Dealing with the devil

Today, I was dealing with some of his minions.

Dahey, through no fault of his own, got a new-to-him employer. Nothing new, just one of the bonuses of working in his line of work.

Said employer, which I shall now call Highly & Grossly iLogical Inc. gave him a mandate to fill out all of the on-boarding paperwork this weekend. This meant I got to use my home printer and my own ream of paper for all the forms. No more print shop for these folks! No submitting online, either, because  they require paper with signatures.

The e-mails were terse and there was a 27 point checklist, including boring stuff as insurance, training plan, and even their social media policy.

I knew they were high up on the illogical part, when Dahey called me, not once, not twice but three times in the last two days about insurance. As a regular employee at the Hotel (with good rates) I get it.  Dahey filed the waiver and Highly Illogical Inc. sends several more terse e-mails saying, "What we had on the waiver is not good enough".

The waiver said to include your insurance information (written) and a screen shot of  your information on the company website (with dependents, etc.) as your proof of enrollment.

The first screenshot was rejected because it didn't have a date on it.

The second screenshot was rejected because I couldn't screen capture the date on my desktop, so I took a picture with my phone and e-mailed that.

The third screenshot didn't have my name (but did have the date, insurance company and how many people I insured ).

Dahey was frazzled. I called the insurance company. The people who can send those "I have insurance" letters were gone for the day. They said they can send me one tomorrow when they return if I have a secure fax. It's in a room that locks (and we get patient info on it, so maybe it qualifies).

 Finally, I hiked over six blocks to the other side of campus to see our HR department. They had never heard of such craziness (and I talked to six of them). One of the staffers (who handles insurance) gave me one of my official personnel record forms with my insurance election on it.

Since it does have sensitive data, I elected to go home and write an e-mail to the supervising (er, harassing) HR specialist at Illogical Inc. I put a read receipt on it so it would sound official (and hopefully, irritating).

Dear Mrs. Dick (not kidding- just slightly altered to protect the guilty):

Here are three screenshots that you rejected earlier today. I hope these are less blurry. I have another form that the Hotel has given me from my official record today, but as it has sensitive information, I cannot send it to you until I can get to a secure fax.

I will forward it and any other information to you tomorrow. My phone numbers are below. Please contact me directly, as I am the subscriber, not Dahey.

Please note: I may not answer your call immediately if I am caring for patients. Please leave a message and I will return your call as soon as I can.

RehabRN

Now I just hope that they stop harassing Dahey. I'm not getting very good vibes right now about Illogical.  They won't like me if they continue to p*&s me off.

More later as the saga continues....

Perils of modern living in the office

If you have e-mail, it just might get hacked if you open attachments you shouldn't. I'm so glad one of my technical people actually confirmed my suspicions recently. Our mail has been terrible. The issues we have with technology are scary, but not surprising.

My latest issue: some of my coworkers want to be exempt from policies and procedures that can cause issues with billing some services they provide. This is another example of following the chain of command. They do it (or suggest it) so I have to make their boss aware of the situation. It sucks, frankly, when these same folks could have been doing this job (they've been dodging) for a few years now, had they let me put the resources in place.

More construction starts at the Hotel. We got some equipment (they forgot until I asked and money was found) for our exam room, so once we get our security devices (probably next month) we can officially say construction is over in our office.

Bye, bye convenient parking when the monsoon comes through later this week. Guess I may actually start wearing my backup scrubs. Our parking lot shuttle is a joke. I often see them at the local Wal-mart. Last time I checked, Wal-mart was not our parking lot.

Patients will be patients. They are now asking pointed questions and so it makes our lives very interesting everyday.

Off I go to another exciting day. Stay tuned.

Meeting agenda and assorted paperwork

Today's meeting agenda was like a ransom note but lacking a weapon. The list of demands was long, but the list of assurances was short.

I know I'll never forget this moment. I tell myself that I'm keeping that e-mail forever because it's going in my book. The book I'll write about the Hotel (and some of my crazy coworkers) that will be called Is this a bad business case or reality? You decide (working title).  If that title isn't snappy enough, we'll get another.

Some of the agenda items were crazy:

1. First of all, when the boss asks each attendee for a meeting agenda item, it does not mean 10 from one person. (not kidding).  He/she is running the meeting, not you.

