Early Morning Shift

Every once in a while I am asked to trade shifts with coworkers. So this morning I pushed myself out of bed a few hours earlier, drove down a freeway with light traffic and made it to work in record time! 7:00 am for me is when I roll over in bed. Suddenly I found myself at work trying to wake up.

Our doors open around eight to the public, but the real internal work was at hand - preparing the paperwork for the staff. Basically my job description changed from doctor to copy boy. How humbling was this.

The steady rythmn of the copy machine was kind of soothing, though the next job wasn't - colating. Try preparing thirty charts with about thirty pages inside of it. The work was tedius and if this was my daily job I would shoot myself. How does the earlier staff cope with this? Each day I take for granted that the charts are ready, in perfect condition, and even our discharge papers are in abundant supply. This morning I painstakingly prepared the forms that simply were always there for me, appreciating the efforts of the unsung heros that suffered the collating, hole punching, stapling, and refilling toner cartriges as an everyday routine.

I hate toner! Why does it always spill on my pants! These smudges will never come off! But my comrades never complain, they seem to wear these shrap metal stains with honor.

Last week I asked a coworker if she dreamed about feeding the scanner, now that we are transitioning into electronic record keeping. She replied "Yes", with a sadness to her soul. No wonder she is grumpy all the time. Wait - - She was grumpy before she even had that job.

The morning crew has to audit the charts from the day before. If a code number is omitted, or a signature left without a title next to it, these folks are on it like white on rice, leaving nasty notes in your box for you to complete your errors! I think the auditors get there frustration out in this process. After years of preparing the paperwork it could breed anymosity. Perhaps that is the reason why so many postal workers go "postal".

With a new appreciation for the office staff, I once again face the flow of people eager to get their medication fix, just in time for the weekend. Today I am a lot wiser, appreciative, and injured - I hate papercuts!!

Gadzooks!

What a week we're having. A brief respite though yesterday, but today we began sending people away at 2:00pm. What rich cases. Domestic violence victims, Cancer patients, Drug addicts, someone who had their first psychotic break. If you want a great education about mental illness, this is the place to be.

I loved the reaction I got from the person who was almost choked to death by their partner two days earlier. It was like a lightbulb went on in their head. When wounded from an early age and never really bonding with another person, it is natural to try to make that bond with somebody - anybody who shows interest in us. However if we are wounded and stuck in Erick Ericksons "Mistrust Phase" of development, we tend to seek others that are at that developmental level as well. It is natural that these early developmental period relationships can foster anger, paranoia, and violence. In learning how to heal this developmental issue, people can grow in amazing ways! The client was giddy as they left which warmed my heart. Then I was off to my next subject.

Probably the most tragic experiences for a human being is learning they have cancer. Then life is suddenly a death sentence. Oh yes, we all are destined to die, but that will happen sometime in the distant future. When that timeline is brought quickly forward, well, you can imagine the panic it puts people in. These clients are a God send to me. It helps me place life into its proper perspective. We all die. Then what? Even though I have had loads of paranormal experiences I have never died. What happens then? And that was what was on the client's mind. They were freaking out and as a therapist, if this issue was unresolved inside of me I would have been freaking out too. Without faith, an upcoming death would incapacitate the best of us. But how do we get faith? Especially when the obvious signs haven't been given to us. It's those subliminal clues that can lead to our enlightenment, if we allow them to. Perhaps that was why I was compelled to write my recent book on the paranormal experiences I had while living in a haunted house almost thirty years ago. It changed me. As would it to the average person. I saw and felt things that freaked me out! I had been compelled to write about it and in a week it should be out on Amazon.com. This client would eat up the pages of it, because step by step I shared my progression from spiritually ignorant to being enlightened - and still I am very apprehensive about death.

I lead a very rich professional life and days like this helps me appreciate my health, my coworkers who somehow keep their sanity, and my connection to God.

May you all have great mental health - PLEASE!

The Day After

What a zoo it was at the Urgent Care yesterday. I was concerned on my drive to work today that there was going to be another repeat performance. Monday and Tuesday were beyond busy, but so far, today has been only completing the charts from the day before.

