WEBVTT
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00:00:41.760Night shift darkness diagnosed i have a different co-host here it's not it's
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00:00:47.580not julie she's still very busy doing life and school and stuff like that so
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00:00:54.360i have my my dear dear friend your boyfriend my boyfriend your husband my husband.
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00:01:01.440All the things hi guys my name is kevin in so
00:01:01.440 -->
00:01:06.020kevin and i we've worked together since 2015 so
00:01:06.020 -->
00:01:08.860a long long time we definitely worked
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00:01:13.120for a very long time we've worked together for 11 years in psych specifically
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00:01:18.400so i've done a couple different things throughout my nursing career but i have
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00:01:21.960stuck with psych for 11 years it's been my one specialty that i've never walked
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00:01:26.900away from and is where i met my good friend laurie Julie. Yeah.
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00:01:33.400So yeah, initially you started out as a behavioral health associate.
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00:01:38.300I did. And I don't think a lot of people know this, but I actually became a nurse because of Julie.
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00:01:42.980I was working an overnight shift, right? This is where we all started on overnights.
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00:01:47.140And I remember one day I was saying to Julie, how the admission exam from my
00:01:47.140 -->
00:01:51.680nursing school was the last day to date the exam was like two days from the
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00:01:55.760day I was like talking to Julie about it. And she literally talked me into it.
00:01:55.860 -->
00:01:57.520She was like, you have literally nothing to lose.
00:01:57.640 -->
00:02:00.640She's like, if you take this test and fail, you're exactly where you are right now.
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00:02:03.940If you take this test and pass, then you have decisions to make.
00:02:04.060 -->
00:02:08.980And I pass and fast forward many, many, many, many, many years later,
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00:02:11.560I'm a registered nurse. I'm a supervisor.
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00:02:16.700I supervise at a behavioral health facility. It's a freestanding psych hospital.
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00:02:18.900And I've been there for 11 years.
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00:02:22.460Yes. Yeah. So you and I were both in.
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00:02:29.230Leadership positions right now. And I mean, we kind of started from the bottom, I guess, right?
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00:02:32.710Absolutely. We started from the bottom. Now we here.
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00:02:40.610Yeah, no, we joke about this, but I've done every existing nursing role at my
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00:02:42.070facility other than CNO.
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00:02:44.130That's the only job title I don't have.
00:02:44.510 -->
00:02:47.090I've literally done everything else. I've been a nurse educator,
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00:02:50.210a complexion specialist. I've been a charge nurse, med nurse,
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00:02:53.050admission a nurse. I've done it all. I've been a tech, behavioral tech.
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00:02:55.670I know psych very well.
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00:03:01.510That's awesome. That's great. So I have Kevin on here because I want to ask him some questions.
00:03:01.610 -->
00:03:08.310And for our listeners, they can kind of get some more insight on what it's like
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00:03:14.510for people like Kevin and I and Julie who work in this field.
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00:03:21.150So Kevin, what does a typical day look like? And what do you think your biggest challenges are?
00:03:21.710 -->
00:03:25.170A typical day for me, it's a lot of management. I mean, that's my primary role.
00:03:25.330 -->
00:03:26.530I'm a nursing supervisor.
00:03:26.730 -->
00:03:30.750I'm a day shift supervisor. So a lot of my job is overseeing the nursing task,
00:03:31.130 -->
00:03:34.310making sure that the hospital is running the way it should.
00:03:34.670 -->
00:03:39.170As a nursing supervisor, I'm the bridge that bridges all departments together.
00:03:39.790 -->
00:03:44.290You know, I, a lot of the work that we do is interdisciplinary work.
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00:03:48.110And so we work very closely with social work, OT, we work very closely with
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00:03:50.390the doctors, admission coordinators.
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00:03:55.210That's what my everyday work life looks like. My challenge is,
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00:03:56.850though, you know, I've discussed this before.
00:03:57.608 -->
00:04:00.868One of the biggest challenges as a psych nurse for me is how,
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00:04:04.268like, if a patient has congestive heart failure, right, and they're in the hospital,
00:04:04.348 -->
00:04:08.308they get admitted, those symptoms and side effects, they're pretty much in line
00:04:08.308 -->
00:04:09.268with every other patient.
00:04:09.408 -->
00:04:11.908It doesn't matter your age, population, ethnicity.
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00:04:16.388If you have congestive heart failure, it pretty much looks the same for every patient.
00:04:16.388 -->
00:04:20.388But now when we get into the psych realm of healthcare and we talk about all
00:04:20.388 -->
00:04:24.088these diagnoses that come with psych, so we're talking about bipolar 1,
00:04:24.228 -->
00:04:27.928bipolar 2, major depressive disorder, anxiety disorders, schizophrenia,
00:04:28.188 -->
00:04:29.028schizoaffective disorder,
00:04:29.368 -->
00:04:32.488those people don't all look the same, right?
