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1972 BOSTON LIFE/PSYCHIATRIC NURSING

 LIVING SITUATION

 

I meet P at the bar down the street; he is of average height, somewhat on the thin side with curly light brown hair. We get along well and make an agreement that we do not want a committed relationship, we date for awhile, and then he moves in while we are planning our trip to move to California together.

 

We got a Great Dane puppy call Jake, whose short hair color is Fawn, that is a yellow gold, with a black mask, black on the eye rims, eyebrows, and on the naturally floppy, triangular ears. Jake is a strong galloping figure, a pretty husky dude: taller than me when he stands with his paws on my shoulders and weighing more than me at 100 to 125 pounds, he grew very fast. Jake’s large and imposing appearance does not reflect his friendly nature; he is a gentle giant, even a scared-y cat at times.

 

Eventually I get a couch for the living room that gets destroyed by Jake in just one day. He also loves to grab the end of the toilet paper and run through all the rooms with it so I have learned to close the bathroom door when we leave him alone. Jake loves to ride with me in my MG Midget with the top down, he squeezes in behind the seats, and his drooling dripping jaws are so close to my head that when he shakes his head I get a load of saliva right in the face, yucky.

 

 

PSYCHIARIC/MENTAL HEALTH NURSING

 

I am learning to be a good listener, reflecting back what’s been said, giving positive feedback, support and encouragement. I have always been a caring person but sometimes I over identify with the patient which doesn’t help them and causes me distress and I become less objective. I am working on balancing caring with compassion without getting lost in another.

 

We now are detoxing the barbiturate addicts with Valium which proves safer and without the high, thus word has gotten out on the streets and less people want to be treated. Valium also known as Diazepam is a central nervous system depressant called a benzodiazepine, with its low potency, long duration of action and the availability of low-dose tablets make it ideal for gradual dose reduction and the circumvention of withdrawal symptoms. Present thinking is that it isn’t as addictive as barbiturates, only time will tell.

 

Barbiturates are a very popular abused substance, available through prescription or on the streets. Theyare drugs that act as central nervous system depressants, and can therefore produce a wide spectrum of effects, from mild sedation to total anesthesia. It seems that people are trying not to be aware or to feel their feelings by taking these pills.

 

 

We see many young men being admitted, in a psychotic state from a bad acid trip, struggling to get their life back together, but their contact with reality has been severely affected. It is interesting how many young people are into this substance that do not have bad experiences and even develop spiritually.Lysergic acid diethylamide, abbreviated LSD semi-synthetic psychedelic drug, well known for its psychological effects which can include altered thinking processes, closed and open eye visuals, an altered sense of time and spiritual experiences, as well as for its key role in 1960s counterculture. It is used mainly as a recreational drug, and as an agent in experimental psychedelic therapy research being done at Berkeley University, UCLA and Harvard University.

 

 

I have learned a lot from the patients who have crossed my path. I am introduced to the concepts of Western Mysticism and Astral Travel by a very knowledgeable young man; I am fascinated by the topic, being on the path of the seeker. I am open to what others believe and think, without judgment, hungry for other ways of seeing things. Psychiatry does not see this the way I do it is a little more closed minded with a focus on altered states being abnormal brain functioning and psychopathology.

 

When a patient gets agitated and possible violent, at least 4 staff grab a limb and take the patient down to the floor, speaking calming word: “breathe deeply”, “Take it easy”, and “Calm down”, telling them “we will let you go as soon as you calm down.” We do not have restraints on the unit, and it takes just a few minutes of physical contact to calm the person down, when they say they are OK, we let them up. No staff or patients have ever been injured in this approach. There is not much written about dealing with agitated and hostile behavior.

 

I had my first experience with a patient faking Grand Mal Seizures, it took the staff a little time to figure it out because it looked like a textbook case, and the patient was very skilled at pretending which he eventually admitted to. When we first choose to ignore the behavior it was very hard to do, because of the urge to protect, but it is in the best interest of the patient. It turned out it helped him to: let go of this way of seeking attention, learning to ask for what he needs, and expressing what is going on with himself. It is always so heartwarming to be with others who are growing and developing new ways of behaving, it is why I enjoy this work. I so believe in others ability to develop healthier behaviors, since I have been able to do so. Besides my father was a wonderful role model who was able to remain loving, positive and motivated through difficult times.

