After our old unit nurse was fired (for reasons unknown by me at the time), the facility was short of medical staff. In order to cover all the units, the powers-that-be decided to fill the gap using Lynn, the nursing manager. Lynn is a forty-something trauma-certified Registered Nurse with many years experience in the field.
If only I could leave you with that impression.
We're having fun in group, that's all!
It started with the groups she ran. Lynn is an RN, so it's not so out of place to have her running our weekly Health Education group; our unit nurse has always done this. Not long after she took over the group, I began to hear quite a bit of commotion during the hour. I'd poke my head in and see if everything was okay to find Lynn smiling and getting along well with the clients.
After one particularly noisy group, Lynn gave a prize to the winners of a game they had played: She agreed to take the winners OUT TO LUNCH. At a restaurant. By herself. Her treat. She didn't ask for permission from Bob, the unit coordinator, or from Kurt, the facility director. She just said it. And before anyone in charge knew, she just did it.
I couldn't say no!
The road to hell is paved with good intentions. :-)
All three of them ordered steak platters and all the trimmings. Lynn was surprised.
She came back in a panic and told Bob of her harrowing tale. Bob was pissed she brought them out at all, but there was nothing Bob could do about it because Lynn reports to the regional manager, not to Bob. She had to spend over $100 and couldn't afford so much. She wanted Bob to assist her by coming with next time so they wouldn't take advantage of her.
NEXT TIME?!
Well, there were six winners. She couldn't just take out three of them. But she is too codependent to say no to them when they ordered their meals, so she wanted Bob to come with and be her support. Bob didn't agree to go with, but he let her take another three clients out of the facility to a restaurant anyway, citing that it would be unfair to them if they didn't get the meal.
A free meal for winning a game in Health Education. Imagine the budget if this was the standard.
This all happened on a Friday.
Oh, you guys are so funny!
Because our unit functions as a form of modified therapeutic community, we ask our clients to hold each other accountable when they step out of line. Most of the guys are from prison or jail, and the idea of "snitching" on each other is hard for them to understand. It is always impressive when a client is able to abide by this system. After Lynn's Friday Health group, a senior client (Client X) confronted the house in Community Issues group. He said that many of the guys had been disrespectful and inappropriate during Lynn's group; they had said some wrong things and that they should know better. Most of the other clients adamantly denied it, saying that Client X was a liar. Client X stated specific sexual comments involving "Swiss hotels," "friendly massages," and how nice her body was.
Client X was taking about the same Health group on Friday in which Lynn had given out trips off the premises for a free meal in return for their good behavior and winning a game.
With terrible timing, Lynn walked in and joined the conversation. She heard that the clients were being confronted about their behavior in her group and immediately jumped to their defense. She said that Client X was exaggerating the issue and that she didn't think the group was bad at all. Of course the clients loved this back-up, and began making all sorts of comments toward Client X.
When the group was finished, some of the other staff members approached Lynn and asked her about the group. Specifically, they asked if the guys had really made those comments.
She said that they had, but that they were just joking around, that it wasn't a big deal. She didn't feel offended and she didn't see why the house should be "punished" for it.
Boy have I learned a lesson!
Of course she's not going to say that they were misbehaving. How bad would she look if she admitted as much after bringing a half-dozen guys out to eat as a reward? I'm not sure if anyone pointed it out to her, but Client X had gone out on a limb to do what we (staff) asked of him as a member of the community, after which we did not support him for doing so. Because of his effort, Client X was effectively ostracised by a large portion of the other clients for the remainder of his stay.
Lynn saw the error of her ways not because of Client X or because of the clear ethical violation of rewarding terrible behavior with absurdly large treats, but because she "spent a bundle of money and wouldn't want to do that again!" Lynn still runs Health Education a good part of the time, and her groups are still loud and inappropriate. I try to sit in on them but I am often being made to do Bob's paperwork for him during that time.
We're buddies!
Lynn wants so badly for the clients to like her. She freely tells them all about herself, her kid, her dog, her car, and her umpteenth marriage. She allows them to say things that are way outside the lines of okay because she likes to "joke around with them." She borrows their things. She challenges me in front of the clients, telling me to "take it easy," and "give them break this one time." She has become involved with clients' personal affairs, going as far as to talk to their families about non-medical issues and recommending medications to them that are not a part of the approved formulary available to our clients (analgesics, cold meds, etc.), sometimes helping to PROVIDE those meds.
But I'm getting ahead of myself. That another posting all together.
-----------
I got a call this morning from Bob. I forgot to request a van for a trip. This is over-looked at least once a week by other staff, but $10 says Bob nails my ass to the wall.
To Be Continued....
