just an all around sad story

This is a story about death.  This is a story about everyday life.  This is a story about the poor and the middle class.  This is a story about people struggling to get by.  This is the story of inequality, unfairness and injustice.  This is truth.  

Everyday in our society people work towards earning money to acquire things.  The nature of the earning and things varies, but in Canada at least, it's neccessary.  Even those who have no official earnings, the kind declared to the government, are generally working to gain income, small though it might be.  While many people think of the homeless as being beggars, theives and panhandlers, there is an entire underground trade system, a black market, which trades not just in weapons and drugs (as many people believe) but in the items of everyday life.  

The poorest area of my city is void of the big box stores one finds in the suburbs.  Most of the stores are tiny corners stores, almost all which are run by imigrant families.  In order for these stores to exist they have to charge more for their items and put in long hard hours just to eek out a living.  Unfortunately, some of these stores turn to less honest ways of gaining money preying on those even less fortunate then them.  

One store in particular, was famous for this, they were known on the street as being willing to buy just about anything from a person in exchange for money, mouthwash or hairspray (to drink).  When we gave out brand new winter jackets this Christmas we found out quickly the owner was buying them from the homeless and reselling them for a higher price... once we started cutting the tags off this petered out, but it continues to happen with a variety of other things.  Because it's not a pawn shop, the police don't run the same checks for stolen property and it's less regulated... and besides, it all happens under the table anyway.  

For whatever reason, the owner of this particular store couldn't handle life anymore, and so, he hung himself, in the back of his store, in the middle of the work day.  My clients were there when his wife found him, my clients cut him down, my clients comforted his wife, my clients called for help, and my clients were there when there was nothing left that could be done.  And it hit them hard.  Staff from one of the other organizations in the area came and did CPR while they waited for the ambulance.  They got a whole debrief session.  The clients who cut the rope, got nothing.  

One of my clients hasn't been the same since then.  Sober for almost three months he's started drinking again, and is now using injectable drugs.  He's in horrible shape.  He talks about the wife of the owner, how she just cried, and cried, and cried.  He was planning to draw her a picture, I don't know if he ever did though... why are there no services for him?  Why is it that staff are more important then clients.  And for the clients, this wasn't just some stranger, this man was a part of their community, someone they knew and interacted with on a daily basis.  Do people assume that these clients have seen so much that it just doesn't effect them anymore?  Because that's just not true... Why is it that we forget about the clients in the midst of a crisis?  

I've had a few conversations with the clients about this.  But my time and resources are so limited.  It's hard to have a deep conversation about death in the middle of a shelter full of people while the phones ring, the intoxicated scream and people are constantly interupting.  I've mentioned it to my boss... but still... just a sad story all around.  

Oh how I miss Social Work supervision aka all the things I wish there’d been time to say

For the most part, I’ve been doing pretty well working without any proper supervision.  As I’ve said before, it’s nice not to have to over analyze every single little thing I do.  Most of the people I work with are completely uninterested in debrief and reflection and are simply there to do their job and go home again.  I really wish there was something more though.  After the whole CPR thing my boss got me to come “check in” with him about how I was doing, but it just felt, empty... So now, you get to hear all the things I wish I could have said to my boss or supervisor (oh wait, I was the supervisor that night... well, to my boss anyway). 

 

For starters, I feel like I handled the whole situation really well.  I’m quite proud of myself actually.  I’ve been put in this position of authority with no extra training, no extra feedback, no nothing, only “seniority” which really isn’t very much.  It’s just been expected of me that I’d be in charge, because I’ve been there longer than other people.  This particular night showed me that I can be a good leader, but that there are also areas that I need to work on.  Yes, the CPR/live saving/hero thing was a part of that night, but it wasn’t the only part of that night, and it was actually one of the least frustrating parts, if I was honest. 

