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bookofmirrorsSo, today was ...interesting...
I get to work per usual. I clock in 2 minutes late, 'cause the receptionists didn't get there to open the doors in time for me to clock in. I was actually about 10 minutes early. This doesn't really phase me, though. I have several witnesses, and to date, that hasn't been an issue for anyone.
So, early in the day, the charge nurse, takes me aside. In order to understand the following, I'll have to take you back to yesterday.
Yesterday, I had 2 clients of note. The first one was a female client who wanted her face lasered. To make a long story short, she was of borderline skin color as to whether to use the machine designed for light-skinned people, or to use the machine for dark-skinned people. The chromatatest, which tests the pigmentation of the skin, indicated she could use either machine, and the appointment sheet had said to NOT use the machine for dark-skinned people. Based on this, I used the machine designed for light-skinned people. I checked over the settings and such, tried to determine what the best settings for her were going to be, came to a conclusion, and started the treatment.
Now, I'm huge on client education. She was a first-time client, so, as I always do, I preface the treatment with an explanation of the laser, the SmartCool machine, the ultrasound gel, etc.. If I can work it into the conversation, I also stress why people should stay out of the sun, shave the hair close before the treatment, use sunscreen, etc.. In her case, I also added that her skin was borderline in color, and that I was doing my best to make sure she got an effective treatment that wouldn't burn her. I explained what a normal reaction to the laser was, and what sort of reaction she should call us about. This was especially important for her, because putting a dark-skinned person on the machine designed for light-skinned people increases the risk of burns. I did all this. When she left, she was having the typical redness, and the common histimine response. I explained again that this was normal, how to treat it if it started to bother her, or wouldn't go away, and again stressed that she call us if she had adverse reactions to the treatment.
My second client of note was my last client of the day. (Come to think of it, I think the above client was my first of the day.) Anyway, this client is getting his entire body lasered, and has paid half up front, which is no small chunk of change. He used to live in Atlanta, but now lives far away, but still travels here on business fairly frequently, so he tries to schedule his appointments while he's in town. It was stressed to me that he'd had some bad experiences with us in the past, as far as being able to get appointments, being able to get done what he wanted to get done when he wanted to get it done, etc., and that I was to acommodate him. I spent a lot of time going over his chart with him, trying to determine what areas he could get done. He was scheduled for a couple of areas that, based on the hair growth cycle, he was WAY too early for, so we agreed he would get those areas done another time. He also mentioned that he had a meeting the next day, so he didn't want to get the front of his neck or his cheeks done. This is understandable, since one can't shave for at least 3 days after the treatment, and often coarse dark hair (which he had) will have what we call extrusion, which means the hairs will pop a little ways out of the skin and just sit there. It's messy-looking, and they can't be tweezed, shaved, or loofahed away for a few days (well, they can't be tweezed at all, 'cause it fucks with the treatment). So, we agreed not to do those areas. What he wanted to do were some areas he was scheduled for for the next day. He didn't really want to have to come back again over the weekend, and was hoping to go back to his home early, without having to stick around for laser appointments. Well, since I'm all about that sort of thing, I was all set to do this. I was aware of the fact that I'd been counseled just recently about working past 80 hours in a pay period (which requires overtime pay, which they don't want to pay), but I was also aware that, because of having my Core classes this past weekend, I was short hours, so I knew that me staying late wouldn't put me into overtime. Win/win. Long story short, the place closes at 8:00pm, I got out of there at 9:30pm. The client was extremely pleased with the process, and told me so more than once.
OK, so back to today.
The charge nurse takes me into one of the offices, and re-iterates that it's unacceptable for me to stay after work like that, that the clients have to work around our hours, and not the other way around. (I'm paraphrasing this, lest I unintentionally misrepresent either of us.) She said that even though this wasn't a hospital setting, it was still a clinical setting, and most of all, it was a business, and we had to keep the appointments on time. This has been an issue of mine in the past - I'm well-known for my thoroughness... my speed? Not so much. Anyway, I did tell her I respectfully disagreed with this, and that I thought it was poor customer service. At any rate, I was told I needed to get out on time, keep things within scheduled parameters, etc.. OK.
That part wasn't so bad.
