The Consultant's Desk

The Consultant's Desk
Poring over the details on your behalf

Tuesday, August 21, 2007

Challenged to Grow

Disability accommodation work can be isolated to one type of disability or span a range of needs. One area of accommodation in particular maps as an almost identical pattern in several categories of impairments yet it is successfully handled with nearly the same techniques. This disability can also be one of the most draining (in all ways) so that the burn-out factor occurs in a short time. The particular issue we examine today is the niche of learning disability.

A learning disability can be mild and not really surface until it becomes a barrier to some type of performance never attempted before. Minor adaptations can be worked out in order to compensate for the small issues. However, there are other learning disabilities that are more complex and profound. They interfere with interpretation of information; they can also interfere with communicating information; and they become impediments to accomplishing tasks and goals.

Other conditions that look very much like a learning disability are those where the person has issues with substance abuse, abusive personality, some psychotic personality disorders (in severe cases), and those suffering from one degree or another of ADD or ADHD. People with poor education or no education also easily fit into this classification, as well as those with little to no training and therefore do not know how to be independent and autonomous.

One of the signs of this type of learning disabiilty, that can be overlooked in a discussion of the signs and symptoms is the unfortunate habit of saying things that are quite obtuse and inappropriate. The person's words can be insulting or demeaning, a bit like spitting in one's face. In the alternative, these people will develop a completely incorrect interpretation of the information they heard or seen and swear that they are correct. Sufferers will even make excuses for what they have said or heard in order to justify its impropriety; they will argue for the correctness of their interpretation. Many times their passionate self defense will convince a few that they somehow did not understand and that they one with the impairment is quite correct in their interpretation. Some bullies demonstrate these propensities.

How to Handle

In its mild form, a learning disability is not easily detected. Being easily distracted can sometimes stem from fatigue, stress, or mere work/life balance issues. In this case, merely taking a break is the solution. All of us are affected by this and it is not indicia of some type of pathology. In fact, sometimes all it takes is turning away from the foot traffic that passes by a desk. At other times, the remedy can be as simple as sitting in an area with a large window in order to collect as much sunlight as possible. In the alternative, turning away from the window in order to avoid being distracted by the many scenes that fade in and out through the window.

Other ways of dealing with the condition may be to work for a particular time period and then take a brief break. Again, this is an excellent technique for very mild forms of learning differences. Many of us thrive on learning in a type of total immersion in our subject but doing it in intervals of 15 to 20 minutes or so.

ADD can compound itself very quickly as we increase the levels of new ramifications of the impairment. In fact, it is not quickly identifiable when you're dealing with a person with learning differences. But it's when a series of situations, taken together, start showing a problem that the issue becomes larger, more severe. Communication begins to be threatened. We need to be very careful about what we're saying and use every means possible to make certain we are being interpreted correctly.

This may mean we give instructions in increments. Or we give instructions (or information) and then have the person restate what we told them in order to insure that the correct message got through and was heard. Repeating the message confirms there was no straying in regard to interpretation of the information. If there was splintering of the information, this is the time to repeat and listen. If there is a misinterpretation, immediately stop their speaking and correct what it is that's incorrect. Have the statement repeated but in the client's terms. Continue doing this until their interpretation of the message is correct.

Coachable Moments

If there are terms the person with ADD is misusing, this is also the time to correct their definition. Make certain they understand that they were misusing the term, why the interpretation is incorrect, and what the correct interpretation is. This is a training moment. Use it. Use it in a non-threatening manner. This is not a time to be argumentative, although your "candidate" will object and say that you are. Just keep letting them know that they have not reached the same definition of terms; you're there to help. It's at this time that the conversation can become trying, even exhausting. Old habits die hard. It's times such as these that being professional and patient are the keys to keeping your candidate and winning this particular battle with the impairment.

These times can be difficult and draining. They will make you wonder why you're going through it. However, these are times of growth for both the accommodation provider as well as the client.

The client benefits because they gain new skills for coping as well as an appreciation of why the skills they acquire are valid. But the accommodation provider, the one who was just about to pull their hair out, also gains.

Getting through working with the client grows the ability to have patience. As you listen to the client, you learn more about different ways of communicating. You gain strength in listening to what others have to say and how they say it. You gain an ability to listen to various forms of logic and better understand them. You learn how to talk to people from all walks of life without judging them. If you are the type of person who has a laissez faire personality and just let things pass as not worth the effort, accommodation work with those who have moderate to profound issues will develop your ability to "push back" or cut the exchangement at the appropriate time.

Just working through these types of communications will enable you to grow a thick skin and will not back down as easily when you understand what's happening. It will help you see through bluster so that you can deal with the hidden feelings of inadequacy. You will also see past the shamed excuses for bullying that attempt to guilt you into accepting that type of communication, making you feel you must have misunderstood. You develop keener critical thinking skills.

Finally, you learn when correcting and clarifying are futile and end up being counter-productive. You benefit because you are challenged to grow in your being able to deal with all people of all walks of life.

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Sunday, August 12, 2007

Hospital Recommendations Upheld

The impact of the announcement left a humming chill in the air that resonated for several minutes. It made the listener want to stop and wait for the next sounds, the syllables that would unfold the remainder of the story, reveal the inevitable. Then the realization came that the suspense would have to wait until July 31 or later.

It was the morning of July 23. Radio news announced that U.S. inspectors had just arrived at King-Drew Hospital for a surprise evaluation visit. The hospital has a long history of troubles, poor performance by the workers, lack of discretion, and a nickname that sends shudders down the spine -- Killer King.