It is like an Accordian at times here. One day you can't sit, another that's all you do. It is nice to catch your breath when the pace slows, but with the budgeting troubles the county is in, our numbers have increased substantially.

In the aftermath it is difficult to relax. Hypersensitive to the buzzer up front and the ringing of the telephone, in a moments notice we have to spring into action.

The staff laughed today about a complaining client who had been waiting to see the doctor for a few hours. Yesterday the wait for him was five! Yes, when a person has a mental illness minutes, even seconds can feel like an eternity. We, okay I thought of a specialized mechanism for the complaining types who repeatedly knock on our door. We would simply ask them to stand there and move their chin slightly forward, as when we depressed a button - a hand would whip around and smack them in the face. Well describing it in print isn't as funny as it sounded, but obviously the entire staff is a bit frazzled from the day before and it is only Wednesday!

How do you handle the chronic complainers? We have no security but can call other adjacent units for additional staff. Do we rush them to the front, like we normally do? Do we usher them out of the facility, even if the medication they seek would do them wonders? Do we continually give them food, cigarettes, water, change the T.V. channel for them like we do constantly and complain about it later? Or do we try to ignore them as they amp up and get louder?

Isn't mental health a real gem?

Overall the real issue is for the staff - me included - to find a mechanism to keep ourselves in balance no matter how busy or slow it gets. The slap mechanism in one's mind goes a long way. We as a staff tend to get musical and sing out appropriate songs like Madonna's "Borderline".

It takes a rare breed to be of service. We sure aren't in this field for the money it seems, though a raise or more private clients would be very nice, thank you very much. I think of us as Weebel Wobbles. We wobble from time to time, but we just don't fall down.

Good mental health to you all.

Too Much!!!

Thinking it couldn't get busier I was wrong. Today took the cake! It wasn't how busy we were, but the caliber of client that came in today. On some days we are busy, our room is filled and clients seem to talk to each other, make new friends, and tolerate the sometimes five hour wait. Not today! The clients today were psychotic, angry, demanding, and ready to square off fighting.

Today I wore a lot of hats. Waiter, office supply getter, medical record runner, phone answerer, complaint department, mom, staff leason, and still had time for an hour staff meeting, seeing five clients, and finishing all of my charting.

This type of day on one hand is thrilling. THere is no down time. It is go, go, go and the day is over. On the other hand, when people are breaking into the facility after they were turned away, when non clients are demanding food, or looking like they want to get into a fight, well that's not too thrilling to me.

This place would make a good sitcom or reality T.V. show! We get it all here. If you want to learn about mental illness, spend a day at our facility and just observe. We had everything today from the demon posessed to those psychotic - and more!

At times I feel like an exorcist. You may laugh about that statement, but trust me, to many - including myself - demonic attacks are real. Why do I feel that way? Because I've lived in a haunted house, felt held down by evil spirits and when clients talk about this phenomenon, I can relate to them.

So I order a lunch for the demanding person. Help another fill out a complaint form because a staff member "disrespected them", and barely have the time to go to the bathroom. I think it's been a week since I've been able to take a break. Yes, by law I need to, but when we are pumping, the whole crew needs to be working in the trenches.

Why do I remain? Until I win the lottery - and I don't even play it, or if I got a better job offer, or if my new book becomes a best seller, I am stuck in psycho land just trying to survive.

Good mental health to you all - please.

Treating Other Professionals

It shocks me when I need to treat other professionals in the mental health field. I can understand working with people who have substance treatment licenses because it is a two year college degree. However I have worked on many therapists who have burned out and even a few Psychiatrists! Let's face it - we are all human. When the stress of life gets too overwhelming, even the president, I'm sure, needs some counseling.

What I like about treating these individuals is them having the mental capacity to look deep inside themselves. Not that many individuals have the mental capacity to look at oneself - only wanting a white little pill to cure what ails them. In fact, on a daily basis, I have to remind people that medication handles 50% of their problems and the other 50% needs to be worked out in therapy.