 

 

Our Day Care Patients are The Chronically Mentally Ill, recently released from the hospital or the state hospital, as the city works to integrate this population into the community. The state of Massachusetts and many other states in the USA are discharging the Mentally Ill out of the State Hospitals and into the communities, there appear not to be enough programs to help them reintegrate. I see many on the streets unable to cope with “normal life” such as maintaining a place to live.

 

They come to the unit Monday through Friday and participate fully in the program. It takes a lot of work and motivation on the patient’s part to create a life outside of an institution. They require active assistance in learning basic skills, we take for granted; like financial management, apartment living, interacting with others as equals, shopping, cooking and cleaning. Patients are more successful when they are provided support and encouragement, while pointing out their accomplishments, giving feedback when they have completed tasks and maintain a caring approach.

 

My last day working at Boston City Hospital Psychiatric Facility in Mattapan is in August. I am Charge Nurse for June and July, which is temporary since I am moving to California, and the charge nurse is resigning. This charge nurse position is harder than at Miriam where I was the only nurse. At Boston City Psychiatric Hospital there are many nurses on the unit that have been my friends and coworkers and we have all been equals. Now I am the boss and need to be fair and equitable and not show favoritism when: making out the work schedule, giving out patient assignments and vacation requests. The staff tries to manipulate me in their favor and since I struggle with being liked it creates a war within and in the end what is right always wins.

 

It is a hard job to leave because I love the people, the work, and I have learned so much from it all.

 

 

MY MENTAL HEALTH

I am still in the Psychodrama Group working on my issues with men and my projection of my stuff onto them that I need to work out in order to be able to develop a health relationship. I project my father issues onto the guy I am in a relationship with. In my present relationship we have been clear we are in an open relationship, meaning we can date other people, I am really gun shy since my last two relationships were with cheaters bringing up issues of abandonment, mistrust and anger.

 

I am suspended from work for 2 weeks, while the patient I had dated previously was re-admitted for detoxification of barbiturates. I realize that I am attracted to men that I perceive need my help, I take on a care-giver role: which is a power position of thinking I am in control and healthier than them; the deeper issue is that I am projecting my father issues on men so I can work them out; it is like reenacting a part of the relationship I had with father, helping him when asked; it is the rescuer myth I am acting out since the age of 4.

 

There was also a triangular relationship happening between my father, mother and me: I was in charge when Ma went to work; I was sharing my father with my mother; which is reflected and being played out through my relationships with cheating boyfriends for they also have another women in their life. I have so much to process and work through that go back to when I was 4 yrs old and father got polio.

 

 

MY COPING MECHANISMS

 

I continue to drink but it has decreased, still using it to medicate myself which I find more acceptable than medications.

 

Since living in Boston M has turned me onto a variety of music. We go to large dancing bars, where there is a large raised stage for the bands, lots of dancing space for the many patrons, and an abundance of tables for drinks and chairs for coats. At one place the bar is part of the stage and we are enthralled and captivated by the Platters performance, a Rhythm and Blues vocal group, with many top hits that I know the words to. During the holidays it’s a pleasure to hear and see Mannheim Steamroller play wonderful Christmas music like no one else can, sounding like a mini orchestra. There are frequent appearances of the skinny BB King, making his guitar Lucille screech out his soulful bluesy tunes. There are many places to go to listen to free live music; I am going to miss this the most.

 

We go to concerts at The Boston Fillmore where less know musicians get their start on a small raised stage with lots of floor space, usually packed with people standing all around, most of the time we sit on the floor in front of the stage. We are enthralled by the outlandish performances and phenomenal music played by these off the wall rock and roll artists: Black Sabbath, Joe Crocker, J. Geils Band, Alice Cooper, Eric Clapton, and Elton John. They all have a look of their own, not afraid to be who they see themselves as, putting themselves out there, without being concerned with what others may think, just trusting in their dream. I love the high pitches sounds that can come from guitars and nothing can beat a good piano player.

