h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

The Evil Green Ball

During my last few years at home, I knew I had one clear enemy -- the floor. If I fell out of my chair, slipped off the bed or flubbed a transfer, I would fall, and we paras don't go down like other folk. Our legs twist into nasty pretzels or don't bend at all, sending us face-first into furniture or walls. Been there! So everything about my posture involved leaning away from danger, and when Dan innocuously asked me to lean forward, just while sitting on the edge of the bed, he discovered a real psychological block in an otherwise willing patient. My idea of leaning forward consisted basically of leaning back.

Dan and Adrienne consulted together -- Adrienne was my physical therapist -- on how to get me past this very real terror. And so Adrienne would come strolling into the room with a grin on her face and the Evil Green Ball under her arm. About two feet in diameter, the EGB would be placed in front of me, and I was expected to LEAN FORWARD, rest my hands on the squishy inflated ball, and then roll it forward and back, then from side to side. I think it took her most of one session just to get me to put my hands on the EGB while she chocked it from the other side with her foot, and even more stern persuasion to get me to remain there, sweating and hyperventilating.

Well, I improved, and meanwhile, in addition to ticking off the self-sufficiency goals each week, Dan organized the acquisition of Harkonnen, and brought a whole new kind of equipment into the therapy department, the Beasy board. I was skeptical (read: scared) the first time he walked in with it, but soon discovered its advantages, and within the month I was self-transferring again.



Being a patient is a license to be self-absorbed, in which pursuit one is aided and abetted by the staff whose job is to make you better. It was a long time after I had been signed off as fit to fly by Dan that I pieced together just how demanding the therapist's job is. Only certain parts of administration are more computerized than therapy. At the end of the day, the CNAs sit down and handwrite updates to patient charts. There is a medical records office behind the nurses' station, and maybe the handwritten notes are transcribed there.

Last year Dan was texting directly to the computer via a smartphone-sized device from my room. Now he's pushing a laptop around on a wheeled table. He, and all the other therapists, must account for every minute of their time to the computer, including time "off the clock" if they want to do something like chat with a patient friend for a couple of minutes. There will be 49 minutes with Patient A, 62 minutes with Patient B, 55 minutes with Patient C and so on. The pernicious part is, the computer system gives feedback about their productivity. Too many stops to chat and next thing you know Dan has a dent in his productivity quotient.

Why is the system doing this to college-educated quasi-medical staff? Because a programmer or tech mentioned that the system ~could~ measure stuff like that, and so put the idea into the head of a business manager. All those wonderful metrics! A time clock gone wild! Management power trip! It's a bad thing. I get that a database of goals exists and that's why it's 45 minutes for Mr. X and 70 minutes for Mrs. Y, but what if a therapist were to give a bit of extra time to one of his cases, a reassuring conversation? There is no leeway there for compassion, for the unplanned extra moments that might make a difference to a patient's mindset. The therapists are on piece work.



I'm on restorative therapy now, a thrice weekly occasion aimed at preventing deterioration, at the very least. Because of how the system works, I had to choose between endurance (going down to the gym and using the arm cycle and some other equipment) and range-of-motion work (remaining in bed and having my legs flexed and rotated through each joint). Can't have both. I loved going to the gym, but chose range of motion, for the continued flexibility of idle limbs and the good side effects for other autonomous subsystems. And, when it's not too crowded, I sneak down to the gym and hang out with the good people there.

Time sheets, the horror, the horror. A deal of my early working life was spent in service industries, customer facing jobs. If three people walked in you were busy, when no one walked in you occupied yourself either by chatting about last nights football match, or if the 'manager on the prowl' warning went off, tidying up and sweeping the floor. Nothing in writing.

The only place I ever worked with time sheets was an aerial mapping business. Every minute of your day had to be noted down on the timesheet. Between this time and that time, preparation (in its varied subsets); between then and now, plotting on the machine, etc etc.
At the end of the day you transcribed your notes onto the official time sheet. It had to add up to eight hours. It never did. Luckily you could intersperse a few extra minutes here and there with the help of GOD.

General Office Duties. Luckily for us GOD seemed to forgive many of our sins of indolence.

It's the same everywhere now, computerised records of everything take precedence to human interaction. What probably started off as a good idea has run out of control, the machine is master.

I wonder if the system monitors how much time is spent entering data into the system.

I'm always having to chase people to submit their timesheets at work, because time has to be logged against contracts. It's important we know what time is spent on so we can factor it in when quoting for new business in a competitive market.

But we're not involved with providing healthcare.

Nearly 20 years ago I worked for a well-known catalogue shop in their call centre, dealing with home delivery issues. During a call you had to update their notes on the computer system & enter a "call type" code into the phone system. The number of calls you took and the number of calls you coded were measured to basically log your worth as an employee. I lost count of the number of calls I took where the person had been cut off before their problem had been resolved - apparently long-standing employees could tell if a call was going to be time consuming so they stayed on for long enough to log the call then "lost" the caller.

Having to account for every minute does not encourage good customer service.

Deb

[Amy P]