All Fun and Games

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I don’t think I have gone much in depth about what I do for work nowadays. To put it shortly, I am called a “Behavioral Health Technician”. The title is rather vague considering I don’t really address behavioral health, but the agency I work for wanted an all inclusive term for all of the techs in each unit and department, so that seemed like the most cohesive term… apparently.

The long version of what I do is this: I am certified through the state of Washington as an agency affiliated counselor. I work in the Adult Inpatient Unit of what simply put is a psych ward. We used to be called psychiatric aides, but that isn’t what every unit does, so the term didn’t make sense. The agency has other units such as the Youth Inpatient Unit, Residential Services, Crisis Triage Facility, and Pacific Hope and Recovery. Basically when you go to the ED in crisis, whether it be addiction, mental, or behavioral health, we get a call asking if we have any beds available. If we do, we can admit them to our facility, usually either my unit or Crisis Triage. If you are going through withdrawals or just off drugs and/or alcohol, you go TO CTF. Once you are sober or if you already were sober, you come to AIU.

We are a 16 bed facility with 4 long term beds for folks who need to stay longer than three months. I work with a doctor who medicates and treats clients, three mental health professionals which are the therapists for the clients, two care coordinators who deal with insurance and plans for clients after they leave, the supervisors who run the unit, and the techs who keep the unit safe. We work 12 hour shifts, 3 shifts a week is considered full time. We have day shift and noc shift (nocturnal; graveyard). So day shift is 7am-7:30pm, while noc shift is 7pm-7:30am. The first thirty minutes is pass down where the previous shift supervisor gives a run down on each client to all the day shift staff and to the nurses. Oh yeah, we have several nurses on staff too for medication and nicotine hand outs. We discuss each client, what they did, how they slept, their diagnosis, their triggers, and their coping mechanisms. Pass down takes longer the more acute the unit is and/or the more clients we have.

As far as what I personally do, we have four techs working the floor with the nurse and supervisor in the locked office with cameras all over the unit in case violence arises. Two techs are assigned meal prep and the other two techs are assigned safety. Meal prep is getting breakfast, lunch, and dinner ready. It’s not hard considering the fact that we have food deliveries every day with prepaid and pre cut food since we can’t have knives or anything sharp on the unit. So we do a lot of reheating in the oven. Safety goes around the unit and into all the rooms to look for contraband. We try to look for any pills not taken and swallowed, sharp objects, drug or alcohol use, etc. We check under mattresses, in clothes, belongings, and take out trash and what not.

We also talk to clients and address needs and concerns. A lot of times, the question is out of our control or we have no knowledge of their specific case. It’s nice that we receive pass down, but there are so many people coming and going that it’s hard to keep track of who’s who and what’s what. But we can usually de escalate situations by saying that the details are being worked out behind the scenes and distract them on something else.

The point of coming to the adult inpatient unit is to return the client back to baseline behavior. It’s not to “fix” them or solve all of their problems. Most people stop their medication and end up in the ER and eventually here. So our job is to get everyone medicated, to reduce problem behaviors, and to get moods back to baseline or their “normal.” After that, people return home, or if they are homeless, go to our residential services, which is a building that houses homeless, mentally ill folks.

A lot of times, clients are court ordered to be detained in the inpatient unit. You either are considered voluntary, if you chose to ask for help and aren’t a danger to self or others, or you’re involuntary where you go to court periodically and a judge determines your mental fitness. Sometimes people commit crimes and are sent to jail and deemed unfit, and are sent to us until the client can be rehabilitated. These are called Jail Holds. Once they are rehabilitated, the clients then return to jail to serve their sentence.

So to answer your dying question, do I work in a safe place? Relatively. People are checked for weapons and drugs before coming in. But people in psychosis can become physically violent and there are some clients that I am extremely afraid of. Especially considering the fact that I work primarily with other females and they aren’t defending my ass when a 6’4″ 260 pound guy comes to intimidate me and beat me up. We have deescalation tools, but it’s not like we are armed so if things go south, we have a button that we press to sound an alarm to alert security and other staff to assist.

Like today was chill. Usually the clients get free time all day long. We have newspapers, books, coloring pages, coloring utensils, food whenever they want it, an outside patio area, and their rooms. There is exercise equipment outside and the chairs are heavy and made of uncomfortable plastic. The tv is covered in a plexiglass shield so nobody breaks the tv. It’s a very cold, white walls, white tile floors. There is some client art work hanging on the walls.

During shifts when I am not either serving food or doing room safety checks, I am drawing. Today we had a painting session for clients so I painted with two of our nine clients and I drew on the paper where I hadn’t painted on just yet. The theme was halloween so I made a spooky painting where I painted the workers “Escape your demons” and demons was all drippy to look kind of eery and I had a tornado to the side of it. I decided to ask clients what I should draw on my painting to fill the empty spaces, so each client suggested things and I would draw them. I added a ghost riding a skateboard, a semi truck, a red pickup truck that is turbo charged, I drew pumpkins and the Narrows bridge, and all sorts of other vices around the tornado. I plan on finishing the drawing this weekend and will hang it on the wall in the unit as suggested by one of my clients’. We also played the game Yahtzee, which is my favorite game. My coworker said she had never played the game before, but it was fun. My client said it is fun but, “Not when you play and the next day you’re hungover.” I laughed so hard because it was so unexpected. She also called my short hair “sexy” which was either nice because it was a compliment or weird because she was hitting on me.

I am gonna end this post on the high note because today was pretty good. I think some days that working there is more therapeutic for me than even for the clients!

Much love,

Dani

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