Arches near Moab, 2007 Standing in the lunch line at work yesterday, someone comes by handing out paper plates. She's giving two to each person because the plates are flimsy and it takes two to keep your sandwich off the floor. My companion takes two from her and carefully separates them and hands one to the lady behind him. He's helping the paper plate lady. She notices and hands him two more to give to the next person, which he does. She tries to give the lady with just one another one and he intercepts it to give it to someone else. Now the paper plate lady has three people with just one plate each. She tries to explain...pushing plates at him. My companion peers sincerely at her through smudged spectacles, and hoists his sagging blue jeans up with his empty hand. He has no idea what she's talking about. There's no point in explaining it anyway...the line ahead has shortened - we put out our plates for our sandwiches and move on.
I love my job. I love these people with the saggy pants and the good intentions.
They have a heckuva time in the world we've created, though. I've been trying to help one woman, for example, who moved from the Denver catchment area to ours, and needed to have her medical records and payeeship transfered. Her therapist had filed the necessary paperwork, followed-up, followed up the follow-up and months were going by without results.
So I started in - I followed-up the previous follow-ups...Social Security here told me the woman was out of the country, so her case had been suspended. "She's right here in my office", I said.
"We show she's out of the country. You'll have to talk to the central office," they said.
So, of course, I did. "Oh!, said the central office. "That's just a code we use to suspend - we can't issue the check until we have the payee paperwork."
"But we've sent the payee paperwork", I said. "We've mailed it and then we've faxed it twice."
"Oh" said the office, and after a lengthy phone interview with the woman, who was, indeed, right there in my office, and an even lengthier pause while they determined the payee paperwork was located in the backlog - the suspension was suspended; and, after a call back to the original office, we were all told to wait for develoments.
That was a month ago. The woman now cannot pay rent, cannot buy food, cannot buy medications...and, after a follow-up to the follow-ups of last month, I'm told that requests to get it out of the "back-log" and processed will be dispatched marked urgent. This is the maximum best they can do. We are told to wait for developments. So it goes.
A few days before that, I was told by the phone company that, due to privacy laws, they couldn't tell my client her own phone number ...my client, they said, would have to wait until her phone bill arrived to know what her number is.
At my new job, I have Kaiser health insurance. I used to have Kaiser, years ago, and hated it. At this job, they'll buy your insurance for you - if you agree to take Kaiser....the "other insurance" offered - which you can buy if you wish - is prohibitively expensive. So, tightwad that I am, when the choice boiled down to Kaiser-for-free or something-else-for-lots-of-money, I naturally picked the Kaiser. I pretty much won't use it, though. Haven't gone to a doctor since I got this job. Feel great. Wouldn't have gone if I'd had the other insurance, either. I think the only safe time to approach doctors is when you're bleeding and broken in some obvious way- or maybe if you have an infection or something...I'll grant that there are times when doctors are necessary, but those times are very rare...and remain rare as long as you don't go in there looking for trouble.
When people ask me why I hate Kaiser so much, I tell them the truth: it's their phone system. Whenever you contact them, they take the opportunity to waste your time telling you in detail about things you're not interested in, before allowing you to complete the business you've called about. I can't take it. I refuse to call them. Period.
So it's not just people with schizophrenia who're having trouble with our "systems"...
We have a guy with schizophrenia, though, who has just been denied benefits for the second time - which, given his current position in life, means that he will be homeless, without medication, without anything at all starting next week. Compared to that, my Kaiser issue is peanuts.
4 comments:
The private sectors is smarter with their budgets than the government. If not they would go out of business. It is the same reason you can walk on a state psychiatric unit and find staff playing Suduku on the early part of an evening shift. Private sector attempts to maximize profit by maximizing potential of staff. The State loses the brightest employees usually to the private sector. Therefore, the remaining remnants are the types that do crosswords, Suduku and basically sleepwalk through life clocking in and out of jobs. I do believe that work should be fun, but State employees are very entitled, yet lack inspiration to fullfil their full potential while moaning about how their is a total lack of respect shown by the management.