 

At the Boston Garden, where the top names in the music industry appear to large crowds, we are far from the stage, in a large auditorium, watching mind blowing rock and rollers like: sexy Jimmy Page and Robert Plant singing and playing guitar in the group called Led Zeppelin; the amazing Ian Anderson swinging his long bushy hair all around while playing the flute standing on one leg, in the band called Jethro Thull; and Jefferson Airplane with Gracie Slick swirling all around the stage, is a sight to behold; Edgar Winter is an albino who writes, sings and plays keyboard, sax and drums in the White Trash Group, we get up close and personal because he walks by us.  I know all the words to these musicians compositions, it radiates through my being, experiencing a myriad of feelings, issues and solutions to problems.

 

At the local small bar venues, there is an intimate feeling because Jazz is less popular than other forms of music; there is a lot to be said about the Jazz experience. We sit along the stage, at a small table; I amerce my five senses in the musician on stage, taking it all in, while M does fantastic charcoal drawing of the musician. The cover is a one drink minimum for 5 dollars, and we enjoy amazing musicians such as: Miles Davis, John Coltrane, Muddy Waters, and BB King. Listening to this type of music requires training my ears to appreciate sounds that are put together in unusual arrangements and letting go of what I think music is suppose to sound like.

 

At Carroll O’Connor’s bar we go to a luscious Sunday Brunch while listening and dancing to the Big Band Sounds which are still going strong, even though they are not on the radio any longer. It is such a body/mind rush to hear a variety of well played musical instruments creating amazing arrangements that bring me through a plethora of feelings. We see such greats as: Duke Ellington, Stan Kenton, Buddy Rich and Count Basie, playing outdoors in good weather, otherwise we are inside in tight quarters where there is no room to dance but the sounds fills you up.

 

 

My mother, Bill and my 3 youngest sisters have moved to North Carolina this year. P and I drive down there in my MG Midget and I am shocked when my mother insists we sleep in her bed. I have never discussed sex with my mother or anything intimate for that matter. I say goodbye to my family because I won’t be seeing them again before leaving for California.

 

 

I sell my MG midget and buy a large Buick station wagon with fake wood on the outside and the back opens out like a door, to the left. We purchase camping equipment. I give my furniture away to my sister, give my long black fake fur coat with hood and favorite picture to M, and stuff all my clothes into a new black footlocker and off we go.

 

I really enjoyed the 2 years I was in Boston; the daytime walks and the musical nightlife were exhilarating and mind expanding. Psychiatric nursing was educational while introducing me to myself through therapy. I am ready to move on to a warmer, sunnier climate.

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1971 BOSTON LIFE/PSYCHIATRIC NURSING

 

leather skirt and coat I had made for me.

 

LIVING SITUATION

In September, M and I decide to move out and get our own apartments, leaving this one to the guys. I find a place in the Brighton/ Alston area which is a neighborhood of single and multifamily homes and not as densely populated as the apartment area.

Walking in the front door, you see the fair size bedroom straight ahead with one window and a door for privacy. From the entrance to the right around a tight corner small hallway you enter the large square living room with two windows flooding the area with light.

When you continue to head toward the back of the apartment you go through a small narrow square hall with a small bathroom on the right that has just enough space for the tub on the right, the toilet in the center and the sink against the left wall with mirror and cupboard.

The kitchen is the last room straight back. In the kitchen I have a table and chairs I brought from the apartment. This place is more open, less walls and lets in more light; the buildings are not as tall or as close together compared to where I moved from creating a feeling of privacy.

My mother and Bill help me paint my new place white, which is what is allowed by the landlord. I really appreciate all the help they give me, getting my place done quicker than if I had of done it on my own. I have lots of years of experience in painting and wall paperhanging with my mother; she is superb with wallpaper, the old fashion way, with that clumpy glue for she doesn’t like the paper with the glue on it.

 

I go antiquing on the weekends from Massachusetts to RI looking for good inexpensive deals. I find an antique brass bed for $35, because the brass footboard is cut off, I polish it to a bright shine. I purchase a red satin bedspread to place on the bed. I love getting up on cold mornings and standing on the red mohair rug with its long plush fake fur fibers that I have placed on the floor.

I bought three antique wooden furnishings that took lots of hard work to remove the paint, stripping them down to the wood then applying the stain, doing it all right in the empty living room. I discover that my purchases are well worth the money I invested: there is a red mahogany dresser with a matching mirror; a walnut armoire with a door that opens exposing four lingerie draws that pull out while the lower third has 2 large drawers on the bottom; and then a walnut smokers table that is carved and has inlaid work on it.