 

I am not pleased with the way I treated one of my coworkers.  I’m not upset with what I did persay, because I think it was necessary, but I still wish I’d been able to do things differently.  Asking me about letting the drop in clients in for coffee when I’m literally in the middle of doing chest compressions just doesn’t sit well with me.  I’m sorry, it doesn’t.  And while I’m not a rude person generally, it’s hard for me to be polite when I have a guy with no heartbeat on the floor beneath me.  So, yes, I snapped at you, but seriously, can you say bad timing?? 

 

I’d love to talk about whether that was where I should have been.  I have a tendency to insert myself into situations, although I’m really trying to work on that.  As the shift manager, should I have been down in a drunk tank cell doing CPR when there was still the rest of the building to worry about.  If I’d been upstairs and sent this co-worker down, there wouldn’t have been any questions to snap at, but is it right to ask someone to do CPR? I mean, it’s part of our job, but I also know they’ve been a bit lax on that lately, and I remember him saying recently that he was “about” to take his training... I am confident in my CPR abilities (and managed to remember lots of important stuff – even head tilt/chin lifts).  So I felt like I needed to be there.  Plus, I sort of stumbled on it when I went to check on what was happening.  So, what exactly should the role of the shift manager be, or is it again situational, as I wrote about a few days ago. 

 

Finally, there’s the fact that only 1 in 7 people whose hearts have stopped and CPR is performed on will live.  So realistically, if this happens again, and if I stay at my job, it will, the person probably won’t live to try and assault the paramedics. 

 

Things to ponder, things to ponder...

I felt his pulse stop...

Most of the people reading this have probably taken CPR at some point in their lives.  Most employers require it these days and even if they don’t, many people take it for personal interest.  Most of the people reading this have never had to perform CPR... I used to count myself in that number. 

 

It always sucks to be short staffed on a Friday, and when it came to me to be shift manager on Friday the 13^th I had this nagging feeling that something was going to go wrong.  Of course, I didn’t want to be so convinced of this that it would up becoming a self fulfilling prophesy, but still, there was something that told me the night just wasn’t go off as planned... and it didn’t, but even though we were busy, things stayed calm until around six in the morning when I overheard the phrase “I’m calling 911”.  This is never a good sign as we try and avoid calling it as much as we possibly can.  So I went down to the drunk tank...

In the drunk tank, one of the staff had a discovered a c/n not breathing when they went to check on them (this being why we check on people every 15 minutes).  The staff member had already begun CPR and the client had started breathing again... and stopped again, twice.  So I joined in.  2 person CPR is SO much easier then 1 person CPR and my co-worker was just a little panicked.  And when I say a little, I mean he was definitely in need of a deep breath.  So I got him to do the breathing, because you have to take slow deep breaths. 

 

After the third or fourth time we revived him I felt his pulse with my fingers, to time it, and to reassure myself that it was there...and it was, until it stopped.  My co-worker started doing chest compressions and I could feel those, each one created a pulse of its own (which I find fascinating, even though I know that’s what it’s supposed to do).  I lost count, but my co-worker says we revived the man seven times.  By the time the paramedics finally got there he was sitting up, conscious, holding my hands as we breathed, in and out, together. 

 

Then the paramedics arrived.  And the guy FREAKED out.  It took six people to hold him down while they gave him some haldol.  I have NO idea what he was on, or how a person can go from no heart beat to seemingly psychotic within such a short amount of time, but he did.  I’ve never seen anything like it, and I hopefully never will again.  

and sometimes it's so so so worth it

There are definitely moments during which I hate my job, moments when I question everything I'm doing, and not doing, and of course, there are moments when I'm simply so overwhelmed I feeling like quiting.  Then there are the things that make everything so so worth it.  The moments that help me see that I am making a difference, even if it's small, and that the work we do does matter.  

A prime of example of this is our van patrol.  Some nights we patrol the street and don't talk to a single person.  Other nights all we do is ferry people to and from the hospitals feeling like a taxi service.  Some nights we give out more condoms then I can count, and I begin to question the principles of harm reduction.  And then some nights, I know that we did something good, and occasionally I know that we may have, or did, save someone's life.  While it feels good, this particular story also makes me really mad as well as making me question my self, good stories do that though.  

