Divine Intervention

It was strangely quiet and dark when I woke up this morning. There was no hum from the heat and the digital clock sat there dark and purposeless, in stony silence, its annoying red numbers vanished. The cats were curled around my legs and we were all more than cold. Soon we reasoned the electricity must have gone off about five a.m. hmmm...Maybe there would be no hot water, no stove, no computer. How lovely! It would be a good excuse to settle back under the covers. After all, I had been waiting for my day of rest to arrive. And a lovely morning of rest it was, that is until I started craving my usual cup of something hot to drink. It was an indecent hour to get up by the time I finally did. I stretched and put on enough makeup so as not to scare anyone, and looking for electric lights shining through neighboring windows, I drove to the nearest Starbucks. "One tall hot green tea, please." The cheery girlish voice offered me three kinds and I chose the green ginger. It was tasty and stayed piping hot through the bank drive thru and to Costco for gas ($2.77). When I got back home - confound it ! - I saw that Duke Energy had responsibly been on the job. But I do appreciate the restful morning.

A Nursing Art

I like to tell my students the best thing to give to your patients is yourself. It is not about giving time - time can be in short supply during a shift - but more about how we use the time we do have. It is in the way we use our eyes and the tone of our voice, the intensity with which we listen, nods of our heads, and words of reassurance; basically letting them know we care. Yesterday we talked about "unconditional positive regard," a term Carl Rogers gets credit for. I believe it lays a foundation for the nurse-patient relationship by eliminating judgment and offers an unstated confidence in our patients, helping them to recover from whatever is ailing them, mental or physical. It is always good to have someone to believe in you! Sure there are people we see over and over again because they have learned how to manipulate the health care system, who do not take care of themselves, and we are tempted to criticize. Why can't they be perfect like us, we ask. But much of our work is the personal philosophies and attitudes that people read in us and not simply tasks. When we work to develop unconditional positive regard and are able give it to our patients, we sometimes give it to ourselves, too.

Mixed Nuts

Those who read and watch the news - please don't forget the entertainment section - are aware of people who are suspected of committing crimes or have extreme opinions or who seem to be going bonkers. They are fodder for attention grabbing headlines and conversation even among strangers. What were they thinking, our inquisitive minds want to know! My nursing students, who today were finishing their psych nursing rotation, and I had a discussion about these newsmakers and tried to identify the various psychiatric disorders they possibly have. We talked about antisocial personality (at one time called psychopath), exhibitionism (a paraphilia), bipolar type 1, depression, borderline personality disorder, pedophilia, narcissism, suicidal gestures, gender identity disturbances and anorexia nervosa. Even though the label of the mental illness or problem isn't mentioned, the symptoms make the news especially when well known people exhibit them. And no doubt to the delight of the competing networks. I have noticed that there is not a big a focus when a celebrity has a medical illness - say a urinary tract infection - but let one of them act out psychiatrically and the world knows about it. Common folk and celebrities alike suffer from problems with their feelings, thoughts and behaviors, but the average person is more likely to get help. People who care notice something is wrong and may try to intervene. And charming average Joe turns out to be a wife killer and will eventually get his due. But pity the poor rich celebrities. They have too many people who rely on the income they generate, and they are less likely to be honestly confronted and as a result, treated. Psychiatry. It is all around us.

Sweet pleasures

It starts every year before Halloween. Bags of chocolates all decked out in seasonal dress woo me at store entrances. I resist for a while - I have trained myself to wait until October 30 - but then I succumb. Deliciously. Oh...to be one of those people who calmly says, "I don't care for sweets," or "I like chocolate but it doesn't like me." That must be both wonderful and horrible. But the Christmas shopping season has officially begun and the relentless, gaudy advertising flyers are out. Responding to a beguiling ad for Hershey Kisses in Sunday's paper that claimed "assorted varieties, buy one get one free," I whipped into CVS on my way home from work yesterday. How nice it would be to have some in my candy jar or to creatively add them to an edible gift, I reasoned. So I bought bags of kisses that were called candy cane, peanut butter, cherry cordials, and mint truffle. I could hardly wait until I got home to see which would be my favorite. I cut a bag open and the aroma of mint excited my senses. I shook one into my hand, peeled off the shiny green foil and stripped the kiss of its last shred of decency. Exposed at last, I popped the luscious little candy in my mouth. Life is short. Eat chocolate.

Psychiatry

The intriguing word psychiatry is more and more often being with replaced with the insipid term behavioral health. Why I ask! Does it have a more warm and fuzzy ring to it and conjure up fewer pictures of crazed maniacs being chained to walls? I am guessing it is not a way of presenting a kinder, gentler image to the public, but has something to do with money. It is, after all, part of the medical business. It is only a guess. I am not a decision maker and wasn't consulted on the matter. I just know I don't like it. Behavior is only a piece, a result of thoughts, experiences, feelings. I have loved psychiatry. Psychiatry was the first big word I learned to spell. As I got a little older, I used to look it up and read and reread about it in the old Collier's Encyclopedias we had at home. The brain was also a fascination. It was mysterious, not like the heart that you could see at work, but a convoluted mass of gray grooves that just sat there underneath the skull, directing all of man's thoughts and movements. Psychology was much less compelling, I thought. From my parents I learned to find all people interesting. Thanks to a series of misadventures in my life, and perhaps destiny, I ended up working in psychiatry - as a nurse. It is enough for me. I aspire to no greater employment except perhaps to share my experiences on what I have learned about life. Although there have been more frustrations than hairs on my head - and not with the patients - I have persevered. There have been enough personally incredible moments to keep me in psychiatry.