Earlier this week, the outcome of the inspection was announced. The hospital will be closed. In fact, one reporter stood in front of the empty building yesterday and spoke of the falling action of this drama. No emergency patients were being accepted. Ambulances were being redirected to other hospitals. Existing patients in the various specialty wings were transferred throughout this week to other facilities.

It was not the equipment that failed. It was not the integrity of the building that lacked. It was not 100 percent of the staff. But there were too many who were charged with the welfare of individuals who could not perform their duties. One reporter cited the fact that a worker could not accurately calculate the dosage that was to be dispensed to a patient. Another could not read the indicators provided by their equipment. Another left things unattended and problems arose.

This does not account for the tales of people being summarily lumped together as stereotypical entities rather than unique individuals. This does not include condescending statements that belittled the patients, making them feel less than human. And the fact that the hospital personnel would provide directions to one part of the hospital campus to another that on any occasion could be accurate or not is also not in the measures of credibility.

This last issue is important because if a person is seeking treatment for a health condition, it is highly likely that navigating two or more blocks to go from one part of the plant to the outlying bungalows on the campus may not be an easy task. Although there was a shuttle, it was difficult to actually catch it because it did not show up at the intervals that were supposed to be its rounds.

It was the screening and testing of personnel that caused the fall. The measures that were too low. The lack of taking charge of a situation that was not acceptable and letting it "slide" because the person in question needed a break. But a hospital, the health and welfare of people striving to live and care for theirselves, is not a place where people should let things slide. An individual's integrity at that point is one of the most critical issues and of paramount importance.

Let this second failure and ultimate closure be a lesson to Human Resource and recruiting professionals. Let this be a lesson to schools and universities. In preparing the people who will work in these environs, there should be care to make certain that their grades accurately reflect ability. Attention to detail is premium and should be part of the main concerns of the candidates. A first mistake can be forgiven but it needs to be attended with remediation. A second mistake needs more drastic measures.

In a previous post, there was an observation that some of the personnel showed signs of being heavily medicated on anti-depressants. Yet they were still on full duty in critical areas and managing records and documents. We will not speculate on whether the records always got into the correct files or not. The sins of the overall facility make that thought to terrifying to consider. But again, management and Human Resources should have worked together to find some means of providing time off until the reason for the medication was resolved and then return the worker to their position.

But that brings me to yet another observation about the personnel. So much reliance on using pills to cure anything and everything, from the least to the greatest. Again, there was no screening with regard to whether that medication was appropriate. In fact, some medications that have been found to be contra-indicated for use were still being prescribed. Other medications created physical dependency on the drugs (not addiction) that cause the condition to worsen and require higher doses. But the patient was still seen as the stereotype who would be suseptible to the family of related maladies. Indeed, the medications being prescribed would become the precipitants of the related conditions and add to the number of issues with which the patient contended rather than actually healing and freeing them from dependence on artificial remedies. Perhaps this last indictment is a failing of the training rather than the practice or the hospital. I will invalidate it -- for now.

We say in the recruiting industry that we are in pursuit of the "qualified talent." King-Drew shows us where things can go when we do not hold our standards as high as possible and settle for less than qualified. But King-Drew's Personnel department, no doubt, was attempting to give these "D" and "F" performers (according to Yaroslavsky) another chance at making it in a reputable facility. Unfortunately, they were given the chance to make it but not the support and supervision necessary to actualize it.

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Saturday, August 04, 2007

The Consultant's Duties

One of the reasons a company (or an individual) seeks the services of a consultant is because there's so much on their plate that work is becoming counter-productive. Eventually, the realization manifests itself that someone with expertise in a unique area is needed in order to do the special project while the more routine things are kept on track in the normal flow of operations.

Being a consultant is a role that has many contradictions. While it involves being a person who cares very much about taking care of the needs of others, one needs to be discrete about allocating their energies. It is entirely possible to work on several projects simultaneously or have some at different stages while developing the next. But giving equal attention to every phone call, drop-in visitor, or shriek for help is not possible. The internal, as well as the public task master, needs to discriminate with regard to their time in order to stay focused and be the expert.

It is then the consultant's responsibility to take control of things and lead the client through each step of the process, from the initial consultation, parsing out the needs, determining whether there is a relationship, bringing forth the contract, developing the parts of the project, and generally keeping the client's life livable and under control. Actually, taking the reins puts sanity into the lives of everyone involved.

Call for Assistance

The ball starts rolling with the call for assistance. It's basically a conversation to determine whether you have the right players for the project. This the time when the consultant will be looking for answers to questions. What questions? Things like what is it you do? What do you do best? How do you go about doing this? What do you want to accomplish and why do you need me to help you do it? What have you done in the past? How did that work out?

Screening and Assessing the Needs

These questions serve several purposes both for the client and the consultant. This is a time when the consultant listens very carefully to what's being said and what's not being said. And in regard to the silence on certain topics, there's something being said by implication as to what's really going on and needs attention. The consultant serves as the independent observer who sees more of the picture because they are not part of the picture.

Asking for the Contract

Once the consultant has an idea of what's needed, it's time for them to take control by first outlining what can be done by this specialist. Milestones are worked out. And it's important for the consultant to speak up when the timing is not realistic or the materials too scant. Then the consultant asks the client for the contract that memorializes the terms and a retainer to start the work.

Taking Control

Because of the initial conversations and screening process, everyone has an idea of where they're going in order to reach the recommended solution. But the most important element here is that the consultant takes control of the situation and manages it from the very beginning of the discussions. It's one of the reasons the client reached out for assistance -- because there's so much going on that they've become distracted and have difficulty managing the priorities.

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