Bong!Bong!Bong!

Good Morning, Bloggers!!!

I must say, most of you have done a spectacularly terrrible job of keeping blog readers and writers informed since I've been gone! Not a single complaining comment, not one public discussion of private hospital goings on. hmmmmm. Could it be that, really, everthing's fine there? Was it really just me?

In which case, Problem Solved!!!

I've had a few days to get reoriented before the start of my new real job and have, among other things, discovered iTunes!!...which is playing in the background right now. I've got it on Grassy Hill Radio...which, I must say, is just really really great... iTunes, in case you're new to all this electronic stuff, is not just a place to buy music...it also provides one with a million radio stations...commercial-free, streaming audio...Ya Hoo!! Just open up your iTunes and pick your music! (Come to think of it, I know one guy out there who already knew this and provided audio for the nurses station...I failed to really appreciate it then...too distracted by the mentally ill, I guess....but I see now that he was right!) Music makes everything better. I suggest that in shift report each day, the oncoming team decide which station to play that day...vote on it...and play it on your computer!

The new Gong on Team One probably speaks to this very impulse! Three dulcet tones to announce smoking!!... It gives smoking an almost spiritual patina...I like it...I always thought those smokes breaks were good for the soul....people stand around, feeling the release of tension nicotine brings to the addicted and chat with one another, or enjoy the weather. On days like we've had here lately, smoke breaks must be especially euphoric. They're a little time out...a moment when everyone's on the same wave length, a hiatus from all the troubling things that await inside. I've had more good conversations with patients during a smoke break than at any other time, I think. To have this time announced 5 times a day with a gong evokes a monastery...bong! bong! bong!, all the faithful go to a period of contemplation...a call to vespers, as it were. Yes. It's good.

I think you should consider announcing med lines in some similar way...maybe some pleasant ring tone played over unit-wide speakers...(AND! installing unit-wide speakers could keep some contractor occupied for months! years, probably....helps unemployment..and there seems to be a large budget for installing hospital-wide communication systems..)

Boy. Think about it for a minute....you could really transform the mental hospital experience totally...just think of all the things you could digitize...you could play that mileau entirely from your computer station....you could announce meals, groups, bedtime...all with a special sound.

Then! When everyone was used to responding to sounds, you could begin to use the sounds for psychiatric purposes....for example, you play a particular sound during something pleasant (like dinner, or a smoke break) until the sound becomes associated with the pleasant state of mind....then, when the mileau is agitated, you just play the sound....everyone suddenly experiences the pleasant state instead....oh yes...this definately has possibilities.

It's good to have a few days off to let the imagination run...I'd never have thought of this while working; a whole new world of psychiatric interventions!

Next week: The New Job!! Yikes...

I'll keep you posted.

A Good News Blog

Amazing, isn't it, how things happen that can brighten one's entire outlook! One change can make the whole world seem friendlier, rosier, more hopeful!

Check this out, for example: There's a website now that plans to use any profits it generates for the indigent patient fund at the hospital! The idea is that employees of the hospital can sell their miscellaneous "stuff"...you know...that "stuff" that piles up in your closets and garages, that's too good to throw away, but entirely unnecessary as far as you're concerned...that stuff. And you can take your stuff to the proprieter of this ebay site, and she'll photograph it, research it (a little), and post it on the Ebay Store:FortBGone. When it sells, you get 75% of the sale price and the other 25% goes to defray expenses, etc. Any profits generated will go to indigent patients at the hospital...my first choice would be that FortBGone should buy unit cigarettes, so that everyone can avoid that painful, recurrent conversation about the hows and whens of their provision. This way, at least the "who's going to pay for this" part of the conversation will be moot. If it takes a smoker a few days after admission to figure out how to get his/her own smokes, no big deal...won't break the budget...give 'em out free.... Imagine! One less irritation for all. Great idea.

So, go look in your closets, garages and basements and sell that stuff!! You'll make a little money, have more space, and be contributing to a good cause! Shop for Christmas presents there, too! The site says if you work at the hospital, you don't have to pay shipping/handling...so things get truly cheap. There's all kinds of stuff there...soup to nuts, as they say. You could get all of your shopping done in one place, and make enough money to pay for it all, too boot, if you play your cards right!!

Gosh, life is good, sometimes!!

And more good news, the Gadde Fly has been given the opportunity to have a look at the community mental health system! I'll be able to report back about what's really going on out there!! Haven't you always wondered?? What happens to these guys after they leave the hospital??...why do they keep coming back??? Well I'll see what I can find out! I promise to report back.

Meanwhile, it's up to you, gentle reader, to keep us all up to date about how the Madhouse is going. If something needs reporting, please report it. And send news! Don't forget to visit FortBGone for all your holiday needs...acquiring or divesting....it's there for you!

Comments since last post on Patient Freed

Patient Freed after Two-Plus Years of Treatment!!!

It's been a banner week at the Madhouse! The patient whose extended stay with us might be considered the prime inspiration for the Blog, has finally been freed!!!! Woo!Hoo! Hi-Five! (picture dancing!!) I'm told he was transferred to his new residence via ambulance...which seems like overkill (...hope the mental health center was paying for that! Egad. We could have rented a limo for the price of an ambulance, I imagine.) Nevertheless! This was great news and brings some resolution to that ***Madhouse Moment***. A Rolls would have been ok with me!

