Let's Call this a Day from Hell (warning long)
Good morning,Just me. It’s about 2:15 am and the kitties decided it was time to be up and atum. So, we go through the processes that are important for a successful start. The kitties have been fed, washroom completed, and coffee has been made. We even went the extra yard and made some more ice water. YAYYYY Diets!!
I’m not sure what to say next, but the thought “we survived a day of hell and back,” comes to mind. Straight off the top of the list, we had our surprise state inspection, a staffing, 5 extra files checked, with the threat of three more on Tuesday, and then we followed that up with lab tests and an MRI. Pshwoo! Like let’s not try that all again in one day.
The worst of it was the state inspection. They used to give you a day in advance and let you pick out your own case files. Usually, we would have two of ours checked and the other Q would have two of hers checked. This time there was absolutely no warning and they chose the files they wanted to check. The first call came from the secretary. She said Sr. wanted us to know that they were in the building. I had been preparing clients one at a time and was up to 10 of the 20 files good. But, then Sr. called back and said, they wanted specific files. One they chose happened to be the client I was staffing that morning, but the other file had not been prepared up to tip top shape.
I went through what I can only describe as white blazing fear. I don’t know how many minutes went by for the shock to wear off. I have to admit honestly that dishonesty was one of my first actual thoughts. Then sense overtook poor reason, and I thought no … I’ve got to own up to what I have and have not done. Please believe me when I say it was a trembly moment. I didn’t think that Sr. would fire me, but I knew this would be reason enough if she had wanted. Not being ready for a State inspection was about the worst thing that you could do wrong as a Q. This wasn’t the usual guys coming to view records, although one of those guys was in too. The lesser state guy is hired from the government to look over our records, where the greater of the two was actually the state government checking records.
I was first between the Q’s, because the other one wasn’t in yet, and they were trying to get me done before the 10 am staffing, which of course, I was still preparing for (although on the better side). It helped that the parent was 30 minutes late, but by then the state contracted guy was going through my files too. He and I are used to each other, so I am not as threatened by him, although you certainly have to be paying attention.
We got through the first file pretty good … I was able to show all the proper documents and I was able to answer her questions. It was like one down, one to go and the second file was the iffy one. I told her upfront that this file wasn’t as good. The inspector was new, although her partner was familiar with our center because he’d been there before.
The one looking at the file was pretty nice. She was very complimentary on two points. The first was that she really liked our Qnote format. I think I’ve shown it to you once before. It’s got three 3-4” calendars representing the three goals for the month, then it has a big pink box and a couple moss green boxes. Hehehe actually its very cool color displayed. Looks sharp. In the big pink box we’ve got the numbers and general comments, then in one of the gray boxes we leave areas to be improved, and the other areas that are successful. She raved about how efficient and good looking it was, to the degree, she made sure Sr. Tess knew how much she appreciated it. It was like on man this can’t get much better. I had worked on the format last July and I was very pleased with it myself, as were the DSPs.
The second area she complimented us highly was on how many personal notes were written on each of the clients. This was another point she brought to Sr.’s attention. She stated that most places they visited there were just bare bones comments that didn’t show any real involvement with the clients. I made sure she saw that I kept Q. Chrononotes on my people. She enjoyed that too. She said this was very helpful and she appreciated that even though she did not know the client, she could read the sentences and feel like she understood the clients problems. The Q. chrono is something that I heard of from the start of my employ, but it had faded from the center’s usage. I had begun them again a year ago and I’ve given good time toward them. I was especially happy, because with the new Q. assistant, I make sure those notes are caught up. If I have any special talks with a client (happens about 6-7 times a week), then it is written on a notecard, and when the assistant comes in Thursday mornings, she charts it officially. I don’t know what possessed me, but the last time she was in, I had her pull all the clients Q chrono’s from her computer and I had inserted them in the official files. That turned out to be very much in our favor.