Then she told me that the other client (the woman I mentioned above) had been burnt by the laser. She said she had crusting (not our favorite reaction to the laser, and not a common one, and certainly not one we like to see, but I do remember them saying once in a meeting that it can happen, and it's not a huge deal - just not the best scenario, and one we'd rather avoid) all over her face, and she had blisters on her upper lip (that's a second-degree burn, in case you didn't know). (FYI - Lips are a little tricky. You have to use the tongue blade to cover up the so-called vermillion border, where the rosy part of the lip meets the skin-colored part above it. The laser seeks out pigmentation, and if it hits that part, it can burn.) I distinctly remember covering her lip, and, while the tongue blade has slipped in the past with other clients, I don't recall this happening. But, be that as it may, she has blisters.
Obviously, this isn't a good thing. She said she understood the confusion with this woman rating herself as a skin type V (the darkest), her pigmentation reading which was in a gray area, and the note on the appointment sheet would have made it difficult to know what to do, but she said the settings I used were too high to have started someone on.
Interestingly enough, she and I had just had a discussion about settings the day before, and about following the parameters set by the company. Which I thought I had. I had spent quite some time studying the sheet that outlines them, in order to pick the best setting. In retrospect, and as we discussed, I was too confident (arrogant) in my own clinical skills. What I should have done was to get a second opinion on what machine and what settings to use. This had not even crossed my mind. Again, I had double-checked everything, and thought it would be just fine. But, she certainly has a point. Anything that falls within a gray area should be confirmed with another person. Certainly for the client's safety, and certainly to cover your ass. My bad. I had also had some confusion with comparing the two machines, and trying to base my settings on that, and trying to give the client the best of both worlds obviously backfired on me.
Anyway, she said she was concerned that I wasn't taking things seriously enough. This is a common misconception I seem to give people - that because I smile a lot, try to diffuse issues with jokes/laughter, that I'm not taking issues seriously enough. It doesn't help that I have, and express, my own opinion about things. Not that I'm mean about it. I just do.
She also said that she liked me, and, in general, considered me one of the best clinical nurses she had, and that the clients love me, and that I'm usually very good at my job (again, still paraphrasing, as throughout this entry), and she was chalking it up to a brain fart. However, it had still had serious consequences, and needed to be dealt with as such. She said she was going to put me on a 30-day probation. When I asked her what that meant, she said that it meant that if I went outside clinical parameters again during that period, I would be fired. She also said she was going to go through a random sample of my clients in the recent past and look at the settings I'd used. I told her that there'd been a general consensus among the nurses (without naming names, of course) that with the new parameters, the higher settings seemed to work best for many clients, and that I couldn't guarantee that there weren't other instances of higher settings being used on clients. She stressed again the importance of following the guidelines, and that the guidelines were there to protect both the nurses and the clients.
More was said. I don't remember what, but it's pretty incidental to the story.
Anyway, she said she was going to talk to the owner(s) when they got in, and make further decisions.
So, I did my usual thing (much subdued) until she called me back in the office. Apparently, it had been decided to send me home for an "emergency suspension" until my regularly scheduled shift on Monday. (This cuts me back about 5 hours, I think - I don't remember what time I clocked out.) Also, apparently, the owners were going to discuss whether or not I would be fired or not, and they'd come to a conclusion by Monday. I said I wanted to talk to the owners myself and at least apologize (I wasn't interested in pleading my case.), but she said that wasn't a good idea, and that chain of command dictated that I speak with her instead. She said she knew I was sorry about it, and that was enough. (Or something like that.)
OK, so this is worse, and obviously not a good thing. Not that the first part was something other than a bad thing, either.
Of course, by now, a couple of the nurses had already wanted to know what was going on, and I had told them about the earlier conversation. They were actually very much on my side, and seemed a little indignant about it. I was actually defending the charge nurse, and agreeing that, if nothing else, I should have gotten a second opinion before starting.
So, when I left, there were different nurses there, and I had to explain it over again, with pretty similar reactions to the first time I told the story.
Now, let me just say one thing real quick, 'cause I'm not sure if the rest of the world works this way.
I didn't want to go out of my way to tell the rest of the office what was going on. But I didn't want to be secretive about it, either. Office politics apply wherever you work, and so-called water cooler talk is pretty inevitable. I'd MUCH rather there by a primary source for whatever information is out there than unfounded rumors going around. I considered it pretty doubtful that the charge nurse would be able to be that primary source of information. Usually, most people consider that bad form. (As an aside, I do NOT consider it bad form to accurately report events, no matter what one's position is, but that's beside the point. The assumption I made was that, she probably would have felt her hands tied to speak about the situation, which left me as the only primary source for any information about what happened.) So, I wanted those who wanted to know about it, to know. Also, I knew that others were working with the same parameters that I was, and I wanted them to watch themselves, lest it happen to them, as it were. I know, of course, that whether the source is primary or not, a game of telephone gets played, and it won't come back to me the way it left me, but I did what my conscience told me to do, and I pride myself on reporting events accurately, and always take care to note when I'm quoting vs. paraphrasing, what's my opinion vs. fact, trying to give all points of view, etc.. (Did I mention I'm a libra?)