In the session today I was reminded about a great Psychological approach that was developed in the turn of the last century called Psychosynthesis. This is a spiritually based approach. Roberto Assigoli, a student of Frued's, believed man wasn't driven by sexual desires, but a desire to be whole. He believed in being created in the image of God, we had that image (blueprint) inside of us. It was taping into this blueprint that made us whole.

What keeps us not whole? Assigoli believed that when we were living in the here in now, we were whole. What pulls us out of this place is past or future thinking. The past thinking usually involves unresolved issues from our past. The future thinking involves us feeling so unsafe that we have to plot our every move. How long can you stay present in the here and now?

I love the saying: The past is history, the future a mystery, but now is a gift and that is why it is called the present."

As we remain in our blueprint, connected to God and amazing experience results. I call it "THE BUZZ". Ever feel it? How often have you felt connected to Our Creator? The opportunity is to allow the buzz remain and expand. How long can you hold on to it?

May you all have great mental health.

Paranoia Will Distroy Ya

It comes with the territory. Treating individuals who are paranoid. You can spot these people a mile away. They wear seatshirts with hoods, dark sunglasses, and slump low in the chair at the corner of the room. Many have headphones blasting in their ears. Most look so angry they could punch holes into the wall. Often these people trigger me. Who wants to put their head in an angry Lion's mouth? Unfortunately for me I have to treat them.

Every once in a while these people are lucid. They can carry on conversations, they want to be helped and seem to, on a certain level be normal. It is the angry ones that make threats I can not stand. Hey, I'm human and I know these folks need the service we provide. Imagine if there wasn't any psychiatric medication for them? This planet would have self destructed years ago.

Our plan of action is to rush these people through our doors. Until they are stable on medication, psychotherapy is impossible. Yes I can give them some tools to curb their anger, and often will, but when somebody doesn't trust you and sees you as being part of a Government plot against them, a therapuetic bond is impossible to achieve.

Today we had a person completely paranoid and irritated - a favorite of the entire staff. NOT. At first this person shook my hand, smiled, told me they remembered my face then started to get angry with me. Fast forward a few hours when they left, they shook my hand and told me they remembered me. Here is an example of a brain ailment. Could you imagine living your life this way?

We have staff that really connect with these people. They become compassionate, communicate well with these people and often redirect them into calming down after getting agitated. They to me are heros. In the face of anger they remain calm and loving. I can do this under most circumstances but fail miserably when people taunt or glare at me.

Antipsychotic medication is crutial for the treatment of paranoia. Unlike the movie about the schizophrenic musician on skid row where they didn't get him to take proper medication, people respond very well to the current meds and go on to become functioning members of society.

Cutters

There is an undergroud movement that doesn't get much attention. It pertains to cutting on oneself. When the emotional pain is so great, those who don't have the emotional tools to handle their state will resort to physical torture on themselves. Why? For the average person this behavior seems upsurd!

The average person will have the emotional resources to handle the stresses of life. For individuals that have surpassed their ability to cope, it is almost like a minor suicide attempt. It is as if a person is tipping their toe into the pool to test the water.

For proper mental health the real issue is not our issue - or the problems that confront us, the real issue is how we relate to ourselves as we face our issues. Basically how we are with ourselves in any given moment is the ultimate issue!

How are you with you when you wake up, drive to work or school, interact with a parent, the boss, or a teacher? That is a great gauge on how you are doing with yourself. Ultimately how we treat ourselves is how we treat other individuals. Therefore it is critical to treat ourselves with dignity and compassion.

When we cut on ourselves, we give ourself the message that we dislike us. This is a red flag. If our relationship with self is at such a low place that we begin harming ourselves, professionals need to get involved. Without the proper tools, approach, and guidance, this behavior will not fade on its own, in fact more extreme measures tend to take place - suicide. This is why there is such a high number of suicide attempts made by teenagers. They tend to lack the proper tools to work through dark upset.

Therapy in these cases can be very successful. In learning how to tend to the hurting part inside of us that we hate and transforming that "inner relationship" is the key to not only cutting, but to overall mental health.

As I told a client today, "We are with ourselves 24/7 for everyday of our life. How do you want your relationship with yourself to be from now on?"

