When rose-colored glasses lose their bloom

I'm in a strange limbo right now.  I have amazing news I want to share with the world, but can't until everything is officially official... and after the false start with the VA offer last year, I'm a little gun shy.  

So I'm sitting with a job offer contingent  upon passing the background checks and urine test. I know I have nothing to worry about, as far as I know.... but there is always the niggling worry that I missed something.  But all the information I gave was given in good faith and as completely as I could do.  But "VA debacle" echoes in my mind... with the caveat that the VA digs a helluva lot deeper than most usual jobs who call and verify dates of employment... or just rejected me due to a box mis-checked somewhere. I chose to not find out, it was just too much last year.

Overall I've been really happy at CUP, but when things went south,  they did so with a vengeance... I've been accused (directly & indirectly) of procrastination, bad time management, too much chatting... basically being blamed for all that is wrong in this work situation...  I'm not blameless, because no one ever is... but management has set this system up for failure.

Let's set the stage a bit: a small (mostly)  managed Medicaid company trying to really become a player in a bigger market and is expanding lines of business rapidly including trying to become an early adopter for behavioral health integration... which will have to be done now or later. However, the push for this has led to the neglect of existing programs and personnel, most of which are state-audited. The program that I work, Health Homes, was pretty much seen as "flavor of the month"  for most of the first year, but has since become the premier model for care management as far as the state is concerned.

The next piece is that the State of Washington has no single documentation system for the program, thus leaving it up to each Health Homes lead agency to come up with their own system as long as they can meet requirements. Enter in my company: we were under one company in 2013-14 and then switched to another in 2015. They knew this was happening and assured us that the switch in  systems should be smooth and no data would be lost. Can you say "famous last words"? Sure, knew you could...  Anyway, the rollout went worse than anyone could have imagined... We just got full access to everything we need a few weeks ago... Member services just got their access for making appointments in May... We didn't get all existing member lists completely loaded until early April... We still haven't gotten old charting imported... Mind you, my compatriot was asking questions in every meeting about many of the problems that have come to pass...

Add in the fact that we have lost 2 people working the program, one of whom was full time and the other who is sure that her preterm labor was from the stress.  Also, include that my job entails all the  utilization review, several call attempts monthly, hospital visits, follow up calls for transition, calls to doctors for members, concurrent review when hospitalized, intake of new members, crisis  &  general calls, and quarterly face to face visits... For nearly 70 members. I'm finding out that at most health insurance companies, these jobs are split out over a team...

So, this is what we have been scrambling to deal with since the beginning of the year.  We have had periodic moments of "get this done now" and "Help this other group! They are swamped!" while being told not to worry about health homes... Until the last few weeks with the state audit coming up.

So now they are freaking out and denying time off, stating that it's due to people not being caught up... funny that the audit is coming up and management had the reporting requirements in hand on 25 May. But we paeans didn't get the  directions & our directives until June 11th (Thursday) to be completed by June 15th (Monday). By placing the blame on non-management, they are trying to deny their own culpability.

I just see a lot of planning for the next big expansion and not a lot of routine maintenance type activities. There has pretty much been little or no support from management for the program I have been working. My fellow coworkers are amazing.... they are what makes working there worthwhile... and I love my clients and the work that I'm doing.  I feel like I'm making a difference.

But, things have started going south, as previously mentioned, but I am determined to not go down the same road as I did with King Co. This hasn't even gotten close to that bad, but I have been paying close attention to my gut and the situation was irretrievably broken when our amazing admin let my compatriot and I know that she'd been told to only communicate with us via e-mail since her coming over to talk to us would "distract us" from our work.  That level of BS was intolerable, considering I'd spent the greater part of the previous 2 months working through lunches and spending several hours, sometimes up to half the day, usually three days weekly, out of the office on member visits for follow up or new patient assessments. It just pissed me off.  It's hard to get all your work done when you aren't in the office to get it done.  

So, I had my interview for the new gig on Tuesday, I went out feeling like there was a good rapport, but it was short... and I kept thinking about what I should have said, asked, etc. It was a first round interview, I was just hoping it went well enough to get to the 2nd round.  It was interesting, though, since they were all taking careful notes about exactly when I was going to be in Kentucky and when I might want to start. I thought it was a little unusual for a first round interview, but let it be what it was. The next morning, just 25 hours 45 minutes after I left the interview, I got a call and was offered the job at a substantial pay increase. I accepted it straight away and admitted I was a little stunned and she said that they usually don't move so quickly, but they also super impressed with me and didn't want me to get away.  My start date is the Monday, 20 July after I get back from Kentucky. 

