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last---past---next---now
�2006 Candor Communications


2005-09-14 - 6:11 a.m.

work, vaginas, and delicate diplomacy


another night on the job, another night of amazing mismanagement... Berry was floated to another unit in exchange for a staff from that unit... so now I either have to train the staff in our procedures or do all the work myself or the work will not get done... oh well, the work will not get done... if they ask why, and the management around here is bad enough so that they probably will not (wait, soon I'll explain the 10% rule), then I'll have the right to ask why they are arbitrarily rearranging staff without warning therein undermining our work schedule and system on the unit... if I ask now I'll be meddling in management business and considered a problem staff...

but they have an open door policy, of course...

the next bit of news is typical of this place... I heard this morning that the audit policy for the facility is being revised... let's call it the 10% rule... here is the reasoning:

- the internal audit policy is in place by mandate from the federal auditors.

- the internal audit is to be developed to insure deficiencies in the medical records are noted and corrected.
- currently the internal audit policy states we are to audit 50% of the medical record paperwork nightly.
- a review of the audit shows 45% of the noted deficiencies are not being corrected.
- solution: revised the policy to require auditing only 10% of the medical records weekly.
- reasoning: this will reduce the number of deficiencies cited and make it easier to follow up on staff not correcting their errors, therein increasing the probability of the data from the internal audit passing the federal auditor's mandate.

ok, so what's wrong with that picture?...

first, the decision is to look the other way... instead of correcting staff who are ignoring the notices that they have made mistakes, management, in their infinite wisdom, decided to check for mistakes less often and therefore find fewer mistakes... not that there will be fewer mistakes, we'll just deliberately not look for as many...

second, the results of this minimal auditing is that the errors in 90% of the charts will be ignored for 12 weeks at a time as we have 20-24 charts on an average night or week... so when the federal auditors return, the internal audit mandate might pass muster, but the facility itself will fail a detailed medical record audit because every chart will have many deficiencies... the feds will then probably mandate better internal auditing, maybe requiring a specific percentage and maybe not... so in a year or few, the facility might raise the percentage of charts audited and eventually maybe someone with a brain will realize that if every document is not audited every night we are cheating the patients out of the best possible quality of care we can provide and we are conditioning staff to develop and maintain sloppy documentation habits...

of course the feds might be paid off or simply incompetent themselves (deliberately or actually) and pass the facility with a brief skim of selected records, records they notify administration in advance that they will want to look at...

it kind of like the way economists and anyone creating a statistical report play can with numbers to get the results they want to publish to support their predetermined premise... corruption and abuse, via apathy or indifference or bribery, is everywhere...

the bottom line is the kids get screwed because the medical documentation is not providing as accurate or detailed a record of their treatment as possible and therefore the behavioral program is not providing consistency... behaviors that need to be addressed with consistent intervention are provided with inconsistent reinforcement therein increasing the negative behaviors (or so the theories, not to mention logic, in this case, goes... Skinner must be turning over in his grave... he is dead, right?)...

that last rhetorical query demonstrates the ambivalent respect I have for the psychological texts, but that's a rant, or mini-rant, for another time... meanwhile, I'm chilling with the computer and going to take off from this bureaucratic and ethical nightmare to far far better places in my mind... or at least weird distractions, you decide... it all comes out in the words...

I think I was spouting off about child care and family values and such in the entry before last, so this would make more entries in a row that are work related than in quites some time... that's probably because the last three nights I've pulled out the spare computer from the storage room and sat here tapping the keys... the entry immediately preceding this one was written at home, though rushed, but inspired by the entry that preceded it, which was written at work... in years to come this vital information will allow scholars to intensify their critique of this diary by comparative analysis of whether location dramatically alters the flow and tone and style of my writing...

in the previous paragraph I was spouting off about how vital this diary is to literature, history, and national security, not to mention the study of anthropomorphic earthworms in the cartoon jungles of New Guinea, but we won't mention that, therein demonstrating the delusions of gradeur that at least several of my personalities bask in on the Riviera at least five times a year, unless they move the party indoors on account of weather in which case any domed stadium will due...

except maybe the Metrodome...

in the previous paragraph I was spouting off about whatever was popping into my head as I wandered off the beaten path and away from the responsibilities and ethics of the medical care-giving professional further demonstrating my uncanny ability to open a bathroom door for a kid who's bathroom is not working and sharing a caring word and sincere smile while simultaneously, through mental slight of hand, not taking anything seriously because I know the things I can change and the things I can not change and the difference is why, as Lenny Kravitz once said, therein still further demonstrating my own particularly peculiar off-brand insanity I sometimes loosely call the method to my madness...

it keeps the ulcers and strokes away...

I hope


now what can I do for you?

actually, working here, especially working with an all female crew on the night shift, is sometimes interesting as we start getting sleepy and giddy and look for ways to keep ourselves awake...

for instant right now L is reading from a magazine... the question (in the magazine) was are you afraid of a man's penis? and one of the suggestions in the article is to imagine the man's penis as an ice cream cone, something you really want to put your hands and mouth around and lick repeatedly... apparently this article was based on some sort of girl-party where they were discussing techniques they use when they have blow job parties... I had to ask what magazine she was reading from... it was Essence... yup, it sure did capture the essence of a man's penis...

they didn't give the address of the parties...

I don't suppose a psychiatric unit for teenage girls who experienced abuse and sexual trauma is the sort of place I should get horny and slide into double entendres... but these girls I work with are sometimes evil, pure evil... and yes Jerry, I am loving every minute of it...

well, at least most of the time...

and now they found pictures of vaginas and are passing them amongst themselves... I had to ask as at first they were not quite mentioning what the pictures were of, but just laughing a lot... they claim the pictures are not exactly pretty vaginas, in fact, L called them downright ugly... or as Oprah would saw, oogly... I shouldn't turn my nose up at their judgment call of physical body parts since I think fat is ugly (if you don't remember that, you missed the recent entry that at least one lovely commenter called a tribute to fat {or was it an ode... my memory is sleeping... see the next entry for why... if I remember to writing it and find it and upload it... no big whoop, just lack of sleep}, or more precisely, my belly... and if you thought an entire entry devoted to my belly was impressive, well, just look at this)...

they were not pretty, by the way... the vaginas, I mean... although the looks on their faces as they put the pictures in front of me were definitely not ready for criticism of vaginas from a guy, no matter how much they agreed that the vaginas were ugly, so I felt the trap closing around me (and they probably didn't even know they were doing it)...

I nodded...

a lot...

that seemed to satisfy them...

but then, to some people they might have been beautiful... and I'm happy about that because otherwise we'd have some ugly horny vaginas roaming around looking for some loving (or red hot steamy action) and I shudder at the thought...

when did this entry turn into a vagina beauty contest?...

see what I mean about working with an all woman crew?...


ah, it's so easy to blame everybody else... and it's fun too...

well, it is as long as you know it's meant to be all in fun and you don't take it seriously, but talking about that is like putting on clothing to have sex... or maybe another analogy would be more accurately reflective of what I mean... come to think of it... half the fun of teasing is not letting the person being teased know for sure if you are teasing or serious...

or something like that...

and to summarize this entry, if the need ever arises, be very careful choosing a psychiatric care for your child, numbers get manipulated every day, corruption and abuse is everywhere, vaginas need really good teasing, abused vaginas need much better management, when stressed, be irreverent, when in doubt, don't discuss sex, politics, or religion, and when working with an all woman crew and they put pictures of ugly vaginas in your face, nod a lot...






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