 

MY ACTIVITIES OF DAILY LIFE

My apartment is right down the street from a bar. My daily routine for this year involves: getting up 5am to get ready for work; taking the crowded subway trains for an hour like sardines in a can; working the day shift from 7am to 3:30 pm; getting back on the rocking shaking trains back home; eating a cheap dinner; napping till 9 pm; walking down the block to the local bar; dancing and drinking till 3 am; stumbling home; then going to bed while the room whirls around me.

Sometimes I wake up puking whatever fruit I ate in the mixed drinks, I love Maraschino cherries. Once I vomit up liquor, I become nauseated just smelling it thus I’m no longer able to drink it. The next night I start with something new, I have not tried before, making it my drink till I get sick on it, and that’s my pattern throughout the year. I average 4 drinks a night and usually only buy the first one. I spend the night on the dance floor moving my body to whatever music the live band is playing.

On the weekends M and I go bar hopping around Boston where there is amazing live music like The Platters, Mannheim Steamroller, and BB King. I spend many hours drinking and dancing, using alcohol to deal with my social anxiety, to takes away my many inhibitions, and to self medicate to deal with my long standing anxiety and depression. I find myself in some tight spots; gun held to my head for example, but my guardian angel seems to be protecting me and I always arrive safely home.

 

PSYCHIATRIC/MENTAL HEALTH NURSING

With a year’s experience under my belt as a psychiatric/mental health nurse and before the next new residents arrive; we decide on the programs we want to do for the year. We are interested, in sharing our assessments with the patients, while researching their ability to deal with the information. Thus every morning we have the patients read their previous day chart notes and encourage them to write an honest note underneath it, it is OK if they disagreed with the staff notes. We then discuss what is written, what healthy behaviors are, the feelings behind the behaviors and the steps to better mental health. In the end some of the individuals do well with the process, some get paranoid while others get agitated, and some are withdrawn and into pleasing so they are hesitant to share their responses.

 

 

MY MENTAL HEALTH

The therapist in the Psychodrama Group is finished with her year of training us in this approach and some of the members decided to continue this group therapy without a leader. We become a close knit group of women, there are new issues brought up for the first time, for half are gay lesbians who are struggling to come out of the closet and are feeling safe and supported in sharing their secret.

 

I start working on my issues with my mother; I get in touch with my anger towards my mother for not protecting me and my protecting her. My mother has emotional and mental health issues which results in her exhibiting fugue states and flashbacks; she acted as if she is in a past situation, except she is experiencing it as if it’s happening now, when she is questioned they are memories from the past.

 

Sometimes on the weekends I drive to RI to visit my family. On one visit I gathered all my sisters and mother around the kitchen table and talked about my shadow experience. I thought I was exposing my sisters to something they were unaware of, and realized I was just bringing it out into the open, for we were all keeping the secret, not wanting to “hang out our dirty laundry for all to see.” I feel very alone.

 

MY COPING MECHANISMS

I bought a white, convertible MG Midget right before moving to my own place. The salesman spends an hour teaching me how to drive a clutch up and down hills; it takes me a good week to get the feel of it. Usually my car is parked on the street, moving it twice a week for street cleaning. I continue to take the subway to work except in the winter when it isn’t running due to the weather. I have difficulty getting through a snow storm, because the snow get compacted under the low clearance of the vehicle, so I get out and remove it in order to keep going.

 

 

One day it feels like I have a flat tire and I am lucky I have AAA, when the guy shows up he states “You are lucky you were not on the freeway or you would have been injured. It is more than a flat tire, your front axle broke.” It cost an arm and a leg to get it fixed. I always take the roads to work because there is less honking, not as much traffic and not as much time idling and now they have proven to be safer.

 

 

Once I decide to drive as fast as I can, trying to get it up to ‘95mph on 95 freeway’. As I hit 95 and going downhill, looking in my rear view mirror, I see a cop car’s flashing lights, instead of breaking; I eased up on the gas. I pulled over and he asks “Ms. Powers, do you know how fast you were going?” “No Officer, my Speedometer is broken” (which it was). “Well, Ms. Powers you were going 80 miles per hour. I am going to give you a warning this time, and I do not want to catch you speeding again, you understand?” “Yes, Officer, Thank You!” Boy was that close.

