Wednesday, March 31, 2010

Casual Acknowledgment

A coworker off offhandedly said to me that my client John is lucky to have me in his life because I've worked with him on a lot of challenges recently. She said it casually, a few sentences as we were walking down the hallway. It felt really good to hear that. It reminded me how simple gestures mean so much.

I'm not sure if it would be the same to hear kudos every day -- I tend to believe it would lose its meaning. But on occasion it's an incredible boost.

Saturday, March 27, 2010

Unwanted Thoughts

I'm standing inside a bubble and the same pestering thought bounces against the walls. I'm able to logically reason myself out of the unwanted thought and understand that I'm holding on to it obsessively but it still persists. It sometimes takes days for me to snap out of it.

This thought could relate to an incident that happened, or remembering a past event and related anxiety. These unwanted thoughts don't happen all the time, maybe once a month, but when they do it's excruciating. I try to distract myself. Do something else, listen to music. Write down what I'm thinking about or talk to others about it in the hopes of reaching catharsis. And as I feel that unwanted thought trickling back in despite my intentions I think about a couple of clients of mine who struggle with obsessive thoughts. How all consuming they can be.

Thinking about this I rediscovered and am rereading White Bears and Other Unwanted Thoughts, a book I had read in college but barely remember I plan report back.

Monday, March 22, 2010

Staying in a Client's Life for the Kids

Clara has two children, one who recently came back to the picture after her husband decided he could no longer take care of him. She contacts me every few weeks asking for items like gift cards to get clothing for the kids. She's not a typical demanding client because she's endearing. We've had several conversations where she's confided in me of her struggles. I know she deals with a lot. Budget is tight but she puts her kids first when she plans. Despite this I see that she makes choices that aren't wise -- like sometimes paying minor debts before paying all her rent. I have made several offers to work with her in the year I've known her. On budgeting, changing shopping habits, nutritional concerns. She's mostly resisted my offers but continues to ask for material items.

Sure, it's her decision to turn down case management services. On the other hand though, I began to feel frustrated that I'm only being contacted as a resource of goods. But then I felt for the kids. Last year we were able to tie the older daughter with a Big Sister program and she seems to be flourishing under it. Lately Clara brought up doing the same program for her younger daughter.

After months and months of trying and discussing it with a coworker I understood that I just won't be able to support Clara like I'd like to. As tough as it was for me to reach this conclusion, but I had tried to offer Clara case management services indirectly and directly, made a few home visits, spoke softer and more harshly. But at this time (and maybe even in the future), she's not ready. I realized too that I'd like to continue and give her occasional assistance because of her children. If I would be able to support them that would still make a difference to the family.

Saturday, March 20, 2010

We All Have Our Moments

A client leaves me a message asking for a provider's number. I call back, get answering machine, and leave the number. I go out of my office for an hour for a meeting, come back and check my messages and find my client had called again.

My client: Ah, yes, you called and left me my phone number...

................ My bad. Here's to trying to do 3 things at a time without always getting the best results.

Tuesday, March 16, 2010

Healthy Level of Insanity at Work, Addendum

I've added my own additions to the original list:

19. When someone knocks on the restroom stall door, answer "Come on in!" Bonus points if you're in a restroom with multiple stalls.

20. Use interpretive dancing to impart difficult news. Imagine a scene of a coworker or yourself delivering the news to a client that medicaid has been cut off so now client will be paying 75% of her co-payments but in dance! Undulating arm movements and all.

21. At the end of a particularly productive/heavy conversation with a coworker, say a random or odd phrase with inspiring flair. Example: "And remember: Take a bite of your orange and look onto tomorrow."

22. Use only cliches when responding to other staff members. See if they answer back with a cliche of their own.

Sunday, March 14, 2010

Challenge of "I Got This"

Sometimes I feel torn between keeping an air that I have a handle on my caseload and letting my supervisor know when it becomes overwhelming. I've gotten into the groove of  balancing the 30 something people on my caseload most of the time. But lately it has been getting tougher managing routine work since two clients have been dealing with crisis situations. I've had to direct hours of time and energy to both these clients and have seen how challenging it is to keep up with my other clients.