So, as I was leaving, one of the receptionists was going outside to smoke. She had already heard about what was going on (small office), and was trying to cheer me up, reminding I certainly wasn't the first nurse to have ever burned a client, and that it was a mistake, but that all the clients love me, and that I'm well-liked, generally considered to be good, etc. etc.. In short, she told me not to worry about losing my job. She also said that she thought I did the right thing by staying as late as I did the night before with the other client. So, she made me feel better.
I'm still scared, though. Less so as time goes on, but still scared. Terrified underneath it all, really. This is reminiscent of the pattern that I thought I'd eliminated from my life. What am I trying to tell myself here? What kind of energy am I putting out into the world that keeps bringing this subject up again and again? Am I overreacting to this situation in the first place?
All these things I must ponder and meditate upon. On the brighter side, I'm home from work early, and my client in the evening is going up to his cabin for the next 3 days and doesn't need me, and I don't work at Sona until Monday, so I have time to grab a cheap bite to eat withblckwngdorcl and relax a bit.
This better not be the fucking Universe telling me I need more sleep. Unless I've won the lottery. Goddammit, I have bills to pay. Either make me a fucking multimillionaire, so I can pay shit off and pursue the things in life I want to pursue (which pretty much all revolve around security and self-improvement), or deal with the fact that I'm willing to sacrifice sleep to achieve my financial, vocational, and educational goals. I don't like it, but until I come up with a better option, or the Universe shines a gleaming white light on a better option that allows me to sleep AND be financially stable AND pursue my goals... well, then, get off my fucking back.
I gots things to DO. And this isn't helping. Lead, follow, or get the fuck out of my way, Universe!
(Hmmm... had no idea this entry was going to end up going there. That was kinda cathartic.)
I get to work per usual. I clock in 2 minutes late, 'cause the receptionists didn't get there to open the doors in time for me to clock in. I was actually about 10 minutes early. This doesn't really phase me, though. I have several witnesses, and to date, that hasn't been an issue for anyone.
So, early in the day, the charge nurse, takes me aside. In order to understand the following, I'll have to take you back to yesterday.
Yesterday, I had 2 clients of note. The first one was a female client who wanted her face lasered. To make a long story short, she was of borderline skin color as to whether to use the machine designed for light-skinned people, or to use the machine for dark-skinned people. The chromatatest, which tests the pigmentation of the skin, indicated she could use either machine, and the appointment sheet had said to NOT use the machine for dark-skinned people. Based on this, I used the machine designed for light-skinned people. I checked over the settings and such, tried to determine what the best settings for her were going to be, came to a conclusion, and started the treatment.
Now, I'm huge on client education. She was a first-time client, so, as I always do, I preface the treatment with an explanation of the laser, the SmartCool machine, the ultrasound gel, etc.. If I can work it into the conversation, I also stress why people should stay out of the sun, shave the hair close before the treatment, use sunscreen, etc.. In her case, I also added that her skin was borderline in color, and that I was doing my best to make sure she got an effective treatment that wouldn't burn her. I explained what a normal reaction to the laser was, and what sort of reaction she should call us about. This was especially important for her, because putting a dark-skinned person on the machine designed for light-skinned people increases the risk of burns. I did all this. When she left, she was having the typical redness, and the common histimine response. I explained again that this was normal, how to treat it if it started to bother her, or wouldn't go away, and again stressed that she call us if she had adverse reactions to the treatment.