 

 

M and I frequently drive around Boston checking out the sights, our first jaunt out we were in the smack dab middle of Harvard Square when the car died, a nice man stopped to help push us out of the traffic and after lifting the hood and trying to start it he said “Lady, you are out of gas.” How embarrassing is that! Gas is 25 cents/gallon, filling my tank for less than three bucks.

 

 

M and I go to the Newport Jazz Festival in Rhode Island in my MG Midget in the summer. We park in the parking lot across the street, planning to camp there throughout the concert. The concert is outdoors, a chain link fence has been placed around the hill, to keep people out that have not paid. On Saturday night a crowd develops on the other side of the flimsy barrier, listening for free, but they are not happy with that, they are piling up, with more and more squeezing into the area, pushing on the fencing till it is down, then all hell breaks loose. The song “What the World Needs now is Love” is being sung by Dianne Warwick while we are being evacuated from the fairgrounds, with the police raining tear gas down upon us, tears are pouring down my face while I try to decrease my exposure by breathing through my clothing. The concert ends early and we go back to the car and camp out for the night.

The next morning we wake to the police standing at attention, on the sidewalk across the street, in riot gear, plastic shields and Billy clubs. We are told to leave because the music festival is cancelled chaos brakes out, people are yelling and screaming, one guy tells us “It is best if you leave quickly.” We put our tent away, get into the MG, and while I am trying to drive out of the parking lot the police are upon us, one officer starts banging my car with his Billy Club. We exit swiftly safe and sound.  We paid a lot of money for those weekend tickets and are never refunded for the rest of the week.

Later we find out what has happened. “Early on Saturday evening, crowds of young people occupying the adjacent hill, high on everything from alcohol to acid surrounding the concert site. The police command force was called to clear the area, but they never came. The young people breached the chain link fence during Dionne Warwick’s set.

The stage was soon overflowing with a crowd who tore the lid off the piano, smashed everything in sight, and the police began lobbing tear gas canisters. It was announced that the city had ordered the Festival shut down. Traffic was halted on the bridges allowing only residents and people with legitimate business in.

At 7AM Sunday the police moved into Miantomoni Hill with bull horns telling everyone to put out their fires, fold their tents and leave within 15 minutes. Within an hour the park was cleared, and police moved on to the parking lots and cleared them.

It wasn’t Dionne that sets off the riots. There was a new band called the Allman Brothers a white blues group which was really a pioneering southern rock group, that wasn’t popular and no popular rock groups were hired because “After Woodstock, no one would allow rock festivals”. So in January they were hired and by July they became rock monsters. So the kids descended on Newport and they broke the fences down and the festival was cancelled.”

 

 

I have had lots of interesting experiences during 1971 living on my own in Boston, being in therapy working through issues, developing caring skills as a holistic psychiatric nurse and having fun in the first car I ever bought. What more could a girl ask for?

1970 LIFE IN BOSTON / A NEWBIE PSYCHIATRIC NURSE

 

LIVING SITUATION

In August we hitchhike to Boston to find an apt to rent. We get the Boston Globe and the Boston Herald newspapers and go looking at places to live. There is this one place we really like; when the black landlord tells us “This is not a safe neighborhood for you girls, I will not rent to you.” We walk out of their thinking it was our choice to make, that maybe he was being too protective, because we did not feel unsafe walking in this neighborhood, but then again it was not dark yet.

 

We check out a variety of places until we end up down the street from the jazz school. It needs a lot of cleaning, painting and repair work; which we are willing to do; and the landlord is willing to provide the paint and supplies. We are in a red brick building on the top floor paying $75/month, having to carry very heavy furniture up 4 flights of stairs for here is no elevator. Neighbors come by and welcomed us to the community and the building even bringing us food; it is great being surrounded by lots of friendly people.

 

Our living room windows looked into the apartment about 10 feet away on the other side of a narrow walkway, privacy and space is a luxury in this densely populated city. As you walk in the front door there is a long narrow hall the length of the huge living room and small alcove which is barely big enough for a twin bed, the door way is on the left. My friend’s brother F has a brown Afro; a husky dude who is happy to pay $25 to live in the alcove while he attends the jazz school. Within a short time one of his school buddies has moved into the living room and is sleeping on the couch.

 

My friend M’s room is on the same side of the building as the living room with a window facing out towards the building next door. M has always been very messy, so she keeps her door closed most of the time. She is of Irish and Italian descent with beautiful red hair worn in an Afro.

