What part of your job is "a pain in the tush" that has to be done?
By The Horse
@TheHorse (238428)
Walnut Creek, California
November 10, 2015 11:51am CST
In one of my jobs, I work with "troubled" families. In particular, I work with children who have been "referred" by their schools for outside services.
In actuality, I take kids hiking, play catch with them, sometimes help them with school projects, and in general help them overcome their anxiety issues, ADHD, or PTSD.
The actual work with the kids is fun. I also enjoy speaking with the kids' moms, whether in person or on the phone, about the kids' progress.
But the part that's a pain in the tush is writing "progress notes." I have to document every interaction, whether it be with a kid, a parent, or a kid's therapist.
Said notes aren't seen by other therapist types. They're really for billing purposes. It's ultimately Medical that gets billed for our services.
Writing them is a pain because I have to "frame" every interaction in terms of specific "treatment goals." I can't really describe what we did, as I would like to.
Is there a part of your job, past or present, that is or was a necessary pain in the tush?
I'm going to write one such note now and "reward" myself by checking in on MyLot periodically. It should only take about 15 minutes to write. But just thinking about it makes my lower back hurt.
The photo of of Borges Ranch, one of the places I take kids when I think they could use some interaction with goats, sheep, and chickens.
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6 responses
@fawkes62 (1276)
• United States
10 Nov 15
That looks like a lovely place to visit. I just did one of the pain in the tush jobs at work today. I work in a school print shop and one of the things we have to do is put comb binding on books. It's not too bad when it's just a few books, but I had to do 96 of them today. Thankfully we don't do too many of those very often.
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@TheHorse (238428)
• Walnut Creek, California
10 Nov 15
Is it just tedious work? I got my progress note done this morning and then rushed off to a meeting. I may do one more short one right now. The reward is that we're seen as "productive" if we generate a lot of "billable hours."
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@ThankyouLord (698)
• St. Petersburg, Florida
11 Nov 15
We call those "SOAP" notes. Medicare and other insurance doesn't seem to care if the patient is actually making progress, only that we can be a creative writer. If I had a penny for every progress note I have done, I could take several trips around the world. I am still doing them, just with an older population now. I was in psych for ages, then worked with the retarded for a time. I've also worked with juveniles, both in school settings and outside. Did some marriage counseling and tons of groups across the spectrum. The nice part right now is I get to work on a tablet that has SIRI, so I can talk my notes out. It's so much better.
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@TheHorse (238428)
• Walnut Creek, California
11 Nov 15
Where does "SOAP" come from? Yes, it is rather funny that I could write pretty much whatever I want in those notes. What I wind up doing is "framing" fun activities in terms of particular treatment goals. Sometimes I'll do a random "intervention" (e.g., calling a kid over to me when he's skateboarding) so I can say I worked on "listening to adult commands". The real therapy (for the kid) is in forming a positive, enjoyable relationship with a supportive adult.
@Rollo1 (16676)
• Boston, Massachusetts
11 Nov 15
I never did like the "checklist" mentality when it crept in at work. Sometimes real intuitive work gets reduced while much more time is spent checking off the list items to prove you did what you said you did. But as a former medical bill reviewer, I can tell you that notes are essential to support that the bill is representative of services rendered. So write your notes.
@TheHorse (238428)
• Walnut Creek, California
11 Nov 15
It's YOU! (Think Seinfeld.) I realize they serve a purpose, so I'll continue to do my best on them. The thing I get dinged the most for is providing too much detail. Humbug. But actually I take pride in them, just like everything else work related. No auditor will ever be driven nuts trying to understand my notes.
@katsmeow1213 (28716)
• United States
11 Nov 15
Dealing with my coworkers. Dealing with some of the members. Being handed projects that seem relatively pointless that somebody else wants done and won't do them himself.
But that's okay... I'll grin and bear it.
I know I couldn't do your job. I can barely handle kids who don't have those sort of complications. I've discovered over the years that I actually don't really like kids, LOL. I have 5 of my own. Not sure if that's why I don't like kids or if I never really liked them and just didn't know it...
@katsmeow1213 (28716)
• United States
11 Nov 15
@TheHorse Isn't it a bad thing to bond with the kids you work with? I mean they're only there temporarily until they get too old or get better medically. Isn't it hard when the time comes not to see them anymore if you've bonded with them?
@TheHorse (238428)
• Walnut Creek, California
11 Nov 15
@katsmeow1213 Good question. In my job with kids referred by the schools, we work with them for up to a year or so. Closure is difficult, but we have a (loose) protocol for preparing the kids for moving on. For me, it's probably like being a teacher. I've grown used to it.
@TheHorse (238428)
• Walnut Creek, California
11 Nov 15
I enjoy most kids, but I really admire those who work with children on the autism spectrum (and parents with autistic kids). I work with one autistic boy, and it's very difficult to feel that sense of "bonding" with him that usually makes my job so much fun.
@JudyEv (382828)
• Rockingham, Australia
11 Nov 15
I can imagine that these notes would be quite difficult to write. It would be hard to document what progress you've actually made I guess.
@TheHorse (238428)
• Walnut Creek, California
11 Nov 15
I can document what progress we've made toward "treatment goals," but it doesn't really capture some of the other therapeutic work that's going on. And it's frustrating knowing that the notes are going into a file that will rarely if ever be read by other clinicians. It (the documentation) really just exists so we can get paid.
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