*Making A Difference*

Over the past several weeks the Adolescent Psychiatric Unit that I work at has been extremely busy with many admissions and discharges. This is unusual because during the summer our census is usually low. I cannot remember being this busy or as easily frustrated with my job because I love what I do.

The mental health workers that I work with are excellent and have become as frustrated as I have. We work many times without breaks and many are working overtime. We sometimes get angry at parents for their lack of parenting skills. These parents bring their kids to us and expect us to 'fix them' in a short period of time and then return them better.
One cannot become judgemental, one has to remain professional in spite of your feelings toward that parent. We also see kids who are autistic, mentally challenged, substance abusers, sexually abused children, as well as physically and emotionally neglected children. Due to budget and healthcare cuts and the closure of most adolescent psychiatric facilities, we now accept children from cities that could be 50 to 100 miles from us.

Last night, after one of the busiest nights I have worked, we made sure all of our patients were cared for, medicated if needed and put to bed. We maintain constant supervision and must check them every 15 minutes as they are all on general suicide precautions. My male and female mental health workers are the best I have ever worked with. However, last night we were all ready to just give up. Frustration does that to you. Nate, my male mental health worker, who was doing a double shift as he frequently does said "I can't do this anymore" because of all of the issues we deal with. We discussed whether or not what we do, what we teach them, what we counsel them on actually makes a difference. The average stay is about 3 to 7 days for most kids. That is a very short period of time to even attempt to undo or repair the damage these kids have experienced. You only hope and pray that you made an inkling of difference in their lives. Did one statement, one short period of counseling them, one instance where you showed that you cared, did anything stick?

We then began discussing some of our really difficult patients in the past 2 years. We had one young girl who came into our facility many times and each time, we dreaded her admission. She was defiant, hostile and very difficult to manage. We gave her timeouts, we put in our Quiet Room, we gave her medication to control her behavior, we had to physically restrain her many times. She pushed everyone's buttons and at first, none of us liked her. One night as I was driving home from work after a shift with her, I said to myself, "I can't deal with her anymore" which I do frequently. I woke up the next morning and decided I had to deal with her, she is my patient and I had to find a redeeming quality in her and focus on that. She had called me every swear word in the book of swear words, she tested my patience to the extreme, but I had to teach myself how to deal with her. So, the next time that she was admitted I tried a different approach with her. I took her aside and listened to all of her complaints, and told her that rather than act out and create chaos on the unit to come to me and ask me for her medication or a private talk and I would stop what I was doing and give her my full attention. She looked at me baffled by my new approach, but she agreed. She became calmer but was still being transferred to a longterm residential facility. She could not return home. This is so difficult for children to accept. They feel abandoned and unloved and act out more. I fully believed that once she left, her behavior problems would accelerate and that there was little hope for her future. We all felt that way, but we tried our best anyway. She is just one example of kids that we try to fix, some stories are even worse.

We began discussing 'Amanda' and her behavior last night and I wondered what happened to her. I found out that she was no longer in placement, was going to college and was leading a good life. I almost cried, it did work with her! We made a difference in her life. You cannot imagine how good that makes a healthcare professional feel. It is all worth it, it does make a difference. Nate then looked at me and said, "yeah, I guess handle it for a little bit longer now that I know she is doing well".

We encourage our kids to call us after their release if they have any problems they can't handle. We have several of these 'discarded' troubled kids call us even late at night. We always take their calls and listen, counsel, and encourage. We are sometimes the only person they trust, but we have earned that trust because we care about them and they know it. We bring them in little 'gifts' such as coloring books, scrapbooking supplies and other things. Nate is a big Star Wars fan and one of best mental health workers I have had the privilege to work with. Sometimes late at night before we put the little kids to bed, we make little 'capes' out of hospital gowns and let them become Jedi warriors. Nate has a 'real' Light Sabre that glows in the dark and they run around the unit with their little capes flowing behind them and their light saber. How could you not love this line of work when you see that?

Our country must take a look at our medical crisis right now. We are closing psychiatric facilities at an incredible rate. We have over 45 million people in this country without health insurance. This must become a priority in our country! We are denying future generations the healthcare they deserve. We are funneling billions of dollars to other countries, we are spending billions of dollars in the Middle East and watching our soldiers die at an alarming rate. Yet, people in our own country are being neglected. This has to stop, our children are our future and we are forgetting that.......................