My Work Week in Review
No matter how “crazy” things get at the hospital, I still have my coworkers / friends to tether me to sanity - at least my brand of it. This was a difficult week by comparison. A difficult week for me means a combination of more than usual paperwork fueled by admissions and discharges, unhappy and unstable patients who zero in on me as their only source of help to hatch their delusional plans, and distractions caused by me having an outside life.
Admissions and discharges are routine, but not every day. Since I function as the intake coordinator as well as a social worker with a case load I can sometimes be overwhelmed with a log jam of responsibilities all having high priority. This work is not the sort of thing you can sit down and do in orderly fashion. It is more like a controlled fall you see on the “X Games” where an individual is plummeting down the side of a mountain. A casual observer might think it is just some poor devil falling off a cliff where in fact it is a highly skilled athlete demonstrating his abilities with grace and precision. My week was not unlike such a free fall down a mountain. Writing this is testament to the fact I survived. No big deal really, it was just a routine difficult week. That IS the job and though I may complain at times - I really love it.
One day I was in the midst of a whirlpool of demands. Two patients were standing outside the nurses station, both talking to me at the same time, both wanting to know what was going on with their discharges, (which were both nebulous for a variety of reasons.) My not being able to give black-and-white answers to their questions only intensified their joint inquisition. Having arrived a bit late, I was scurrying around getting the data to churn out the morning reports necessary for the intake meeting which immediately followed the group I was supposed to lead in about five minutes.
I was standing at the confluence of several rivers. The river of “Me Being Late” was flowing into the rivers of “Discharge Planning Unsettled” and “Bad Karma.” Then from the west the rivers of “Bad Luck” and “Today You Are Going to Get Yours” were at flood stage. “John Strain, telephone for you.” It was a mental health clinic with an admission. “John, I need to get some information about these two discharges,” asked the charge nurse. “It’s group time, let’s go,” one mental health worker announced loudly and began herding the patients into the group room for the group I was supposed to conduct. Just then another patient walked up and began rambling in mid story as though I completely understood his context. He was angry and was demanding his rights and demanding in general. Instead of trying to swim against the current, I let go. Noticing the smile on the face of one of the mental health workers who seemed to appreciate my situation, I began to laugh.
My situation was typical stuff and it always works out. I told the two gentlemen to give me a minute while I took the call. I told the nurse I would get with her once off the phone. The other social worker covered the group while I finished the call and completed collecting the data for the intake meeting. Sometimes the number of demands are so numerous at one point in time it is comical. During those times I think of “I Love Lucy” when Lucy is working at the chocolate factory or those guys who balance spinning plates on poles. If you can see the humor from the inside like others can see it from the outside, you will handle your inundations just fine. If you take it too seriously, your mind will begin to function the way a stuck CD sounds, “nyn nyn nyn nyn nyn nyn.”
Laughter is the shield I use. Some of my coworkers may notice my situation and try to add to the overwhelmingness of it by making things up. “John, the operator called and we have a walk in up in the lobby.” This is a bad thing, because I have to drop what I am doing and assess the person. This is a one hour unexpected joy ride into the unknown. I am not complaining about this seemingly sadistic act though because if I notice a coworker in a similar state of stress I would do the same thing. “If you live by the sword you die by the sword.
I may have gone too far once when I thought it would be cute to call the administrative secretary and tell her the State Surveyors were in the lobby for a surprise inspection. Apparently the administrator, nurse manager, and medical records lady were in a meeting so the announcement had an even better hysterical impact than I had planned. Pam the administrator at the time failed to see the humor. Somehow though she could not stay mad at me long. When she was in power I left my balls at home. I knew that she would like nothing more than to add mine to her collection and I was determined to hang on to them even if it meant leaving them at home.
The other social worker is a female. We often ask each other to sit in at family sessions. The dynamic in the session can be completely different whether there is a man a woman or both as therapist. She may say to me, “would you mind sitting in on so and so’s family session, I need a man in there.” She may also add, “and you are the closest thing to a man we’ve got.” Har Har Har. This week I sat in for just that reason. The idea was I had a better relationship with the patient because I have not had to be the “heavy” and deliver bad news. That all changed. Shortly into the session I made the mistake of characterizing her “long winded, bombastic diatribe” as a “rant.” The patient fixated on the word “rant” and used it as proof I was a bad therapist because I did not know what a “rant” was. She then proceeded to go on a “rant” about the word “rant.” My counter argument was, “I may be a bad therapist, but not because I don’t know what a “rant” is.” You have to have a thick skin to work with these folks. They will call you every name in the book and accuse you of every known and some unknown offenses. The trick is to keep things moving along productively.
Work certainly gets in the way of my personal life. The closing for our refinance happened this week - finally. I have had major problems with the bank. The closing was scheduled, rescheduled then when we got there they had the wrong amount on the paperwork, so we had to reschedule again. I have been pretty mad at these people - mad enough to pursue what I feel are major customer service problems. The hectic work week coupled with this pain in the “you know what” only increased the tension.
Along with unexpected problems are unexpected acts of kindness. I have to give credit to one of the nurses, who besides being beautiful, has a knack for bringing a surprise cup of Starbucks Coffee just at the right time, guaranteed to diminish problems and increase ability to deal with them.
Friday was better because it was Friday. Still, not without problems. The unit “milieu” is the overall feeling and dynamic on the unit. For instance the milieu may be paranoid, depressed, angry, or anxious. Friday it was loud and angry. Several patients still lacking complete medication stability are loud, illogical, broken records that find it necessary to verbally accost staff, demanding help, while refusing to stop talking and listen to any help we might offer. At first, I listen, then after the story repeats a few times I attempt to talk. After I begin to move my mouth to speak I am interrupted and the story gets retold with heightened volume and more colorful adjectives. When I have made several attempts to talk and the other person talks over me I tell them “If you do all the talking and keep interrupting me I can’t help you.” At some juncture I determine the interaction a lost cause and ask the individual to step away from the desk or come back when ready to listen. Then they will say something like, “you’re not even trying to help me . . .you’re a bad social worker . . .I want a different social worker.” If their protest reels me back into another attempt to help it usually winds up the same way. Can you say “exasperating?”
This weekend I should go in for a few hours and finish my paperwork. I left at 5:30 PM on Friday with charting still undone. But you know what? I had already cut into happy hour 30 minutes and I was not going to delay the start of the weekend another second.
Just another week, but I love it and I love the people who work with me.
Until the next time
John Strain