Audit Time...Crunch, Crunch

The successful person is the
individual who forms the habit
of doing what the failing
person doesn't like to do.

Donald Riggs

Surprise, surprise.  That's what our state funding source, OASAS, said yesterday when they showed up to audit our charts....five months early.  They are not due until November, but this is the way they try to get you.  With funding getting tight, they are pulling these spot audits to see who can hack it and who can't.  They're not stupid; they know that early in November our agency would be scrambling to get the charts together, so let's catch them on the sly.  

As I watched my office mate scramble about trying to get her charts in order, I had to breathe a sigh of relief because my work ethics are totally different.  I am paid to do a job, and I do it to the best of my ability. Don't get me wrong.  I love the counseling part of it, love working with the clients, and seeing a client succeed is all the reward I need.  But, alas, paperwork is a huge chunk of the job.  It shows the auditors what we are doing, how we are working with any given client...and if the paperwork is not up to par. they either pull the funding or give the agency a 6 month license, the lowest you can get, and if in 6 months there is no improvement, then they will pull your license. I'm just glad my charts are all in order and ready to go....

....and my bosses know this, so when they asked for a third chart from my office mate's caseload, my boss offered another of my charts instead.  He's always done that, even at the other job; he has always used my charts to cover for her shoddy work.  Talk about enabling someone. It angers me, yes, but, hey, I want to pass this audit.  This is my livelihood we are talking about.  

Just to show you the kind of insanity I work with, I just have to share this one with you.  It has to do with our illustrious nurse.  I think I have mentioned her before.  This is a person who still believes that you have to be careful because you can catch HIV from drinking from someone's glass, and once advised me to put hot compresses on an eye infection.  Heat spreads infection.  Even I know that.   I swear, it scares me sometimes that our clients trust her and go to her for advice. 

Well, it seems that she had not done the nursing assessment on my client, and if she had, it wasn't in the chart.  She had lost it.  So, I am working with her to complete a medical assessment so we can avoid a citation.  The client has been here since October so I know her very well.  We come to the question, "Does client practice safe sex?"  Mind you, the question does not ask, "Has patient 'always; practiced safe sex?"  

I tell the nurse to respond, "Yes, she does".  After all, the client has told me a number of times that she doesn't want another child and always makes sure that her partner uses protection. 

The nurse tells me, "No she doesn't.  She had a child.  If she was practicing save sex, she wouldn't have gotten pregnant."  

I respond, "But she had the baby six years ago when she was still with her husband.  Since that time she has been practicing safe sex."   

"No, no, no,"  she argues.  "I don't want them to question my license.  If they see she had a baby, and I say she practices safe sex, how would that look for me?"

By now, I am speechless.  I mean, how dumb can one be!  Heck, if that were the case, there wouldn't be a soul here on earth who practices safe sex.  I decide to try again.  "But this question is asking about NOW, not six years ago.  What is the client doing now?"  

In one ear and out the other.  Not worth arguing about.  Who am I to question the Nurse?  After all, she is the medical professional...or, at least she is supposed to be.  I'm just wondering where she bought her license because I want one.  

The price of success is hard work, dedication to the job at hand,
and the determination that whether we win or lose,
we have applied the best of ourselves to the task at hand. 

--Vince Lombardi--