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Work Vent - I'm so over being micro-managed
I just need to get this out someplace, and maybe someone else might understand. I will also preface it by saying that I am very grateful to have a job (4, actually. But that's a whole other story)
I am a home health occupational therapist and have been with my company almost a year. I have done home health for about 7 years and this is the first company that has actually kept me busy full-time. Because of this, I am reluctant to leave because I don't really believe there are actually greener pastures.
But the micro-managing has me ready to drink every night when I come home - if it weren't for the 2+ hours of paperwork I have to do.
Like I said, I have done this for 7 years. This is the 6th home health company I have worked for in this time. This is the ONLY company that goes over every chart with a fine tooth comb and almost literally makes sure all your I's are dotted and T's are crossed.
I am not REQUIRED to work weekends as an OT, but if I don't, I get QA alerts saying "Jane Doe was opened on 7/15 and you did not see her until 7/18. Please write a note explaining why the delay in service". I honestly want to write "because I have a husband and a 2 year old and I want a fvcking weekend to enjoy". Occasionally I can't get to a patient within 48 hours of them being opened and I get another lovely QA asking why and I just want to write "Because there is only one of me and I already work more than what is considered full-time and I simply can't get to everyone in one day".
I did take all of this up with management to let them know I'm already working 7 days a week for them and doing my absolute best to be timely, and because there is only one OT and 4 physical therapists I just can't both treat patients and get new evaluations done within 2 days all of the time. I got this response:
"Thanks for your email. We are very aware of how busy you are. And we know you do your best to see the patients timely. I really wish we had some flexibility within the regs, that would allow us to schedule evals within a wider time window. Unfortunately, we don't. (We don't write the rules). So, outside of patient or the physican requesting the eval to be on a different day, we need to see them within 48 hours. So, if you are absolutely unable to see them within the first 24 hrs, please try to see them the following day. We do have more flexibility with the patients that had already been opened, since our orders are usually twice or three times per week, and we are not tied to particular days of the week. So, the existing patients can be rescheduled for another day of the week.
Also, I am sure this will get easier to accomplish when your schedule is a little lighter, and/or when your patients are within a smaller geographic area. We do appreciate your efforts. Have no doubt about it!"I have worked, as I said, with 6 different agencies and the only regulation that I have ever been informed of was that the patient has to be open to care within 48 hours - meaning the RN or PT has to open them to care. I have definitely not been able to eval every patient within 48 hours at my other agencies and never once did anyone approach me about this. I'm doubting that all 5 other agencies don't care about rules and regs.
And FYI, my schedule has never been lighter and my geographic area just keeps expanding.
Anyway, I just needed to vent. Besides all of this, we're expected to do office time, chart reviews and attend board meetings (at 6pm, often). All of this is unpaid. I'm an hourly employee and only get paid for actual patient care time.
I'd go look for other employment, but as I said this is the first company in 7 years that has actually been able to give me full time hours.
Re: Work Vent - I'm so over being micro-managed
Let me be sure I understand. So they have a requirement that new patients are seen within 48 hours, so anything opened on Friday would have to be seen on the weekend. THat really sucks for you. But it sounds like the rules that you must abide by. If you continuously break that rule could it not come back to haunt you later on, either in a performance review or perhaps worse?
Can you propose to management a policy that you and your peers rotate who gets new requests on Fridays and provides weekend coverage? That way only some of your weekends are shot, rather than you working 7 days per week, week after week.
Or is it that your management needs to be educated on what "opened to care" means, as you explained quite clearly above? Even if this is the case they may not budge.
The thing is, these "rules" seem to only apply to this company, it's not a Medicare requirement that all disciplines (PT, OT, RN etc) see a patient within 48 hours. It is just a requirement that they are opened to care by at least one discipline by then - and OT is not allowed to open patients to care. If they do have this specific rule, it was never presented to me upon employment.
There is no other OT who can take weekends. I am the only OT with the company, so it is me or me.
I am not specifically breaking this rule, I am doing the best I can do to get things done as timely as possible, but I am already working 10 hour days + weekends to do the best I can.
Katie Talks About...
Wow, I'm exhausted just from reading your schedule let alone living it. I don't really have any advice. You have every right and reason to vent! It sounds like a no win situation. You will probably have to get used to the fact that you will never be 100 percent on top of it and it will always be one more patient etc. I bet your employee evaluations will be high, in that they know the nature of the job itself is impossible but they are required by 'regs' to request and expect the impossible from you. You will probably just have to get yourself to a mental state where you will need to leave work at work, walk away from it and have your weekend and be O.K. with the fact that you cannot do the impossible they are asking you to do.
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I guess I could check with the other agencies I do PRN work with and see what they say.
I know they have ads out for PRN help, but so far no biters.
thanks for the suggestions!
Katie Talks About...
Katie Talks About...
Why are you only being paid for time you're seeing patients? What about travel time or office hours/meetings?
To me, it doesn't sound like you're being micromanaged. It sounds like you work in an organization that (a) requires a lot of flexibility on your part and (b) is understaffed for the workload.
If they have a rule (regardless of whether or not you think it is valid) that the patient needs to be seen in 48 hours, then it is what it is. You can choose to work for a different organization with different rules or a different staffing model, but for now, this is the organization, and they've been upfront about the rules.
Good luck... it sounds like there's still an uphill battle until you settle into a work schedule that works for your desired life schedule, too!
Ditto. I wouldn't want those hours either, but it sounds like those are the requirements of the company. There's no point in finding out if their regulations mirror those of Medicare or whoever else - the company has set out its requirements, and as long as they are not in violation of OSHA it's up to you to either work the hours or find another job.
And ditto that you're not being micro-managed. Being able to set your own schedule doesn't sound like a part of your job description.
DS1 born June 2008 | m/c at 9w March 2011 | DS2 born April 2012
That's policy for almost any home health company. I get paid a trip visit per patient for mileage. I have yet to work for a home health company that has paid for monthly meetings or chart review time, except for when I was salaried.
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