Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Tuesday, February 20, 2007

When you do everything right but all that matters is money

One of the hardest parts of working for me has always been my "productivity number". I'm mentioned this before, but in case you don't memorize the details of my life, what this is the percentage of the time I'm paid for that is billable. It is supposed to be 85%. This is not particularly realistic for anyone since we do massive amounts of paperwork that is not billable, and many things comes up during the day that need to be taken care of. Checking people to see if they need therapy services, walking place to place, setting up/cleaning up, all those things take time.

In my case it is just impossible to want this consistently because I can't do paperwork at the same rate as other people. To best meet the requirement you need to write while you treat and I can't do that. Some days I can't smoothly proceed through an evaluation as it is, and I've done thousands of them, the same basic thing each time. I am also more affected by noise, etc than other people are, and nothing really can help that but giving me a quiet place to work. At one place I share a tiny (and I mean TINY) office with 5 people, and at the other I work at a desk in the treatment gym. The word gym should say it all in terms of noise. Additionally my work is affected by how tired I am (and one must realize when considering how tired that can be that I take ENORMOUS doses of sedatives daily. I've now surpassed a huge dose and moved beyond that, and that's one of 3 sedatives. But the sedation is not a cure-all; when I'm depressed it can feel like far too much, but it can't be reduced during those times because that just makes me cycle as I need this much sedation for mood stability. When I'm not depressed it can be not enough sedation, which means I have to add Ativan during the day, which makes me even more tired and out of it. On top of these things my atttention span has been affected severely, and a lot of paperwork is harder for me because I mess it up if I'm not extraordinarily careful. To top THAT off I have visual problems. My pupils are extremely dilated from meds, which means that I get a lot of glare and am susceptible to eyestrain. I have lazy eye, so I don't track well, and this makes me mess up paperwork even more.

Four years ago I had no problems with my previous employer. They were kind about the whole thing and I never put it into writing. Over time the numbers increased and they started pushing. Every company around started pushing, and some will dock pay, etc. if you don't meet the standards. Just in the last few years the normal requirement has increased from about 75% to 85%. Some places want upwards of 90%.

Therefore when I took this job I had it in writing that I cannot be held to normal productivity standards. They acted like they couldn't really give in on this, but the truth is they have to and they know it. So after a while nobody said much about it, although I am obsessive about it because I feel like I'm constantly on the verge of getting in trouble over a number.

And then today happened. Today I got a lovely note, left in a public place, telling me that every DAY that I'm not at 80% I have to account for it. It has always been that it was every week that mattered. Last week I was 79% and would have been higher except for something she was aware of. One day that was low was low because I was doing paperwork from the preceding two days, which were during the blizzard. I'm really upset about this.

Last week I worked 43 hours. I drove in some really bad conditions to make sure that patients were seen so we got paid the most possible. Thanks to the weather I had to work 5 days even though I should have had only 4 and a vacation day. I was sick the whole week with a cold. I made a LOT of money for the company. I know this because every 15 minute evaluation I do makes about 3 times what I'm paid per hour, and I did a lot of evaluations. I constantly seek new patients and find them for all 3 therapies. I effectively treat my patients.

I'm not sure why it is so hard for people to understand that the ADA accomodations I have are not just favors I get. (This is exactly what co-workers think, I've heard so many times people tell me I should be grateful they "let" me do this or that when truthfully they have absolutely no choice). I especially am angry when it is managers who are supposedly trained.

This is the point of some of my vocational rehabilitation services. But every time I get a note like that and never get a note that says good job I feel more and more like it's pointless, that I can never do a good job beccause I can never have good numbers.

That pretty much sums up my day. I ran constantly and then wound up feeling like I'm terrible at everything because I can't find a way to force myself to not have problems that just will never go away.

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