Hierarchy of Care

Yesterday I took a client to a doctors appointment.  We arrived about 5 minutes before the appointment time, but as with most doctors this one was running late.  No biggie.  After being there about 25 minutes, we and one other gentleman are the last in the waiting room.  The doc calls the other guy in and tells us "there will be no more waiting, I am missing my lunch hour".  I told him I couldn't continue to wait over his lunch time, so he let the other guy hanging out to dry and took us instead.

I told him I appreciated him seeing my client first, and he told me that next time we should not expect our appointment to be on time.  I told him I was okay with waiting 20 minutes or so and try to account for this in my scheduling, but I have other appointments to get to as well.  So he said that when I am bringing a client to see him I should not book any appointments for the rest of the day.  Because he might have to fit in patients who are suicidal, or in crisis.  WHAT DOES HE THINK I DO ALL DAY????!?!?!!?

I get that doctors are busy.  Their job is important, and I have certainly been appreciative when they will rearrange their schedule to see one of my clients who is in crisis or suicidal or whatever.  But why is his schedule so much more important than mine so that he can tell me how to arrange my day, and how to do my job?  I have other people to see too!  And don't expect me to feel sorry that your lunch will be delayed when I had to eat a sandwich in my car while making the 40 kilometer trip to pick up this woman whom he will now see for 5 minutes.   I may have been more sympathetic if he hadn't been so rude about it.  An over-inflated sense of entitlement won't get you far with me.

Academic Envy

A couple of my work colleagues are back at school this year, doing an upgrading program for working professionals.

Just overhearing them in the office have academic type conversations about white privilege, gender disparity, and social norms is making me itch to go back to school.  Or just butt into their conversation ;)

Everybody Wants Something

(Overheard at work)

"I want the Zit Remedy to reform and do a duet with Drake."

If you get it, you get it.  Made me laugh anyway.

I did it!

Today is November 1.  And I got all my October contacts entered!*  On time!  Aaaaand---I made my numbers for the month!  The last time these two things BOTH happened?  I have no idea.  But I can tell you that it's been a while.  So Imma celebrate and high five myself.

*yeah, so the notes that belong to those contacts haven't all been written and entered yet, but I'm working on it.  At least they'll get counted.  This will not spoil my celebration!

What Makes Me Happy

This is about a client I had when I first started this job. I may have reflected on this story before in my blog, so bear with me if it sounds familiar.

He had been in the system for years, and had previously been supported by a coworker who left for another job.  He was a young man with schizophrenia and developmental delays.  He lived with his family (who wanted the best for him) including his grandmother who brushed his teeth for him even though he could do it himself.  It is fair to say there was a lot of learned helplessness going on.  

I was a little more eager and a lot less experienced then.  This man was more ill than anyone I had worked with previously.  My normal tactics did not work.  We were down to real basics - getting him to remember who I was, and remember his appointments.  Our appointments consisted of me trying desperately to make some kind of conversation while he was more interested in watching soccer or getting me to take him out for pizza.  All the while granny is knitting in the background and making me hyper aware of my youth and inexperience.  

I don't remember what the incident was, but somehow he ended up in hospital.  The family and I worked with the doctors to get a med review and he was started on Clozapine.  While he was still admitted I advocated to get him in with our ACTT program (Assertive  Community Treatment team - a more intensive level of support than what I provide) and he was accepted, so I never really saw him after his discharge from hospital.

Until one day I was in the waiting area of a psychiatrists office with another client.  I recognized this man's sister and then he came out from his appointment.  He looked me straight in the eye and said "Hi Nectarine" and then proceeded on his way.  

That was it.  But it was so much!  This person, who had met me at the door with a blank face week after week, giggled when he couldn't remember my name for months over a year prior at this time had said HI and addressed me by name!  He now attends one of our drop in programs and I see him over there from time to time.  Every time this same thing happens.  He says hello to me the same way, and then walks away.  It's all I'm likely to get, but it's so much.  It makes my day every time.  

Will this client continue to recover?  Probably.  Will he recover to a level that other people find "normal"?  Probably not, but to me, all the work he and his supports have done is so worth it to bring this human being out of the bubble his illness and medications had put him in.  I'm grateful to have been a small part of it.

Me Days

If you work in mental health services like me, or other health care settings, or hell - any job at all, does your employer offer mental health days?

Mine does.  They used to be classified as "mental health days" and now are part of our "personal days" which includes our sick days as well.

I've always thought this is a really great benefit, and makes sense since a mental health focused agency should understand that we all benefit from staff being in good mental shape.

Somehow I stopped to think about this today and realized that in my five years working here I have taken two - just 2! - mental health days.  Once was when we learned we were loosing our child care provider.  I was in a panic and needed time to focus on finding a new one.  The second was when my partner had been away for about a month on a job and had a really miserable time.  I wanted to be there for him when he got home.

So why?  Why if I value this benefit so much do I not take advantage of it?  There is guilt involved for sure.  And the dread of having more worked piled up when I return.  Plus the time consuming factor of having to rebook appointments.  Worry that I won't make my "numbers" that month if I miss a day.

I think I just like to know they are there.  That I have the option to take some me time without having to lie about being sick or something.  Maybe I'm just waiting for a really good reason to take a day.  What would that reason have to be?  I likely won't know until it hits me.

The Big Barn in the Sky

For some reason I remembered this story the other day and thought I should share.

This was a couple years ago when I was in an intake worker role.  A young woman had been referred to us who at the time was staying in temporary crisis housing for people with dual diagnosis (in Canada that refers to mental health and developmental disability).  Usually we would do intakes at our office but since she had no transportation, was not familiar with the area where she was housed and was in a pretty dire situation we agreed to meet her at the place she was staying.  Since this was an off-site visit with a client we'd never met before, and since we were curious about the program supporting her (hadn't dealt with them before) my intake partner and I decided we would both go to meet her.

This young woman had been through a lot.  Most notably, her mother had died recently and that among  other things ended her up in the crisis housing.  She had no other family, but did have close friends who were now her guardians and she would be moving in with them soon.  Despite everything she'd been through and her DD, she was engaging, optimistic and had a sense of humour throughout the interview.  We got all the information we needed, told her about our program and let her know we would be in touch.

Once outside, I commented to my partner that I was impressed  and pleasantly surprised at how together and well this young woman had seemed.  She looked at me with utter confusion and said "What?!  She was either psychotic or her cognition is lower than we thought.  All that talk about how her mother "bought the farm"?  I don't think she understands that her mother DIED, I'm really worried about her!  She thinks her mother is on a farm somewhere!"

At which point I burst out laughing and had to explain the euphemism.  It was a cute moment.