Thursday, January 22, 2009
Saturday, January 10, 2009
Grab The B**** By The Throat
A 21 year-old client told me he wanted to learn how to play a song on guitar. I play, so Friday I brought my guitar in to teach it to him. After the clients had eaten breakfast and finished their morning chores, my "student" and I set some chairs up in front of the staff office with our guitars. While we were fiddling around, my boss walked by and started doing a silly dance to our music. The clients smiled at him as he entered the office.
"You go Bob," I laughed as he jiggled by.
As he emerged from the office, someone requested he sing something for us. My boss, my supervisor, the guy I report to in a clinical rehabilitation center sang out....
"Grab the biiiitch byyyy the throooooat..." He smiled at the clients to see if he had gotten their approval.He had.
I am not supposed to argue with or correct other staff members in front of the clients. I have gotten very good at acting like things don't bother me. I don't think any of the clients saw the look on my face after he sang it.
Other things said by my boss to the clients:
"You should want to get out of here so you can go to Hooters and get served by waitresses with big titties!"
"Maybe you'll be lucky and you're hair stylist will have big titties all up in your face while she's cutting your hair."
"Are there any women around?" Glances. "If you get a piece of ass while on pass, that's your business."
My boss Bob was once a counselor who got bumped up because my old boss left the company. This is his first job in management and he had no management training. He hates training and complains whenever any is provided. He cannot work a computer and depends on me to fix his reports when things go wrong.
Bob Holford is fifty-something. He has Cirrhosis, Hep C, Emphysema, smokes like a chimney, and eats McDonalds everyday. He spent 10+ years in prison and is a "recovered" drug addict who used to go to 12-Step meetings. He had quit smoking but started again when he got the manager job. Bob refers to the clients as "the little darlings" with a sneer on his face.
Problems with women, Bob?
When I told him that some female staff members were uncomfortable with how our clients were looking at them, I was told by Bob that "Men will be men," and that women who dress a certain way bring that upon themselves.
Even if they follow the corporate dress code?
"Hey," says Bob, "There are days when Mandy walks by my office and even my mind starts going places!"Bob said this in front of eight other staff members, two of which were women; they disagreed, but they were under 30. The next day, he called Mandy into his office to ask her if she thought that maybe her way of dressing was inappropriate. He then told her to her face that his mind goes to places.
In a fashion not unlike a Seinfeld episode, Bob will opine the exact opposite of anything I say.
Bob (Looking at a bottle of generic Scope): Does this have alcohol in it?
Josh: Yes.
Bob: Its not listed in the active ingredients.... I don't think there is.
Josh: I found this pill in Client Z's jacket pocket. The pill belongs to Client X. Jen the nurse is letting Client X keep these on his person and he's giving them to other clients.
Bob: Have you told Kurt (the facility director) yet?
Josh: No.
Bob: Lemme ask you this. Do you really want to show this to Kurt and cause Jen all sorts of grief, or do you want to go to Jen and say, "Hey, what the fuck?"
Josh: I want to tell. I think she's dangerous, irresponsible, and inappropriate for this unit.
Bob: Well.... well, alright. Lemme... okay. I'll uh... I'll talk with her.
Josh: Do you want to tell Kurt about it or should I?
Bob: (walking away) I'll tell him.
Josh: I caught a client smoking in his bathroom. I put him on loss if privileges (LOP) for the day.
Bob: Don't you think that's a bit much? You don't want to be too heavy with them.
Josh: I found cigarette ashes all over a client's bathroom floor. I took away two outside smoke breaks.
Bob: I dunno. They need to smoke to blow off steam.
Josh: So-in-so was cussing in the milieu again. He's really pissed off.
Bob: Get his ass in here. You know what? No. Put him on LOP. Cool his ass off.
I asked Bob once if he was taking good care of himself, if he had some support system in place, he told me that he had his girlfriend and his pets.
Bob is the manager in a unit specializing in chemical dependency. He is in charge of every counselor on the unit. Bob does not see a therapist and has no one in the building that supervises his clinical practices.What would you do?
"You go Bob," I laughed as he jiggled by.
As he emerged from the office, someone requested he sing something for us. My boss, my supervisor, the guy I report to in a clinical rehabilitation center sang out....
"Grab the biiiitch byyyy the throooooat..." He smiled at the clients to see if he had gotten their approval.He had.
I am not supposed to argue with or correct other staff members in front of the clients. I have gotten very good at acting like things don't bother me. I don't think any of the clients saw the look on my face after he sang it.
Other things said by my boss to the clients:
"You should want to get out of here so you can go to Hooters and get served by waitresses with big titties!"
"Maybe you'll be lucky and you're hair stylist will have big titties all up in your face while she's cutting your hair."
