Christmas Thoughts

I am not sure if I have thoughts this Christmas or not. In fact, in some ways, I'm really just kind of numb. I'm plugging along though, one day at a time, I just wonder if I'm being true to myself and letting myself grieve, or if I'm living in a state of constant denial. In some ways, I feel kind of blocked, like there are parts of myself that need to open, and face the feelings, face the emotions, face the realities.

Last night I went to Christmas Eve service at my dad and sister's church. I haven't been in that church since the funeral, and the time before that was also not the most pleasant experience. I was confronted with so many people who knew my mother, so many more then were at the funeral, and I left as soon as I possible good. I played the piano for the 11 PM service at my church, it felt good to be there, even if I did continually psych myself out on nearly every introduction. I wish it had been the whole worship team rather then just me up there.

This morning it was off to my dad and sister's house for awkward good times of my sister acting like a child, me defending my dad from her and dad and I planning our September vacation to the place where my parent's honeymooned. Then Christmas dinner at a family friend's, where I met a nice single man who seemed to meet most of my "criteria". My poor father was incredibly hung up on the fact that he was of a different skin colour and couldn't stop asking about his culture even though he was born and raised in Canada. My sister kept bringing up my cats, revealing just how crazy a cat person I was, which is NOT something I generally do when I'm trying to "flirt", or even just appear normal.

Then it was home to listen to my dad and sister wrap their presents, because apparently they don't plan ahead. Then opening presents, including some presents from mom which she bought before she died. That was hard. I left soon after, before 5:30 and then realized I had an entire evening to myself and NOTHING was open and NO-ONE was around to hang out with. I tried to drive and look at some Christmas lights, but I couldn't remember where we used to drive and didn't see many good ones before giving up and going home.

I went for a walk later, too cold to be out for too long though. Sophie Cat and I had snuggles, as did Ollie and I, and now, now it's bedtime I guess.

The first Christmas is over.

taking a vacation

WestJet is by far my favourite airline, and in just 45 short days I will be taking a plane, just like the one pictured, to go see one of my very best friends. I can't tell you how excited I am. The catch? I've never met her before. So, how are we such good friends? Well it all started five years ago when I was young and angsty... (And now it's time for story time with Still Dreaming).

Back in first year university, my life was pretty screwed up. I was living in residence and spending much of my time with two pretty disfunctional older woman at the non-profit I was involved in. Of course, being at Bible College, things got pretty touchy feely one night and I was all like "i cut myself" and yada, yada, yada... No alcohol involved in my "confession" either. So then we made this convenant to tell people and blah, blah, blah, I told these two women (okay, this is turning into a horrible story). The point is, that since we couldn't find a face to face support group they suggested I look online. And I found this awesome support forum.

This forum was my "everything" for a really long time. I couldn't go for very long without looking at it. And as I spent more time on it, I began to make friends. Good friends. Of course then came holidays and birthdays and we would even exchange letters and cards. And some of the friendships I developed way back then I still have today. Including the friendship I have with the person I'm going to see. I seriously can't imagine my life without her. She knows just about everything there is to know about me.

What I found interesting, while reading the message boards, was the number of teenagers on it who reported that their therapists didn't want them being a part of the community. Now, I understand a therapists hesitation. The internet can be WAY out there, and I think we more commonly think of websites encouraging disordered behaviour such as "pro-ana" websites. It's important however not to put things in boxes and label them as good or bad. Some websites are good for some people and some aren't. Whatever helps the person, and finds them support should be encouraged, not restricted.

Another common assumption is that "online" relationships aren't as meaningful or valuable as "real life" relationships. This is something I both agree and disagree with. I love my "real life" friends, or perhaps I should say, the friends in my city, but I also have great relationships with friends who've moved away or I've met in other places. And very honestly, my online relationships are just as "real" to me. Maybe it's a generation thing, but it doesn't bother me that I haven't met them.

So in anycase, I'm super excited to be taking some holidays to spend with an amazing friend! I'm counting down the days :D

What brings you here today?

