Monday Muse August 17th 2015

MONDAY MUSE – and yes….. it’s huge, and confrontational, and… well its Monday Muse

Good morning to everyone whether you are behind the desk, in front of the deck, under the desk or simply feel as if sometimes you are the desk….

Here she goes… I can see you thinking and yes here I go! Onto my unicorn with the lance of goodness and light in my hand, the helmet of truth and honesty on my head, my trusty armour of courage, and a packet of scotch fingers, chocolate coated with coffee, in my special cup.

I have had conversations with people over the last week who are all experiencing the same frustrations, and that is dealing with bureaucracy when under the strain of being unwell themselves (and OMG I experienced this myself) or caring for someone who is not well. My first thought was to go to the top – which is what I usually do. But then ‘the top’ investigate complaints, write politically correct memos that hopefully appease the complainer and does not upset the delicate balance of the sensibilities of the person they are complaining about. And what happens… nothing. It is not even a slap on the wrist with a wet tissue, nothing changes. Everyone gets an email and its considered done and dusted.

So where should we start. We start at the bottom. Not with the politicians, directors, CEO’s but with the people who we deal with, from the moment we walk into that waiting room. Now please understand that I know very well there are wonderful people out there in government and private positions who do all they can to make sure that as a client/customer we get everything we should. But it seems that with public and private sectors, such as WINZ, ACC, Insurance Companies – all of the places where we put our trust, and we trust that when we need them that they will deliver the service they promise. You know who you are if you are fabulous. This is not for you, but it might be something to point out to a colleague whom is less than fabulous, less than what they should be.

The Archetypal Bureaucrat that you and I have to deal with behind the desk can be varied, my two main archetypes I have come across are the ‘bright young things of twenty something with a degree and no life experience’ (yes that is cliché, but it is true). How does a 24 year old who just spent the weekend in the city getting absolutely bladdered on shots, cannot remember quite where they left their knickers or boxers, and are genuinely upset that the boyfriend or girlfriend might find out. Their mind is not on you sitting in front of them. As far as they are concerned you should be old enough and wise enough to already know what to do, and they would rather like you to go and sort your own shit out please.
The other archetype is the older bureaucrat between 50 and 60 – who has been behind that desk for far too long, has seen it all. Instantly knows who are the ones deserving, and who are not. And … they know before they talk to you. The minute you sit in that chair and put your form on the desk you are summed up. You know it, I know it. You have a window of about one minute to change their perspective or you are screwed.

So whatever desk you sit behind, if you are dealing with people in stress either because of their own troubles or someone else’s have a little think. You can make this day more difficult for me, or my friend, or you can make it a little easier, so that my friend can visit her loved one and smile, knowing that all is in hand. Or she will sit by his bed trying not to show how upset she is, and trying to focus on giving him the best attention she can without having to worry if there will be money in the bank tomorrow.

And why won’t there be any money in the bank? Because you Ms/Mr Bureaucrat did not give her all the forms. She gave you a letter that you asked for. You said nothing about a form. And now she has to  get to her email, print out the form, fill it in, scan it and send it back. And another two days are gone. That is easy you say… no it is not easy to get to your email when you are rushing to the hospital every morning so you are there in time for ward rounds so that you can hear what the doctor has to say, because your loved one cannot focus and therefore cannot make decisions for themselves. And then you stay at the hospital all day to make sure that drips are put in at the right time, that medications are at the right time (and believe me, I know from personal experience that you have to be on the ball – two of my drips were missed, with one nurse insisting I was wrong until she checked the chart, and another nurse bringing me double the dose of something that had I not pointed out her error would have sent me plummeting into god knows what – sugar related). And so you come home after a long day, and you are faced with this email, and you have to deal with it, when all you want to do is go to sleep, and prepare for the next day.

And you know Ms/Mr Bureaucrat all you had to do was hand my friend the form, so she could fill it out then and there, and all she then had to do was send the letter to you. You staple it together and process it.

And don’t tell me that it is not your job to tell us what forms we need to fill in. You know – the minute I walk in with a broken leg (pardon the pun) you know that I will need care and treatment and financial support for six months. So sit me down, give me a packet of forms. Give me a timeline. I might forget, so a printed timeline would be nice. I still might forget but I have the packet of forms, I call you up and say my money isn’t in the bank for my MRI or whatever it is, and you say ‘Its ok Jackie, did you send in the letter?; Yes I did. ‘did you attach form 21Bxys?’ – no I did not. ‘Go into your packet, get out that form, it is yellow, with stars at the bottom, fill it in and fax email to me, and we are sorted’.