There were two more situations that worked out in our favor. The first was that she told me that in reality two extra weeks added to the time frame of which an annual report must be made. The annual is supposed to be in exactly one year or less from the time of the last one. In both situations, I had clients that had extended time in Mexico 3-4 weeks which made them late, but fortunately, they were each within that two week spare time. She also gave us the directive that in the future, we could have the staffing without the client and family, and then have a second meeting afterward when they’d gotten back. That was very good information and will help us in the future. But, for the time being I was safe!
The second thing that had helped me was that although I’d had one file caught up on Qnotes officially to the right date, the other was behind. But, I had thought while she was looking at the file of the DSP Goal Data Sheets which are in the same format of the Qnote, but hand written and not quite as specific as a Qnote. BUT, the lady accepted the DSP Goal Data sheet as having gotten in a Qnote. She considered it as a rough draft, which is basically what it is. The numbers haven’t been tallied, and I know that not all state inspectors would have let me gotten by with that because they weren’t signed by me or dated, but if I hadn’t mentioned it already I was pretty darn lucky.
I will never, never go through this kind of fear again. I am going to get those files ALL in shape, so I never have to be this scared.
The second part of the story is that which happened to the other Q. She like us had planned to have always ready two files, and she showed evidence when I looked at also having worked on 10 files, though none of them were complete, but as I’ve mentioned before, the State chose their own files, which didn’t include ones she had worked with. And to make matters worse. One of the clients was new, and had left already, but for the 4-5 months he was there, there weren’t any notes or records. Nor were there any monthly Qnotes from her second client they had chosen. I felt very badly for her. She was at a terrible, terrible place.
She then made things worse for herself. After waiting about 20 minutes from when they’d asked for the files and when she came out with the first, she claimed that her computer had gone down, and that somebody must have messed with it, and erased everything on her system. Of course, the odds of this happening are pretty slim and didn’t go so well with the state. Not only had she configured a lie, she was blaming it on other staff or clients, which in my book is so super uncool it is unbelievable. There was a time during her period of being with them that I was watching the switchboard for the secretary, the other Q. and Sr. Tess because they were either out to lunch or tied up with the state people. The other Q. was supposed to go back for the second file and as she passed me at the secretarial station, she hissed that this was all my fault. She said, I was going to make out as the perfect child and she was going to look like sh**. We only gave her a sympathetic look. We knew this was her style and she was running like a scared rabbit.
Later, when Sr. was down in our office, because pretty much she’d been going from one staff to another telling them how horrible this was and what the other Q. had done, she asked me about helping the other Q. retrieve her lost notes. I told her I honestly believed that the notes weren’t done and the computer was a cover up. I also told her that the other Q was having the assistant write the notes, so if they had been done they would be on the assistant’s computer, which they were. But, for the sake of argument, I went into my computer and pressed the right network buttons. And, true enough the other Q’s files had all been erased. I showed Sr. … this is your computer files, and I should have been able to press the other Q’s button and gotten access to her files as well. But, they were clearly missing.
Later after I was done with my upfront chores and had had a smoke, I thought, maybe to the other Q’s benefit I should check out her computer. I had passed her while she was working on Sr.’s computer and she looked pretty much like she was in shock. I had also heard, because the grape vine was running rampant that she had asked lesser knowledgeable DSP’s to look at her computer, though very clearly, she had not asked me although at the Center I am the one who holds the most knowledge in this area. When I got to Sr.’s office where she was … Sr. had come in and had just stepped back of her desk. I looked at the other Q and noted she was typing in Qnotes from scratch and I thought, maybe she was past that other point and had settled down into the fact she had to do the work. When I looked up at Sr. she gave me a silent but kind gesture not to say or do anything.
I think bottom line, no matter how angry Sr. was yesterday, and will be today and for many months now afterward, I appreciated that gesture of humanity; she had shown to the other Q. The other thing going for the other Q. was that the State people intentionally took a two hour lunch they told Sr. to give the other Q. a chance to have gotten some of the work in. There was one more thing going in the center’s favor, well several more actually. The general 97% of the center was in very good shape with no problems noted, the center and the clients always do well, the interviews had gone well with the parent (who had the staffing) and with the staff, and because there was a meeting for the center’s advisory counsel, our friend had been in the building and was helpful in calming down Sr.
