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TerpGal02 TerpGal02 (Member)

Not so sure about psych anymore

Psychiatric   (1,489 Views 7 Comments)
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I have been working in psych for 6 1/2 years now, my entire nursing career. I knew I wanted to work in psych my first day of psych clinical in nursing school. I have seen it all as far as psych goes. Children, adolescents, adults, geri patients, psychosis, mania, depression anxiety, personality disorders, self injury, acute detox.......seen it all. I am currently working with adults on an ACT (Assertive Community Treatment) team. We provide services to clients wherever they are, be it a homeless shelter, their home, etc. In February, I was assaulted by a male client while I was in his home. He was intoxicated at the time. He grabbed me repeatedly and kissed me. Thank God it didn't go any further than that, but on its own was pretty traumatic. I filed charged against him and we went to court. He been in jail for a little over 2 months and got time served. He ended up spending more time in jail for other reasons and just got out recently. My team is continuing to serve this person.

I thought I was doing ok as far as coping, until he got out. I am not expected to complete visits with him at all but he is in the office frequently, I have to see him, at times I have had to speak with him (briefly) on the phone. I am having a really hard time with all of this. I am terrified half the time to go in to the office for hear he will be there. If I see him or even really hear his voice, I am immediately in panic mode. My co workers do their best to run interference but it is still hard. Based on this and my many other experiences working in our very broken mental health system, I don't really feel good about what I'm doing anymore and am thinking about changing specialties. Has anyone on here ever done this? I am worried I have pigeonholed myself.

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This is a very tough situation to be in. Have you been able to have a stress debriefing and counseling to address what seems like PTSD. It is not good to live in fear and as this was a work related incident your counseling should be covered by Workman's comp.

A critical incident stress debriefing is an important part of the healing process. Weather you stay with your current employer or not you owe it to yourself to seek out care and treatment.

In 2017 my sister was attending the Highway 91 concert in Las Vegas and saw someone shot and killed less than ten feet from where she was standing. She started to have a great deal of difficulty following that incident and asked me what I thought. I gave her the name of a psychologist who did these kind of debriefings and she was able to discuss and process all her feelings about the incident.

If your work won't provide the debriefing, please seek out someone who can provide it.

Hppy

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Has anyone on here ever done this? I am worried I have pigeonholed myself.

My heart truly goes out to you, TerpGal. Having read many of your posts over the years, I get the sense that you're a competent, caring professional.

I was stabbed in the back with a pair of scissors back in 1998 by a patient in the community that I was seeing through an ACT program and experienced PTSD symptoms. I sought services through an art therapist for six months and it changed my life.

Learning how to forgive, art, and exercise allowed me to transcend the psyche pain and and, I believe, changed my consciousness.

I could go on for volumes, but just let me say that I am your virtual supporter in any way you choose- through this forum, PM, etc.

The very very best to you, TerpGal. You are in my thoughts.

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I thought I was doing ok as far as coping, until he got out. I am not expected to complete visits with him at all but he is in the office frequently, I have to see him, at times I have had to speak with him (briefly) on the phone. I am having a really hard time with all of this. I am terrified half the time to go in to the office for hear he will be there. If I see him or even really hear his voice, I am immediately in panic mode. My co workers do their best to run interference but it is still hard. Based on this and my many other experiences working in our very broken mental health system, I don't really feel good about what I'm doing anymore and am thinking about changing specialties. Has anyone on here ever done this? I am worried I have pigeonholed myself.

I wanted to reply more to your thread as time allowed, Terpgal, and give you more information that is my wish will be helpful to you.

After the stabbing incident, some time off and subsequent therapy, I found that I, as you mentioned, didn't feel good about what I was doing: working as the community nurse in the ACT program.

I put in for a transfer to the mental health clinic's inpatient program. To make a long story short, let me just say that the clinic's administration dragged their feet, I confronted two ACT administrators on their behavior, was suspended with pay, met with the administrator of the clinic, and was given a position as an inpatient nurse.

I worked at that clinic for an additional three years, was unjustly terminated, and segued into an administrative position at another clinic. There, I had to work with the patient who had stabbed me after he was released from a two year stint at a maximum security forensic facility.

Unlike your situation, I loved this patient who had stabbed me. In his delusional state, he believed that we were both actors in a movie and the director told him he had to stab me. The patient told a psychiatrist something like, "I didn't want to do it, but the director said I had to".

When I met with the patient at the other mental health clinic, I believe he tried his best to apologize, saying something like, "Doc (he always called me 'doc' ever after I had informed him several times that I was a nurse), I'm sorry about that thing. You know."

What I wish to convey to you, Terpgal, is that even though I no longer wanted to work in the ACT program, other doors in psych, (albeit some hit me in the behind on my way out) opened for me.

I discharged my last medical client in home health in 1996, have continued to work in psych for over 20 years, and have not regretted it.

I hope the same positive experience for you,TerpGal. I believe you have been an asset to this field of nursing.

Whatever you decide, Godspeed on your journey!

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That is egregious! This individual committed a crime against you. While the team may elect to continue to treat him, he should be precluded from coming to the office or approaching anyone who is not directly involved in his care. Your employer is not providing you a safe environment. I suggest you contact legal representation to determine your options, such as obtaining a restraining order and to clarify your employer's legal obligations regarding its staff.

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I would RUN, not walk, away from this employer. It's not worth it. I'd probably move more into an outpatient community health type of setting if I were you. I'm so sorry this happened and he really, really deserved more time in my opinion. I wish you well moving on from this.

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Thanks all! Yes, I have been in therapy for this incident and am now going through EMDR. This individual basically has to come to the office as we will no longer see him in his home if 2 people can't go. He has a long history of violence when intoxicated. The reason I keep hearing that we have to keep him is that the county mental health authority will not allow us to drop him. I was never given a debriefing. A co worker came to court but she was primarily there to support him and give info on our program to the judge. In fact, she didnt know that it was my case she was showing up for until she saw me at court. She was pretty upset that no one told her beforehand. One of the directors at my agency was trying to find me another position in the agency but she resigned. Our agency as a whole is great, it's the leadership of our team that is the problem. The directors did not know about this until almostn2 months later and supervisors are expected to notify them immediately in incidents like this. This has all been handled pretty horribly IMO. I just worry that this level of anxiety and frankly I am worried that I am experiencing some symptoms of dissociation is really negatively impacting my work in general. I dont know what else to say. I was never really offered any time off and I had no idea that my therapy could or should be covered under workers comp. My insurance has no copay for therapy so I haven't even thought about it. But thanks for the well wishes all.

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