Therapy

As most of you know, the past year has been a year of incredible change for me. Yesterday, while in my Mental Health clinical, I came to the realization that I have come very far in just the past semester of nursing school: my world has grown in many new ways and directions and most importantly I have been enlightened on SO many things I never even considered. Maybe that’s one of the biggest blessings of working with people in a healthcare setting: you become witness to things you never would have had you not been in these situations. Needless to say many days I have left my clinical sites angry, sad, frustrated, upset and sometimes incredibly happy. 

Yesterday, in the course of one day, I found myself having waves of happiness mixed with waves of frustration and anger. I began questioning so many things that are going on the world. When I left clinical I called Terri and asked the one question that had been begging my attention all day, “How do you do this for your entire life?” And I didn’t ask that question because I think this job is horrible or that I couldn’t do it: truth is, I want to. But the part in me that aches for many of the patients I have met wonders how a nurse can deal with things that often seem unfair or unwarranted. How do you not become run down, frustrated, upset or how do you go through life as a nurse without questioning God about why things are this way for some people? Of course I had a great conversation with her and my Poppa and then I was home – where my family becomes my therapy from all of these things that I am beginning to question. 

I’ve found myself trying to talk about the things I’ve been thinking – the things I’ve been feeling, wondering, questioning. What I’ve found is that sometimes the words that come out of my mouth don’t truly convey what I am feeling. Writing has always been my therapy but in the past few years I have often put it on the backburner. Lately I’ve come to think that now is the perfect time to start again: not only can I find a place for reflection but I think if I come back to this again in ten years I will be amazed at how much I have grown on this journey. And most importantly, writing will convey what words can’t always express. So with that said…

Yesterday was my last day of my first weekend of clinical in Mental Health: overall it was a great day with many great experiences.  It was also a day of great reflection for me. I found myself questioning so many things when I encountered so many of my patients which ranged from those with depression and those in detox to those with schizophrenia and psychosis. My patients weren’t crazy: they were suffering – suffering from some sort of chemical imbalance or, in many cases, suffering from deep emotional pain or trauma. 

Take my schizophrenic friend, for example. He’s homeless. He’s been in the facility more than once. He comes in, is stabilized and then is released to the world where he once again “relapses” and returns back to the facility to be stabilized again. Why, if stabilized on his meds, does he relapse? Well, what homeless man do you know of that can afford medication? Not many if you ask me. But he also has a bigger problem: his wallet was stolen. He doesn’t have any form of identification – he is only who he says he is but with no proof. Can you imagine going through life without ANY form of identification? I never thought of that – I’ve always had an ID or a way to get a replacement. He can’t get his ID from the DMV because he needs his birth certificate and social security card: he has none and doesn’t even have the money to pay for a replacement, much less a stamp. Most importantly, he can’t apply for help getting his meds because he doesn’t have an ID, or a social security card. It doesn’t quite seem fair to me to release someone back into the world without the ability to pay for or receive their medications. It’s like asking for a relapse. I did, however, learn of a wonderful program in Orlando called IDignity, which aims to provide identification for the poor. My schizophrenic friend has been adopted by them. I am grateful for that. 

I’ve learned that meds are touchy subject. Yes, I’ve heard people talk about them but being right in the center of it has given me a darker reality of the battle with medications. Many of the patients I met were depressed – they knew they suffered from some form of depression and many of them VOLUNTARILY checked themselves in to protect themselves from, well, themselves. I can’t tell you how many times I heard something like, “I couldn’t afford my medications so I had to check myself in before I hurt myself”. They KNOW they have a problem but they can’t afford to treat that problem. Which begs the question: are those with money, or insurance, more important than those that aren’t? What if this was my family member, my friend, my husband, my son, my daughter? I don’t know if universal healthcare is the answer but something has to change. No one is more entitled to health than anyone else.

The AMOUNT of medications that are prescribed definitely doesn’t help either. Take addiction: it’s a nasty thing. Whatever the addiction may be, the detox is twice as bad. Everyone knows this right? So, instead of dealing with the nasty parts of the detox process, let’s just medicate our patients so much that they can hardly even stand up: we don’t have to worry about them being combative, we don’t have to hire extra staff to deal with them and we don’t have to pay much attention to them at all right? How is this fair? You put someone detoxing on a regiment of eight or nine medications so that they can’t feel the “pain” of their detox. Doesn’t make much sense to me because now we are just trading one addiction for the other: these people are craving meds, meds, meds and guess what? In three days, when they are released, they will stay on those eight or nine or ten meds. And when those eight meds run out and they can’t afford them they will substitute the next best thing that they can afford. Overmedicating DOES NOT treat addiction, it BREEDS addiction. And they wonder why so many of these people keep coming back?!?!? 

Truth is, I care. These people have stories. Some of these stories are incredibly hard to stomach. What if I had gone through those things? What if I had been raped my entire life and then my parents were murdered and then I had lost my children? What if I had grown up in an orphanage in a war-ravaged country and had never received the love/acceptance that every child needs? Did you know that many orphans from the war in Poland who are now reaching their teens and early adulthood are increasingly showing signs of mental illness? Many people believe that they grew up in such dire conditions in orphanages (warehouses) that they never received the love and acceptance that they need to thrive as adults (remember the monkey/motherly love experiment?).  I made an extra effort (although it doesn’t take much effort) to hug my babies last night.

I’m brought to another point of frustration in my experience: burnout. I’ve met some pretty great nurses, but I’ve met some - for lack of a better word -bad nurses. I don’t know what’s going on in their lives but their patients suffer from it. Being a nurse isn’t just about going through the motions. It’s not just about the physical part of care.  It’s about CARING. Why was my patient on Thursday covered in pressure ulcers when her nurse has been taught and knows about the importance of turning and repositioning a non-mobile patient? Instead, her nurse lets skin and muscles deteriorate until there is an open gaping hole in her back. Why? I’m not sure. One part of it is burnout. I know it. There often aren’t enough nurses to care for the amount of patients they have. It’s a hard job sometimes. In many cases we need a smaller ratio of nurses to patients, otherwise, quality of care is affected. Some nurses are just in the profession for the money and that truly affects how they view their patients. I’ve seen it. I’m writing this down for one purpose only – in ten years when I come back to read this I hope I can look at myself and say, “Thank God I am not one of those nurses!” Let’s hope. 

One thing is for sure: the past few months have left me with such a deep appreciation for the things I did and do have. I will never take the health of my mind, body or spirit for granted. Nor will I take my family for granted – they are a therapy like none other and are probably much of the reason that my mind, body and spirit remain healthy. They keep me whole.  

And maybe, as I work more and more with patients they will keep me whole too. When I left my patient on Saturday I told her that I would be back on Sunday. "Will you?" she asked. "Yes, bright and early." I said.  Sunday morning, with excitement, she said, "Wait here..." and ran to her room. She came back with a painting and said to me, "Not many people in my life come back when they say they will. I made this last night and told myself if you came back like you said I'd give it to you." A glittery barrage of paint became one of my favorite pieces of art.