Tender Loving Care

It always amazes me when the conditions for a psychological assessment flow perfectly - regardless of the ailment. Two cases back to back today worked out like a dream. Both were people suffering from psychosis who were gaurded and "just there to get on meds" as they said.

Two different techniques had the same result - instant bonding - a process that generally takes six months if you are lucky.

The first client was delusional - unfortunately this person was very high functioning and the scheme her mind created made a lot of sense to her. THis "organizing principle" helps the mind make sense of the situation and for a therapist we need to avoid taking it away from them. "So the government is spying on you through your T.V. What makes you suspect that?"

The other person had voices screaming in their head. Possibly the result of a past head injury. Even with the voices going on we connected. I listened, my replies made sense, and then I saw a spark of happiness inside of them and made a comment. It was as if we became instant best friends! Ergo the magic of psychotherapy. Now on the same page, let's do some healing work.

It is an interesting feeling, making an intimate connection with somebody so fixated on their delusion, or psychotic, or in the midst of a panic attack. This is sacred ground to tread. This is why I continued my education and received a Doctorate. I had a knack of caring so deeply that clients took notice, opened up, and I needed to learn how to properly close them up. The key word is UP because that is how to finish sessions - on the Upswing!

How do therapists close up clients? This is an art form. This can be a dance. It is being sensitive to what is happening in the moment, being caring, honest, and above all - real. The robotic speaches or the do as I say, not as I do approach tends to fail miserably. If there is nothing to say, then say nothing, but love them internally. It is in the loving connection that heals the most.

Everybody, underneath is exactly the same. Mother Theresa said it best. "When I treat people on the streets of Calcutta, I see Jesus in all his disguises." When the disguise is removed and your heart is shining, God speaks.

Wishing you all good mental health.

Is Everybody Mentally Ill?

In the past eight years we have seen over 15,800 different people at the Urgent Care. Many return six to eight times - that is a lot of crisis sessions. At times it feels like I am in a Horror Movie as the undead come crawling in trying to satisfy their thirst for human blood!

We were basically set up to serve the Los Angeles County area though we have seen those vacationing from foreign countries, those living on an island off the L.A. Coast, people from Vegas, New York, etc, etc, and how great is it for these people to have a place like this to go to where they don't need to have insurance to get their psychiatric and emotional needs handled.

A year ago I looked up on the computer how many people I had seen in a year's time - the number was over 800! Wow! THat number even shocked me. One by one we try to make a difference. Listen to what they talk about, give some suggestions, make a call or two, bring a family into the room and hash out differences. I like what I do because it is instant gratification.

This is in marked difference with my last job - working with the learning disabled. I worked with the same clients for more than two years and barely saw any changes. Oh yes, they changed - they were able to use soap in the shower, create a marketing list, and clean their apartment, but it wasn't crisis work where frowns turn to smiles on an hourly basis.

Don't get me wrong. I am not complaining about the sessions. I love meeting new amazing people who have suffered greatly and desire to do what it takes to change for the better. I really admire those with HIV who have to not only take a slew of medication, but also psychiatric medication added to it. I have difficulty taking vitamins on a daily basis. Imagine taking twenty pills three times a day!

The Los Angeles Area seems to be a magnet to not only the mentally ill, but also to homeless people. The weather is so great year round. I'd rather be homeless here then in Chicago. Imagine suffering through a winter's night there without a home? And shelters can be breeding grounds for brutes. Fifty percent of the clients I've seen here have lived in or live in shelters.

One by one, day by day, year by year adds up. I feel proud. Maybe I have provided the needed relief to a few of these folks. One thing for sure I am a great listener and give them a lot of time to vent. My support staff at first got upset with this, but haven't complained much recently. I figure if that was me in the chair opposite of me, I would want somebody to hear me out - so I do.

Every month or so I wonder if it is time to move away from this place because the stress level is very high. If I find a job with the same benefits and better pay I'd consider it. I feel I've got this down, why not test my skills elsewhere? Only time will tell, but one thing is for sure. There will never be a lack in the Los Angeles area for clients. Now finding clients that can actually pay me for my work is the ultimate issue.