It's a cold Canadian night and I'm cruising back from picking up donations at a convinence store with the new guy watching for girls working the street along the way.  Suddenly I notice something on the curb "did you see that?" I say to the new guy as I make a u-turn in the middle of a somewhat major street pulling up along side the object of my interest.  Only it's not just an object, it's a person.  A person lying in the snow dressed only in jeans and I t-shirt.  "What do we do?" asks the new guy, "we start with the basics" I answer, and so we do.  

The new guy and I put on gloves and jump out of the van to try and rouse the person.  It takes awhile, but we're able to get them to come around a little "what's your name?, what's your name?"  Nothing.  We are however able to get him sitting up on a planter out of the snow.  Of course, our normal van is broken and the one we're using doesn't have blankets in it... so for the second time this winter I take off my jacket and remove my sweater (thank goodness for layers) put my jacket back on and wrap my hoody around this freezing person.  As I'm doing all this I am also calling an ambulance/police/help from my cell phone while new guy looks after our frozen victim.  

The paramedic response time is surprisingly fast, the last time I called about a person passed out in the snow it took 20 minutes, this took about 3.  "What's the story?" they ask.  "I'm not sure, we couldn't get anything out of them at all, not a word".  The paramedics try also, but to no avail and they take them off into the nice warm ambulance while I quickly steal back my sweater.  Talking with one paramedic, the new guy asserts that "it looks like the person was pushed out of a car and left here".  It could be very true, the positioning was right, and the lack of clothing fits that story.  But that's all we know about this mystery person, we don't get follow up on these calls, especially when we have no names, and we drive off to continue our patrol.  

Here's what makes me mad.  This person was on a busy street for who knows how long and nobody did anything.  On the other hand, new guy didn't see them whereas I was looking for things, many drivers probably didn't see a thing.  Of the people who did see them we have to remember that concept I learned about in Social Psych but can't remember the name of.  Basically that we all assume someone else will do something.  There's also the whole "not wanting to get invovled thing".  I can't say I blame them.  It's interesting however that once we stopped, someone else stopped to make sure that we were okay.  I'm not sure what I would have done if I was alone driving past a person on this particular street.  I'm not sure I would have felt safe getting out of my car, and calling 911 is so ANNOYING if you're not up close and personal with the situation.  Something to think about.  

I guess every situation's different... 

overwhelmed - or something

I'm feeling a little overwhelmed these past few days. The enormity of the problems I see on a daily basis can be kind of consuming. For the most part, I'm quite good at maintaining a healthy distance, putting things in perspective and staying positive. This past week however there have been a few situations which have been hard and the mind numbing cold just doesn't help anything.

This week for the first time I found someone sleeping under a heating vent, by choice, not because they were passed out drunk. For some reason, this really touched me. When I asked them why they made that choice, they simply said they had no place to stay. Another person, in a doorway, refused even our offers of a blanket, let alone a warm place to stay. A man what I believe was an actual heart attack. I have a lot of people with chest pains, most of the time they beg for the ambulance. This man, clutching at his chest, gasping for breath, wanted no help at all (note, we called and he was taken to hospital). An unrousable man later told us he wished we had just let him die. And of course, the girls working the streets just keep getting younger and younger.

I am sick of fighting with the other shelters. The politics of homelessness are stupid and frustrating. I'm sick of watching my mouth and having my actions be dictated by our directive not to do anything to make the clients go to the media. Why, because they are, they're making good on their threats, and we can't afford the negative publicity. I'm sick of not being able to say what's really happening because we're not allowed to say negative things about the other shelters (although I do understand this). I'm sick of not having enough space for freezing people.

Working in the drunk tank is also difficult. Until you've done something like that, it's hard to explain. It's hard to explain the death threats, the law suit threats, and the constant insults. It's also hard to explain how it can break your heart to have to lock someone up and forceably hold them. On the flip side, it's also hard to explain what it's like to have to kick people out of a safe warm place because there are drunker people coming in.