 

The medium size rectangular kitchen is at the end of the hall which consists of wooden counter space with cupboards above and below on the 2 long walls, while the sink is in the center of the counter space on right side, the stove and fridge are along one of the shorter wall near the entrance, and we place a small table with 2 chairs at the window in which minimal light comes through. The first night we walk into the kitchen turning on the light and see hordes of coach roaches running all over the place to escape being seen, this really freaks us out. It looks so nice after being freshly painted white, deceiving ourselves into believing it’s clean. We decide to store all food in glass containers to keep out the roaches. We have a contest at night with a fly swatter; we quietly sneak in, quickly turning on the light and seeing who can kill the most coach roaches. We only use the kitchen to store food and cook in it.

 

Next to the kitchen, on the right side of the hall, across from M’s room, is the rectangular bathroom; with a large porcelain tub, a small sink and toilet and a window overlooking the courtyard. The Coach roaches are in too but not as many as there are in the kitchen

 

The entrance to my large room is also on the right side of the hall across from the living room. The window in my room overlooked a square courtyard that is only accessible on the first floor by windows; there is even grass on the ground. Sound traveled and echoed well; like in a tunnel or a canyon in the wilderness, lots of music students live here so all kinds of instrumental noises reverberate as the artists practice their scales throughout the building. I furnish it with a full bed, a bedside table, a LP record player and a chair.

 

I love buying new LPs that stack up and play throughout the night, I still need a distracting and comforting sound to be able to sleep, in order not to be awakened by sounds in the environment that my brain tries to make sense out of. I am dealing with a trigger that is connected to the Shadow.

 

 

PSYCHIATRIC MENTAL HEALTH NURSING

In September we start working at Boston City Hospital at the Mattapan Psychiatric Facility located outside of town. There are a few buildings situated on a hill, which are isolated by being outside of town, like many similar structures built at the time. The Psych Building is a two story structure with the Substance Abuse unit upstairs while the psychiatric/mental health patients are on the first floor. The building is rectangular with one hall way and the rooms coming off both sides; there are 2 patients to a room. There is a large Day Room in the center of the hall with a large therapy/meeting room across the way. Next door to Day Room is the Nurses Station which contains the medical records with table and chairs for charting. The medication room door is only accessible from the nursing station. There is a locked box on the wall that houses the controlled substances which we count every shift.

 

At one point a patient is having frequent seizures even though he is on medication, we start investigating the cause, when we examined the pills which are suppose to be Phenobarbital, and realize they are being replaced by Artane which is used for EPS. A staff nurse must be involved because they are under lock and key and are the only ones with access. Barbiturates are very popular medications being misused and highly addictive.

 

Phenobarbital is a barbiturate that is the oldest and most widely used anticonvulsant that also has sedative and hypnotic properties. It is use as first-line for partial and generalized tonic–clonic seizures also known as grand mal.

 

Our emergency response to a generalized tonic-clonic epileptic seizure is simply to prevent the patient from self-injury by moving him or her away from sharp edges, placing something soft beneath the head, and carefully rolling the person onto their side which is the recovery position to avoid asphyxiation, so the tongues does not block the airway. If a seizure lasts longer than 5 minutes, or if the seizures begin coming in ‘waves’ one after the other it is called ”status epilepticus’’ which we treat by administering Valium IV push. We believed a person could swallow their own tongue during a seizure or bite their own tongue, so we placed a padded tongue depressor in the mouth.

 

After a seizure, it is typical for a person to be exhausted and confused. Often the person is not immediately aware that they have just had a seizure. During this time a staff person stays with the patient – reassuring and comforting them – until they appear to act as they normally would and have returned to their normal level of awareness. Many patients sleep deeply for a few hours after a seizure, and headaches may occur. Those present at the time of a seizure would make a note of how long and how severe the seizure was.

 

We treat many people with Psychosis, which comes from the Ancient Greek word meaning “psyche”, for mind/soul, and “-osis”, for abnormal condition or derangement which refers to an abnormal condition of the mind, and is a psychiatric term for a mental state often described as involving a “loss of contact with reality”. People suffering from psychosis are described as psychotic. Psychosis is given to the more severe forms of psychiatric disorder, during which hallucinations and delusions and impaired insight may occur. The term psychosis is very broad and can mean anything from relatively normal aberrant experiences through to the complex and catatonic expressions of schizophrenia. Sometimes we get people off the streets experiencing a bad acid trip that are psychotic. People experiencing psychosis may exhibit personality changes and thought disorder. Depending on its severity, this may be accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and impairment in carrying out daily life activities.

