one lousy hand

Two days after my meeting with Nova last month, the supervisor called me and did some serious eating of crow. Her people had let her down. It turned out that the numbers weren't really as bad as they had told her and that Elizabeth HAD made progress. She was still learning her job and wanted to apologize, and the director/CEO of the facility was going to sit down with them and look at treatment goals. I felt like I was holding a handful of trump cards and that we could get some things accomplished now. There were some good folks there and I knew it would be very disruptive to Elizabeth to start over somewhere else. Transition is not her strong suit. I was ready to move ahead.

I'm obviously a pretty lousy poker player.

Elizabeth's Child and Family Team has been busy this last month. We've met twice and worked over email to come up with some thoughtful goals. We invited NOVA to participate via conference call at last night's meeting; no response. I finally called Disability Rights NC; it turns out they have had several complaints about NOVA, and they called and talked to Elizabeth's therapist there about some of them. They asked me to report her threatened discharge to the state, saying they couldn't just decide to kick her out like that. The worker I talked to at DRNC actually had met Elizabeth on another visit there. They were concerned about her diabetes too.

When they called yet again about another restraint, I asked once again that she be put back on the beta blocker that was looking successful when she came. The psychiatrist had pulled her off it in the first week. At clinic on Tuesday, he agreed to put her back on it for seven days to see how she did.

Today I took the reworked goals to NOVA for our monthly treatment team meeting there. Our team charged me with presenting these goals and asking them to work with them to hone her treatment. They had said they didn't know what to do, and our team was going to help. When I arrived, I was pleased to find their director/CEO had come to the meeting and I passed out the goals.

He held out a hand to stop me. "You aren't going to like what I'm going to say," he said. "Effective February 12, Elizabeth will be discharged from our facility." I said something about their inability to change their treatment to help her, that I knew they were out of strategies, repeating what they had said last month. "Oh, no," he said. "We can work with her just fine; it's you we can't work with." He quoted their handbook, saying that the therapeutic relationship was too broken to continue and that was grounds for dismissal. When I asked for specifics, he said that I had copied regulatory agencies and legislators on my emails and that could be construed as a threat. 

I asked about the diabetes testing. They had records showing that they had been testing all along, their nurse said, but no, I couldn't have them. Besides, a blood sugar of 274 isn't too high and they don't believe she has diabetes. The director/CEO said that he had diabetes and he knew about it. She certainly didn't have type 1 and she was too young to get type 2. I asked for the incident reports about the restraints she had while she was there, reports that I had been promised. They were refusing to release them. I asked the supervisor about her telling me that her staff had let her down and that their numbers were wrong. She never said that, she told me.

In the two days she's been back on the beta blocker, she hasn't had a single aggressive incident.

So there we are. I have a child coming home in a month. I'm not going to fight their decision and I'm trusting that she is okay in the time that is left. There are some good folks there and I have to believe they will watch over her. I have a lot of work to do in the next thirty days.

But not tonight. Maybe tomorrow.