I was also relieved because the work I do as a staff trainer had been caught up and officially filed in Sr.’s office. I did catch some hell for the fact that one of the staff who acts as job coach, driver, and housekeeper did not complete her first aid training. She was gone on the day that I had somebody in for the training and when I asked her when she was going in, she shook her head and said, I’m not going, I don’t need it. At that point, I should have realized, but didn’t that I had to enforce her going. Although, I knew at the time that Sister always sheltered this employee from doing the regular stuff. Like if it had been more convenient that the woman pick up milk and bread for Sister instead of attending a staff meeting, she would have gone that way. And, as it turned out while we were up with Sr. looking at her daughters (the assistants) first aid record and knew she didn’t have to go to July, I told her I had no doubt the daughter would have gone somewhere with her mother to get the task accomplished. The mother has though a 8th grade Spanish education and would have clearly wanted to avoid the classroom work. Sr. told me in her low, private voice that if we got through this without them specifically telling her to get the training done, we were going to skip it, which was my take on it the first time, but I realize that Sr. needed someone to blame, and in part it really was my fault although this usually comes in Sr.’s range of doing things, because I have responsibility over the staff, but no authority and this particular person is like a protected pet of Sr.s because she is so valuable to Sr. *Sigh* so much, so much.
I also came out pretty well in the interview portion. There weren’t any questions that I couldn’t answer and in truth many of the questions were safety orientated like what would happen if someone were hit, abused, or found missing or dead. Also, there were rights questions. All of these things I had covered with the staff training in recent months, or had answered through our work with CARF accreditation, so we were in good shape. He told me afterward, that I knew quite a bit of information. To which I thanked him and proudly stated, I should know these things because I was the staff trainer. I think the last question that I thought was interesting was that he had asked not only about my understanding of Sr., which of course we gave her a high rating EVEN THOUGH she wrote us up hehehe, I surely know HOW to answer an interviewer as to “public” information. And, he asked if I felt challenged. I told him that Sr. had shown good confidence with me and that I not only had the client part of a caseload, but she’d given me staff training and CARF accreditation, so there was plenty to keep me interested and motivated. YAYYYY V. would say, [Top answerer!] *giggle*
There was one last thing I wanted to write for the record. Although, I feel sorry for the other Q to the degree I told Sr. I wouldn’t say anything bad about her, because it could have as well been me in that hot seat, I won’t demean her even though she lashes out at others. No gloating on this one. I was more fearful the other Q. was going to have a heart attack, the pressure on her was so great. The thing of note was though interesting in that first, the regular state guy who was in for the staffing and had stayed to read notes hehehe I know he would have, even though I think he was as interested in the drama as everyone else. He stuck close to our office at the Assistants desk right past my desk wall. I know you can hear things through the door/wall, but most often I’d left it open. But, the thing that was soooo funny, was the amount of traffic in my office. Because I was so aware what the regular state guy was thinking, I just had to laugh. Everyone it seemed picked up more and more information, including Sr. and our friend, and they returned to my office often as an update station. I don’t know why that tickles me the most. I guess in one way it could be seen as “gossip,” but it was really more than that. It was the center at its best in supporting each other. People needed help in calming down. Didn’t hurt also that it was at the opposite side of the building from where the official state people had been staying in Sr.’s office. I did give up my office to them for a couple of interviews, but as always, I’m proud to have people back there, because if nothing else Sr. has given me a wonderful, wonderful office. YAYYYYYY
At one point another state contraction inspector had called while I had both Sr. and our friend in the office. She wanted to set up dates for a Tuesday visit to see our joint clients. She only has three of mine, and I felt wow! Simple, no problem, because in actuality, there will never in this entire year be a day that was as much pressure as the day was. PSHWOOO!!
