Drunk Tank Ethics

Mr. nice guy and the enforcer got in an argument a few nights ago. It's a common discussion, but things got pretty heated with both of them saying that management was on their "side". I've never heard mr. nice guy be so outspoken about something, but I was very glad he was. Here is the basic scenario.

When someone comes into the drunk tank we hold them between 4 and 24 hours, it's at our discretion of when they are safe for release into the community again. Between midnight and six in the morning, clients have to sign an extra form saying they are aware of the risk of leaving in the middle of the night in a bad part of town, and that they want to go anyway. Here's where things get complicated. What happens when someone doesn't want to go? What if we know that they have absolutely no place to go, the shelter's full, and the weather is horrible. What if IPDA is full, and we have police outside waiting. What do we do with these people?

This particular night, the shelter was full, but the drunk tank wasn't. There were people who'd been there quite a while, but they were people who had no place to go, and it was POURING rain. The enforcer tried to make mr. nice guy kick them out, and he wouldn't. He said, "they don't want to go, they have no place to go". The enforcer said, they've been here 8 hours, they're sober, they get a phone call, and the buses are still running. Mr. nice guy said, these people have no money, no one to phone, no where to go. The enforcer said, that's their problem. What happens if we fill up and have a back log.

See, the drunk tank is funded by the city, not our organization. So, us shelter sober people, just cause we know they have no place to go is kind of, well, cheating, especially if the police have someone possibly dangerous or extremely disruptive that they need to bring in. The enforcer is worried that we will get a back log of 5 or more cars, and that the police supervisor will be calling and complaining, and since he's in charge, the buck stops with him. He says he's discussed this with management.

Mr. nice guy says that we cannot release people who don't want to go, and then get them to sign a form that says they do. It's unethical. And, how do we release people to, well, nothing. The thing is, he's also working with situational ethics here, because if we were full, he would do the releases. But because we weren't, he was arguing his point. However, we can also argue, that if we were full in the drunk tank we would try to squish people into the shelter wherever we could find room. The enforcer is very black and white. He doesn't do situational ethics, at all, it's the principle of the situation. Mr nice guy has plenty of shades of grey and is able to adapt his practice to the situation, but should he?

I have to admit, I'm strongly on mr. nice guy's side, but of course, I'm biased in that I'm having issues with the enforcer. However, I've always been of the same position as mr. nice guy. It's an interesting issue, one that I hope management will continue to discuss.

less then healed but definitely better

I'm finally almost better! Actually, I've gotten over whatever this was very quickly, and today I'm not even taking decongestants. As long as it doesn't settle in my chest I'm free! Considering it was just three days ago I was lying across three chairs in the emergency room crying, I've made an incredible recovery (I will give complete credit to the 2 liter bottle of ginger ail I drank).

Work yesterday was the pits though. I had a couple really great conversations with clients, but it was marred by staffing issues and the fact I felt feverish. I will be SO glad when I don't have to work the evening shift any more. We had 20+ people in detox, which is a lot. It also means a lot more laundry and a lot more dishes. We also did two intakes. Fine. Problem is, my supervisor left me basically on my own for the second half of my shift (there's supposed to be always two staff back there when we're more then 10 clients. On a day where I was healthy I could have done it no problem, but because I was feeling crappy, I just wasn't in the mood.

Mr. nice guy tried to help, which was sweet, but he was training a new staff at the front, so really couldn't. Best quote ever though. I answered the phone in detox to record a new intake from the front and he says "what's wrong with you?". Because I know him, I knew what he meant and answer "I have a flu/cold thing which is screwing up my voice", but I found his bluntness and choice of words amusing.

I'm sure today will be equally "pleasing". I'm hoping for a good partner, cause I'm sure I will be working detox again. It should be nice, as I'll get some good client time in which I always appreciate, and since it seems like everyone got their "one load of laundry while in detox" laundry done yesterday and there were only a couple scheduled discharges there shouldn't be too too much laundry!

Warehousing the homeless part four

Can you believe I found this photo when I googled "transitional housing"? Oh well, google image search isn't perfect! Looks more like jail to me. Or I dunno...in jail you don't have quite so many roommates!

Anyway, when I was talking to mr. nice guy about the staff evaluations I also told him about how we need some structured wet housing. He was totally on board with me, which was really nice. I first brought up the fact that we really need someone whose role is to try and encourage and help people to find housing. Some might argue that this process needs to be initiated for the client, but I think for some people, they've just lost hope that it's even possible. They need a boost, and a reminder that there's help and hope before they are able to begin to grasp the possibility.

Then we talked about how valuable it is to be able to have a sense of ownership of something. To be able to have anything, even just a little space, to call your own. I place where you can store a couple things, where you can do your laundry and know that you're not saying goodbye to those clothes forever. Where it's possible to own more then one set of clothes! He agrees with me, that having a safe place to stay that's "yours" is a very, very good start.