If Pera was eliminated or privatized like a true 401k many of these type of staff would be eliminated. Therefore, creating a competive atmosphere for staff that want to be here.This would strengthen the psychiatric treatment on patient and possibly make them more susceptible to change in their lives. Lets be honest how many have continued to gain knowledge on modern psychiatric movements of today.
How many are just here waiting on Pera? That is the true issue and is very different than the private sector. That is why psychiatric groups are missing from daily shifts(besides the few staff that do groups that don't expect to be in the same position 20 years from now). You can tell those that really try at groups and those that play "pattycake" with the client.
It is the difference between pure Capitalism and Socialism. One promotes growth, while the other promotes stagnation and despair. I believe in the elimination of Pera(or early buyouts) to clear out the lifers who practice outdated psychiatric techniques to help promote growth within the everyday functioning of the hospital.
I may not agree with Keith or Management, but I do respect them. I respect them for wanting more in life and having the drive to attempt to obtain it. That is what is missing on the bottom and is what really hurts this hospital.
We can blame them for our troubles or we can take responsibility for the choices we decided upon in our life that placed us in such a position as to not be heard.
Do you want to take the steps to promote change within this hospital?
Then start with yourselves, we are supposed to motivate patients for change. But how can we do that if we lack the gumption to change ourselves.
Nurses and Clinicians we create issues ourselves not management. It's the small things such as; gossip, worry about others' pay, each others' weight, dress, stereotyping, and basic jealously over entitlements we think others are getting.
That is what seperates uneducated peons from professionals. It could be why many of us are not heard.It may be the reason that many in a "suits" here run to their offices and close the door behind them. If we act like housekeepers than that is what we will be treated like. Act like a professional even if you lack the education(or position) to qualify as one, and your voices might begin to be heard.
That is pure Capitalism at its finest. There will those who wallow at the bottom and others that demand more in life. IT'S CALLED WORK! Not overtime, a smart man(woman) uses his/her mind while a fool uses his hands to do the smart man's work.
Which are you?
A "go getter" or a Bullsh!tter.
This hospital has many Bullsh1tters and that is the beauty of Pera system.
40 year term life clinicians, housekeepers and dietary aides.Yawn!!
I wonder if Walmart had Pera if we would have Geezers(I mean Greeters) with 20 year retirement plans. Oh I forgot most businesses would be out of business or close to it. Ask Ford, GM and CHrysler.
Let me get this straight - the retirement plan is responsible for uninspired employees? Hmmm. That's kind of a stretch isn't it?
Eliminate Pera and everyone would start studying new psychiatric techniques?
I agree that the private sector is smarter with their budgets than governments have been...I just don't agree that's the way it has to be. Government agencies could be the smartest, most efficient, professional agencies in existence; it's not the retirement plan than makes bad government (or management)...and I agree that we each have a personal responsibility for our own lives - we do make choices and live with the consequences. One of the choices we make is to abdicate responsibility for good government by failing to educate ourselves, failing to participate, failing to care about the society we live in. The consequence of this choice is to suffer the effects of bad government, (or, in the case of the madhouse, bad management).
One of the new psychiatric techniques employed by privatized state psychiatric hospitals is scripting, in which minimally paid/educated staff are hired and given scripts to learn and then use when interacting with patients or their families.
I don't know what their retirement plan is.
The State hospital reminds me of the Post Office. There will be a line out the the door and half the employees are on Lunch break. Meaning it is a necessity therefore it survives. Could you imagine UPS having the same standards as the Post Office. Of course not, it would sooner or later go out of business. That is the difference Between the State and a private hospital.
I come to work and see so many just counting the days, while complaining about the company. Yes this hospital has some issues, but it is a very easy job compared with what is expected in the private sector. You actually, get time to read, play games and minimal interaction with the clients(unless proactive). So I do not believe Pera helps the sitution, Clinicians, mental Health Workers was never created to be a retiring job title. It was supposed to be a "stepping stone" for those going into case management, therapist and advanced college degrees disciplines. But with Pera many have stopped learning, going forward and just "clock" into work. I think that is an issue that needs to be looked at, you cannot expect a person to act like a professional that transferred from Wheatridge(where they worked since high school). That is like asking a CNA to act like RN. Nothing wrong with being an Lpt when you are 25, but if you are still one at 55 well thats another issue.