2. The need to define our "communication terms". Last time I checked, you had a company-provided cell phone, a desk phone, a laptop and a desktop PC. If you can't communicate with that, I don't know what to tell you.

3. Asking the boss for prizes. Don't you need an extra trinket for nurses' week? Maybe I'm just weird because I don't.

My assorted paperwork continues. Paperwork for the siblings, paperwork for this agency and my all encompassing travel paperwork that will probably get rejected on the first round.

I feel like a hamster in a wheel...stay tuned.

You get what you wish for...

Or at least it seems that way right now. What a week!

For almost five years, I've been asking for help and/or equipment. While I can't get them to give me the help, in terms of personnel I want, I am getting equipment, so it's keeping me busy.

My favorite thing: I'm finally having days where I actually do the job I was hired to do for almost the entire eight hours I'm there (and sometimes then some...). The patient flow is something I have to work on, though. I follow the guidelines, but somehow, I always have a patient who wants to tell me more.

This week, I got to go to training that was cancelled many moons ago. It was interesting, even though I had to attend with my boss, who, with his/her MBA, knows everything. He/she succeeded in driving a lot of people nuts, which got me lots of sympathy from the folks I already know.

Finally, after working on my last patients this afternoon (and one emergency with a speech therapist), I got the e-mail I've been waiting for from the boss. He/she's recommending that the holdouts complete things they need to do to work with me in my clinic.

Five years is a short time where I work but almost a lifetime anywhere else. That e-mail made my week. I can only hope I'll get a few more wishes...

Happy weekend wherever you are. More to come...

Dear Parent Scheduler

It's really nice to see that you can send and read e-mail. I've noticed something lately,though, of which you should be aware. If you notify the guy who MAKES the schedule two weeks beforehand, he won't schedule your kids to participate in the service on the weeks you are busy.

I know it works because I've told him each time we go on vacation, and Bubba isn't scheduled that weekend. Problem solved.

I know that means all of us on the mailing list won't know EXACTLY where C and J and your family are going on vacation, or dance competitions, or band recitals, but we will just have to live with seeing you every so often on the weekends, so we can ask about you in person.

Hope you enjoy trying it out.

Pleasant journeys (and you don't need to tell me about them, if you don't want).

Sincerely,

RehabRN

Reeducating the boss

My task this week: bring a boss up to speed when I've sent e-mails.

The ones I sent (meant to be on top) got buried in 400+ when he/she had to take an extra week of sick leave.

More to come...

Just say no

When they ask you to forward e-mails that just don't seem right at work, just say no or you could end up in a situation like this one.

That is all...more to come.

Old school communication

Call me a dinosaur, but I still love my e-mails. Especially stuff from the listservs I'm on.

Rehab nurses who rarely speak out about anything will have long, torrid discussions via listserv about the best way to put on a leg bag and how many times a night to turn patients.

It may be old, but it is still highly entertaining.

The gift horse (aka "I ain't got time...}

Heard at the Hotel (or relayed by stunned observers).

1. When our nurse manager (who now does quality review) asked one nurse about his/her documentation and lack of a shift assessment, the answer was "I don't have time for that".

Really? So what is it we hire an RN for...assessment skills? Maybe you need to take one of our open CNA positions.

2. One nurse got a chance (was selected) by the Hotel to go all-expenses paid to a national conference because he/she has gone for years on his/her own dime. The catch: since we have a new chief nurse at our location, she told him/her that he/she would have to do a presentation to the unit staff when he/she returns.

After lots of paperwork, discussion, permission from umpteen people (because  you can't just GO to a conference anymore at the Hotel....) he/she comes to my office and says, "Oh, I'm going to call and let them know that I'm going to go on my own. I don't have time to do a presentation."

3.  One (actually several) of our professional staff notes that patients request information, etc., via  e-mail or text message. This is even in their notes.

Will he/she/they even contemplate using the Hotel's patient portal, with secure e-mail included (it even writes your notes for you)?

Nope. It requires one training class (about 30 minutes) and you have to teach your patients (most of whom already use the portal) to contact you that way.

I just wonder what everyone is doing with all that extra time...

Bully pulpit

I have a friend (no April Fool-- call him/her M) who is having this problem, and because he/she felt threatened while we completed our studies, he/she kept quiet until his/her internship was over. He/she suffered.