Our detox unit might be moving, and I want to turn to the existing space into wet housing, instead of making the shelter bigger. I'm not sure exactly how that would work, but eventually (this is a long term moving plan here), I will put something in writing to our executive director, because I think it's an awesome idea, and having a place like that on site would make it quite comfortable for the clients who were likely to use it. I mean, there's a million things that would have to be considered, but, I just keep talking to people and getting them to open their minds to the possibilities.

what if the clients did the performance evaluations part two!

Two nights ago I had a long talk with mr. nice guy about the clients doing performance evaluations. He was busy making a list of things he thinks need improving and trying to get some ideas on paper, and when he asked for my ideas I was totally ready to give him some!

He agrees with me, which was nice, because it means someone else in the organization is thinking the way I do and I'm not crazy. Unfortunately, he realizes the same struggles that I do with making it all work...I was hoping he'd have the answers! We talked about how empowering it is to say to the "your feedback matters", "we care about what you think". We talked about the fact that when we treat the clients as if they matter and have opinions then they are more likely to treat us as if we matter and have opinions (ie respect us). If treat the clients like animals, or consumers using up free services, then it only makes sense that they are going to "behave like animals".

We talked about the fact that realistically we don't get performance evaluations at all. He's been there five years and thinks he might have had 1. I'm not expecting any. That of course is the first challenge towards getting things in place. The second challenge though, which is a big one, is literacy and the fact that many of our clients don't read and write. That means to administer something like this it has to be verbal, so who does that... management? I mean, I guess, but are the clients really going to talk to them? Who would the clients talk to? It's hard to know. An anonymous suggestion box would work for those who are literate, I mean, we'd get spam as well, but who doesn't. It also isn't quite as targeted. Although, how do you get targeted feedback.

In any case, mr. nice guy wrote it on his list, and so now there are two of us thinking about it and possibly more. We'll see what happens. It something I'm not going to forget about, and will keep advocating for whenever I have the chance.

freaky

I had a kind of freaky day at work today. I really wish we had proper debrief! It just seems sort of...expected... that we won't have issues with the stuff that happens there, and I just don't get that. However, with some of the newer staff, I'm feeling able to form a bond so that maybe some of that debrief can take place, just informally, amongst ourselves. Because, maybe it takes place informally amongst the others, and I just don't fit in yet.

Anyway, not long before shift change one of my detox clients had a really bad seizure. At first I didn't know what was going on, I thought she was just joking around. She started gasping for air and stiffening and falling over. One of the other clients caught her. Mr. nice guy and I ran over to her and the three of us lowered her to the ground where she continued to seize. She started vomit a little, so we quickly got her on her side. Not a long seizure, but then a long period of unconsciousness with no rousability and odd twitches/eye movements. As she started coming out of it, Mr. nice guy left to check on the status of the ambulance and I stayed with her.

The client started coming around, but was behaving oddly. After getting no verbal response, I took her hands and asked her to squeeze them. The client squeezed, but instead of just squeezing she kept trying to put them in her mouth, and she was STRONG. I called for Mr. nice guy and he helped me wrestle myself away from her. Anyway, first response took a looooong time to get there, and my client was freakishly altered. No sense of where she was, how she got there, and asking very strange questions. Her voice was different and so were her mannerisms. Firefighters arrived, and did all her vitals and stuff, and then we waited, and waited, and waited for the paramedics. A consious female, even a very altered one, just doesn't take priority.

My client was SO altered though. And just odd. Every time a guy walked near us, she FREAKED out. She grabbed me really hard one time and freaked me out too. And she was freaking out all the other clients, because they wanted reassurance she was okay, and she didn't know who they were. She told me that the one man "had beat everyone up" (nope) and another had been kicking her purse (nope). She still didn't know where she lived, or where she was or anything like that. Strong denial about having a seizure.

Finally paramedics came and she was able to walk out with them. She wanted me to go the hospital with her, and I was quite sad that I couldn't. It's hard when you're with someone through something like that, and even though they have no clue who you are, they realize that you're someone safe and then you have to leave them. She'll be okay though. The paramedics were nice, and she's a white well groomed female.

But yeah, after that, shift change was over and it was time to go home. I thanked mr. nice guy for saving me from being eaten, but that was it, he didn't seem to want to talk, and one of my favourite staff just said, yeah, people have a post seizure period of alterdness. But, it freaked me out! I'm okay now, but yeah, it would have been really nice for someone to acknowledge that it had been a bit traumatic for me! Maybe I need to speak up more. Or maybe everyone at work is just so used to it now they don't even thinking about it. I mean, I've seen a few seizures already and I've only been there 3 months.