Morning meeting

Imagine you are sitting in a conference room at the agency you work at. It may be 8 AM, 9 AM, or whenever the agency decides that it is time for morning meeting. You might be required to have your caseload list handy. That is, the most current list of everybody on your caseload, printed off the electronic health record system. You did remember this, right? The 5 pages of the list, stapled together, with highlighter marks showing which of the 150-250 people you have contacted so far this month. It's the 21st century, Excel spreadsheets can be used to track this, but you can't access a computer for this at the morning meeting. It's nice to have a chair to sit in. The walls of the conference room may be some shade of yellow, or tan. There may be a carpet with some stains, or the floor may be the faux-wood that looks a lot better than stained carpet. It's nice to have air conditioning, but for some reason it's either too cold or too stuffy in the room. You might feel like the coffee you drank has not yet kicked in. You might wonder if you are drinking too much coffee this early in the day. The aftertaste of the coffee from the break room sits in your mouth, reminding you that there is far better coffee out there.

Whatever the status of the coffee issue you are having, right now you're at least alert enough. The site director, or a supervisor, starts the meeting. Usually the first thing talked about is what happened overnight. The person in charge of the meeting has a list, printed from an email, of clients who had something happen overnight (or over the weekend). Someone may have gone to the crisis center (or was taken there by police). Someone else may have been admitted to one of the psychiatric hospitals. A client's family member may have called overnight because he was worried about the client. Or something else happened. You listen for the name of someone who is on your caseload--if you know of this person, since your caseload is quite large and you may have never heard the name before. Don't worry, the person going through the list will let you know, and usually understands you don't know who this person is. If you know what was going on, you say what it was. If you weren't aware of this, you promise you will find out. All of this is good use of the time. You are here to serve your clients.

This might go on for several minutes, depending on how many things happened overnight. Your chair, once comfortable enough, is starting to get uncomfortable. You find yourself wanting to move around a bit. Another case manager next to you, normally known for her great performance, is drawing beautiful doodles in her notepad. You wish you were able to draw like her.

Talk shifts to billing. For the umpteenth time...oh, you've lost count of how many times this has been discussed...the team is reminded of the importance of billing. You have to bill enough to meet your metrics. That is, you have to write enough notes for enough services to meet your minimum quota for the day, or the week. If you don't, the agency may fire you. You all agree, of course, because this is true. The case manager next to you has started writing "just kill me" in her notepad. Everyone is wearing very neutral expressions, carefully developed for discussions like this. You don't want to draw the director's attention for looking disagreeable. Your agency is paid by the state for each billable unit, and if your agency does not get paid enough, then people may lose their jobs. You may hear the director say that the CEO is looking at each person's metrics to decide who to fire. You keep your mouth shut, while wondering why the CEO doesn't have better things to do. You hear the term "cutting the dead weight." Now, for those who exceeded billing, little awards may be given out. Maybe the director has a certificate to give to one of you, for having billed $10,000 for the last month.

The chair you are sitting in is almost hurting your butt by now. You adjust position just a bit, and this helps for maybe a minute. You glance at your watch, or check the time on your phone. Or if you're lucky, you can see the clock on the wall. But the clock is not helpful because it has stopped working.

Next, the reminder comes that you all must update the demographics for your caseloads. An email will be sent out with the names of clients whose demographics will soon be due for update, and those who are overdue. You are all reminded that these must be kept current, or else the RBHA will fine the agency. You remember updating demographics last week, and wonder if any of yours have somehow fallen behind. You shift your position in your chair again, unable to make your rear end more comfortable at this point. You try and fail to not drift off into a brief daydream. Fortunately, you have become quite good at maintaining a neutral expression, so it does not show.

Eventually the meeting ends. You and your coworkers are now free to go do actual work. You have lost 30 to 60 minutes that you could have used working toward your metrics. You get up, and you feel relief that your rear end is no longer in that chair. You and your coworkers exit the conference room, going toward the cubicle farm where your desk is. The day, which should be fresh, already feels a bit stale. This feeling will of course pass as you get to do actual work.