Let's all bow our heads and pray for adequate out-patient case management.

And then I heard that Social Services had investigated the Adolescent Unit over their "rockin' 4th of July weekend" and issued a "corrective action" (sic)...(misery loves company :) ) ...institutional neglect, if I got the story right. That's somewhat reassuring...although I also heard that a similar event at the RTC has flown under the radar. I wish somebody could reassure me about having DYC kids housed and treated with mentally ill kids in general. Are there any readers out there who can make a good argument about why that's ok? Please blog!

And, there was a panic alarm this week, too. Of course, with our current system, I didn't even hear it. Some of us did, though, (thank heavens) and as the responders were pounding down the corridor, our door flew open and in ran responders from another unit. "Is the Panic here?!?" they asked. "No, must be upstairs" our guy responded.

It kind of puts my teeth on edge that for years now, our panic alarm system causes more panic than it solves. Honestly, when I started and we had the "old" system, everybody always knew where to go. And now we've added a new fire alarm system. Therefore, in the aftermath of the panic, somebody pushed the new "Abort" button and somehow summoned the fire department.

......sigh

In the good news column, have you noticed the new landscaping in the courtyards? Wow...it's so nice to see some energy put into those again after all these years!! Don't know the hows and whys of any of that, but it definately is heartening to see the place cleaned, tidied, and planted again. It's an absolute improvement!!

Hey, could we put whoever's in charge of that, in charge of the alarm systems, too?

Finally, people have been asking about my "corrective action" for insubordination and what's become of it. Well, as it seemed pointless to talk to the personnel board about it, I contacted the State Auditor instead. That's who would be interested, if anyone is, in wasteful practices at a state agency, after all. As as for my training, September is actually the month I took them in last year, so I figure now I'm legitimately due for them. So I'm content; once a year is more than enough for me.

The comments continue to be stellar! See Hi Ho

Hi Ho

On the way out of work today I had a couple of those experiences that remind me why I like this work. (I've kind of avoided writing about patients since all that early Hippa uproar but, hey, now that we all can see what a real Hippa violation looks like...and what the consequences aren't....I feel emboldened to blog about the real stuff.)

Anyhooo. I'm on the way out the door when a patient starts to talk about himself...about his experience...about how he got here and about what he wants to achieve. He tells me he's had a childhood of sexual abuse, of incest, of homosexual events...although he is not homosexual. He tells me he wants to take care of his aging father, now neglected by his other siblings. He tells me that when he decided to divest himself of an offending body part, it didn't hurt...it stung like a swarm of bees, but it didn't hurt...and that it was Justice. He feels like he got off easy. He paid for his childhood sins. He says that the medication he'd been given in the past blunted his emotions so much that he couldn't experience any emotional catharsis...a cry of distress was delivered - and experienced - in a monotone - a rote recitation of distress - unhelpful, unsatisfying. Now with the new medication, he has a full range of emotions and he is grateful. Now he wants actual therapy..talk therapy..he wants to work through those childhood issues...he wants to deal with what's happened to him.

He gave me a facinating look at his humanity...our humanity. As with so many of our patients, his story is dramatic, complex, emotional...and is still being written. He's a young man with a lot of life left to go.

Therapy, unfortunately, is not available. In his four years of mental health treatment he says he has never been offered therapy...not that kind of therapy. He's been given medications, case management, supported living situations....but never good, weekly, talk therapy.

There is, in fact, a disinclination to provide this kind of therapy these days. His Case Manager tells him "don't get into the past...it's the present you need to deal with". Well. Yes...because we don't have time....the mental health system today has neither the time nor the expertise to help someone work through the kinds of things this patient will need to work through...and he sure as hell can't afford a private therapist.

So where does that leave him? He's on his own. He can get meds. He can get a group home. But nobody with any training and skill will listen to him talk once a week about his life.

Hi Ho...as Kurt Vonnegut would say.

My conversation with this patient was untimately interrupted by the arrival of a second patient, agitated and in tears. She said she'd slapped herself because someone had taken her food. Upon inquiry, it was revealed that she is quitting smoking. I won't bore you with the details of how we got from food stealing to quitting smoking, but we did. Her crisis was resolved with a glass of orange juice and a piece of nicorette gum. Things I can provide. I provided them with alacrity, released for a moment from the reality of my own helplessness.

Because patient number one's issues aren't so easily solved. Patient number one needs what the system apparently doesn't have...therapy. Talk therapy to accompany medication therapy...talk therapy that takes years, not days....the kind of therapy that we don't seem to believe in anymore.

But that half hour was great. I hope he'll give me another before we send him back to his group home.

Much less interesting is that I got back the official response to my grievance about my corrective action. The response simply restated that I hadn't gone to the competency fair, added that even though I'd turned them in twice, Staff Development didn't have a record of my computer training (the writer of the response had the certificates in hand but apparently has no avenue to communicate this to staff development) (?) and that therefore the action stands unless I want to take it to the personnel board. Talk about bored.

I might. But I think, if I'm going to waste time on stuff like this, I'd rather submit a request for a performance audit...more possibilities there.

Really good comments on Hard Work since last post