My second client of note was my last client of the day. (Come to think of it, I think the above client was my first of the day.) Anyway, this client is getting his entire body lasered, and has paid half up front, which is no small chunk of change. He used to live in Atlanta, but now lives far away, but still travels here on business fairly frequently, so he tries to schedule his appointments while he's in town. It was stressed to me that he'd had some bad experiences with us in the past, as far as being able to get appointments, being able to get done what he wanted to get done when he wanted to get it done, etc., and that I was to acommodate him. I spent a lot of time going over his chart with him, trying to determine what areas he could get done. He was scheduled for a couple of areas that, based on the hair growth cycle, he was WAY too early for, so we agreed he would get those areas done another time. He also mentioned that he had a meeting the next day, so he didn't want to get the front of his neck or his cheeks done. This is understandable, since one can't shave for at least 3 days after the treatment, and often coarse dark hair (which he had) will have what we call extrusion, which means the hairs will pop a little ways out of the skin and just sit there. It's messy-looking, and they can't be tweezed, shaved, or loofahed away for a few days (well, they can't be tweezed at all, 'cause it fucks with the treatment). So, we agreed not to do those areas. What he wanted to do were some areas he was scheduled for for the next day. He didn't really want to have to come back again over the weekend, and was hoping to go back to his home early, without having to stick around for laser appointments. Well, since I'm all about that sort of thing, I was all set to do this. I was aware of the fact that I'd been counseled just recently about working past 80 hours in a pay period (which requires overtime pay, which they don't want to pay), but I was also aware that, because of having my Core classes this past weekend, I was short hours, so I knew that me staying late wouldn't put me into overtime. Win/win. Long story short, the place closes at 8:00pm, I got out of there at 9:30pm. The client was extremely pleased with the process, and told me so more than once.
OK, so back to today.
The charge nurse takes me into one of the offices, and re-iterates that it's unacceptable for me to stay after work like that, that the clients have to work around our hours, and not the other way around. (I'm paraphrasing this, lest I unintentionally misrepresent either of us.) She said that even though this wasn't a hospital setting, it was still a clinical setting, and most of all, it was a business, and we had to keep the appointments on time. This has been an issue of mine in the past - I'm well-known for my thoroughness... my speed? Not so much. Anyway, I did tell her I respectfully disagreed with this, and that I thought it was poor customer service. At any rate, I was told I needed to get out on time, keep things within scheduled parameters, etc.. OK.
That part wasn't so bad.
Then she told me that the other client (the woman I mentioned above) had been burnt by the laser. She said she had crusting (not our favorite reaction to the laser, and not a common one, and certainly not one we like to see, but I do remember them saying once in a meeting that it can happen, and it's not a huge deal - just not the best scenario, and one we'd rather avoid) all over her face, and she had blisters on her upper lip (that's a second-degree burn, in case you didn't know). (FYI - Lips are a little tricky. You have to use the tongue blade to cover up the so-called vermillion border, where the rosy part of the lip meets the skin-colored part above it. The laser seeks out pigmentation, and if it hits that part, it can burn.) I distinctly remember covering her lip, and, while the tongue blade has slipped in the past with other clients, I don't recall this happening. But, be that as it may, she has blisters.
Obviously, this isn't a good thing. She said she understood the confusion with this woman rating herself as a skin type V (the darkest), her pigmentation reading which was in a gray area, and the note on the appointment sheet would have made it difficult to know what to do, but she said the settings I used were too high to have started someone on.
Interestingly enough, she and I had just had a discussion about settings the day before, and about following the parameters set by the company. Which I thought I had. I had spent quite some time studying the sheet that outlines them, in order to pick the best setting. In retrospect, and as we discussed, I was too confident (arrogant) in my own clinical skills. What I should have done was to get a second opinion on what machine and what settings to use. This had not even crossed my mind. Again, I had double-checked everything, and thought it would be just fine. But, she certainly has a point. Anything that falls within a gray area should be confirmed with another person. Certainly for the client's safety, and certainly to cover your ass. My bad. I had also had some confusion with comparing the two machines, and trying to base my settings on that, and trying to give the client the best of both worlds obviously backfired on me.
Anyway, she said she was concerned that I wasn't taking things seriously enough. This is a common misconception I seem to give people - that because I smile a lot, try to diffuse issues with jokes/laughter, that I'm not taking issues seriously enough. It doesn't help that I have, and express, my own opinion about things. Not that I'm mean about it. I just do.
She also said that she liked me, and, in general, considered me one of the best clinical nurses she had, and that the clients love me, and that I'm usually very good at my job (again, still paraphrasing, as throughout this entry), and she was chalking it up to a brain fart. However, it had still had serious consequences, and needed to be dealt with as such. She said she was going to put me on a 30-day probation. When I asked her what that meant, she said that it meant that if I went outside clinical parameters again during that period, I would be fired. She also said she was going to go through a random sample of my clients in the recent past and look at the settings I'd used. I told her that there'd been a general consensus among the nurses (without naming names, of course) that with the new parameters, the higher settings seemed to work best for many clients, and that I couldn't guarantee that there weren't other instances of higher settings being used on clients. She stressed again the importance of following the guidelines, and that the guidelines were there to protect both the nurses and the clients.
More was said. I don't remember what, but it's pretty incidental to the story.
