Clarifications

Regarding my previous post, I probably ought to clarify a few points bout this blog so as to keep me focused onto my greater ambition, which is the ultimate independence, which is working for myself.

• Being involved with people in nursing homes, I am bound to pay attention to HIPAA privacy rules (the acronym stands for the Health Insurance Portability and Accountability Act). I do not use any names, nursing homes, or medical conditions regarding any individual consumers I work with. So I keep the subject of nursing homes and residents quite bland  
• I keep the names of state agencies unnamed, one of these a very well known acronym. As well as the individuals who act egregiously. 
• There are state employees who have worked professionally, too. So I wouldn’t want to imply that the (union) workers are in the cause of the majority of the workers. 
• Given that anonymous persons and agencies are cited, the situations change slightly in actual context, but not scope. I am not anti-union, nor against bargaining units for the employees. But things like not being able to attend meetings ‘because I couldn’t get a state car’ type excuses are vexing, even if the state car is in the contract…

So I write about what I know in the attempt to keep me focused on the next phase of my independence in career. I want to remember the incidents that will compel me to work for myself, to succeed or fail on my merits, work ethic, on what I did (or failed to do). That’s all.

If any reader remembers the Dragnet TV series (1967-1970) the stern voice on the intro would say something that I have paraphrased as follows: ‘The post you are about to read is true. The names have been changed to protect the innocent guilty’  As Sgt. Friday might have intoned to the witness “Just the facts”

Smashing through any doubt...

Breaking through not so insurmountable barriers. Photo taken by Grandpa (Ralph I), ca. 1939

I do not care for much of what I do. I offer an example of how the frustration of the job affect my thinking about said part-time job. There is another state agency (lets call it unnamed II), and one employee I needed to work with who is a non-performer according to some. This person made three (3) scheduled appointments in a three week period. with a client, and didn't show up. The job (TC) I hold is the one where we are taken to task because we are more visible, the state employees who choose not to, well, not so much.

I was advised to contact the supervisor of the offending state employee. I was only able to leave a voice-mail missive, polite but to the point. I even used the term 'unprofessional' (I was advised later to keep opinion out of it. A fine thought, but as I had had it by then, I'll try better next time. It would be nice if all government employees worked as required). A day later without a reply, I contacted the employee and left that person a voice mail missive, polite but pointed. I received a Arrrugh message later that she "didn't appreciate my tone". So be it. This is what I have tired of, the state employee sense of entitlement. Yet I have to work with them - without the authority to make them work...

The baseball shatters the glass with ease. I need to be hitting my own line drives to move beyond my own limitations. I posted two different contractor positions on the local craigslist (here and here), but I need to sell my own abilities - to myself!

Finger pointing exercise

The term ‘transition coordinator’ seems innocuous enough, you coordinate others who perform the duties that they are assigned, and all works out in the end, a safe discharge the result.

Pointing the way??

That’s the theory, anyway. 

The ‘responsibility vs. authority’ argument seems pretty clear here. I am the point person, the visible one who has to be certain the care plan is adhered to by the various care planners. I am merely an administrator. So the discharge on Monday occurred, with an interesting mix of problems that indicate a lack of focus by others - that I have to address and hopefully fix. Not my job? So there!

Lets start with the facility person who arranges the discharge. As medications will be needed, an appointment with the consumer’s physician is needed. Given that this person doesn’t drive, a method of transport to the doctor’s office is to be determined.

So the  appointment was made for the following day at 3:45 PM. I set up the PCA schedule, and can you guess - there was not a PCA scheduled who could drive the consumer then! Call it a mistake, but hey, why ask me what a good day might have been since I only created the schedules. Thanks...

Exit stage left??

The bigger issue is that after a call to the doctor, there were no other times available this week and there is a finite supply of meds. The transport for Title XIX (Medicaid) requires 48 hour notice. A fabulous sales job by me (30 minutes) convinced them to schedule a pickup for the appointment in <24 hours.

Let’s follow the what-ifs:

• the meds run out
• the consumer was unable to get to the doctor to get a new supply

Who has the ultimate responsibility here? You’d think the nursing home personnel, who have to provide a safe discharge, might have sweated the details a tiny bit. Au contraire! Any problems fall onto me. I am not averse to work, but where ought the blame ultimately be placed? There are a few other sidebars to this story I’ll ignore, but you get the idea...

Let’s not be silly Ralph - the blame is to fall on you! Responsibility vs. authority. It is a simple enough concept that I get it. What about the other players?


So much behavior here seems so old. Change can be good for the soul, my mantra should be change is good, change is good, etc. Wheelchair or not...