How hard is that? Which scenario is the easiest all round. The stupid thing is Ms/Mr Bureaucrat is when you make it difficult for us, you make twice as much work for yourself, because we will call you, we will email you.

During my sojourn with the hospital system I came across one thing that I found quite shocking – even for me, who has worked in both the Social Welfare and Health Systems (Yes, some of you might not know that I was an Exec. Director for DSW in the King Country way back when, and I spend over 15 years in the health system as an administrator, and a Team Leader of Hearing Vision Services). What happens when you are in the system, is you get referred to everyone. So I went in to have a breast off, and ended up in all sorts of different clinics. One being the Diabetic Clinic. I won’t go into details too much except that because of the chemo drugs, it affected my sugar balances and I had to take more potent drugs than usual. I went to the clinic, and a nurse took my details.

And then…. She said she would go to the doctor and get her opinion and prescription. Ummm, excuse me? Don’t I get to see the doctor myself? Already during the conversation the woman had misunderstood something I said (this was at the time where my hair had fallen out, I could hardly walk to the letterbox let alone spend an hour in a clinic) and I had to correct her. I was worried that she still had not got it right, I was quite stressed. She came back, handed me the prescription. I asked for confirmation that she had given the doctor the right information and she snapped back that of course she had. She then instructed me to take my bloods three times a day and email to her weekly for follow up. Which I did. Now I will say at this point, that the receptionist at the clinic was AMAZING, and the epitomy of a caring health person. She saw I was unwell, and she asked others in the waiting room if they minded if I went first because of the chemo and cancer, plus a couple of them had the flu and this could be dangerous for me. Everyone kindly let me go first.

So… A week later, I email the results. All is well. I am told I can come off the stronger medication when chemo is finished. Let’s move forward to chemo being finished. I emailed my bloods – all normal, perfect. The nurse emails back that the doctor wants to keep me on the high meds, and I email back to ask why. No reply, no follow up for a week. I go to my divine GP who says I can come off them, and no reason to stay on them now. And he suggested I make an appointment with the clinic and get myself discharged back to his care. You cannot just ring up, or email for a discharge. So I made an appointment, went in, pointed out the total lack of response, and of answers when I asked a logical question, and that my GP was taking over. The nurse agreed, and discharged me. Interestingly she did not go and consult the doctor.

So what bothered me about this? What if I was not so pro-active about my care? What if I was too sick to focus, and what if I carried on taking the medication? Because the upshot was if I kept taking it I would have to keep taking it for life because my body would become dependent on it. Why do I see a nurse and not a doctor? If the nurse has to take up the doctor’s time to relay information about me, why couldn’t I have that time in front of the doctor… ok I know I am rambling. I think I am still quite angry about some of the things that happened. Not quite so much for myself because I could be pro active and when I wasn’t in any fit state my daughter was very staunch about what happened to me.

In dealing with WINZ I found my case worker to be in the 50- 60 archetype, but she was pleasant, and regaled me with the story of her sister who also had breast cancer, and that was ok, but as I got up to leave with surgery looming in the next few days she said loudly ‘well dear, look on the bright side, it could be both breasts’. Everyone heard, everyone looked, I was mortified.

So if you are behind one of those desks today, and someone comes in about a medical insurance claim – think about what they are going through right now. And remember that one day it might be you at 60 years old sitting in front of a bureaucrat who you trained… who looked to you on how to treat clients. How would that person treat you?

And if you are sitting in WINZ behind your desk today, and I know it is hard, and I know the security guards remind you every day of the danger you are in, and the people that sit in front of you do try and cheat the system, and you have to make sure that the right people get the right things. But there is a way of doing it…. and remember one day you may be 60 years old and sitting in front of someone whom looked to you for guidance and inspiration on how to do the job. How would that person treat you?

