of the residents are already asleep, my patients seem to like seeing me later in the day: they have settled in for the evening, are often sipping tea, and appreciate the fact that I’m not taking them away from their daily agenda. For most residents activities include watching classic films or playing bingo. For the Wild Bunch they include drinking moonshine and arguing over whether Eva Longoria or Jessica Alba would be the better lay.
It was dark when I got to the home this week but the parking lot was filled with police cars, giant portable lamps like those seen on film shoots and, most importantly, protestors. Most were holding signs and shouting with great urgency, but the lights were blinding the text on the placards and their voices all overlapped. A few people snapped pictures of both me and my car and everyone started screaming more loudly as I walked toward the facility, crossed through the police barricade that was removed for me, and entered the building.
Jose from the Wild Bunch was glued to the window, hands cupped around his eyes, face pressed against the glass. “Roberto,” he said. “You crossed the picket line.”
“I didn’t even realize what I was doing until the cops moved the barricade for me. Then it hit me and I didn’t know what to do.”
“Tough call, man. Tough call. You want whiskey?”
“Not tonight, Jose, but thanks.”
“Okay, hombre. Be safe.”
It turns out that the entire nursing home staff is striking over health benefits. However, some of the medical and para-medical staff are not actual employees of the facility. I am a consultant, sent out by the equivalent of a Temp Agency for psychologists. This isn’t my main source of income so the money isn’t an issue, even though I could be fired from the agency for insubordination. And although I have little to no knowledge of the finer details of the battle between ownership and staff I was always told that you don’t ever cross a picket line. I also know that nursing home staff is known for being notoriously overworked and underpaid so I don’t want to see them get screwed over. Would I be helping their cause if I don’t go to work until the situation is resolved? Should I support the cause they are fighting?
If I do, what about my patients? Their mental health will likely suffer if I don’t tend to them. But perhaps I’m not the best person to make that decision. I decided to ask all four of my patients about what they know regarding the strike, their reactions to it, and how they feel about me crossing the line. If all of them were to support the staff and could handle not having sessions for a few weeks or a few months then I would support the strikers and risk reprisal from the temp agency.
Therapist Rule: When discussing a sensitive issue that is not directly related to the client’s difficulties (e.g., finances, scheduling, angry picketers) bring this up at the beginning of the session. This will allow for an in-depth discussion if the client has a very strong reaction that needs to be addressed.
The first resident, a very elderly woman who has only known me for about three months, had no idea what the strike was about. When I explained to her the basic parameters per my understanding, she expressed indifference toward going on hiatus with me. “You’re a nice man and good to talk to. But I can do that with anyone here, so you’re not that special.” Not the greatest boost to one’s ego, but if that’s how it is so be it.
The other three patients weren’t so passive. One said that “the staff here sucks and this is a great way to get new blood in here,” while another, an elderly Christian man, said “fuck them, let them burn in hell for abandoning us.”
The third was a woman whom I’ll call Ruth who I have known for about two years now. At a relatively young age of about 70, she and her husband came to the facility together three years ago, only to have her husband pass away a few months later. Over time she’s done some good work with me, having come from completely isolating herself and screaming at nurses to spending her afternoons in the common room watching movies and being much more polite toward the staff. She stated that while she understands their plight, without proper medical care in the facility, everyone here would die.
“I don’t think the medical doctors would leave you in the lurch,” I said. “You are safe.”
“Yes, but you’re my doctor and you’re saying you might leave.”
“Well I am a type of doctor, but not the one who gives you your medicine and checks your heart and makes sure you are physically okay. You know I don’t do those things for you.”
“No, you do something else, something better. You are my only friend. I need you.”
“Do you worry about the staff? They are fighting for what they believe in.”
“Please don’t leave. Please.”
That brief exchange sealed the deal for me. I want what is fair for both ownership and staff. But at least one person needs me in the building. That’s my job, and although I’m probably going to get pelted with Depends and used syringes when I go back next week, that’s the choice I’ve made and I hope the picketers will ultimately respect what I need to do. If not at least Ruth will rest a little bit easier knowing that I’ll be sticking around.

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14 Responses to “A Tough Decision”

  1. Amber says:

    Ruth’s pleas pulled at my heart strings. I’d walk through the picket line for her as well if I were in your shoes.
    You’re right, something like this is a tough decision. And I respect the reasons the nurses left, but I can’t respect the nurses for leaving. Everyone needs someone, and the people at the nursing home need their nurses. The only people getting hurt in their leaving are the patients. And that my friend, is the saddest thing of all.

  2. Anonymous says:

    “Tough call, man. Tough call. You want whiskey?”
    “Not tonight, Jose, but thanks.”
    When you say “not tonight” does that mean you sometimes partake on other nights?
    Dr. Rob: No.

  3. Mike says:

    Never had to cross a picket line, but my general thought/belief is that if your not replacing the person on strike. It’s okay. The world doesn’t just stop because you do. The strikers might not like you, but you’re not hurting them or helping them.

  4. Drew says:

    “Please don’t leave. Please.”
    Jesus man, that’s heartbreaking!

  5. Joy says:

    Kudos to you Dr. Rob for making the appropriate THERAPEUTIC decision. 🙂

  6. LexiconSheDevil says:

    Dr. Rob, you’re a good guy. I wish my parents would have taken me to someone like you, I probably would have benefited from it.

  7. Maggy says:

    *tears* DocRob deserves a hug.

  8. Jenna says:

    You did the right thing, doc. You seem like a good man.

  9. Anonymous says:

    Dr. Rob is, if he tells the truth (and I’ve no reason to believe that he doesn’t), is a good shrink, and this just adds more weight to that claim.
    Why didn’t my parents take me to a good shrink? Why did I feel like I was not being picked apart to help me, but rather to serve some deep-seated need for superiority? Probably the line, “You seem to have a shell built up; I’m going to enjoy tearing that down. I always like butting heads with the ones that think they’re smart.” In those same morbid words, no less.
    Why are there no good shrinks in shitty towns like this one?
    Dr. Rob Note: Thank you so much for the compliment. It sounds like you met up with some shitty analyst. Check out this if you haven’t read it:
    If you are still looking for someone, maybe this can help. And always, ALWAYS tell a potential therapist about bad experiences you’ve had in the past. He or she needs to know this so as not to replicate it. There are good shrinks out there you just sometimes have to do a lot of looking to find them. Don’t stop looking!

  10. h3llc4t says:

    You did the right thing, Dr. Rob. Thank you.

  11. Wayland says:

    That was cool man.

  12. scootah says:

    Fair warnig rob – I don’t know what your local unions are like – but I know crossing a union picket in a lot of places can result in bashings, property assaults and generally lots of pain and suffering.
    I’d consider reaching out to the union rep or something to explain your position and the fact that you can’t leave your patients unattended and then I’d start parking a few blocks away and either walking or getting a cab – just to make sure you don’t come back and find your windscreen smashed.

  13. Alex says:

    You the man, Dr. Rob.

  14. You made the right call.
    I had a kid plead with me to stay, but I couldn’t. Unfortunately trusting in ‘the system’ is a hard sell, particularly when the system has shown to fail pretty consistently.