Feona, my supervisor, has shared a few duties relating to my more demanding clients but I still carry the brunt of the load and pressure that comes with it. But I do like knowing she can rely on me to handle my job and know I also have high expectations of myself.

I suppose it's hard for me to admit I need help. But it's getting too hard to manage things.  In thinking about how to approach asking for help, a friend of mine suggested I sit with my supervisor and go over my caseload to ask for her advice on specific cases. It may be possible to transfer a few clients out for particular services or share some tasks with another case manager. I have the benefit of working in a supportive team and I don't take that for granted. But I should take more advantage of it.

Thursday, March 11, 2010

Why Don't You Smile?

"I'll hurt my lips." George Harrison

Many many months ago I wrote about my annoyance re: women and smiling. That women are associated more with smiling and are more likely to be targeted with an admonition to do so. Miss Manners recently tackled a question relating to this in her column. I liked her response.

Tuesday, March 9, 2010

Redirecting a Client's Request

It's nice when a client leaves a message on my voice mail about needing bus tickets or a different item and it's a person who frequently makes these types of requests, and I call back and am able to troubleshoot and give them another option. And the client thanks me and doesn't mention needing anything from the agency.

Doesn't happen very often, but it's nice. Specifically because of our own limitations on material assistance we may provide to clients. Sometimes I go into troubleshooting mode ("Have you tried to do this?") without even bringing up client's initial request.

Sunday, March 7, 2010

Casual Conversation into Making a Choice

Holly usually checks in with me at least once a month. She has lived alone since her boyfriend passed away 3 years ago. Sometimes she has a specific question but she also comes just to talk.
Yesterday she came in and we talked about an upcoming kidney checkup event taking place in the neighborhood. As we talked conversation steered towards thinking about the future. Holly has been living off inheritance from her mom but that it was starting to run low. She has not working in some time and was supported by her boyfriend when he was alive.

I tried to broach the subject of how she was feeling about working or filing for disability as she would eventually need a steady source of income. Was there was something stopping her from working, mentally or physically? Did she want to work? Holly said that she felt she could work and that when she was laid off she thought she could've continued working. I mentioned our sister job counseling program and asked if she was interested in participating. She said yes and I admit, it encouraged me a lot to hear that. Encouraged me to know she wanted to do something to help herself.

It took me time but I've realized that for a variety reasons many of my clients don't work. It would certainly not be easy for Holly to start working and supporting herself as a woman in her mid-fifties and after having not had a significant job history. True, economy isn't in good shape and positions aren't readily available but it's a start to have motivation to try and supportive resources help. Despite the challenge of finding work it would still be far more difficult to be approved for disability benefits. That process may take years. Not to mention the higher earnings through work. Now wait to see if she follows up.

Thursday, March 4, 2010

We'll Meet Again, Don't Know Where

Me: "So let's set up an intake appointment and then we'll look into the health referrals." I say.
Potential New Client: "OK. Could we meet on Thursday? I'll be out of town until then. One o'clock works best for me."
Me: "Great, that works."
PNC: "All right. Good. See you then!"
Me: "Wait, do you need to know where ou--"
I call back.
Me: "Hi, I wanted to make sure you know our office's address."
PNC: "Oh... Yeah, that would be helpful!"

Tuesday, March 2, 2010

Recognizing My Own Traits in Clients

It's challenging when I come across my own characteristics in clients, particularly qualities that I find are a hindrance. For example, my client who stubbornly refused to consider moving to a new apartment because he wanted his neighbor -- the cause of the problem in his eyes -- to move out. Though I think had I been in his shoes I would've decided eventually to move, I am very familiar with the "it's the principle!" attitude.

What is at times amusing is when I'm encouraging a client to overcome a bad habit that I myself have. One bad habit is my ongoing challenge to keep my bedroom organized. I know that a clean living space is good for my mind, but it's hard for me to maintain my space like that. I naturally spread my books and papers around. It doesn't necessarily motivate me to become more organized after talking to a client about how important it is but it does make me think more about how yeah, having items put away actually clears the mind. Sharing similar bad habits makes it easier for me to understand the difficulty in changing them.