Of course, my heart is not literally breaking, and for the most part I am able to put aside all this stuff and effectively do my job. I'm able to go about my everyday life and not think about this stuff. These past couple days though, it's just seemed a little much. Someone at church said I looked sad, and i just didn't know how to explain. There's just so much, so much I see, and sometimes it just gets to you, especially as my clients start to worry about Christmas. I'll go to work tonight, and I'll do my job with a smile, just like always. But inside, inside I'm a little sad tonight. Sad because a job like mine has to exist, and sad because its just seems like we're not doing enough. Sad because people are hurting, and there's only so much we can do to change that.

maybe I just need a good cry...

passed out in the snow...

One of the things I do at work is go out in our van (with someone else) and drive around looking for people. We hand out condoms, safe rides home, and a watchful eye. People in our city know that we will treat difficult situations with compassion and so they call us, often before they call police or ambulance.

Last week a concerned taxi driver stopped by about a man passed out in a deserted area of town, lying on the road. So, our faithful van patrol headed out to the rescue.

We would have taken him back to the shelter to warm up and assess the situation, but we couldn't rouse him, thus, we had to call an ambulance, and there began our 20 minute wait in the wind, as we tried to keep ourselves, and of course the man, warm. I'll admit, I was SO not dressed for the weather, riding around in the nice warm van gives you a false sense of security I suppose. Then, after tearing apart the van (which I got in trouble for not tidying later) I discovered that we didn't have a single blanket. I covered the man's torso with my sweater and put my scarf under his face (which was freezing in the snow) and we waited, and waited, and waited, all the while trying to rouse the man who was eventually able to mumble his name and answer a few questions.

When the paramedics final arrived they were creeping down the street without even their flashing lights on. Drives me crazy, I'm waving at them to hurry up, and they're creeping. Then they're rude to us, and rude to the poor guy. Sigh. I don't care how many frozen people you've pulled out of the snow that day they each deserve the same respect.

over confidence

Okay, so I just slept from 4PM to 8AM with only minimal interruptions. That is so, so, not healthy. Neither, apparently, is my over confidence.

I've noticed at work, that my favourite supervisor has been really laying into me about putting myself in unsafe situations. Part of this it turns out is that management has been spying on us through the camera system and he got a lecture about us, but part of this is very directed at me.

At first, I was mad. I thought, what the heck, I know what I'm doing. I have experience, blah, blah, blah, I'm right, he's wrong. I was taking it as a personal insult, and I was FRUSTRATED! Because it kept happening though, I realized I should probably take a look at my behaviour and figure out what exactly was going on.

I've always thought of myself as having a healthy fear level, especially recently. Having struggled greatly with anxiety in the past, feeling confident is something relatively new for me. I tend to be more fearful them some staff members and less fearful then others.

The biggest issue seems to be in the drunk tank. As staff, we have the option of giving detainees water, or not. I rarely, rarely do, this is not my issue. The first issue seems to come in the way we wake people up. Generally, we're supposed to bang on people's doors and scream. I have a hard time with this, because sometimes everyone else is FINALLY quiet, I don't want to set it all off. I'd rather open the door, lean in, and speak loudly. If they don't wake up, then I have to "kick" them (shake gently with foot while holding door). I NEVER let go of the door, I never bend over and use a hand unless someone else is present. I'm CAREFUL.

My biggest issue seems to be however, when a client is having a medical or psychological emergency. I like to right in there with them. If the person is having a hard time breathing, I want to be in there rubbing their back and monitoring breathing. I want to be ready to perform CPR if necessary. If a client is having a panic attack, I want to be in there, looking into their eyes helping them ground themselves and breath through it. I've had panic attacks, and they're freaking scary. This, is where I get myself in trouble though. My instinct is to reassure and protect, and I tend to forget about MY safety.