ANA discusses bullying in their Healthy Nurse section on Bullying and Workplace Violence:

Lateral violence refers to acts between colleagues and bullying is often described as acts perpetrated by one in a higher level of authority. This behavior may involve covert or overt acts of verbal and non-verbal aggression. These types of behavior have been reported to result in enough psychological distress to nurses to cause them to leave the profession (Dellasega, 2009). 

The person perpetrating this bullying is in a higher level of authority. Ever heard of C-suite? Well, he/she is up there. It's hard to believe that your former preceptor would, out of the blue, accuse you of theft of intellectual property and assault your character in company e-mail of a prominent hospital system, but the former preceptor did.

All the while, my friend was just happy to receive a national award recently. When he/she came home the other day, there was a family crisis. Off to the hospital, but not for work. One of the family had become ill and required emergent surgery.

After I calmed him/her down, we discussed what happened since school. Everything is documented. Since the degree is done, I suggested he/she contact an attorney. Life's too short to live in fear of this crazy person.

As the saying goes, tough times never last, but tough people do.

More to come...

Just when you thought the poop was over

I got this information in a fitness newsletter I receive via e-mail.

Still drinking E. Coli Bacteria Feces?
If you are drinking or eating any amount of aspartame (the main sweetener in diet pop), then you are drinking poop from genetically modified E. coli bacteria. Now that the patent is available online, the cat is out of the bag and everyone is talking about it. I always thought diet pop tasted like crap...

Guess I won't be drinking diet soda again, especially after all the other artificial sweetener news lately.

Enjoy  your weekend wherever you are...and don't feel guilty about drinking that regular soda, either!

So happy TGIF

Yes, so, so happy. Go to work, do work, get lunch and coffee, go to a meeting, come back and finish the day on an up note. Stuff actually gets done. I don't feel like I wasted my day sitting at the computer sending endless e-mails.

Joy, joy, joy!

Hope you all enjoy whatever the Flag Day weekend brings you.

More to come.

Teamwork...not!

How's this for teamwork....

1. Boss tells you, "I'll handle that." and proceeds not to do what you ask him (communicate).

2. So, doing the job your boss asked you to do, you send an e-mail to all the affected parties for further feedback and updates on the plan Boss asked you to implement.

3. One of the teams sends a very inappropriate e-mail with feedback, then demands your presence at their next team meeting.

4. Boss also mentions that he/she will go with you to meeting.

5. Since you thought this was a team project all along, you invite some of the other folks who helped you work on the plan.

6. Said team (who wants you at the meeting) says, "Why do they have to come?"

7. You kindly reply that you thought an interdisciplinary team was just that...an interdisciplinary team.

And pray, that your boss will actually show up for said meeting since you think he'll just ditch everyone and leave you out in the cold.

We shall see...so much for team cohesiveness in RehabLand.

Monday again

Surprisingly, I did not have hundreds of e-mails when I returned to the office. I had about a dozen.  One of these days, the crazy admin who works for us will figure out that we ALL really don't need to receive a 9MB attachment on every e-mail she sends. (I bounced this request to the tech people today).

I worked with a patient (Mr. X) who always seems to show up in my office. Some therapists need to be working with him, but they're off doing other things, so I think of things for him to do. I allot about 30 minutes a day on this. I wish I could bill for my time in a clinic visit like the therapists do.

Meanwhile, Mr. X thought he was evading the medical staff on rounds by hiding out in an area near the remodeling being done in our part of the Hotel. Nope. They saw him. I managed to coax him out of the corner so he could talk to his doc. Once she arrived, I was out of there.

I also got a referral to one of our docs today. Patient found us on a website, made a phone call, and ended up in my voice mail. Before I could call, he called me. Mr. Persistent wants a second opinion with a specialist who works with us. He has a disease that requires a choice between two medications that will keep his disease at bay, but one, if he's got certain conditions, could actually kill him. Once specialist is back from his family jaunt across the country, he'll be on his consult list.

One patient made my Monday melancholy. Mr. E. has been coming to our place for a few years. His wife has never really coped with his issues very well. The caregiver stress they talk about in nursing school is starting to show. Mr. E. came in to a clinic visit with a week old beard. This is highly unusual for him, since he tends to shave every other day. Mrs. E. didn't come in with him, either, which is unusual.  She told us he had some issues and that she thought he was sick. She was correct. He got admitted.