Good mental health to you.

Complaints! Complaints!

Yes I understand we have a difficult job. Yes I understand that it is difficult to learn paperwork, systems, and protocol. Yes I understand that the clients have been waiting for five hours to see the Psychiatrist. Do I have to hear all of the complaints?

The staff today was worse then the clients. "The computer doesn't work for me. I give up!" One said. I'm tired of calling the help desk!" Said another. "Who stole my paperwork?" Questioned another. I have to go, move my client to the front or no one will translate for them." Demanded another. When twenty people are vying at one time for attention, at times it can be a bit much.

"Try closing down the computer and starting over." I reply to one. Did you look at the chart order sheet?" I asked another. "I saw Johnny shredding your documents", I replied with a smile to another. But when the Psychiatrist entered the room everybody leaped to attention! But as the first person was about to speak his phone rang and he started to talk about the Smart Car he had his eye on.

Hurry up and wait. This has been a long occuring model around the crisis room we as a staff are all too familiar with. We have tried to fight it, even complained to the doctor about it, but you can only mold Jello into a mold for so long and it will eventually ooze back into its original form. Trust me, the doctor will find a way to see twenty people, talk about cars, clothing and Jessica Alba. Only if she knew about the crush he has on her.

So with confidence at an all time low with the department heads, who does the staff turn to - yep - yours truly. I should wear a sign on my forehead - "The Complaint Dept." I knew I signed up to help those in crisis, little did I realize it would be the staff I worked with that would dominate my time.

May you have good mental health

Homicidal First

Well a first happened today. A patient came in wanting to kill their parent and the parent sat in on the session. Well there goes my Tarasoff warning - they heard it all. In fact they knew it very well. Often a parent will be the target of rage - mostly to those with a learning disability. The average person can suppress these feelings and I am sure they often happen to even the best of us. When the brain is altered with Schizophrenia, hasn't matured, is under the influence of a substance, the gate that stops our rage can be damaged and violence can ensue. In this case it was a question of hospitalizing this person or not.

I hate making these decisions when it can go either way. The client didn't have the harmful thoughts currently, but it had become a daily affair. The parent was aware of this and trusted their child. So I needed to get the client to sign a contract for safety - something that doesn't hold much weight in court, but makes me feel better. The client and I then devised tools and strategies in case rage occurred.

What was interesting was the focus on the color of the wall. Certain colors made this client get angrier during a fit. The antidote - paint. First of all painting soothed this client, and secondly taking action may be the best medicine. And referring to medication - it was changed of course. The psychiatrist and I felt confident that this person would do much better on his elixor.

I couldn't imagine being this person's parent. Parents try so hard to provide, nurture, and mold their children. How frustrating it must be to hear the younger version of yourself confess desires to terminate your life. But the parent was given resources to contact, the client was given a bottle of meds in one hand and a paint brush in another, and now it is up to them. Will I worry about them? Hopefully not - I got a signature on a worthless piece of paper to protect my license.

Peace to all.

Off The Hook!

Busy time once again. Down a co-worker to jury duty and had to pick up the slack. Being busy makes the day go by fast! Part of me likes it, another part wants me to fiddle around with the computer - blogging about new insights, and playing backgammon against the rude people from England who quit right before you beat them.

I enjoyed today. I saw people who, without medication would be living in asylums. Today's medication is amazing. One person came in, who I had seen a few times before - I recognized his face but not his smile. He was psychotic as hell a few months ago, now he is stable enough to work - as a roofer!

I like most aspects of my job - even if I have to interact with people just out of the psych ward and barely present. It sometimes surprises me when they smile, say something insightful, then go back into a stupor. It shows you that a person exists under the ailment. I take my hat off to those that work closely with the chronically ill.

The movie Awakenings with Robin Williams is a must see. It depicts a man hungry to connect with catatonic patients. I have experienced clients like this only a few times and found it frustrating. They were so petrified they simply stiffened up and went into mental hiding. I can't even imagine the type of abuse these folks must have experienced - if that is the cause. Mental illness to that level often has a family history element or hard core substance usage.