Unfortunately, my supervisor's right. I need to be more careful, and I'm glad he's willing to reprimand me. See the thing is, I trust him, and I trust his judgment, he's very discerning and perceptive, and he really is trying to help me. He doesn't want to see me hurt, or on leave for PTSD. He's been there WAY longer then me, longer in fact then I've been alive. Of course he knows. He's seen it all before.

And so, goal of the week. Watch myself, and discuss. I love having a supervisor I can actually talk to, even if he's not a social worker. This week I am going to pay attention to my confidence levels, the risks I take, the risks I don't take, and the feedback I get from other staff. It sucks to be wrong, and told you need to change your actions/attitudes, but it's important, and I'm glad I have a supervisor willing to do that.

bad bad day

I had a bad day at work last night. There's no other way to describe it. Yuck. Part of it is that I'm really stressed about packing, cleaning and moving, but part of it is just that last night sucked. I went into it with a really good attitude, but alas... it sucked all the same.

The drunk tank was a gong show. It just never slowed down all evening. At one point we had seven police cars waiting outside. Seriously. Don't they have anything better to do then pick up drunk people?

But the thing I found hardest was a woman who was going through a psychotic episode. Situations had lead to her going off her meds, and here she was, drunk and delusional. She was just freaking out, and my supervisor would NOT let me go into her cell to calm her down and it pissed me off. I was eventually able to calm her down through the window, but seriously. I mean, the poor woman was lying on cement crying and shaking, she's wasn't violent. But, I know he's just trying to protect me.

We called an ambulance, because we couldn't release her to herself in that state, and she'd been there a LONG time. Because it's a mental health crisis though, it's not an "emergency" apparently. We'll, I'm sorry. She was far more in need of intervention then many of the people I call the ambulance for who have physical complaints. This woman was seriously, seriously freaked out and desperately needed help. Bah. It took 40 minutes at least for an ambulance to arrive. I mean, I call for a possibly broken ankle and it comes with sirens blaring (read: not an emergency), and yet for this, they just slowly drive up.

We were also short staffed. TWO people called in. Thankfully a couple people but in a little over time, but we were still short. We'll be short again tonight. I am NOT impressed.

So much more happened, but nothing all that exciting. I just feel very...beaten down. Most of the time I find with my job, but tonight just really wore at me. A lot. sigh.

light as a feather, stiff as a board

For those of you who are my age or a bit older, you probably remember that after the movie the craft came out, people used to try and do the "game" "light as a feather, stiff as a board". Well, an IPDA I had a little while ago reminded me of that, at least the stiff as a board part.

So, in IPDA we do breathing checks every 15 minutes and then wake ups every two hours. It's our death prevention plan. One of the reasons for having a drunk tank is to supervise people coming down off drugs and alcohol and keep them safe. That means checking breathing and rousability.

When I went to wake this IPDA up, I started by banging out the door and shouting their name. No response, fine, that often happens. Open the door and shout, nothing. Shake the person at the hips with my foot, nothing. Kick their feet and shout, nothing. So I get my coworker and he "observes" (makes sure I don't get killed) while I pinch the persons shoulders, nothing. I pinch harder with both hands while shouting, still nothing. Finally I make a fist and rub the persons sternum, still nothing. I rub AS HARD AS A CAN (which is quite hard I do think), nothing. Now consider this, that is a very painful thing to have done. I can inflict pain on myself by rubbing my sternum far less hard with my knuckles (try it, you'll see). My coworker tries the same things; no response.

So, I phone an ambulance (we get to dial direct and skip 911, which is awesome). Emergency services though seems to have this delusion that I can be in two places at once. We phone them at least once every two days, maybe more like once a day, there can't be that many operators, and yet they never seem to realize that if I'm on the phone with them, I'm not with the person because we don't have a cordless phone. I guess they're following a script though... oh well. Anyway, they ask me a million questions so they can fill out their form. And some of them are SO dumb. Bah.

me: "Hi, I'm calling about a person I can't wake up, even with a hard sternal rub, they're breathing okay, but we can't get any sort of response" them: "are they consious?". "are they breathing". Then we have to go through a process of steps which I have to yell to a coworker because our radios aren't working (but that's a different ramble).