Staff are getting bend out of shape about Mr. E. not being cared for. He's not the only one. I think Mrs. E. has finally broken. The strain of caring for her loving husband, who was once a tall, strong, highly educated man is killing her. Her back is strained from the weight. The role of loving wife and partner has been permanently replaced with caregiver. It's not what she signed up for. She doesn't say it, but the vacant look in her eyes tells you. The folks who promised to help just aren't doing it anymore.

The burden has fallen to us to carry at the Hotel,  as we wait to see how the rest of the questions in our minds will be answered.

Stay tuned...

Some people

Dear Specialist:

Please do not call me when I purposely put my status (out of office) on my e-mail, phone, voice mail, Office Communicator and the call list. I will not answer because I have your number in my phone.

Just because you think of something while you're on vacation with your kids on spring break is not an emergency for me. And while you're at it, please stop cc'ing the world on e-mails because it makes you feel better. All it does is drive the people listed (including me) crazy...and fills up our mailboxes.

Go have fun and stay out of our hair. It's our vacation, too (if you'd ever stop checking your e-mail and voice messages.)

Sincerely not,

RehabRN

A great end of day

So when you can't reach the people you need to via phone, just send e-mail...again and again. That was part of my day today. We'll see tomorrow if anyone responds.

It was a beautiful day here, and I was so glad I could escape for a few minutes into the sunshine. The humidity has disappeared for the moment and the afternoon was glorious.

Reminds me of those lazy days in college reading my books under a sycamore tree as the wind blew by...ahh! This time was even better at a table with a good book and a coffee.

More fun tomorrow...stay tuned!

Bad!

And I'm not talking Michael Jackson, folks!

The housework is done, I'm sitting at the computer relaxing and the fun just rolls in via e-mail.

First, no grant money is available for these researchers due to the economy.

Second, these nurses lost their jobs for doing their jobs.

And if those two didn't seem bad enough, and you have the time, read this Peter Singer article about Why we must ration health care (from www.nytimes.com)

Enough! I'm escaping...more later.

Nuggets for May 16

Here are a few interesting and silly tidbits I've found on the internet and in some of my favorite blogs. Enjoy the ride!

In the rehab and sports category:
Disclaimer: I love reading the New York Times. I've been a reader since the 1980s (yes, I'm dating myself!) when I discovered it in my high school library. I'd read the Sunday Magazine from cover to cover each week.

I particularly enjoyed this story about wheelchair racers called A blur of hands, spokes and determination (from www.nytimes.com)

As a spinal cord rehab nurse, I'm always thinking about what Dr. V. used to say about wheelchair athletes and clothespins...that some athletes use them to increase their blood pressure during events.

Some fun and some sobering facts:
JustCallMeJo of Sinus Arrhythmia, an escaped from rehab to ICU nurse, has had some great posts of late. Here are two of my favorites:

The fun:
...and then there are good days (about the patients you enjoy)

The sobering:
If you haven't seen this you need to discusses medical triage and what might happen in here in a pandemic or other mass casualty situation.

For silly stuff:
In the e-mailed joke category, DisappearingJohn has a good one this week. Let's just call it...
Going to third grade.

From the e-mail and snail mail boxes

I usually give my e-mail newsletters a passing glance, but a couple of links in my ADVANCE for Nurses e-mail today were pretty good.

Professional vulnerability
This editorial discusses the "who can call themselves a nurse" issue. I've heard some of it before, but this is a good read nevertheless.

A clean exchange
This article discusses the fine art of the handoff. As a new nurse, this was a good article and made me think.

From the snail mail box:

I subscribe to AJN, which is a great publication if you haven't read it lately. I find at least two good articles in there every month. October's issue is no different. One of the more interesting articles this month (a CE article) discusses motivational interviewing. It's more outpatient than inpatient, but I think it has tips that are valuable, even in the inpatient setting. I also thought that the article about insulin management, Rethinking Sliding-Scale Insulin, although, geared toward ICU nurses, has great tips for the rest of us on the floors. At least, I'll have something interesting to discuss with the endocrinologist when he's on the floor next time. (We have a very, very wonderful one at Saintarama. He's the best!)

More next time...enjoy! I'm off to be computer geek for the rest of my day off, since I'm back on at the Hotel Rehab tomorrow. Ciao!