Anyway, she said she was going to talk to the owner(s) when they got in, and make further decisions.
So, I did my usual thing (much subdued) until she called me back in the office. Apparently, it had been decided to send me home for an "emergency suspension" until my regularly scheduled shift on Monday. (This cuts me back about 5 hours, I think - I don't remember what time I clocked out.) Also, apparently, the owners were going to discuss whether or not I would be fired or not, and they'd come to a conclusion by Monday. I said I wanted to talk to the owners myself and at least apologize (I wasn't interested in pleading my case.), but she said that wasn't a good idea, and that chain of command dictated that I speak with her instead. She said she knew I was sorry about it, and that was enough. (Or something like that.)
OK, so this is worse, and obviously not a good thing. Not that the first part was something other than a bad thing, either.
Of course, by now, a couple of the nurses had already wanted to know what was going on, and I had told them about the earlier conversation. They were actually very much on my side, and seemed a little indignant about it. I was actually defending the charge nurse, and agreeing that, if nothing else, I should have gotten a second opinion before starting.
So, when I left, there were different nurses there, and I had to explain it over again, with pretty similar reactions to the first time I told the story.
Now, let me just say one thing real quick, 'cause I'm not sure if the rest of the world works this way.
I didn't want to go out of my way to tell the rest of the office what was going on. But I didn't want to be secretive about it, either. Office politics apply wherever you work, and so-called water cooler talk is pretty inevitable. I'd MUCH rather there by a primary source for whatever information is out there than unfounded rumors going around. I considered it pretty doubtful that the charge nurse would be able to be that primary source of information. Usually, most people consider that bad form. (As an aside, I do NOT consider it bad form to accurately report events, no matter what one's position is, but that's beside the point. The assumption I made was that, she probably would have felt her hands tied to speak about the situation, which left me as the only primary source for any information about what happened.) So, I wanted those who wanted to know about it, to know. Also, I knew that others were working with the same parameters that I was, and I wanted them to watch themselves, lest it happen to them, as it were. I know, of course, that whether the source is primary or not, a game of telephone gets played, and it won't come back to me the way it left me, but I did what my conscience told me to do, and I pride myself on reporting events accurately, and always take care to note when I'm quoting vs. paraphrasing, what's my opinion vs. fact, trying to give all points of view, etc.. (Did I mention I'm a libra?)
So, as I was leaving, one of the receptionists was going outside to smoke. She had already heard about what was going on (small office), and was trying to cheer me up, reminding I certainly wasn't the first nurse to have ever burned a client, and that it was a mistake, but that all the clients love me, and that I'm well-liked, generally considered to be good, etc. etc.. In short, she told me not to worry about losing my job. She also said that she thought I did the right thing by staying as late as I did the night before with the other client. So, she made me feel better.
I'm still scared, though. Less so as time goes on, but still scared. Terrified underneath it all, really. This is reminiscent of the pattern that I thought I'd eliminated from my life. What am I trying to tell myself here? What kind of energy am I putting out into the world that keeps bringing this subject up again and again? Am I overreacting to this situation in the first place?
All these things I must ponder and meditate upon. On the brighter side, I'm home from work early, and my client in the evening is going up to his cabin for the next 3 days and doesn't need me, and I don't work at Sona until Monday, so I have time to grab a cheap bite to eat with
blckwngdorcl and relax a bit. This better not be the fucking Universe telling me I need more sleep. Unless I've won the lottery. Goddammit, I have bills to pay. Either make me a fucking multimillionaire, so I can pay shit off and pursue the things in life I want to pursue (which pretty much all revolve around security and self-improvement), or deal with the fact that I'm willing to sacrifice sleep to achieve my financial, vocational, and educational goals. I don't like it, but until I come up with a better option, or the Universe shines a gleaming white light on a better option that allows me to sleep AND be financially stable AND pursue my goals... well, then, get off my fucking back.
I gots things to DO. And this isn't helping. Lead, follow, or get the fuck out of my way, Universe!
(Hmmm... had no idea this entry was going to end up going there. That was kinda cathartic.)
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no subject
Date: 2005-01-14 09:15 pm (UTC)no subject
Date: 2005-01-14 09:20 pm (UTC)Much love, sweetie!
no subject
Date: 2005-01-14 09:48 pm (UTC)no subject
Date: 2005-01-14 09:58 pm (UTC)I'll give you real ones on Sunday.
no subject
Date: 2005-01-16 07:07 am (UTC)no subject
Date: 2005-01-18 09:32 pm (UTC)