Anyway, EMS responds much faster to this then to my stabbing incident on the weekend, and try the same things I have. The fire fighters say they've never seen anything like it (i believe one was a paramedic), then though, the guy tries to put some sort of air way in, and my IPDA's teeth are clenched, apparently, this isn't normal at all, and he lets me no descretly "their faking"... Vitals are all normal, and paramedic dude is getting some sort of painful stimulus response. When the ambulance gets there, they realize the persons faking it too. So they sit them up, person stays sitting up and the paramedic says "if you were unconsious that would be impossible. Get up, and stop it, we'll take you to the hospital.

So they take them to the bench, walking I might add. The IPDA is still really...odd though. Second one in recent history I've had who plays sick and then doesn't want hospital. It's hard to figure out. Most people want the hospital. They beg us to send them for non existant complaints.

I think this particular IPDA was tripping on something weird and was still high. Becuase seriously, it was odd. When I tried to roll them on their back to assess breath they stayed completely stiff. It was the total opposite of an unconsious IPDA who normally is limp. This person was literally stiff as a board...

van patrol!!!

Okay, first of all, I have to say that most of the girls working the streets around my area don't wear boots like that, but that's besides the point I suppose.

Saturday evening/night I worked a double, and it was AWESOME! I got to take a paramedic student out on van patrol (just us, cause we were short staffed) and talk to her about the streets, and addictions, and prostitution and homelessness and it was awesome. Basically we were supposed to just hand out condoms and stuff (through the window) but we wound up stumbling across what we thought was a stabbing!

So anyway, because it was just us two girls, one of them not staff, when we first saw the guy on the street we didn't stop. I thought he was drunk and crying and didn't see any blood. Going back the other way though, some girls flagged us down. And when I say girls, I mean these kids were under 18, out in a BAD area at 2:00AM. So we stopped, and when they said he'd been stabbed we put on gloves and decided to see what was up.

I was right, the guy was pretty heavily intoxicated. At first he wouldn't let the student see his eye, eventually she looked and it didn't look too bad. At first he told us he was 12, and since he was covering his whole face with his shirt it was hard to guess an age. At that point I turned that van back on and radioed base to phone 911 again (the girls said they had). I probably should have radioed when we stopped in the first place though...oops. Anyway, being intoxicated, the story kept changing. Eventually though I got a birth date and name... the guy was 20! I told our student though; maybe he was feeling 12. He was beat up and crying on the street after all.

It took 15+ minutes for any response from emergency services. I was NOT impressed. I mean fine, it's Saturday night, it's busy, but when 911 was called we said a 12 year old had been stabbed...12! Anyway, three cop cars, a fire truck, an ambulance and 2 medical supervisors show up. Talk about over kill. I mean I guess it's a bad neighbourhood, but it made me feel kind of weird that we just hopped out of our van, but the ambulance couldn't come with out police. I feel kind of...reckless? But I didn't feel unsafe...

Anyway, guy should be just fine. All the blood turned out to be from the punches he got in, and his eye was likely just punches. My guess is if he wasn't intoxicated he wouldn't have been so worried about it. It'll probably be black, but that's about it.

So today my supervisor pulls me aside to talk about the incident. "I saw on the report you went a stabbing...". He mentioned that need to get radios that don't need van power to run (YES), and said I did a good job, but I also felt like I was being reprimanded for taking unnecessary risks. I don't know though, I'm not convinced it was a bad situation. There were two of us, and we both felt safe. There were four other girls there, and two across the street. There was no sign of the people who'd done the beating, and there wasn't five minutes before that when we went the other direction. 911 had already been called, and so I kind of expected a quicker response!! I don't know... I do get scared of things, I really do, I'm not reckless, I have limits, I just felt like I was within them. Maybe it's a "you had to be there" type of situation.