A sad note was having to walk a person who was placed on a hold to the lock down unit in our complex. After listening to them give a disertation on why they didn't need to be hospitalized the documents had already been signed (this time not by me). But after all the negotiations ended, they dejectedly took the "death walk". Trust me, this client had it good. With no insurance and looking at a facility like County USC or Harbor UCLA to go to, La Casa has a great, compassionate staff, our same Psychiatrist in whom the client already had a relationship with, and better food I am sure.

Now I am not knocking the county facilities, but having hordes of clients who are in extreme states with you, or a cozy place where you can watch the Dodgers woop the Diamond Backs on the T.V. I choose La Casa.

Just another busy day. All my paperwork is done, and I am pleased.

Four O'clock in the Morning

Something woke me out of a dream this morning at four A.M. Something I had been pushing down inside of me for many many months. Call it discontent if you will, but when I wake up in the middle of the night, frustrated about work things are wrong! Really wrong!

Not able to go to sleep I started to type. In the writing process it helps me organize thoughts. Four hours later I had composed a letter to the regional director of our facility. Now I had a decision. Do I rip this up and let it go? Or, do I take it to the next step and hand deliver it.

When I dragged myself into work this morning - and I mean drag, I needed some input from other staff members. We had been under scrutiny recently due to a recent suicide attempt on the unit and our boss was trying to finger those he felt were responsible - namely me - since I have more seniority and expertise in his eyes. Still people have experienced a rash of punitive measures and I felt included in this new and exciting club - if I do say so in jest. A coworker read this gem of a paper and thought it was brilliant of course. Well another one got angry because I had kind of implicated another nurse like her in the paper. Okay so I pointed my frustrated finger to be blunt. Hey it was four o'clock in the morning for God sakes.

Now I needed to weigh my response. Talk to the regional manager or take the paper to the shredder. The devil on one shoulder and the angel on the other. When I bumped into the regional manager the devil won out!

Of course the manager was nice - he likes me anyway and has always been kind. Why shouldn't he, in eight years my efforts have impressed many of the higher ups - in his own words - thank you very much. So he listened, said a few kind words, a few words of advise, promised nothing, and accepted my five page letter.

This is new for me. I have been a great duck and have let water roll off my back to this point, suddenly I was judging myself both positively and negatively. The positive was speaking my truth and sharing my feelings, the negative was anticipating the reaction from my immediate boss. Yes I have to work with him on a continual basis. This may breed something awkward - perhaps.

As I type this another coworker is reading a copy of said letter and enjoying it emensely. I feel a lot better with her reaction - since she too is a nurse.

Anyway this saga will continue I am sure. It makes for good blogging.

Peace

I am Angry!

This has been building, but the staff and administration have finally gotten under my skin - with good reason. I am a firm believer that a staff is as good as the higher ups, their training, and their communication ability. We have begun to rate very low in my opinion with the influx of new staff, green to emergency room work, and being bogged down on redundent paperwork. In addition the punitive nature from our higher ups has got the more seasoned staff grumbling to themselves.

I am still wondering if I should play my Trump card and contact our Regional manager. When an entire staff is complaining about punitive measures it doesn't make for a pleasant work environment - to say the least. But this is real life in the E.R. People are angry - for righteous reasons. They are also anxious because they don't know how to handle their affairs. Suddenly I am thrust into a world where clients, staff and even myself are exactly the same!

I am angry! I don't want to feel irritated when a psychotic client complains about how long they have to wait while a person who is playing with the system for SSI benefits gets catered to. Our job is to assess who needs to get rushed to the front of the list for quicker stabilization. Our new staff member was oblivious to it and as a result the psyhotic person leaves frustrated and doesn't get the help they came for.

Trust me, I've done this too. It's all part of the growth process in this industry. Does this staff person need to have this incident on their permanent personell file? Our administration thinks so. "They may go out and hurt themselves or others." Yeah right. This incident isn't that dark and mental health shouldn't be about taking punitive measures towards people who are busting their tails trying to improve the lives of the thousands that enter our doors. Is in the same personell file examples of incredible deeds of compassion depicted? There aren't any in my file and each day is filled with that.