I think reducing Pera to more of a supplimental pension role like the Feds do is much better. Additionally, a 401k with a better match. This will help in moving many out and pushing others forward. Secondly, making the Clinician job hiring requirement of a Bachelor's degree and RN management position with a minimum BSN level requirement. Honestly, many of the Clinicians here probably never "cracked" open a DSM in their life.
I will not blame Nurses(Asn or Bsn), they have a certain position some do know about Psychology while others do not. The problem is that many of the Clinicians do not understand Psychology either. Therefore, nurses cannot depend on good advice from a staff member(Clinician) thats speciality is supposed to be Psych(at least by the job title given).
As a therapist why would I consider a Clinicians' advice on a Patient if everytime I see the Staff member their doing crossword puzzles and clients are wandering everywhere.
Why should I respect a Clinician that did not have the gumption to finish a bachelors that they began in 1985? Why should I consider what they say about a client when I have never seen them do a group? Why should I respect their advice when their progress notes look so simplistic that it should have been written in crayon? It is not my fault as a therapist that I'm in my 30's explaining psychology to you and your almost twice my age. You had the same chances(maybe more than me) to further yourself.
Elimination of Pera would help "weed out" many including buyouts. You would see many(young & old) that are in the process of becoming therapist come through here adding a quality psychiatric knowledge that has been lacking for a very longtime here. This is not a knock on all Clinicians about 25% are really good and stand out in discussions, knowledge and general ways they carry themselves.
These are the questions you need ask yourself if you are a Clinician.
Have I been a clinician for 6 years or more?
Am I working on a Degree(actively, seriously)?
If I had to give my advice on a client do I have knowledge of DSM criteria?
If you answered most of these questions with a no you are likely a Pera Hold out, waisting funds and waisting our clients' time.. Do not say you stay because of the clients, because if that was the truth you would be furthering your knowledge beyond Wikipedia psychology and actual real world education, conferences and workshop trainings(not the manditory ones either).
Get rid of Pera get rid of slackers and general malcontempts that undercut the Psychiatric progression of this hospital into modern times.
Many do stay in same position while continuing on a Path of enlightment. That is very few however and most spend 70% of the shift talking about the "good ole days". You know the days when they expected even less of you.
Psychiatry is a real fun field, but it is practically like walking into senior citizen convention on many of these units. Between the retirees that cannot stay away, those that decide they want Pera and begin working here at say 52! I wonder if I can get short term disability if trip over a staff's walker and hurt myself.
I'm being funny but lifer Clinician influence new clinician. Either they scare them off or they become just like the "ole guard" and so continues the cycle.
I like your enthusiasm! I like it a lot that you are irritated at bad treatment...that you can imagine a better way.
I think you may be overlooking something, though. I, for example, who used to work there...worked there for 13 plus years, actually...had an advanced degree...had worked for (at that time) two community mental health centers in various capacities...had a private practice..and dabbled in various business endeavors...I'd been around and with the chronically mentally ill for many years, in different phases of their lives...I had a lot of experience...combined with a superior education...and I could not convince management to let me participate in any constructive way in that hospital. Every offer I made, every attempt I engaged in to improve the treatment there was rejected...often rather rudely.
All those old foggies who drive you crazy, have a lot of experience...with patients and with the system they're in. When management doesn't want you to do anything but check little boxes...if you're restless at all, you'll find more challenging boxes to check..like Sudoku...when years of experience informs you that your real participation is not required or desired...well, you wind up with what you've got there.
This may happen in other government agencies...I'm sure it does...but its not "necessary"...and it's not the fault of a retirement system...it's the fault of leadership. You've got a guy running that place who is exactly what you are objecting to...he's old, incompetent, there only for the retirement...doesn't give a s*** about the mentally ill, his staff...any of it...replace that one guy with someone who really wants to do a good job...and who defines a "good job" as "good treatment for the chronically mentally ill"...and you'd have a totally different place.
That's what I think, anyway...(and my experience really has confirmed this for me)...good management makes all the difference. Management at the madhouse sucks.
g.f.
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