After things are wrapping up, the state has an exit interview. We will find out more about that today. Normally, we’re included in that, but there was the matter of radiology and lab appointments. Although, I’d volunteered to reschedule, about 2 pm, Sr. realized that it was more important to take care of the medical stuff then to have me stay for the exit interview. I’m not sure if the other Q. was involved, but I know Sr. stayed for the State meeting and our friend went to the other 3 pm meeting for the Advisory Board. Wow! What a day. I’m reminded now that this morning there is going to be a behavior/human rights meeting that I have to attend and take notes for, and in all my terrible means of doing things, it means I have to type the notes this morning of the last meeting. AGAIN, nothing is as bad as a surprise state inspection!
Hmm, somehow without my knowledge a kitty snuck into my arms. Oh man … what a day … good kitty! I guess we’re just a babbling now. But, there is a little more.
I think in general the trip back to the University for medical stuff went pretty good. I had a little problem with the blood work, because after a half a dozen vials were drawn, she handed me that d*** urine cup and said that I was supposed to go down the hall to the bathroom. That pretty much stunned me. I said, “WHAT!?? You are going to make me go through that packed waiting room with a cup of urine!??” From that point on the lab person stopped being nice. She said in a bad attitude, well our bathroom is broken and that’s the best we can do. I thought certainly this was not satisfactory. So, complained for a few minutes about it before jamming the **** cup in my coat pocket. The bathroom down the hall I knew was going to be a problem, because they are the central bathrooms right off the elevators and everyone and their cousin use them, so they are the least sanitary in the medical center. Of course, when we got there they were being used, and one of them had a housekeeper darting in and out trying to spray down the place, because somebody very messy or smelly had been through there first. Then I was soon joined by another gentleman who said he’d been looking for an empty bathroom for the last half hour. I thought ohhhhhhhhh Lordy!
The second shock was after getting back to the lab. The tech had given me instructions to go through a door and leave it on some counter. I had of course in the nature of all wise people, cleaned off the little cup, buried it in paper towel, and pushed it into my already complaining pocket. I could here an infant crying behind the door and I knew the set-up enough to know that I would be walking in on someone else’s lab work. I stopped a passing tech to confirm this is what I had to do. The tech must have talked to the first one, because she loudly shouted for all to hear, “What, you have a URINE SPECIMEN!??? Where is it? You PUT IT IN YOUR POCKET! By then there is nothing to do but say, “Oh fu**, fu**, fu**,” and beat it the he** out of there. It’s like 20 people crowded into a 20 x 30 room. Think there is a chance nobody heard??? I may go back there today to write out a formal complaint. I’m almost past that shock, but not looking forward to a bad reputation since I’ll have to go back. Actually, I think it was panic from the day gone a muck. We are very aware of multi-cultural issues due to the course work and between techs, check-in staff, and clients, I was the only white person. BUT, this might be more do to the functioning part of my brain that says there is a conspiracy to take over my brain by anyone who wasn't me.
The experience in radiology was much better. It was a smaller portion of the hospital/medical center. There was only one quiet receptionist, a waiting room for 10 people, and just an elderly couple of women waiting. That kinda puts you on a little guard thinking hmm, not many people have to do this test?? I should have known better going into it when they were asking me if I was claustrophobic. Yeesh. But, at this point, I still did not know. I was happy when someone came out within only 7-8 minutes of me sitting down. A nurse who was about the most passive, relaxed person I ever met escorted me to a dressing room, where she apologized for the fact she was going to ask me to completely undress and don gown. I was pretty ok, until I realized she’d given me only one gown, and we all know by now … that doesn’t quite cover the ummm whole of things. I sat there waiting for a while hoping she would come back, but eventually I crept out of the room back facing the walls and had to use my loud voice because she was “chatting” with someone else. BUT, she was a very nice mellow woman and said, “oh sure, let me help you with that!” Afterward, when I was handed a satisfaction survey, this woman received high marks.
