Tuesday, February 10, 2015

Community Acupuncture from an Acupuncturist's Eye View

At Sarana, we schedule return acupuncture appointments at 10 minute intervals yet you almost never have 10 consecutive minutes of your acupuncturist's time. What are we doing when we're not treating you? Here's the view from my side of clinic operations.

My clinic day begins the previous evening. I'm not an early riser so I look at scheduled clients' charts on-line the night before. I make a list of who I'm seeing along with reminders of things I want to follow-up. I usually arrive at Sarana before 9 am, about 30-40 minutes before my morning shift starts. This gives me time to turn on the lights and heat, make sure that the chairs are neat, the bathrooms clean, and to check for stray needles on the floor. Meanwhile, one of Sarana's team of wonderful receptionists arrives to print out the list of clients for the day, check telephone messages, and set up the waiting area. By now, I will have about 5-10 minutes to open the back-area computer where we do on-line charting and look up the records of clients who booked in the last 12 hours. Or if someone comes early, I can get an early start.

Treating – the part of our interaction that you experience – is limited to about 5 minutes of talking, feeling pulses, adjusting pillows, inserting needles, and spreading blankets. Once I've done these and wished you a good nap, I have to trust that the healing process is set up. What happens to you next is a result of time, the group energy in the room, your ability to go into deep relaxation, and the needles doing whatever they do. Now it's time for me to move on.

Having treated you, I take a look around the room and make sure that everything appears in order. It's my job to “hold the space”, to be aware of what's going on, to ensure that you can nap securely. If other clients have entered the treatment area, I will want to greet them. If several arrive simultaneously, I will want to let them know how long they can expect to wait. If someone has woken, I will check if it is time to remove needles. If someone has left, I will “fluff” the recliner and make the area welcome for a new arrival.

I also need to record treatment notes for each client. If I have a gap in my schedule, I can type notes directly to each client's record. But if the schedule is busy, after every 2nd or 3rd, or 4th client, I will need to jot notes on my cheat-sheet: a list of points needled, requested wake-up times, and sometimes reminders of chief complaint or future follow-up.

A few times each shift, I will check in with the front desk area, sometimes to verify the identity of a client I don't recognize, sometimes just to see if everything is running smoothly. I must also take care of my own needs, check that the bathrooms are still clean and stocked with hand towels, and wash my hands frequently.

At the end of my shift, I need to have written a chart note for every client I've seen. On a busy day, this could be 25-or-so people. Sometimes, I also need to follow through on things I've promised clients: information, herb prescriptions, billing statements. Typically, I'm done by about 3:30pm on a day when I'm scheduled to treat people from 9:30am to 2pm. By this time, I'm ready for lunch and my own acu-nap.

~ by Pam Chang, 2/8/15

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