Giving notice will be interesting. I don't want to give notice until I have the officially official word, which should be Tuesday or Wednesday this week.  It will be a fitting revenge for my massively passive aggressive supervisor, who has been described by another coworker with Katy Perry's help.

I have also kept myself from Unravelling ala Deb Talan:

The other song in my head is:

 

Another good one is:

Waiting for Ferguson

The killing of a teenaged boy is not a flap-a-doodle A community being outraged over a pattern of disproportionate arrests, fines, etc for one race isn't playing the race card, especially after years of the same behavior. Blaming the victims of a situation for their reactions only serves to minimize and obfuscate the root cause. A statement of how someone different than you views or deals with the world is not rhetoric, it is you showing a stunning lack of respect for that person and a great deal of arrogance about your own position.

Depression, PTSD, Apathy and rediscovering my intrinsic value as a human being

It’s been over a year now since I was fired from King County, but the sequelae of that experience is taking a long time to heal. Honestly I am healing, but the process is slow… much slower than I would like it to be. It was a devastating 3 ½ months, so much so that I am still trying to root out the messages that were driven deep into my psyche. She’s “Not good enough”, “not perfect enough”, “doesn’t ‘get it’”, “doesn’t fit in”, “untrainable”, etc. were pretty much the spoken and unspoken refrain… to use an Army term, I pretty much got the message that I was a “soup sandwich” over and over.  Perhaps the experience would not have established such deep roots had not been at such a vulnerable transition in my life.  I went to Seattle full of confidence, but missing my support system dreadfully…. heck, I’d done this with my mobilization to Texas with the Army, why would this be any different? I could do this… but I didn’t have the familiarity and support of my Army unit… so it was different.  No number of video chats, phone calls, or other virtual contacts could make up for the lack of that support system.

Mark moved out in February, soon after my being spit out of King County. We have discussed whether his presence would have made any difference during my short tenure, and we really don’t think it would have. Their apparent prejudice against me started quite early on, within 3-4 weeks, my gut knew something was off.

So the last year has been a rebuilding effort, very slow, sometimes 3 steps forward-4 steps back, but forward overall.  It has led a re-evaluation of my self-worth, my capabilities, and a slow schlog out of depression, doubt, anxiety.  Fall down seven times, stand up eight has been kind of where I have had to live while the ground has shifted repeatedly under my unsteady feet. There have also been roadblocks… unexpected, sudden, and devastating.  So I have had to re-evaluate my reasons for moving to the Pacific NW at all… looking back with both longing and a strong sense of having made the right move.

Starting slowly to regain confidence began with the temporary gig with the Highline Schools in an LPN role.  I am eternally grateful to everyone there for their acceptance, friendship, and support during that period of time. It was a great experience during which I learned a lot and regained a good deal of confidence and trust. It was nice to have the expectation of competence back. I really did love working with the kids, too. It was the bridge that I needed to get started on the road to a new sense of self.

The next step was spending 3 weeks at Ft Knox KY for my summer Army training. I was there mostly alone but did get to meet up with some friends from my old unit. I was pretty much embedded with another unit entirely and did quite well with them, building my confidence even more. Before leaving for Kentucky, I had interviewed for several positions and while I was there, I interviewed for a Case Management position for the Portland VA. So in addition to my confidence rebuilding, things were definitely looking up.

We decided to make the switch to Portland and found an apartment. On the way back from getting the apartment, I got a call with the tentative offer from the VA… I was over the moon.  So I called all the places that were pending and withdrew my applications from them… then the VA withdrew the job offer… which had something to do with their inability to credential me.  I was crushed and a lot of my confidence bled out with that. I still don’t know what happened and I chose not to find out.  However, I had no choice but to start the whole job search merry go round again.

Very soon, I was in the running for 5 jobs and had a crazy week of interviews and second interviews.  I finally came down to two jobs in Vancouver, at the Vancouver Clinic and at a small insurance company called Columbia United Providers. Exactly one month after I applied, I started at CUP. This company has been a blessing. I am totally in the right place for me. I fit, I am accepted and I feel good about the work that I’m doing.