 

The Antipsychotics, we use to control psychoses such as schizophrenia, include: chlorpromazine also called Thorazine, thioridazine known as Melleril, and haloperidol called Haldol.

 

The extra pyramidal motor system is a neural network located in the brain that is involved in the coordination of movement. Extra pyramidal symptoms therefore are symptoms that manifest themselves in various movement disorders. The extra pyramidal symptoms, often known as EPS, are a neurological side effect of antipsychotic medication, also known as major tranquilizers.

 

Extra pyramidal symptoms can begin within a few hours, days or weeks or even years after commencing treatment with an antipsychotic medication. Common signs and symptoms include: Involuntary movements, Tremors and rigidity, Body restlessness, Muscle contractions, Mask like face, Involuntary movement of the eye called oculogyric crisis, Drooling, Shuffling gait, Increased heart rate, Delirium and Symptoms can be very distressing and frightening.

 

We are Psychiatric Staff Registered Nurses functioning as: Primary Therapist, Group Psychotherapist and Family Therapist. I become a Psycho-dramatist and am a Consultant for the Rehabilitation Unit, to assist non-psychiatric staff in dealing with difficult patients and psychiatric problems.

 

The nurses supervise the medical workers staff trained in Psychiatric Care. The nurses have clinical supervision with the nursing director. Clinical Case supervision is a hospital Policy for all staff, which is for one hour a week to discuss and get feedback on: patient care, to explore patient transference and staff counter-transference. We do follow up and Home Visits since there is a state policy to integrate the mentally ill into the community. All staff is required to attend a weekly therapy group focused on issues with patients and staff.

 

I am exposed to new theories and treatment approaches for mental health nursing, learning to work with families from Virginia Satir, and experiencing many great teachers through the connection with Harvard residents. Nurses get to define the program every year before the new residents arrived this has already been done before we started working.

 

We have an open door policy on this Adult Psychiatric Ward with 20 in-patients; which including 3 barbiturate addicts, alcoholics detoxifying, and 10 Day-Care patients receiving services during business hours. The ward functions on a team approach using the therapeutic community milieu approach to care which is holistically oriented. We have daily community meetings with the patients; to give positive feedback for improvement made; and to discuss issues that have come up; and exploring ways to resolve conflict and encourage growth.

 

When we first started treating the barbiturate addicts we gave them Pentobarbital, also known as Nembutal 100mg, and the street name is yellow jackets, we administered it every hour till they were feeling elated, we would then total up the dose given, which would be their starting dose, then it was decreased over 7 to 10 days. They literally are “bouncing off the walls” as they stagger from side to side down the hall, their arms out as their hands contact the walls. The major problem we have with this approach is when there is liver involvement, for example: once a patient all of a sudden passed out and required immediate intervention. We detoxify the alcoholics with Librium which mellows out the cravings and delirium Tremors as long as they give a true report of the amount of their alcohol intake.

 

Our 10 Day Care Patients are on the unit Mondays through Fridays, from 9am to 3pm. All in patients and out patients participated in the program’s activities. During those hours: we played indoor games such as cards and dominoes; outdoor games such as volleyball and baseball. We have individual sessions with all patients, a variety of therapy groups, community meetings and morning meetings to start the day.

 

 

MY MENTAL HEALTH

I start personal group therapy as a requirement for my job; I co-lead a Psychodrama group with another staff, so we are in a therapy group, which lasts about a year. There is a woman in the group who had recovered from Polio and has a son about my age thus we do a lot of work together, she plays my father while I play myself or she plays herself while I play her son, after awhile it doesn’t really seem to matter for the roles blend because the issues are similar. I work hard on my father issues: feelings of loss, guilt, anger, and abandonment; development tasks of trust and security. It is easier to role play the issues rather than talking about them because I am less guarded.