I had to wait in another waiting room for not so long. The nurse had already relaxed me by informing me this time, I would not have to drink any dye or get an intravenous. I thought Man …. No matter what God takes care! After the tech came out to greet me I was happy to find that she was one of those cheerful women who seem to know their job is going to be a lot easier if they are nice to the patient! It took a bit to get settled in. She was talking and talking and arranging me on this thin metal tray, repeating the question, you are going to be ok, right? You are not going to give me any trouble? Let me tell you, these words are a clue, that you are supposed to not upset the tech who has obvious experience dealing with trouble makers!
The position she put me in was not comfortable. Couldn’t be. And, as a first attempt failed at putting me head first into this machine, God smiled down upon me and allowed us to be turned around feet first. PSHWOO!! That was only the first obstacle. What I had realized in the first attempt was the claustrophobic question was with purpose! I asked, since this was only going to be a test for hips and leg, would I have to go all the way in. Because by this time the reality was zonking me to pieces. I thought, don’t give her trouble, don’t give her trouble! What I had realized was that there was not going to be room for an inch of movement. As she reinserted me my body was scraping the sides of the tube and my thighs and knees were pressed with pressure. Although the nice tech had said ONLY 20 minutes, I believed more the nurse outside who state it would be 45. And, of course they had pinned my arms and head directly over me, as if it were a stick-up. This was such an uncool thing to be going through for 45 minutes. I can’t explain more clearly what TIGHT means!
Through the ordeal though, I went through calming exercises. I thought of everyone I had ever known that might give me mental support. I imagined people caressing my head saying, “It’s ok, your doing well, it’s going to be ok.” I went back and forth between eyes closed or open not knowing which seemed more problematic. During 1 minute intervals, I remembered to wet my lips and swallow. I imagined that I was having sex, I imagined that I was floating on an intertube, I imagined I was floating on an intertube having sex, and when all else failed I begged for my Dr. M. presence of mind. The tech said something to me over the intercom as far as how are you doing. I said, “fine, fine.” Then added a little more panicked how much longer?? She said only another 20 minutes. I thought DAMN the woman lied to me. It was a trick to say 20 minutes when she should have said 45!
“ok, ok we’re not going to panic.” She must have certainly gone through this before, because she started breaking the time up for me. She would say, “Only 4 more minutes of THIS one.” Which of course leads one to be thinking there are others parts to follow. What she was talking to was in reference to the sounds. I should have expected something, because right before slipping me into the catacomb, she inserted ear plugs. Wow! What an understatement the machine was terrifically loud! The thing I had realized helping me get through the series of sounds the cameras were making, was that if I paid attention the sounds although somewhat disturbingly loud could also be construed as a musical concerto! Hehehe I told this to the tech afterward, and her response was really? We laughed as she was trying to unglue our arms from their raised position. Really, truly I thought the sounds had become quite wonderful. Almost as if in a National Geographic movie where you are hearing natives for the first time drumming a celebration.
Afterward, the first one out was Casey. She said, excitedly, we did good, right? The tech was appreciative I’m sure that it was over and we didn’t bail on her, but she confirmed we had done VERY good. Then Casey thought to exclaim, “And, we didn’t even cry!” But, then the tech said, “Well actually you cried a little.” This dismayed Casey very much. She said, but not REAL crying?? She said, “well no not real tears, but you were whimpering!” Casey looked down sadly. But, because she was a nice tech person, she said with hand patting our back, “But you did VERY good!” So, we smiled.
So that almost wraps it up. The very final thing was that our friend did the nicest thing as far as meeting us back at our home, to which we received very, very good hugs and nuzzles. We kept repeating, “We did it, we did it, it’s all over now, isn’t it?!!” We were soothed to bed by his soft caresses and the knowledge that we had indeed surpassed the day. YAYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY!
posted by Ann Marie @ 1/19/2006 04:34:00 AM
Comments: 6
