They Don’t Teach You That in School

This is a blog completed by my interns:

 

During my practicum, I was sitting next to a woman who was diagnosed with schizophrenia, paranoid type, during a daily group session.  I was there to observe the licensed mental health counselor who held two groups a day – one in the morning and one in the afternoon, an hour at a time – who worked specifically with women and men such as the like I had positioned myself next to. My pen and pad were at the ready to mark down master tips. I was fresh out of my classes, chomping at the bit to make a difference. I smiled at the woman next to me before returning my gaze to the counselor. The woman then turned to me, stood up, bent down, her face inches from mine, and in a clear, loud, incredibly ferocious voice yelled, “Why the hell are you looking at me? Are you gonna write about me? You can’t write about me. Hell to the know, you aint’ gonna write about me.” The shift from the smile in her eyes upon sitting next to her to the pure rage looming over me now was instantaneous. I was clueless as to how to handle it. I quickly hid my pad of paper and pen under my chair away from her vision and softly spoke to her until she calmed down and sat next to me, patting me on the knee and apologizing for the disruption.

 

Um, no. That is not what happened. That is what I wish had happened.

 

If I am completely honest with myself, I think I just mumbled something incoherent and looked straight ahead, trying to send a message of help by osmosis to the counselor at the front of the room. I’m not even sure I hid the paper and pen, although I remember thinking I needed to fling it as far away as I could because it had somehow become some vile instigator from which I had no idea the powers it held. Truth is, I was completely immobile, gripping that pen and paper like it was a life raft. And I was completely mute. The counselor, bless her, swooped in, asked the woman to please sit down, got her to refocus (I have no idea how – I was having my own out of body experience at that point) and group moved on like nothing had ever occurred. That was my first day on the emergency services thought disorder unit. I had no idea what I was in for. No class prepared me for what I was all the sudden in the middle.

 

Skip ahead to internship. I have moved on to working in a private practice. I walk in, prepared for anything. I have had chairs thrown at me, seen patients go to the bathroom on themselves in hallways, been lectured by patients who believe they are god more times than I can count, and been many a nurses’ punching bag. I have learned to wash my hands at hourly intervals after having a patient lick a stack of playing cards, card by card, and hand them to me. It was the only way he would communicate during sessions. I have my armor on and I am ready. Practicum in Emergency Services has seasoned me well. I could write a book. I should write a book.

 

This office is quiet. Calm. There are doors that do not automatically lock behind me and couches that clients can sit on. There are boxes of Kleenex and charts that are easily found. There are pens that are not hidden away in sealed drawers and if clients want to write down things, it is not a two hour chart search to see if they are going to hurt themselves if I give them a Sharpie. It takes me a week to adjust to not having to check where the nearest door is in location to where my client has chosen to sit. It is different, yet the same. I have yet to decipher all the shortcut symbols clinicians use (did I miss the class entitled “Inane Shortcuts Such as “noc” for night and “s with a line over it” for “without?”). I still am desperately trying to understand all the synonymous terms for the same medications (Depokate is the same as Valproic Acid is the same as Divalproex sodium is the same as Valproate sodium). I don’t know how insurance works (How can there be so many?). I don’t have the slightest clue as to the most succinct way to say everything I need to say about a client in a small paragraph. And the clients? They still break my heart to the point where I dream about them at least three times a week.

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