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.

Friday (or was it Saturday) night.

So I'm in IPDA (the drunk tank). And it's a Friday (or was it Saturday) night, and it's crazy busy. The police are sitting outside like vultures waiting for us to discharge someone. One comes out the door and in they bounce. IPDA full, IPDA accepting, IPDA full, IPDA accepting etc... There are of course the usual bangers and screamers, the regulars, the "kid" high on E, and the new and different ones. It's Friday (or was it Saturday) night.

We had a woman in from a bachlorette party, never been in the drunk tank before, and just crazy emotional. Alcohol does different things to do different people, many people are quite angry, but she was sobbing and crying and begging us to help her. It was honestly one of the hardest things I've ever had to listen to down there. Anger is so much easier for me to deflect then anguished pleas for help. Anyway, she was kicking her door, crying, screaming, begging etc... and she WOULDN'T go to sleep! I rarely let people out if they haven't slept. But, the police didn't give her a mat, they had to carry her in basically it said on her form, so she was understandably cold. I finally gave in, despite my coworkers complaints of "oh she's just a jerk" and threw a mat in her cell. This puts me at risk, but I'm a softey, what can I say.

Anyway, it's getting close to 9 hours and she's slept some, so I'm ready to discharge her. She's finally calmed down or so I think. And then the screaming and begging starts up again. I'm like "what the heck"? So I investigate, she tells me she's having an asthma attack, and her breathing really is quite screwed up. She has no inhalers in her belongings, and she's not calming down to my verbal reassurances. So, I call an ambulance (yay for direct dial bipassing 911), and then go into her cell to assess her and try and calm her down.

For someone who called me every name in the book that night, she latches onto me like glue and I can't leave, even to waive down the amublance. I tried to stick half my body out the door and she freaked. I'm trying to get her to stop talking and work on breathing instead, so I'm trying to babble so she can't get a word in, but at least use calming words, not random stuff. Nothing's helping and she just keeps begging and pleading with me to help her. I'm usually pretty good at calming people down, but not this, not this at all.

So firefighters get there. Take her vitals etc... she won't let me let go of her, so now I'm trapped in a cell behind two firefighters and their equipment. Can't get out to get her info for them (yay for radios). They put her on oxygen and she "starts" calming down... sort of. Paramedics get there. Thank goodness. Super nice paramedic. I really need to write a thank you card. She was awesome. Turns out, my IPDA is having an anxiety attack (which makes total sense). It takes me and the nice paramedic a LONG time, but we get her calmed down. She's breathing fine, her lungs sound fine. The paramedics are going to leave and I'll discharge her when we all discover, her ankle is broken/sprained and very swollen. So she winds up getting an ambulance ride to the hospital after all, probably freaking out all the way. Poor woman.

So that took up half an hour when I should have been doing discharges. Because I was trapped, and because we really are supposed to stay with them while the paramedics are there. It's just that we were short staffed, and yeah, usually they take them right away, not so much figuring things out. Oh, and did I mention the paramedics left ALL their garbage around for me to clean up? Oh well. I really do want to send a thank you note to the one who was so awesome... I just have to figure out how!

ethics part one

I think I've mentioned this before. I work and volunteer in the same area of town with the same population. I always knew it would be a challenge, but now it's getting really confusing. Maybe it's a horrible idea, but I'm just not sure I can give up my volunteer work.

Today's case study. I recently dealt with my first seizure at work. People seize all the time. They're coming off and on a bazillion different drugs (both prescription and non) and many of them do have seizure disorders. I will see this a lot, it just so happened that this was the first time. The guy had two five minute long seizures. That's a lot, and long. Anyway, a family member of his was watching, saw the whole thing and was upset. I didn't have long to talk to her, because I was going out on van patrol and had to document and do other stuff. I made sure she was okay, told her she could come talk to us, but really, didn't have a lot of time for her... and I felt bad.

