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.