One of the questions I like to ask when I'm doing an intake, an assessment, or now, a first counseling session, is "what brings you here today, what was different about today that made you decide to come in".  What I'm trying to
get at is the motivation for change, was it a sudden revelation or was it a long time coming?  Sure, you may have been thinking about seeing a counselor
for a long time, but what changed that you picked up the phone today, because something did.

What I've discovered, is that people seem to have a really hard time answering that question.  When I was doing detox intakes it was often "well, I'm drinking too much" or "my worker made me".  Well, those are decent reason, but what prompted you to walk in our door, what was that mental process, it's not an easy thing to do after all.  Perhaps you said to yourself, "enough is enough, I'm ready for this" or something similar.

Now, I'm getting transfer clients to build my caseload.  Basically, not everyone in the program is required to attend counseling, but they are able to access it when they need it.  Often they spend more time working with the job people and the employment support people.  So, I'm getting clients who are partway through the program but are looking for counseling now.  This is good.  BUT they seem to also have a very hard time.  What brings you here today.  The answer I usually get, is "life issues".  Well yes, but you've been thinking about this particular thing for a while, what was the thing that pushed you to make that call?

Thinking from the clients perspective though, it's a hard question.  What was that thing that made you do it.  I know when I first chose to get counseling, I found it really hard.  Making that call was agonizing.  I purposely planned it so that I would be leaving a voicemail rather then having to talk to a live person.  I stood there in the kitchen with the cordless phone in my hand deciding whether to dial.  But, I had a good reason for why that day out of other days, it came the day after I felt I had been intensely betrayed by two people I trusted a great deal.  That was what pushed me over the edge.

Change is a hard process and I really believe that it's important to be aware of our motivations for change.  Why are we doing what we do.  It's a lot easier to stick to your plan if you understand the reason things came about in the first place.  Further, it helps us understand ourselves better when we're aware of our motivations and the reasons we do things, even if it's things we learn in retrospect.

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.  

leap frog...or something

My last post about finding a person passed out in the snow reminded me of another story, a kind of weird and slightly embarrassing one.  This happened a while ago, but I don't think I ever got around to posting it.  

A coworker and I are driving around on van patrol one night when we come across a person passed out in the snow.  We'd scene this guy earlier in the evening wandering around seeming intoxicated but he had denied our help and since he was conscious, walking and not creating a disturbance there wasn't really anything we could do.  

Of course we do the usual things and try and wake this person up.  We get nothing, so I do the whole 911 thing, or maybe he did, anyway, we call an ambulance and continue our efforts to get the man to wake up and come into the van where it's warm.  Because we'd seen him not that long ago we knew he hadn't been down all that long and we were kind of hoping we could just take him back to the shelter (this before we had to call 911 of course).  

My coworker says the guy is coming around a little and so we try many things to try and get him to get up, or at least get his face out of the snow so it doesn't freeze.  Finally we just stick something under it as he is just not moving...for anything.  Then the ambulance gets there.  The paramedic says to him "get up, come in the warm ambulance".  The guy then LEAPS up, stumbles, and then walks with the paramedics.  It was seriously embarrassing, we looked pathetic with our "unresponsive" guy positively leaping up!  He was definitely on some weird drugs or something, because that is just not normal.  

Much as we love our clients the next time I called an ambulance for an unresponsive client part of me was praying they'd stay that way...at least till they got to the ambulance!  

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...

van patrol and coffee runs

Last night was my first time doing van patrol. I really LOVE doing Street Patrols in my volunteer work with the Salvation Army so I was super excited to get to do it for my job! While we do it on foot Friday nights, my work uses a van, this means we can go a whole lot further, carry more stuff, stay warmer (and out longer), and take two people instead of four. There's great opportunities on foot though that you don't get in the van.

Part of doing van patrol means picking up a food a local 7/11 donates to us and doing coffee runs for the staff. Going through the Tim Horton's drive through not once, but twice seems to be a common occurrence.

