Five Minutes to Five

The time of day at which I put my phone to "Do Not Disturb".  Because no phone call at this time of day will last less than 5 minutes.  It's like, a law of nature or something.

Sleep Dialing?

09:26 - Woman leaves me a voice message asking me to call back to reschedule her mother's missed appointment

09:40 - I return the call.  Woman answers and asks if I can call later today, as she's still in bed/just waking up and will be out to another appointment at 11:00.  I'm busy all day with appointments and won't be able to call her back, so instead spend 15 minutes on the phone with her while she tries to book an appointment with me and asks me who I am and why I'm calling about 10 times.

This is what I get for returning phone calls promptly.

Call to the Resource Line

Mental health resource line, can I help you?

Hi, I'd like some help to find resources for my daughter, she's 23 and...oh shit!  Here she comes and she looks pissed! *click*

The Problem With a Waitlist

Image found at http://oldgoldandblack.com/?p=27171

Is when you call a client who has been on it for months, possibly a year or more and they have NO idea who you are or why you are calling them.  We do check in calls with people while they are waiting, but there is still so much confusion.

Amongst other issues.

First Contact

Meeting a new client for the first time can present many challenges.  Not least of these is figuring out WHO you are meeting.  I mean this literally - as I rarely see clients in the office, and won't go into their home until I know them a bit (and barring extenuating circumstances) I generally make these appointments in some kind of neutral, casual public place ie. coffee shop.  Such places generally have all kinds of people strolling in and out, so without any face recognition, it can be tricky to identify your client. 

I try to ask them for a bit of a physical description when we arrange the meeting.  I have learned that most people are not very good at giving this type of information.  Unless there is a really obvious feature like they use a wheelchair, or have 3-foot long dreads, most people describe themselves in pretty basic terms - I'm kinda short, I have dark hair...useful stuff.  I don't know if this is lack of self-awareness, or self-conciousness that prevents people from being more specific.

So I try to describe myself in order that they can find me.  I try to go with some specifics that won't easily confuse me with others - I have a nose ring, I carry a large purple bag, I wear a red scarf.  But many clients are nervous about a first meeting, and may not approach me.  To be sure some are the complete opposite, but I've had at least one woman sit in her car staring at me through the Tim Horton's window for almost half an hour before she could psych herself up to approach me (I'm really not that intimidating!). 

Then there's always the tried and true but slightly embarrasing method of "asking around"  - is your name Bob?  No?  Sorry to bother you.

I can't help but feel this gives people the impression that I'm there for some really lame mid-afternoon scuzzy-coffee shop blind date or something.

Some clients have cell phones and sometimes they even give me the number, so then I can try to call them.  Hopefully, their phone is turned on.  And hopefully it has minutes.  And hopefully they're not screening calls thus ignoring my "restricted number". 

Usually, we track each other down eventually.  Sometimes we don't.  When this happens it may mean days or weeks of trying to rebook and not miss each other again.  In my experience, when a client and I miss each other the first time, it's not been a good sign for things to come.  These have often turned out to be the clients who don't want to engage, or that I will end up chasing down just to get a few measly face-to-face contacts before they disappear completely. 

I have two new clients to meet this week.  Look for me, I'll be the anxious, jilted looking lady with purple bags under my eyes.

20minutes@350degrees.com

From a client assessment by one of my co-workers:

Roger is responsible for paying his phone bill independently.  He does this through online baking.

*yes, small things like typos amuse me.*

Operator, what's wrong?*

The fax came through, but the page must have twisted or crumpled a bit, because the extension number was obscured.  Tried to guess at the number, but guessed wrong (sorry to have bothered you ma'am). 

Called the main line of the hospital and gave the new "automated voice system" a try, but the computer figured that "Andrea" was close enough to "Angela" and patched you through wrong again.

Called the main line, pressed 0 for the operator to ask a real person.  They gave you the extension for the department, which didn't even match the 4 out of 5 numbers you could read on the original document.  Spoke to a very nice lady who told you no, you need to call our downtown location.  Gave you that number, and you give it a whirl.

Another helpful sort answers the phone only to tell you:
1) the person you want to speak to is not in today
2) the whole department closed half an hour ago &
3) you'll need a new release of information before you speak to the person you've been trying to reach anyway.  The one you have is out of date.