But I am still working off the reflexes caused by PTSD. If called for a meeting to look over a mistake, my gut clenches up with no reason-but that reflex exists. I hate this, I want this to end, but it’s a careful pruning process, one nerve at a time. Is there a type of RoundUp for emotional scar tissue?

The deepest thing I am fighting now is trying to lose the weight that I have put on in the last 13 months... I have a deep seated apathy.  I just don't give a flying rat's rear end because I had my lack of self worth drilled in so deeply.  So I eat to feel something.  Doing what I want to do is my own way of having control, of feeling like I have a say in my situation.  It's not healthy, but now I have to get myself back to feeling like I have a level of self worth that merits self control.

The year in purgatory...

I feel as though I'm finally coming out of a long dark tunnel that I entered when I left Missouri last year on October 8th.  I can't believe it has been a year.

Last year when I left, I felt I was leaving a good place to come to a good place... it just took me a lot longer to find my good place than I thought.  But sometimes those journeys  make you appreciate the before and afters a bit more... make that a whole lot more.

Callaway was a wonderful place with the best of people... and I so miss them all. I wish I could tell them how much they have truly been a wind beneath my wings.

I had to journey to a very dark place before I could get back to a good place... I have travelled some interesting by-ways, and met some great folks as well... the nurses at the Highline School District were wonderful.  So despite the depths and the negative people I encountered in one place, it has been almost universally refuted by every other person that I have met... and by all the other experiences that I have had. Sadly, sometimes it takes reaching the end of the dark journey to realize the gifts that have been given along the way.

However, being on uneven ground in terms of employment and everything else made for an unstable year.  I think all I had was my anger and desire for revenge against those who wronged me.

I have now been in my new job for three weeks, I cannot even believe it's gone so fast.  I am loving what I'm doing, I'm loving the people, I'm loving feeling like I'm doing a good job.  My confidence is growing with my knowledge.

My feet feel like they are on solid ground and now I can move forward and leave all the bitterness and anger behind... and really embrace forgiveness for them and solace for myself.

I wrote this poem at possibly my darkest, lowest time emotionally:

They start out so kind 
You let them in 
But then you disappoint
And they are in your mind 

By opening that door 
You allow them to destroy your peace 
Your confidence 
Your hope... that anything will work again 

You run over & over - 
Details that are done 
Things you cannot change 
(Though you wish you could) 
You defend yourself to the destroyers 
The cold, stone cold, mouths
Who you could never have had hope of pleasing 

And the fear seeps in 
-ice in the veins
-sickness in the stomach 
And all visions of the future dim 

The door is shut tight behind you
You are in a pit, feeling for handholds
Fumbling, blind, with no plan 

There is only pain, darkness
fear illuminated by angry flashes

Fumbling for a handhold to open a door forward - anything to get out of the pit. 

Time ticks by 
You drown in the accumulating minutes - the only sound is your breathing and the rush of your blood in your ears. 

You look back and the wound that had barely begun to heal is ripped open afresh by circumstance 

The dry leaves of what was swirl up in a bone dry dance if pain,, darkness, and fear... repeating the cycle you worked so hard to rest. 

Go forward, guarded - ready to play the expected role - it's your only protection. 

And this is where I am now:

Ferguson

I know that I have had a lot to say about Ferguson, I'm fatigued and I know just about everyone is. However, I see different kinds of fatigue: those who are fighting for justice for Michael Brown (most of who have been fighting this since they were born), and those of us who have joined with them... we see it as a fight for fairness and justice and have a hard time understanding why that is so hard to impart. The other fatigue is for those who want to go back to their comfortable, oblivious bubbles and just want everyone to shut up already.... we've discussed it, can we be done now?!

I lived in St. Louis for the first 21 years of my life, growing up in Florissant, right next to Ferguson. In retrospect, I can recognize the bubble of privilege in which I was raised. I didn't have to worry about being followed around stores or being judged because of my skin color. I had several black friends and I just didn't notice problems.  We really didn't talk about race, we were just friends, kids hanging out.  Those were good times.

The first even that started to raise my awareness was when my close black friend, who was also male told me that he had to work twice as hard as the white people around him to earn his full ride scholarship to a state university. He is brilliant, moreso than I could ever hope to be, and deserved every penny of that scholarship... and he had to work twice as hard to earn it, what sort of message is that about equality?  That same friend and I also went to visit a mutual friend going to school in eastern Indiana, our Moms were worried about us travelling together, but mine didn't bother to tell me about it until after we got back.  I really didn't understand, I was that oblivious.  We were friends heading off on an adventure, period, end of story, in my mind.  Now I understand much better that racism exists, but I still don't understand why.

