Saturday, July 25, 2009

I should not even be conscious right now!

Ok - its 6 am.

I am awake.

I've been awake for the last three hours.

I'd only been asleep for about 2 hours.

I won't be getting back in bed anytime soon.

I should not even be conscious right now!

Okay, enough whiny Socialwrkr24/7. Just know that this girl does not enjoy being sleep deprived. And HATES being awake at 6am. Or anything that ends in AM really. But definitely anything before about 8am, preferably more like 10am on a Saturday.

Okay, seriously done whining. There is actually a bigger point to this blog post.

I'm on call this weekend. I'm still doing on call work for my old job because I have to have a second job and on occasion, when working on call, I get paid for doing absolutely nothing. Its a win - win situation for me. :) Also, I really enjoy doing crisis work. As much as I love developing a relationship with my clients and seeing them through - crisis work is nice because I get to use all my clinical skills, engage briefly, hopefully make the whole situation a little less horrible than it is currently, and then be done. Sometimes its not so fun - on a particularly crazy weekend or when things go terribly wrong. But other than occasionally being woken in the middle of the night - usually I really enjoy it.

Tonight (or this morning?) I ran across a "helping professional" that made me want to scream. If I haven't made it clear in the past - let me do it now. Absolutely nothing in this world makes me as angry and frustrated as a "helping" or "service" person who IS NOT HELPFUL OR PROVIDING THEIR SUPPOSED SERVICE. (Okay, there is one other thing that makes me madder - but another post, another time.)

Here's what happened: I got a crisis call at 3:00am. I got up, drove an hour away, and managed to put my pleasant face on by the time I got to the hospital. If the above whining didn't alert you - I am not a cheerful person when I wake up, even after 10 hours of sleep, much less only 2 hours. But I know what my role is and I consider it part of my role to BE PLEASANT. Because I just don't see how I can be helpful if I'm cranky. I spoke cheerfully to the nurses and techs in the psych ER and requested the patient's room number. I went into the room and listen to a 15 year old girl recount the horrific story of finding out that her roommate (in the group home) had committed suicide yesterday - she had succeeded in taking her life.

Since that time, my patient had been "confused" and "feeling a lot of different feelings". But mostly she said she felt depressed and was having her own suicidal ideation.

This is NOT uncommon. Suicide can be contagious - especially in a setting like a group home where the children are already vulnerable and susceptible. Extra counselors and crisis workers had been brought in yesterday. But this girl was just not able process the incident and to feel safe. She had engaged in self harming behaviors - using a broken plastic cup to make multiple cuts up and down her arms and had attempted to run away twice during the day. She also reported a past history of sexual and physical abuse - a brief glance into her chart told me that her childhood was horrific. I asked if she had been hospitalized before (routine - I assumed she had) and was shocked to hear her answer - "22 times".

When I completed my assessment, I went out to complete paperwork and start making phone calls. The patient had requested that I ask about someone coming in to dress her wounds and possibly give her a couple stitches. I was briefly irritated because I'm not even supposed to be called until the patient is ready to discharge. I (nicely) asked the nurse if the doctor was going to be coming in soon. Her reply?

"Yes, he'll be getting to it. He's been very busy with, you know, serious patients. Ones who really need something - not just attention seeking manipulators."

Yes - that is a direct quote.


I thought through a million retorts. I tried to come up with something that would make her understand this child. I racked my brain for a comeback that would shock - but also educate. I wanted to tell her that "attention seeking" behaviors are learned because she has never gotten appropriate childhood interaction. I wish she would understand that threatening to commit suicide is not something to be scoffed at. Even if she truly had no plan to carry out her threats and was purely using them to "get something" - they still reveal a child who has been hurt, and is still hurting, and has no idea how to tell anyone that she needs help other than to make those threats.

I couldn't come up with anything. I don't like to be snarky and I try to make my words helpful and not harsh. I saw from the look in the nurse's eyes that she wouldn't have heard it anyway. Ten minutes later her shift was over and she left - and I was left angry and frustrated.

I understand the toll that seeing self-destructive behavior repeated day after day can take on a person in these fields. I completely relate to feeling irritable at the end of day that was filled with people who, albeit because of their experiences, continue down the wrong path despite you yelling and waving your arms and trying like mad to show them a different road. I get that some days you want to throw up you hands, bang your head against a desk, go home and never come back.

On those days, I dream about becoming a toll booth operator.

But then, as quickly as possible, I shake myself. I try to look at why I am so frustrated or angry or feeling hopeless. I pray for some strength and perspective. Then I remind myself that I don't have to keep doing this job - I can leave at any time. And then I sternly tell myself that if I can't get it together, and remember that it is NOT ABOUT ME, and put aside my feelings about it - then I had better leave this job.

Because the people I work with did not get the choice about what has happened in their lives. And they often don't even have a choice about coming to see me - most are mandated or things are just so bad that something had to be done.

But I have the choice.

Starting over would suck.

I wouldn't like going back to school or changing careers.

My parents would probably want to kill me for all the money they spent on grad school.

But they would get over it.

And if the day ever comes where I am as bitter and cynical as that nurse - I'll do it.

I will sit in a toll booth all day and exchange bills for change.

Because, it is just not an option for me not to do this job the best I can. To see each client as the person - not just their actions. To see that their actions are telling me something - something important. To find a way to teach them new ways of getting their needs met. Or, sometimes, to just be the person who they can't push away.

So, while I still firmly believe that I should not even be conscious right now, I'm grate for the reminder about the kind of "helping professional" I don't want to become. And I hope that the rest of the social workers, psychologists, nurses, etc who read this blog will think about how they interact with those we are called to serve.

And now I'm off to drink lots of coffee - its already been a long day.


  1. I read that "helping professional" comment and said "whoa" out loud. I am now fantasizing about finding her and kicking the crap out of her. Honestly... if you're that jaded and bitter and angry at your job, do the rest of us a favor and do something else with your life.

    I highly recommend an afternoon nap in the A/C. Almost as awesome as a good night's sleep.

  2. I face this too on a different level. My H is manipulative and whiny and needy and it can be frustrating. I get that. Most people we encounter don't. And by people I mean her teachers and child care personnel, ones that know her story and have privy as to WHY she acts this way. They still scoff at her or blow her off and are basically not helpful at all - usually the opposite. It's heartbreaking...

  3. I think this kind of attitude can become contagious when you have people that encounter someone like that and they think to themselves, "If they don't care, why am I putting so much effort into this?" You take a different approach and use it as motivation and an example of what you don't want to become. If you didn't take this girl seriously, then who would?

    Hope you catch up on your sleep!!

  4. I think one of the most frustrating things about being a social worker is dealing with ignorant professionals that you come across while trying to help clients. Recently I've been really, really annoyed at people working in the psychiatry area. You know doctors and such, that think they know eeeeverything about your client that you have worked with for months, after meeting them one time. Or that tell you all the things you should do to help this person, but who does nothing themselves. I really think people like this are a lot harder to deal with than my clients. I might have to write my own blog post about it soon just to get it out of my system, lol.

    Thanks for an interesting blog! :) Being from Sweden it's really exciting to read more about how social workers work around the world.


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