So I am angry. Feel abused. And wonder when in the world is this irritation going to end. If it doesn't soon I'm playing that Trump card.

Peace to you all!

Choosing My Battles

Eight years at a Mental Urgent Care. Eight years of battling with clients, staff, and administration. To this point I have done pretty darn well. Of the over 15,000 people and more than triple the amount of sessions, this place remarkably has run pretty smoothly. It is interesting that on the way to work I listened to the Phil Collins Song "You and Me in Paradise" about the trouble there is in paradise. Though the urgent care is far from paradise for sure.

We have had some troubling incidents on our unit recently. Because I have fostered a great relationship with the regional manager of our corporation I have hesitated to make a mention of anything to him - which to me is being extremely cool. Hey, every job has certain incidents that take place and people have an innate way of wanting to cover things up to keep the status quo. I get it. I even understand when a person blatently fabricates information to protect their or the company's good name. Yes I get that and understand the human condition. But lately the rope that holds me back from being a snitch is fraying. So what do I do?

I am not perfect, no far from it, but I do know right from wrong and will admit when I fall short of my own and professional standards. So here I am trying to choose my battles. Because perhaps a few incidents didn't have the t's crossed properly or the i's dotted the way I and other staff members would like them, does it mean to go to the higher up with guns ablazing? What would that prove? A small majority being "right"? Then what? Okay what if my side won? Would that mean there would have to be a loser? If that is the reality of the situation then everybody loses.

So here I type with rope fraying, wondering if I should yank or release. Yanking would cause ill feelings, releasing would me understanding the human condition - the desire to struggle in the right and wrongness of a situation. Releasing to the path of lease resistance I guess. Though often times the releasing feels abusive to one's morals. Who wants to allow people to have their way when your opinion differs 180 degrees? Who wants to let go and let God so to speak when the righteous part rebelling from God just has to win. The acronym for EGO is Edging God Out for those who never knew. I am well aware that the Ego me is week and wants power in order to be safe. Releasing to the status quo is not very empowering to the Ego, but to the overall good screams strength!

So I choose to release my rope for now, though do know that it is dangling somewhere within reach for the proper battle - if there ever really is one.

Peace.

The Good Old Days!

When the Mental Health Urgent Care first opened more than eight years ago. It was the brain child of the county of Los Angeles to take pressure off of the local Emergency Hospitals and Jail system. Many people where incarcerated who didn't need to be and at the same time the Emergency rooms were clogged with individuals who needed emergency medication. So we were born.

Originally we were staffed with two "social workers", a nurse, and a Psychiatrist. Coming in as a Doctor of Clinical Psychology was a bonus for the organization, if I do say so myself. Anyway there were four of us that went to battle and saw on average fifteen to twenty people daily, sometimes less, sometimes more.

We flowed. Each member counted on one another, saw as many clients as possible while answering the phones, answering questions in the front lobby, assessing people at the door, and working closely with a psychiatrist, who at the beginning of our facility, didn't know if he was a man or a woman. You may find this hard to believe, but when a man looks you dead in the eye and says a little make up on everybody is a great thing.

Today we are clogged with staff, clogged with clients who are very familiar with our unique service, and have an over abundance of paperwork. But today was different. One of the staff members called off and suddenly it was only two social workers, the nurse, and the Psychiatrist who is now male through and through - though I still believe he wears make-up and has extentions in his hair.

Maybe this blog is becoming a blog about Dr. Jenkins... No, not yet. It would literally take a book to describe the antics that this guy does on a daily basis. I was wondering this past weekend as I worked on my vacation home in the desert if people could relate to the nicknames he has given me throughout the years. When you first work with him, he takes it upon himself to choose a fitting name to describe your special qualities. For example Anisa is known as "Scooter" because she is quick, fast and seems to be working at hyper speed. Aaron is known as "The Porcelean King" due to his drinking antics. I should have never worn my Scotology shirt to work - Yes he has morphed that one. My dad for my birthday bought me a shirt that said "Scotology, the study of Scott" on it. Well at first I was the Scotologist, then I was the Scrotologist, and now, well I am known by all as Scrotum. But my nickname has morphed even more and on special days I am simply known as Vagina.

