So last weekend was my first weekend as a DSW (Direct Service Worker) which a) means I’m getting paid less as I am responsible for less and b) am working hours and days where I am the only clinician present, though I am not acting in that capacity officially.
The 1-1 staffing wasn’t bad, as the client is presently in the ‘honeymoon’ stage with me, so he isn’t pushing his luck with me… yet.
Activity driving? GOOD LORD. We got lost going to the first scheduled event, and then we had a complete breakdown in the van as two of the clients got extremely angry with me and started yelling and calling me names, resulting in my scrapping of the backup “let’s get a beverage somewhere instead” plan and simply returning to campus. I misunderstood that one of the clients that isn’t “true” SIL (supported independent living) as we basically are providing him all the services as the cottages, but he just can’t live there as he terrorized everyone, and I didn’t think he could go on the SIL grocery shopping, so he was pissed at me. (This is the same client I was 1-1 with on Friday and Sunday. Those days? Complete angel. When I screwed up because it was my first day and I was confused? HOLY MOLY.)
In the interim, I had a client who has been decompensating all week and threatening suicide, again threaten it while I was talking to him, and then producing the bloody razors he’d been hiding him his room for self-harm. Razors confiscated, I called 911, and then had a 20-minute argument with the responding paramedics that yes, you’ve taken him every day this week and that is frustrating, but we can’t keep him safe on campus as we can’t very well lock him in his room and campus is not fenced in or anything, and yelling at me for wasting your time, and subsequently wasting MORE of your time, is not productive in any way. I had to get the program manager on the phone to yell at them, but I was holding my ground and wouldn’t let them leave without my client. This was immediately before the 6:00 outing, so those clients interested kept milling around, wanting to know when we were leaving, and looking hurt when I had to set boundaries with them that yes, we’d be going on the outing, but can’t you see I am presently handling an emergency?
I was a bit frustrated at how the cottage staff didn’t seem all that concerned about his threats of suicide. Sure, it’s a bit of a constant, but this isn’t attention seeking behavior as the paramedics insisted; he has attempted in the past when the voices are really bad and “torturing” him a lot, and they’ve been really bad, as he kept saying the “mental torment is worse than Auschwitz!” Yes, he kept referencing the Holocaust as an example of how bad it was in his head. (Sidenote: this client looks and sounds a lot like Lewis Black, including his overall intensity, so I was trying SO HARD not to break out laughing when he was clearly upset and needed help.) Sure, the wounds thus far have been superficial, but he has multiple extremely detailed plans that are 100% plausible, so FOR THE LOVE OF GOD TAKE HIM TO THE HOSPITAL ALREADY. After five attempts last week, he was FINALLY admitted. Hopefully they’ll tweak his meds and he won’t be so tortured anymore.
The final outing, to the Tim Horton’s up the street, took THREE trips, for seven people, so nobody killed each other in the van. And nobody wanted to just sit and drink their coffee and talk; everyone drank their beverages of choice and/or inhaled their pastry and immediately went outside to smoke, which took twice as long as the rest of the process. It would be funny if it wasn’t somewhat sad.
Today I return to case management, which is MUCH more within my comfort zone, and today is the “Walk a Mile in my Shoes” event hosted by NAMI. I’ll be going along, I think, and I hope it’ll be a good day and not soggy raining like it’s been doing all week. I think it’ll be fun and the clients who were interested hopefully will have a good time.
Overall, having a weekend helped, though my weekend is Monday and Tuesday, and I spent Tuesday afternoon with a feverish, sick nephew, so that cut it a bit short. Ah, well. He’s doing much better, but can’t go back to daycare until he hasn’t had a fever for 24 hours. Glad the family friend who watches him sometimes can come over and do so again tomorrow, as I think I was going to get the short end of that stick and have to stay home with him otherwise.