My biggest frustration, as I intimated earlier, is trying to get across to other white people that they need to really listen and open up their eyes, to stop seeing what it is to be a person of color in this country from the privileged perspective of being white.  A scary thing that was brought up by a friend and echoed on the media is the fear that persons of color worry about whether their young men will reach adulthood without being killed or incarcerated....and I was accused of it being rhetoric. That doesn't sound like equality to me or something that you can blame on those experiencing it.

We have to embrace discomfort and start asking the hard questions of "Why?"  We have to look at ourselves and our own assumptions and accept that some of the stuff we have been taught is a lie that whitewashes the truth.  The very fabric of our country has deeply woven racist threads, from even earlier than the infamous 3/5 solution.

I believe it is very human to choose to go where we find comfort, but taking some comforts for granted just hurts us all.

Walk, Don't Run... directives vs. tools

A friend of mine on Facebook posted the following graphic on her feed the other day:

I found it triggering, mostly of memories from when I was in school. I was one of those sensitive kids, and in many ways I still am. I really don’t know why, but it is simply part of my make-up… and it’s not something you outgrow or unlearn when you are hard-wired that way.

Over the years, I have learned some coping mechanisms, but it never really goes away… and despite efforts to cope, sometimes that hard-wiring kicks in automatically and takes me by surprise. It also makes me feel like you have to explain to other people why I reacted the way I did to “X” situation… borne out of years of being misunderstood, ridiculed, or thought to be a weirdo.

Even though my family was a pretty safe cocoon, they sometimes would obviously not “get” me either. I think my Mom was wired a lot like me and did her best to prepare me for the reality of the “outside world.” But she didn’t want to completely protect me from it either, because I had to toughen up to a certain extent just to learn to survive… and treating me like a hothouse flower wasn’t going to achieve that end.

I guess the hardest part, apart from not having my feelings honored, was the lack of tools. I was told to “stop overreacting”, “stop crying”, “stop losing your temper”, etc. But nobody told me how to “stop”, never gave me the tools or helped me figure out the “how”.

One of the wisest things I have ever heard was from a Parents as Teachers educator, she asked rhetorically, “What does ‘stop running’ look like? Tell the child to walk.” What a huge shift in perspective for me, and it is so universally applicable. If someone had taken me aside and told me what to DO instead of what to stop doing… it might have been more helpful. Perhaps it wouldn’t have been less painful, but it would have made me, as a child, feel as though I had some power in the situation… rather than being just a victim reacting to the bullies harassing me… and left holding the bag of responsibility in the situation.

When you tell someone to just “stop” doing something, you only appear to be giving them control over the situation. Instead you are giving them a destination with no map or directions to get them there… and the implicit message that what they are doing is the cause of the harassment.

These people, children & adults, need help in recognizing what triggers them and validation that their feelings are okay, whatever they may be. Then they need tools to help them learn to deal with those feelings… be it walking away, asking for help, etc. They also need help in learning to gauge what is appropriate for a given situation.

Sadly, though, we often don’t have the time or emotional space to deal the issues another may have. It’s easy to say “stop that” but not as easy to teach.

Sometimes the ice pack isn't enough...

Today was a sad day as a school nurse. We had a child who has developed a rash on the face, arm and hand on one side. It was first noticed by the counselor, and then the next day by the school nurse and then today by me... and it's been getting worse each day.

The problem was that we needed to send the child home to be seen by a doctor before we could allow him back to school since we didn't know what the rash was. We couldn't get hold of the father and the grandmother's car had broken down.  The counselor called the grandmother to try to arrange someone to get the child, but nobody ever showed up.  The child got to me at 11:35 and was in the office until school ended at 3:40.

I called the grandmother just to let her know we won't be able to have the child back in school tomorrow and she described the pressure she is under. She has given the kids and their parents a home so they won't be homeless, but they haven't given her any sort of rights or power of attorney and accuse her of being the evil bitch grandmother.  So she's totally stuck between a rock and a hard place.  I just listened and gave her a kind ear.

Now we may have to hotline the family... not the grandmother, but the parents.