 

Sometimes on the weekends I go visit my family in Pawtucket, RI. One weekend Mother and I play with the Ouija Board; it appears to move on its own, picking up speed and darting all over the place very quickly, saying “I am sorry it is not your fault”. I did not know what that meant; tears were running down my checks, because a part of me knew what was being said. My mother starts to tell the story of how “You wanted a bike”, “Your father was working a lot to pay off a hospital bill from my miscarriage”, “You would cry when he would go to work” and “We lied to you, telling you he was going to work to get you a bike, we didn’t think it would become a problem”, “It’s your father who is telling you ‘It is not your fault he got polio.” It was freaky, scary and comforting all at the same time. I realize that my father chose not to get vaccinated or maybe he was just putting it off for a more convenient time and seeing that he was overworked it made him more susceptible to getting polio.

 

I am still seeing D who has also moved to Boston in a high rise of 15 stories and it is difficult for me to look out the window or even go near it. Being 22 yrs of age I now drink more frequently, to the point of blacking out. I am using alcohol to be more social, it has helped me relax and give myself completely to D so I won’t lose him, besides it decreases my inhibitions which also contribute to other risky behaviors.

 

My experiences with drugs start. At our first work Christmas party with the psychiatrists and staff, I asked M “What is in the pipe they are passing around the circle.” I am so naive. We have a Christmas decorating party at our place, inviting about 20 people, and placing chairs up against the walls of the living room. Someone passes around a pipe and within a short period of time we are experiencing an inability to control our limbs, come to find out we have been smoking animal tranquilizer called angel dust/PCP, I will never do that again feeling to out of control. The group was so out of it giggling and laughing, we were all connected by a large string of white lights, while we were replacing the burnt out bulbs before placing them on the tree which was set up in the alcove.

 

I am obsessed with D, one night I realize he is in his apartment with that same girl again! I take Benadryl 50 mg to go to sleep but it has the opposite effect on me getting me so agitated that I go to his place banging on the door but they pretended they are not there. I decided to confront them both, so I sit in the hall waiting for them to come out. I so want the truth to be brought out into the light of day.

 

In the morning they are surprised to see me; they back up into the room. She has a box of boots in her arms that D bought on one of our shopping trips, I comment asking “Are those the boots we bought for your cousin?” She throws the boots at him. He now has to explain to both of us what is going on. I am so emotionally distraught and want everything out into the open, even if it means more pain and suffering, so I say “I thought we have been planning on getting married?” He responds with “Yes we were, but I love both of you.” I go into shock and disbelief as does she while he talks like a two headed snake. I leave to go home to lick my wounds.

 

I continue to see him for a short while, as I allow him to seduces me with more lies, but I know I do not want to be with a liar, and that I need to move on. So I act out by dating an x-patient which is inappropriate and doesn’t last long because he becomes an obnoxious substance abuser, besides D finds us together and makes the guy leave. D gets jealous, becoming very controlling, and slapping me across the face. This is the last straw for I refuse to allow myself to be physically abused; later after he leaves I realize that he has stolen my month’s supply of birth control pills. He leaves and refuses to believe it’s over, and when he calls to apologize I refuse to ever see him again. So much drama, anxiety and pain, while I explore why I continue to be attracted to unavailable men, who are unwilling to commit to one person, looking at my relationship history and thinking I must also be projecting my stuff on them. I must not be ready for a committed relationship.

 

 

MY COPING MECHANISMS

I love walking all over Boston: from my neighborhood to Cambridge, downtown and to all areas of the city. On Saturday afternoon, we Folk Dance on Harvard’s courtyard campus, where they teach a dance, which we do over and over to different songs, I love group dances. I take a silkscreen class in Cambridge to stimulate my creativity, and planning to do it on clothing. We participate in the Anti-Vietnam demonstration near our place; the police are on horseback with riot gear, Billy clubs and dogs chasing us out of the park. “Johnnie Got His Gun” The Movie was briefly at the theater for 2 weeks before it is banned because of its controversial nature.

 

Weekly we treat ourselves by going out to eat at McDonald’s; coke, fries and cheeseburger for 75 cents. We buy cheap food at the market; lots of chicken pot pies and Kraft macaroni and cheese each costing less than 25 cents, sometimes 5 for a $1 and we really enjoy these meals.

 

This has been a great year living and experiencing life in Boston Massachusetts, learning and working in Psychiatric Nursing, and looking at and exploring my own Mental Health Issues through a commitment to my own therapy which is the underlying reason that I have found myself here.