Aaargh!

*I dial stupid number all day long! 6060-842

Inquiring Minds Need To Know...

Co-worker to a client on the phone: Who or what is that screaming in the background?!?

Tinnitus too

We have a new microwave in the office. The tone when you push the buttons is extremely annoying.

The photocopier won't stop beeping because it is angry that it has nearly run out of cyan toner.

My co-worker must be very popular today, because she left her cell phone on her desk and the beeping, bleeping, and ridiculous ringtone are incessant!

There are at least 6 people in here all on the phone at once, yelling at the poor people on the other end of the line in order to hear themselves over everyone else!!!

THIS NOISE MUST STOP!

If this is some weird test from the universe to see how well I handle what many of my voice hearing clients experience every day then I fail. Miserably.

O-H@W

Coworker speaking to a client on the phone: I don't know what that is, but I'll give that a Google.

Really people, maybe we're taking this whole "google" as a verb thing too far!

A Day in the Life

Thursday February 3, 2011

8:30am – park a block away from first appointment and check messages on office phone and cell phone. Remarkably few, possibly due to yesterday being a “snow day”.
9:00 – pull up to client’s building for first appointment. He’s a big guy (with severe back, neck and knee problems) who struggles to get in my little car, but we make it. We head off to check out a new grocery store, a figure out a route for him to take the bus there on his own next time.
9:45 – take same client to coffee shop for a caffeine fix and quick chat about plans for next week’s meeting.
9:59 – return to client’s building, help him load his groceries in.
10:00 – back in the car, call the pharmacy to see if next client’s prescriptions can be made ready for pick up. Ah, crap – there are no more refills. The pharmacy offers to fax a request to the doctor’s office, and I call the client. He swears that he did see this doctor in the past few months (can’t remember exactly when, but…) and forgot to ask about those prescriptions.
10:10 – Call the pharmacy back, they say it might take awhile. Call the client again, tell him it might take awhile and is it okay if I drop his meds off this afternoon. Yes, that will be fine.
10:20 – Eat my lunch in the car trying to ignore the fact that it’s -10 Celsius outside but I’m dressed in several layers so that’s okay. Relish the fact that I have a few minutes to listen to Q on the radio.
10:45 – Head downtown to start searching for a parking spot.
11:00 – Find parking, dash across the street to the church to set up for the Outreach lunch program. My co-facilitator has beat me there, as have several of the clients, even though we don’t officially open until 11:30, but hey, it’s still -10 out!
11:30 – Serve chili, chips, and veggies to familiar faces, and some new ones. The attendees are mostly male, 40+ and kinda rough around the edges. They make loud conversation about politics, people they know, their plans if they won the lottery, and “the way things used to be”. They’re a good natured lot, and the lunch tends to run a lot more smoothly than its breakfast counterpart at the other church. Breakfast gets a bigger crowd, and there is sometimes “trouble”.
12:30 – start tidying up as people leave. Spend some time supporting an elderly couple whose son lives out east and was recently diagnosed with bipolar. They’re frustrated that “the system” out there isn’t giving him the support he needs, and they wish they could do more to help. They went to visit him last fall when he was in the hospital, but the motel was expensive, and it’s hard for them to travel.
1:08 – I realize that I’m late for my next appointment, and try to call but get the answering machine. The outgoing message wishes me a “happy new year” and remarks about the date 01/11/11 for several minutes before cutting me off, so I don’t get to leave a message.
1:15 – I arrive to my “happy new year” client’s building, but there’s no answer when I buzz the intercom. I wait inside the front door for several minutes then try again. I call her phone, and the answering machine seems to work this time so I leave a message asking her to call and reschedule.
1:30 – Back in the car, I drive to the neighbourhood of my next appointment, and park across the street to check messages again. One marked “urgent” from a new client whom I have met only twice telling me that he found a room to rent and is no longer living in the shelter, and he’ll call me later to set up an appointment, because he doesn’t have a phone. Another from a current “high needs” client crying and upset because she’s lost all her ID. This could be pressing, but I know if I call her back it’s possible I’ll get stuck on the phone for a long time so it will have to wait for a more opportune moment.
1:40 – I check my email and notice a message from a client I did an intake with a couple weeks ago. He let’s me know that his housing arrangements “didn’t work out” and he, his wife, and their two children are now in the family shelter. He sounds pretty desperate for help and is planning to rent a truck to go sleep in. I remember him as extremely depressed, anxious, and suicidal. I email him back quickly to ask if it would be okay for me to refer him on to our outreach program which can meet him right away.
1:55 – I call my 3:00 to see if we’re still on because he often cancels. He has schizophrenia, and is also going through cancer treatment so he’s not always in the best of shape to meet. He asks if I can come earlier than planned and I say we’ll see.
2:00 – I check in with my next client. It’s dark in her apartment as the balcony door is blocked by the snow and she never opens her curtains. She finally let her dad know that her cat died, so he’s not worried any more about why she’s acting out of sorts. She missed her psychiatrist appointment last week because she’s scared that if her taxi runs out of gas it’s winter and she’ll be stranded in the snow. She’s scared that no one will save her. I try to understand, and try to support as best I can.
2:30 – Back in the car, call Mr. 3:00 and let him know I can come now. He wants to go to the grocery store and has his list ready.
2:35 – I pick him up, and off we go.
2:50 – I’m getting a grocery cart while my client starts his shopping inside. An older gentleman is trying to light his cigarette with a burnt out lighter, and I suggest to him that he’s probably not allowed to smoke in here and needs to go outside. He asks me for a match, but I don’t have one. He goes back to trying the lighter.
3:45 – Groceries are done, and after a stop at the post office I take my client home. We make arrangements to meet next week if he feels up to it.
3:50 – In the car I call the pharmacy from this morning and learn they finally got the refills, they didn’t think they would cause this doc has said no before. I call my client to update him, message my boss to update her about the changes to my schedule/location (for safety purposes, understand) and head off to the pharmacy.
4:05 – At the pharmacy we commiserate for a minute, and they tell me my client called them about 20 times today, anxious about his medication. They’ve known him for years, since he was homeless down the street from their store, long before I came around. They want to know does he also need his foot cream, I call, he doesn’t, I take the bag of pills (these have got to be worth $$$ on the street!) and zip over to his place.
4:20 – I get there (just in time) hand over the drugs and apologize that I won’t be able to stay and chat. I’ll call you tomorrow to schedule a check-in appointment, okay?
4:30 – I finish my day on time somehow, and call home to let them know I’m on the way.

