Saturday, January 20, 2007

On being assertive/a hard ass

Having patients "no-show" for appointments is nothing new for many professions: doctors, nurses, and therapists. In the "world" being a therapist and having someone not show for their appointment can be frustrating and expensive. In prison, it is likewise quite frustrating. Because in this setting, I have to actually hunt them down and talk to them, even if they decide not to show. And they know this. They can request an appointment, knowing full well that their rights as offenders means I have to see them within 48 hours after I get their request. So I go through the TDC computer and have a special pass that gets printed and handed to them the night before, in their dorms, that says they have an appointment for the next day. They use that appointment to get out of going to work or to school or whatever. And sometimes, they then decide to just hang out in their dorm and sleep, watch TV, play dominoes, or whatever. After all, they know I've got to come find them, right? So that's what I've been doing. And whenever I try to bring this up as a therapeutic issue, they tell me they did not get their pass or else they got it and the security officers wouldn't let them. And because I do know these things are POSSIBLE, I have let them go. Other folks do not and write them disciplinary cases for this. So I finally started writing cases myself the other day. And sure enough, I had two patients who came in very angry with me. One reminded me that he was in prison for assault. Yet I held my ground and informed them that we would deal with their anger therapeutically. Likewise for their lack of accountability. It worked out okay and both ended up leaving much less angry than when they came in. Since I wrote an additional five cases yesterday, I'm sure I'll have lots more angry men on Monday. And eventually, I'll have a lot less no-shows. One of the nurses said I officially became a member of the hard ass club, congratulating me. And you know what? I'm okay with that. And with the respect that it garners.

3 comments:

StaceyG said...

That sounds a lot like when I was working with addicts. They always had stories that were possible...but you knew that mostly none of it was true. We didn't have to hunt anyone down, but did have to rearrange schedules a lot. Now, I get to charge when people miss a meeting - though sometimes that doesn't work either.

Cheryl said...

Yes, that's the basic premise behind me writing cases for missed appointments - most practitioners of all kinds do impose penalties for missed appointments. It's just the way life is. Only problem is, most of these folks have spent their entire lives trying to avoid consequences. And, of course, so many have substance abuse histories.

The Muse's Oracle said...

This is why I am so amazed by you! You deal with things in such a matter of fact way and don't let any situation intimidate you (at least not on the surface). Some day you will have the life you want coz I know that you are gonna fight for it tooth and nail. I have never known a more positive person than you. Yes, I know we all have a dark side and you are no exception. But that is just reality and our dreams are much stronger and we will get our miracles, one by one, baby steps to take us where we deserve to be.