The important part of van patrol however is driving through the back lanes, down local streets where prostitution is common and just keeping the area as safe as possible. It was raining and cold yesterday, so thankfully we didn't see a lot of people on the street. It's hard to know where the homeless go, but they mostly, they find somewhere. Unfortunately, this often means a lot of drug use as people are able to crash at crack houses and such.

The one thing we did do was drive a young woman who was prostituting home. As we drove down the street we called out to each one just checking to make sure they were okay and didn't need anything. This way if they're being watched by someone they won't get hurt later for being interfered with. The last one we talked to said she was going home and accepted our offer of a ride. We didn't push anything on her, just asked her if she knew about local resources; she did. The person with me said she seemed very new at working the streets, and she really did. It's sad, that this is what she has to do, for whatever reason.

After that we got a call to pick up someone at the hospital. We have a relationship with a couple local hospital emergency rooms to do trips for them. It's not an official policy relationship or anything, just an agreement with the ER nurses. The nurses are able to call us when they have a patient they know has no way to get home and is marginalized and vulnerable. They don't overuse us, and so we're happy to do it. They do A LOT for our clients, it's the least we can do for them. Yesterday we drove a woman younger then me, who seemed A LOT younger, to a downtown hotel. She had been medevaced from up north for a possible spinal injury which turned out negative. She had no idea how she was getting back to where her mom was staying (the hotel), let alone back up north, so the nurses called us.

Driving people around can sometimes seem like a waste of resources, but I'm sure for the two women we helped last night, it meant a lot.

first night shift

Well, I'm off to Starbucks for a Carmel Machiato and then off to work to work my first overnight shift! It'll be interesting to see how it goes...

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!

Really, I can do this laundry

Tonight was my first evening shift, and my first time working in our "Chemical Detoxification Unit" (Detox). It was...interesting, to say the least. The work itself is easy and fairly self explanatory complete with it's multiple redundant sets of paper. The staff I worked with tonight though...not sure I really quite fit in with them...

Detox is a fairly basis service. We're none medical detox, which means we don't have any medical professionals on staff and anyone who needs medical supervision has to detox at the hospital, not with us. We do accept people with a wide variety of disorders and on a wide variety of meds though.

Clients make appointments for intakes through our front desk. We usually do four a day (based on the number of beds available and expected discharges). The clients much be medically cleared and have all their current medications with them, in the correct bottles and on their medical clearance forms. Clients usually enter within 24 hours of their inquiry, space and forms permitting. If there's something wonky with their meds, we can't let them in. Clients fill out and intake form which gets brought to their intake interview.

As a crisis worker I get to do intakes. We have a form to fill out (as I said, the job is very self explanatory), and then we take their vital signs, search their stuff and go over the rules. The person I was with tonight did what I would consider to be a bare bones intake. I mean, it was pretty basic and if I was the client I would not have felt heard or understood. But, each staff has their own style. The other staff I was with tonight did a really long intake; I wasn't in with her though, so I can't judge the clients feelings. We get the final decision, based on this interview, about whether the client gets to come in our not.

The detox area is made up of three dormitories. There are 15 mens beds (all in one room), 6 women's beds and 4 "assessment" beds. These beds can be used as extra women's beds (or extra mens) or for people with special needs of some sort. My orientation day they were using that room for a couple people with seizure disorders so they could keep an eye on them. The clients have to attend to groups a day, one is a group run by the transition team and one is either AA/CA/NA (I think there's a couple days when there's two 12 step meetings...I'm not sure). Other than that though, their time is theirs. There's a couple computers, a TV, and tons of board games, and a lot of people sleep, especially at the beginning.

Each crisis worker gets half the files and is responsible to check in with those clients. We don't need to do much, just make sure they're doing okay and see if there's any pressing concerns. One cw is in charge of meds and gets the keys to the med cabinet, they're held responsible if anythings missing at the end of shift. (The shift coordinators have to count all narcotics and mood altering drugs at the end/beginning of each shift). The other cw does laundry; fun, fun...

