Got home from work not too long ago after a long couple days, worked 24 hours in the past 48 hours. I was surprised at how well I handled everything and handled the work and my mental health pretty well. I bonded with most of the clients there in the past two days and I felt that I might have even helped deescalate some situations into becoming more acute or severe, whether it be with someone’s suicidal or homicidal ideations, with psychosis symptoms or what have you.
As a team, we got one of our most acute, long term geriatric clients sleep for about five hours after not sleeping for weeks at a time. Later in the evening, the unit played bingo and she won a soda pop and she was so kind as to wanting to share it with me. We kept saying “Cheers” and clinked our paper cups after each drink like we were two drunk people at a bar. Except it was soda and we were in a mental health unit. Then she proceeded to burp in my face. I felt it was a real bonding moment for us and she liked me… not that it mattered if she liked me or not but I liked this experience over her calling me a ballerina for whatever reason.
There was a client I like a whole lot but she has severe schizophrenia and bipolar one disorder. The event that got her into the psych ward was she hadn’t slept in two weeks and had a lot of spiritually based delusions and her dual personality caused her to trash rooms because her other persona had taken over. She feels as though she was called to be the messenger. She also feels as though being “locked up” means that everyone, clients and staff included are trying to kill her or poison her. The other staff ignore her delusions, but I actually ask her questions about them to understand better because to her, she feels threatened and that should be taken seriously. I don’t encourage the thoughts by directly saying that they are legitimate. I tell her logically that there are others struggling with their own internal stimuli and that we are not trying to poison her. I try to calm her down with going outside and deep breathing and talking about her coping mechanisms and things she enjoys. She is a pleasant person to talk to and she graduated from my rival school, University of Washington years back. She is quite intelligent, however her delusions take such a strong hold of her so she is unable to function properly. She is afraid of taking her medication in case she has an adverse reaction, but with a little coaxing she usually responds well to meds.
My favorite client, she is close in age to myself and we do white board challenges where we draw random things or animals or portraits with a time limit and eyes closed. She seems the most stable, like someone I would want to be friends with but could never due to company policy. I feel bad for her, it just seems like she was at the wrong place at the wrong time and her trauma and situations have forced her into inpatient treatment. I often think about how I was often a candidate for inpatient treatment myself due to my bipolar disorder. I personally think it would have been a step back for me and it would have made me feel inferior and weak; not to say that getting the help you need is weak, it is very strong. However, I feel as though for me personally I wouldn’t have gotten much use out of an inpatient stay.
The primary focus of an inpatient stay is to stabilize a client and give them the services needed for them to survive in the “real world”. A lot of the people who come in have criminal backgrounds, suffer from mental illness or addiction, and/or struggle with homelessness or unstable housing. Most stays are temporary and most people are detained, which means forced to stay inpatient until a judge orders otherwise based on tech notes, mental health provider’s notes, and the doctor’s note. Until someone is deemed to be no longer a threat or danger to self / danger to others and their medication has been stabilized, they will not be released.
As far as long term patents go, it’s mostly finding a place for long term care for them. So we act kind of as a liaison as we the patient stabilizes on medication and their suicidal/homicidal ideation decreases. Like for the client I listed earlier who is primarily non verbal and elderly, she is a long term client who needs to go to a long term geriatric and psychiatric facility that accepts her funding and has the means to take care of her for the duration of her life. The problem with that is there is so few solutions for her that her long term solution may be us, but our facility and staffing ability is not adequate in caring for her.
It is unfortunate to call myself a mental health care provider and to feel like we are doing a disservice to these clients because we do not have appropriate staffing and the ability to care for someone with the needs that they have. Like, why would we accept her to begin with if we all knew we could not adequately take care of her needs?
It’s not just her but I am an untrained and uneducated healthcare provider and I have a certification through the state and all that is required to take care of the country’s most vulnerable population is a negative TB test and a background check? I am happy to have this job, but in order to make a difference in my workplace, there is a lot that needs to change. So I got that weighing on my shoulders as I sit at home on a Saturday night “chilling”. Ha!
Well I will leave you with this rant so I can shower and get ready for bed. Yay weekend.