"Are there any women around?" Glances. "If you get a piece of ass while on pass, that's your business."
My boss Bob was once a counselor who got bumped up because my old boss left the company. This is his first job in management and he had no management training. He hates training and complains whenever any is provided. He cannot work a computer and depends on me to fix his reports when things go wrong.
Bob Holford is fifty-something. He has Cirrhosis, Hep C, Emphysema, smokes like a chimney, and eats McDonalds everyday. He spent 10+ years in prison and is a "recovered" drug addict who used to go to 12-Step meetings. He had quit smoking but started again when he got the manager job. Bob refers to the clients as "the little darlings" with a sneer on his face.
Problems with women, Bob?
When I told him that some female staff members were uncomfortable with how our clients were looking at them, I was told by Bob that "Men will be men," and that women who dress a certain way bring that upon themselves.
Even if they follow the corporate dress code?
"Hey," says Bob, "There are days when Mandy walks by my office and even my mind starts going places!"Bob said this in front of eight other staff members, two of which were women; they disagreed, but they were under 30. The next day, he called Mandy into his office to ask her if she thought that maybe her way of dressing was inappropriate. He then told her to her face that his mind goes to places.
In a fashion not unlike a Seinfeld episode, Bob will opine the exact opposite of anything I say.
Bob (Looking at a bottle of generic Scope): Does this have alcohol in it?
Josh: Yes.
Bob: Its not listed in the active ingredients.... I don't think there is.
Josh: I found this pill in Client Z's jacket pocket. The pill belongs to Client X. Jen the nurse is letting Client X keep these on his person and he's giving them to other clients.
Bob: Have you told Kurt (the facility director) yet?
Josh: No.
Bob: Lemme ask you this. Do you really want to show this to Kurt and cause Jen all sorts of grief, or do you want to go to Jen and say, "Hey, what the fuck?"
Josh: I want to tell. I think she's dangerous, irresponsible, and inappropriate for this unit.
Bob: Well.... well, alright. Lemme... okay. I'll uh... I'll talk with her.
Josh: Do you want to tell Kurt about it or should I?
Bob: (walking away) I'll tell him.
Josh: I caught a client smoking in his bathroom. I put him on loss if privileges (LOP) for the day.
Bob: Don't you think that's a bit much? You don't want to be too heavy with them.
Josh: I found cigarette ashes all over a client's bathroom floor. I took away two outside smoke breaks.
Bob: I dunno. They need to smoke to blow off steam.
Josh: So-in-so was cussing in the milieu again. He's really pissed off.
Bob: Get his ass in here. You know what? No. Put him on LOP. Cool his ass off.
I asked Bob once if he was taking good care of himself, if he had some support system in place, he told me that he had his girlfriend and his pets.
Bob is the manager in a unit specializing in chemical dependency. He is in charge of every counselor on the unit. Bob does not see a therapist and has no one in the building that supervises his clinical practices.What would you do?
We Make Clients Sicker
I'm starting this website because I'm bursting at the seams. I want to say these things out loud to a non-biased audience to see if things are really as bad as they seem to be.
I work in a long-term residential inpatient treatment center for substance abusers. Almost every client is mandated to stay there by a judge. It is a 4 month treatment stay. There are 35-40 beds.Many of the counselors treat the clients however they please. The clients are treated like inmate children.
There is no clinical supervision on the entire unit.
We make clients sicker.
I'm writing because I am unable to change things. My name is not Josh Rux. I'm changing names and details as I write.
If I'm an idealist it's because I think the clients need help and shouldn't be treated like criminals.
I am trying to make a difference, and it might get me fired. I work part-time as a counselor's assistant on the unit. This makes me the only one with nothing to lose.
I'm going to write about the things I see and the people who work there.
If I figure out how to let you, please tell me what you think, what you would do, what I should do, anything.
I'm tired of being quiet.
I work in a long-term residential inpatient treatment center for substance abusers. Almost every client is mandated to stay there by a judge. It is a 4 month treatment stay. There are 35-40 beds.Many of the counselors treat the clients however they please. The clients are treated like inmate children.
There is no clinical supervision on the entire unit.
We make clients sicker.
I'm writing because I am unable to change things. My name is not Josh Rux. I'm changing names and details as I write.
If I'm an idealist it's because I think the clients need help and shouldn't be treated like criminals.
I am trying to make a difference, and it might get me fired. I work part-time as a counselor's assistant on the unit. This makes me the only one with nothing to lose.
I'm going to write about the things I see and the people who work there.
If I figure out how to let you, please tell me what you think, what you would do, what I should do, anything.
I'm tired of being quiet.
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