The best thing perhaps, is that they drive you home at the end of the evening shift because it doesn't end till 12 or should I say 2400 hours. That was REALLY nice at the end of the day!

First Day of Training

My orientation went well enough yesterday...kind of boring, lots of PHIA stuff I already knew. I started training today. Seriously, whose idea was it to start shift at 7:30. I realize that's common, but argh, I am just so not good with mornings. Tomorrow I'm on evenings and the back on days for Saturday. We'll see how things go I guess.

I spent all of today in the Intoxicated Persons Detention Area (IPDA) aka the city's "drunk tank". IPDA was...interesting. I'm not sure how I feel about it. It raises some ethical issues for me in a way, but not. I understand the reason for it and seeing the people that were brought in today I totally understand the way it is the way it is. It is just hard to see in someways.

Basically my role in IPDA is to process intakes and discharges and make sure no one dies. The intake process is far too complex and sure there are many ways it could be made more efficient, but alas, who has time for that? This is generally how it works, except when we get behind.

1. The police or downtown watch (BIZ) bring in an intoxicated person picked up for causing a disturbance or being a danger to self/others (ie blindly stumbling across the road). They bring this person to us.

2. While the officers strip the person of all possessions and everything but one layer of clothes, I try to establish their name, medical conditions, medications and current intoxicant. Sometimes this is aided by police or they're frequent customers. Once I have their name I can search them in the data base and get some of the medical stuff as well.

3. I choose a cell. Some have cameras and some don't. We save the cameras for people with seizures, other severe medical issues or who are especially upset or combative. The officers pat down the client and make sure they have nothing, and then escort them to the cell which automatically locks.

4. I make an itemized list of all their possessions and count the money etc... we make note of every last scrap of paper "personal papers". I also get the details of the incident, where they were picked up, the unit numbers of the officers and the incident number. Then the officers have to sign off. They get a receipt for the client they brought in.

5. I fill out the rest of this form which indicates all the medical details, birthday, condition on arrival etc... Then I enter it all into the computer as well.

6. I fill out a form for "punches" (not nearly as physical as it sounds).

7. Then I fill out the log which basically repeats information I've already put in two or three places. There is nothing new on it.

8. Then I add the client to my cell map so I know what time they were in and who is where so I can easily tell the officers where to put new people.

9. Somewhere in this process I store the clients stuff in a locker which corresponds to their cell number. Rubber gloves and plastic bags are of the essence. If they have more then 20$ I have to do another whole form and get the shift coordinator to sign it. The money goes in an envelope in the safe.

And that, is intake.

Now while this is all going on, I also have to be doing "punches". We have a time clock at the very back and we have to turn the key every 15 minutes. We also have to check and make sure every person is breathing. We look for chest movement or listen for breathing through the window...it's not as hard as I thought it would be. Then we have to fill in their form with whether they're awake or sleeping, if there's any movement and our employee number. Every two hours we have to wake them up...bang on the door, shout, whatever it takes.

And lastly, we have to keep discharging people when they sober up. The minimum stay is 4 hours and the max is 24. Most people are in for 8 or less. It can depend what they're on though, and today we had a guy in for 12 cause he kept refusing to go...he wanted to sleep! To discharge them we just talk to them, ask them a few questions, try and figure out if they're sober enough to go. Then we have to walk them out, offer them a phone call, get them to sign a form (two if its night time) and then give them their stuff back. Then we have to fill out a bunch more paperwork in five places. PLUS a cleaning sheet.

After a person leaves, we have to clean, although it's good to let it air out for a while... Then we have to mop, refill the toilet paper, scrub the mat and prop the door open to air. And then of course, fill out some more paperwork! But, don't get too caught up in cleaning, or you'll forget to do punches! I need to buy a watch w/ timer asap, and some closed toed crocs.

So that was my first day. I had a great trainer who was easy to talk to so things weren't awkward there. I got free lunch, gotta love donations. And I got PAID! Such a differences from paying to do practicum.

Tomorrow is job interview at the church, meeting with my best friend and then working 3:30-midnight...so we'll see how things go!