Of course I tell my best friend about my experience. I need to debrief the situation cause the paramedics were kind of cruel and there was a lot of intensity to the situation. The people in the shelter are sort of like a family in many cases.

Then comes street ministry. I have an opportunity to sit down and have a long chat with this family member. A much more in-depth one then I had the chance to at work. It's a great conversation.

Now, here's the ethical part. My best friend is also a team leader at Street Ministry. We generally tell each other - and the rest of the team in debrief - most of what the clients say. We keep each other updated etc... So, I tell her about our conversation. It's only natural. Then PHIA comes up, and the privacy act. I mean, she talked about it on our street ministry property, but I witnessed it on work property. See how it starts to get confusing? It's not like I told my friend the name of the person who had the seizure, she doesn't even know the last name of the women I was talking to. And the fact of the matter is, I've known her far longer at street ministry then at work, but we only started to have a deeper relationship after I started working.
So I'm going to puzzle this one out. There are many more situations, which I'll get to. Writing helps me sort things out in my head. I'm not sure what the answer is, but I'll be doing some reading and some advice seeking in the near future.

trainee, trainee

This, is a testosterone model. Why is it in my blog you ask? Well, because I've decided I love it. Sounds strange? Let me explain. I worked evenings tonight, and I was the only girl on shift; there was a woman doing Main Stay, but that's in the other building so we never saw her. Six guys, and me. I thought it might be awkward, but it was wonderful! There was almost NO gossiping! Everything was so much more laid back and there was none of that catty infighting that happens on day shift.

Unfortunately, there was a lot of talk about an incident that happened last night in IPDA. When the staff was doing checks, they found a non responsive individual. They had to do CPR while waiting for the ambulance, and the man is in critical condition; it's almost for sure that he is going to die. The man is a regular, and so the staff were hit pretty hard. It's going to be hard working here I think. There seems to be a lot of these critical incidents.

Tonight was my first evening doing shelter. As usual, it's full of it's usual paper work, not as much as IPDA though, thank goodness. I have to speak to each person individually on the intercom (once I know all their names it will be easier). Then I put them in the computer to make sure they're not barred and there are no concerns. They may need searching, in which case if they're male, I have to get a male staff to do that. We're just looking for inhalants or non potable alcohol (hair spray, mouthwash etc...). Then they have to sign a form for Employment and Income Assistance (EIA) which is I guess where we get part of our funding from.

Because we're a small shelter, we almost have to encourage people not to use our services. We completely max out at 60 people, which is really not a lot of "beds" (mats) in the grand scheme of things. We look at the record of the last time a person was in our shelter and if they haven't been in a while we need to ask where they've been staying. If they have anywhere else to say we really need to encourage them to stay there. I drew the line tonight though when a man, who was intoxicated, said his girlfriend kicked him out. My trainer was encouraging him to go back there and I wouldn't agree with that. Without knowing the story, my gut instinct is to protect his girlfriend. If I had kicked my boyfriend out, I sure wouldn't want him coming back and saying "the shelter told me you had to let me in". I shared that with the testosterone team and they let him in.

I got to do first aid tonight, which for whatever reason, I love doing. The guy had this really gross elbow scrape/cut thing going on. It looked like it might be getting infected, so I covered it with polysporin and then bandaged the whole thing up. This guy must have been totally intoxicated though because while I was waiting for one of the other staff to cut some tape for me he set his arm down on top of my hand, I could feel his bone digging into my finger tips and thought for sure it must hurt. I asked him though, and he just looked a me, same with when I put the polysporin on. I got compliments on my bandaging from one of the staff, yay.

It's interesting, because another one of the staff asked me tonight if I'd ever thought about going into nursing. Interesting, because I have, a lot. But, at this point in my life, it just doesn't make sense to start school all over again. It doesn't. And if I keep doing a job like this I'll wind up doing a lot of first aid stuff anyway and hopefully that will satisfy that medical itch. We'll see. If I could do it all over again I'd go into psych nursing in a second. But, I really do like what I do, and I don't intend to quit anytime soon!