So there we were, just like the good old days: Scrotum, He/She (the Psychiatrist), The Shadow (Susan), and "Shirley you Jest" the Nurse. We were AWESOME! Unfortunately the paperwork was still too involved, but this skeleton crew got the job done!

Peace!

Rewarded

This week was a great week. There are certain perks when you work for an organization. On three times this week I was provided with lunch. The Corner Bakery sandwiches by the Abilify People, The Elephant Bar for an exotic lunch by my boss, and In and Out Burger mobil truck feed the army of a staff at the building today. I am full, I am really happy, and I feel energized. You would think I need a nap but that just isn't so.

Our numbers were down this week allowing the staff to catch their collective breaths and refocus for the upcoming week. Lots of learning this week however with hospitalizations, foolish interplaying with staff, and an enhanced comraderie we all feel. My favorite story of the week happened yesterday:

One staff member known to play pranks - especially on April fools day asked if I wanted to use his computer station, since I didn't have one. Another staff member was leaving and I guess he wanted to use that computer. So I grabbed my stuff tried to log on and discovered the ball of the mouse was missing. Prank? I thought so at the time. When I confronted the staff member, he denied knowledge of said mouse problem. So, being the responsible one, I obtained a different (functioning mouse), installed it, and while he was in a session, replaced the faulty one with his. Oh did the rest of the staff laugh when he tried to use the faulty one he left for me, now at his terminal. We couldn't hold it in when he exclaimed, "What the hell?"

In the long run his innocent act was blown to pieces. He had accidently knocked the mouse into the trash and the ball came out, he couldn't find it and tried to pawn it off to me. The average person might have asked for help and I would have rushed forward to do so. The way it played out made him appear like a fool.

Sweet justice occured when he put on latex gloves and went through the trash can and within minutes found the elusive ball.

Too bad. Too bad a professional can not be responsible, communicate their desires and has to resort to childish acts. Okay so I was childish too. Hey - it was a blast! The other onlookers are still laughing and talking about this today. As for me, I am well fed, happy I stood up for myself, and have had a light client load.

Have a great weekend.

Medication and Pregnancy

We see it. The psychotic, depressed and moody woman who is pregnant and demanding medication. This is a sensitive situation. Psychiatric medication ingested by a pregnant woman can harm the fetus period. Therefore we make it a priority to avoid prescribing medication to them. It is better to err on the correct side, so often women who have missed their period will be asked to get a pregnancy examination from their medical doctor before any medication is dispensed to them. The frieghtening fact - many could care less, they just want to feel better.

If I was carrying a child inside of me, I would eat the perfect diet, exercise, take all the proper vitamin suppliments and avoid negative atmospheres. I would want to give my child the opportunity to have the healthiest body, mind and emotional make up possible. This is our future, my future, and I would want the best for them. But, when it comes to the chronically ill, it is all about instant relief.

We live in an era where knowledge can be found instantaneously! Substance use is still running rampant even for those who are pregnant. Studies have shown when alcohol is introduced to a fetus, the brain (which wires millions of connections) fails to wire properly. Certain target cells are thrust out to wire into. With alcohol in the system, the brain falls short of wiring to these cells. On the other hand if radiation is introduced, as what was seen in Hiroshima, the brain circuits grow past the target cells. What results is somebody who gets confused, angry, and easily frustrated. Pertaining to psychiatric medication, the unborn fetus can not only get altered, it can easily die!

The emphasis is on psychotherapy in most cases. Of course there are always exceptions to the rule, especially with psychosis and dangerousness to self. However even amidst tremendous mood changes attributed to Bipolar Disorder, there are some beneficial tools that can "ride out the storm".

If you've missed your period and are considering psychiatric medication, get a pregnancy exam, if negative, get assessed by a psychiatrist and seek counseling. It is good to cover as many bases as possible.

Good mental health to all.