And you, yes you – sitting in the ACC office promising to text, or call at a certain time, and then not doing it, and when you finally call leaving a message that says – oh I called and you did not answer so… we have to start all over. Call me.  Think very carefully because one day you may well be a parent with a child who has had an accident, and you come in to get funding for treatment that you are entitled to, and the person at the end of the phone or across the desk is someone you trained, is someone you showed how to handle the work. How would they treat you?

It is you and me, at the bottom of the ladder that can make a difference. I have been a bureaucrat, but you do not have to be the archetypal bureaucrat, you can be one to respects people and gives them the courtesy and help that is your duty of care when you take on the job. We can change things. Whatever you do, in whatever industry, me included … let’s make today the day we change from the ground up. Let us make someone else’s day easier, let’s do our job how it is meant to be done.

Give my friend the forms she needs, and give her the information she needs about what she is entitled to, because her friend should not be the one telling her she is entitled to taxi chits, that is your job.

Give the woman who needs WINZ support the time for her to explain who she is, and why she is here, don’t pigeon hole her on dress, looks, and demeanour. She has had a bad day, she is going into surgery tomorrow, and she does not know what is ahead of her. And so yes, she is distracted.

Give the man the courtesy of explaining what he can claim on his wife’s medical insurance for her, and send him all the forms, and offer to explain if you know that he is not sure. Take the time because he is worried about her, and he hasn’t had to fill in forms for years, because she has always done that for him.

Give the person who comes into your salon, into your place of business for a consult the opportunity to explain herself, and give them your full attention for the time they are paying for. And give a little extra.

Give the patient in your clinic the courtesy of making sure you understand exactly what they are trying to tell you. If they say you have it wrong, then know you might have it wrong. You might not, but better to check than to override them and find that you cause them unnecessary angst and worry.

And so to the woman in the Radiographers room – don’t take my hand and tell me that we don’t know what is going to happen tomorrow, and that Jesus will see me through the dark night – I am a Druid, and the Goddess will take quite good care of me thank you.

To the woman in the bed next to me who spoke Tongan to her Pastor, be very careful what you say even in your own language, the white woman in the bed next to you can understand Tongan quite well and I could well have reported you for benefit fraud, because those children were not yours and you are one of the reasons why the bureaucrats have to be on their guard.

To the nurse who came to my home to change Mr Sucky’s cartridge, and then realized after she had taken the dressing off (a complicated suction thing) left me with a towel tucked under my arm and told me to go to A & E because she didn’t know how to do it. You walked out! I had just been a day out of hospital! You said you would not take me to A & E – it was not your job. I was devastated.

To the young man in the pink shirt, with the smug face and the white stick – you do not hand a woman something that has to be inserted and tell her to do it herself! You might like to explain the most simplest of things first…. Like which end do I insert?

To all of those who are not anything like the above. I thank you. The receptionist at the Diabetic Clinic you do not know how much you made my day by letting me go early that day.

Thank you to Denys the District Nurse who explained everything every time I went to have Mr Sucky changed, you answered all my questions no matter how crazy, and you gave me my confidence back. I could change my own cartridge by the time you finished with me, and that empowered me.

Thank you to the girls in A & E when I presented with a ‘Mr Sucky’ that was less than operative through no fault of my own. I did not have to wait in the queue of rugby and drunken Friday night injuries – you were wonderful.

Thank you to Dr Charles and his team who gave me ‘Mr Sucky’ and treated me with kindness and respect.

Thank you to the Registrar and House Surgeon on the Oncology Ward when I chemo’d out; teaching me how to play Angry Birds Transformers gave me something to amuse myself; and to the Registrar for giving Elaine and I all the information to make an informed decision.

Thank you to the Nurses in the Infusion Rooms, I was such a cow at times; and I still feel badly that I yelled at the Volunteer Worker. I will be ashamed of that forever I think.

Thank you to the people in the Post Office queue who allowed me to go first and get my business done. And to the check out man at New World who carried my groceries to the car. Also the Post Women who bought me a parcel to my door and showed such concern.

Ok rant over, I have got totally carried away, and now I am going out to do the banking, get coffee and cake. As you know muses tend to well… wander away with me. And yes I know not everyone is like this, I know that it does not always happen like this. But the mere fact that it does happen sometimes is not good enough. It should never happen.

I love you all. I have decided it is going to be a creative afternoon – so the beads will be out, and if you are passing by I would kill for a mocha and a cake!