Tuesday, May 31, 2011


Please put underwear on before your case manager comes over.  Please!

Adventures at the Doctor's Office pt 2

Sometimes I read Dr. Grumpy and feel sorry for the doctors. Sometimes I sit in a waiting room and feel sorry for the patients!

A woman came in and I overheard this exchange:

Ms. Skrewd – Hello, I’m here early as usual!
Receptionist – I’m sorry, we don’t have you down for an appointment…
Ms. S – What do you mean? I see Dr. Nohelp twice a year to check my ____________. I booked this appointment 6 months ago!
Receptionist – (checking computer)…I’m sorry I really don’t see your name here. Although we did change our booking system a few months ago, so we may have lost your appointment.
Ms. S – Look, I had to take off work to be here. Can she fit me in?
Receptionist – She’s not here today. She’s never in on Wednesdays.
Ms. S – Well how soon could you book me in to see her?
Receptionist – I’m sorry, she’s about to go on maternity leave. This is her last week.

I think that’s when Ms. Skrewd’s head exploded. They did get her in to see one of the other doc’s however.

Friday, May 27, 2011

Comment Probs

I would just like to say "hi" to some recent followers and commenters!  For some reason, Blogger is not keeping me signed in to comment, so I haven't been able to reply to anyone.  Is anybody else having this problem?  Here's hoping it's temporary!

Thursday, May 26, 2011

Adventures at the Doctor's Office pt 1

Found in a doctor's waiting room yesterday.  It's not the best shot, so in case you can't tell that is a National Geographic magazine from October 1977.  I know doctor's offices are notorious for providing out of date reading material, but this is a little ridiculous!  There was an ad for "color TV" on the back.

Tuesday, May 10, 2011


Written assessment answer from a client...

Alcohol: does drinking cause you any problems?
        Not mine, but other peoples around me.

Breaking Up Is Hard To Do

I’m breaking up with a client. At least that’s what I’m trying to do.

I’ve been seeing her for two and a half years. I picked her up from another program, and she has had case management support since 2002.

She doesn’t need me anymore. She’s said as much herself: she’s got an active life in her community, great family and professional supports, medication that works well for her. But she sticks around because she wants a ride. I drive her twice a month to her trustee, which is a fair way from her house.

This arrangement made sense when she started it with her previous case manager. She needed help not to miss the appointments, and to understand the information she was given when there. But not any more. She’s had time to learn and get used to the process, and she can do it by herself, but doesn’t want to. I can hardly blame her. Why spend money on a taxi when you can get a ride for free? And taking the bus is a pain. That, and the fact that my “support” is tied to her housing makes it difficult for me to disengage.

This is the bigger (systemic) problem. More and more the focus in community mental health services is on “recovery” and this is definitely the right idea. People don’t need to stay sick forever, and support from people like me is supposed to help. This woman has had an incredible recovery, but as it stands our supportive housing program provides no exit as long as she relies on the rent subsidy. I would never say that her subsidy should be removed before she can afford it, as having safe and stable housing is obviously a huge contributing factor to keeping her well. She can afford (IMO) to do without me.

After having explored this issue from every angle with my supervisor for months and months, examining myself for counter-tranference, and trying everything to be sure we were not under-serving her or missing ways that we could connect or provide support, my supervisor told me that I have her backing to start withdrawing transportation support. I have no desire to leave her high and dry, so I will propose that we agree on a timeline in which we can develop a new transportation plan and then I will stop chauffeuring driving her. I began practicing in my head how the conversation would go, and how I will handle her possible reactions.

I went to pick her up yesterday. She was dressed very nice and had a big smile on her face. I wished her a happy belated mother’s day and she thanked me. Then she informed me “and it’s my birthday today!” Oh crap.

I couldn’t do it. I couldn’t rain on her birthday parade with my difficult news. Put plainly, I chickened out.

We meet again in two weeks. I’ll do it then, I swear. Otherwise, I know I’m only prolonging the pain.

Wednesday, May 4, 2011

Job Posting

From a Social Worker/Therapist job listing that came through my inbox...

Second language is considered an asset;
Willingness to work at multiple sites due to program scheduling & requirements;
Evening work will be required;
Subject to a Police Reference Check;
A nice sense of humour wouldn’t hurt.

Tuesday, May 3, 2011

The Morning After

Woke up this morning trying to stomach some bitter-sweet election results.

At a downtown courthouse with a client, overheard two cops laughing with a judge about being parked illegally in front of a fire hydrant outside.

Got to the office in the afternoon to find that the pantry no longer contained my beloved Tetley's tea, but RED ROSE! Ack!

My faith in institutions is being tested in ways big and small today.

Monday, May 2, 2011

Case Manager: Expert in Everything

Voicemail left by a client over the weekend:

"I got my flyers today, they have a sale on an 8GB ipod for (insert $$ amount) and my sister says she can get an extra 10% with her seniors discount. Can you call me back and let me know if that is a good deal?"