Worry? Me? Nah.

Voicemail left by a client:

"…I know I asked you for that taxi voucher thing last week so I could go to the food bank? But I was just calling to ask you if I could use it to go to my doctor for my stomach instead, I can get to the food bank, I don’t know if you know that guy George? He’s that kind of blind guy that goes there a lot, but he drives around and I can get a ride with him. So I just wanted to call you to tell you don’t worry about it. Call me back!"

Clients without phones...

...make for a lot of work.

WHERE ARE YOU??!?!?

Get Yourself Together Man!

So you know how sometimes someone will leave a message on your voicemail, and then fail to hang up the phone afterwards? Sometimes all you end up hearing is what television program they're watching, or the rumpled sound of being tossed into a pocket or purse. Sometimes however you are lucky enough to hear something a little more exciting! These calls seem to happen a lot when working in mental health.

Today’s such message goes like this:

(msg left by a client for a coworker on my voicemail, my comments in italics)
Hi Liz it’s Mr. Defective. I tried to call you earlier, but I couldn’t find your number (duh). I’m wondering if you could send me a taxi, I really don’t want to miss this appointment (he’s calling at 1:24 for a 1:00). If you could call me back that would be good.

(apparently this is where he thought the call ended)


…f**k, what is this shit?.........ah-choo!.........BURP…this is such shit, I was going to call before, but…ah-choo!............ah-choo!......ah-choo, ah-choo, ah-choooo!!!!!!

My co-worker is not here today, so I don’t even know if he made it in on Friday. I kindly forwarded the message to her ;)

Can’t…do…it…

Just can’t. Answer the phone. Not today. I will check the message and call you back, promise.

Why does this little piece of technology cause me such anxiety? I don’t know, but it always has. I should talk to myself about this – I counsel my clients regarding their anxiety all the time.

What I wouldn’t do to have a receptionist!