Disclaimer: All persons, places and things in this document are imaginary; any resemblance to actual persons, places or things is purely coincidental.
Whew! Just got through working several days in a row, each day on a different team. A veritable kaliedescope of patients and staff.... Really! so much variety! - from the anal to the laid back, the narcisist to the saint - the servant of god, the prophet of god and god himself, all in a few days....and that's just the staff (just kidding). Maintaining a minimal level of sanity in such a situation means establishing a regularity in the work that is independent of a particular staff, paticular patients, particular programs. All new all the time is just too stressful; we all need to have a lot of our workday consist of things we don't have to think about too much...you know? to rely on routine, to float down the river, go with the flow...you know what I mean......I think in many jobs, workers can rely on some consistency in their work environment and make some kind of workable peace with its drawbacks. One comes to expect certain behaviors from certain coworkers, some understandable progression of symptoms on the part of the patients, some predictability about how the day goes program-wise...meals at these times, groups at those times, smokes, meds in an order that requires only minimal thought or attention once the pattern is learned.
For me, though, I have to find my work stability elsewhere...a different unit every day means I can go either bigger and think of the hospital with its multiple units as one single workplace and discover reliability, predictability on that level, if I can; or I can go smaller and find it in myself - in the way I do my job, the way I approach patients and the problem of mental illness in this society. Actually, I suppose I do some combination of both....I have a pretty consistent individual approach to my work, and to the problem of being mentally ill in society and see the hospital as a single entity, a component of "society". Since my approach to patients is to help them find a way to live in society if I can, often the hospital, as a element of "society", becomes the "other" the patients (and I, as their staff person) are stuggling against.
"Us" and "we" are terms I use more often when talking with a patient, than I do when talking with hospital administrators, who seem to me to occupy an entirely different world.
I use them a lot when talking with other mileau staff, though. We're all there, slogging along through a crumbling landscape, shepherding the mad through the deepest, darkest part of the mental health system...hoping, if we hope at all, to set them free, back into the community, to have some kind of life...because this is, honestly, no place to live...for them or us.
Really.
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6 comments:
I have just heard something new...On some of the teams the pool staff can be counted as regular team staff....How that came about who knows....Until a few weeks ago we had a 50- 50 rule, you have 50% team staff to 50% pool...... But all of sudden on some teams that is not the case. I bet JACHO would love to that new rule......
Yes!...and I'm here to tell ya...pool staff, great though they are, are not team staff.
g.f.
Hey, I've got to say that the majority of us worker bees at the mad house do good work in spite of it all. What I'm told about other aspects of the Mental Health System that exist under the HUMAN SERVICES umbrella make our facility an attractive alternative to some placements. I was told straight up that some of the state locked nursing homes are "shit holes". As a matter of fact we have a client going to extremes to block discharge. What does that imply? The other end of that is the client that has burned those rotten bridges and has nowhere to go. Are they better served just turned loose?
Hi, Cricket,
Yes, I hear ya....and totally agree that most of us do good work in spite of it all...and that the other possible placements aren't very desirable...but I'm thinking about your other comment about safety issues and concerns (can't remember now which page it's on) ...do you think these things are related? i.e. that poor care, however we define that, leads to more assaults, or more dangerous interactions with patients? Perhaps using the jail as our most common placement for the mentally ill, for example, actually contributes to dangerousness of patients...seems like a possibility to me...
g.f.
Remember when we believed that it was possible,to liberate ourselves and others from the limiting,constricting,oppressive,punitive,covert,and the ,destructive underbelly of politics,war,authoritarian regeimes,power and money mongers, I have to say I never expected to face this beast in health care of the most vulnerable of our fellow humans.........but why not.........historically.......one can look back at the exact replica of these institutions who falter and fall to the darkest greed and ignorance of whats possible.Talk is cheap...............smiles even cheaper,..........and deadlier.........especially for the idealist who still has a little place where one keeps the flame alive.......protected from the cynicism of the powerful and moneyed.I hear that whereever you go,there you are............they say greed,hatred and ignorance rise endlessly......I also hear that there are exciting new paradigms for leadership that actually does support the mission of whatever the business is,available to anyone comitted to genuine change,.........not to just the "PRETENSE' of change which only fosters a cynical,painful failure of our courage to step up to whats new and revalutionary,but i am not so naieve as to realize the Enron debacle and exhibit of these few peoples willingness to step over all the dead bodies to scoop out whatever jewels and gem they were persuaded would relieve them of whatever ennui they needed relief from in their lives and this was the way to do it.basically...........the cynicism and duplicity that permeate big hospital systems feed on splitting,chaos,unrest,attacks,information withheld,and generally keeping the heat on as many folks as possible.................so its easy to see.....the patients get the short end of the stick,,,,,,,,,,,,and hearing some people mouth...."we are here for the patients" sounds like a mouth of ashes and are the very ones who undermine the whole project.......except it sounds REAL GOOD to the agencies that pass the institutions for their liscenses,the other day I happened to witness one of the liscensing persons,"inspecting"a procedure.........instead of watching the procedure,or even doing the most rudimentary inspection,.................he got waylaid by an attractive young girl and spent the time cajoling her............and then the "inspection"was over.........gosh........I guess we passed with fly...........ing colors,or thats what i heard. Lets leave the dinasour age and black lists and MCARTHYISM,AND move on down the road,because its going to happen anyway,this duplicity,scare tactics,and cronyism can only take us down,And not only that..............what happened to honesty and kindness.................Imagine working at Enron and someone saying that to one of those people.......ha,ha,ha, see ya later sucker,thats what.
VERY SIMPLY,MORE ASSAULTS AND DANGEROUS ENCOUNTERD ARE VERY DIRECTLY RELATED TO STAFFING PATTERNS.........I HAVE NOTICED THAT GIVEN THE OPPORTUNITY TO JUST TALK AND BE LISTENED TO FOR AS SHORT A TIME AS TEN MIN..,PATIENTS FEEL LISTENED TO AND RECOGNIZED AS SOMETHING OTHER THEN AN INTERUPTION TO OUR "PAPERWORK"AND FRENZY OF MEETING THE VOLUMINOUS EXPECTATIONS OF BEING SURE WE HAVE "OUR SOAP WITH US WHEN THE INSPECTORS COME",OR THE SHINEY (ALBEIT AGED) LINO FLOORS THAT HOUSEKEEPING ARRIVE AT FIVE THIRTY IN THE MORNING TO BUFF UP THE EXHAUSTED TILES,AWAITING THE FIRST LITTLE SHOE TO PLACE ITS LITTLE FOOT ON THAT GLOWING SURFACE.........THE MONEY AND TIME ON THESE SURFACE AMMENITIES IS SHAMFUL WHEN COMPARED TO THE DISMAL PATIENT TO STAFF RATIO,WHEN TWO NURSES ARE BASICALLY TAKEN OUT THE MIX,RACING AGAINST TIME TO DO THE NURSING PIECE,THE REALITY IS USUALLY TWO CLINICIANS FOR TWENTY THREE OR TWENTY FOUR PATIENTS.I HEARD THAT A COMMENT WAS MADE BY SOMEONE WHO SHALL REMAIN UNAMED........LET THEM JUST BLOG ON.....................AT LEAST WE CAN RECOGNIZE THIS SENTIMENT FOR WHAT IT IS NO EXIT
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