00:04:32.768 -->
00:04:35.828So you can have 10 patients in front of you with congestive heart failure,
00:04:35.848 -->
00:04:39.128and every single one of those patients are going to have symptoms that look
00:04:39.128 -->
00:04:40.948and mimic what each other has.
00:04:41.028 -->
00:04:46.148And the treatment is very similar. But when you talk about like our psych population
00:04:46.148 -->
00:04:50.748of patients, a schizophrenic patient might have tactile delusions, right?
00:04:50.828 -->
00:04:54.728So they may be feeling something that's happening that isn't necessarily happening.
00:04:54.988 -->
00:04:57.888But our patients who are dealing with auditory hallucinations,
00:04:58.228 -->
00:05:02.248they may be hearing something that isn't necessarily happening.
00:05:02.488 -->
00:05:07.408So the presentation that delusion looks very different depending on the patient. Right.
00:05:07.568 -->
00:05:12.448And so our job is to identify what the delusion is, how to reorient the patient
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00:05:15.508to reality and kind of figure out a treatment plan that works for that.
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00:05:18.948Right. And then like different meds, too. I mean, work differently.
00:05:20.048 -->
00:05:25.348Exactly. I mean, we definitely have like the golden standard of psych meds,
00:05:25.428 -->
00:05:28.068but a lot of it is trial and error. Yes.
00:05:28.468 -->
00:05:32.928And not everybody has the same effect or the same results. I'm one of those
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00:05:36.988unique nurses who does have a background in a lot of different healthcare settings.
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00:05:40.706And one of the most difficult things for me when it comes to psych is,
00:05:40.766 -->
00:05:46.006you know, their med compliance, it doesn't look the same as it would.
00:05:46.246 -->
00:05:48.986If a doctor came and talked to you and said, hey, you have congestive heart
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00:05:51.386failure, you need to take this medicine and this is going to help you.
00:05:51.526 -->
00:05:53.126You take that medicine. Right, right.
00:05:53.326 -->
00:05:55.886A lot of these psych patients, you may reason with them and say,
00:05:55.966 -->
00:05:59.186listen, if you take this medicine, it's going to stop the delusion.
00:06:00.506 -->
00:06:04.046But that component of that med compliance isn't always there.
00:06:04.246 -->
00:06:08.906Exactly. And it's really hard to see these patients go through,
00:06:08.906 -->
00:06:13.546you know, the start to finish because of that med compliant component. Exactly. Exactly.
00:06:14.106 -->
00:06:19.586What is one thing that you know now that you wish you knew prior to starting?
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00:06:27.866One thing I wish I knew now, I mean, you know, when you walk into the world of psych, you,
00:06:28.486 -->
00:06:31.326You may think you know it all, and you really do not.
00:06:31.706 -->
00:06:36.526And I think that one of the funniest and one of the biggest shockers for me
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00:06:38.526was that psych patients, they flirt.
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00:06:43.326Yeah. They don't care. They're like us. They're like any other normal human being.
00:06:43.926 -->
00:06:46.526You know, they see something they like, and then they'll say it.
00:06:46.526 -->
00:06:48.066Well, their inhibitions are a little bit lower.
00:06:48.286 -->
00:06:54.086Their inhibitions are very low. And not just that, but that impulsivity to say,
00:06:54.206 -->
00:06:57.266hey, you shouldn't probably say this, but you say it anyways,
00:06:57.446 -->
00:06:59.706it's gone. It does not exist, right?
00:07:00.206 -->
00:07:03.366Whether it may be because of the medicine or their side effects due to their
00:07:03.366 -->
00:07:07.566diagnosis. It does not matter, though. They flirt. They flirt.
00:07:08.306 -->
00:07:13.086Definitely. Not with me, but I guess with you. What's going on there?
00:07:14.086 -->
00:07:19.306I mean, they flirt. I always say there's two populations of patients that always
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00:07:23.026flirt with me, and it's always a very attractive males who are just completely
00:07:23.026 -->
00:07:28.106psychotic or the older, and they're having all two, right? They're just confused, right?
00:07:28.686 -->
00:07:31.786And I can actually vouch for this because I've worked with Kevin.
00:07:32.266 -->
00:07:36.166It's so true. It is true. They leave their numbers after discharge.
00:07:36.306 -->
00:07:37.486They hope they hear back from me.
00:07:37.706 -->
00:07:40.286It's just like, no. It's like, go home to your wife. Stop it.
00:07:42.566 -->
00:07:46.126But I think that was the biggest shock for me, truthfully, is that,
00:07:46.166 -->
00:07:49.466you know, they, especially for our high functioning patients,
00:07:49.486 -->
00:07:53.006because for people who've never worked in psych, there is a population of people
00:07:53.006 -->
00:07:56.626who are diagnosed with a psych diagnosis and they still operate at a high level.
00:07:56.946 -->
00:07:59.906What do I mean by that? There are everyday nurses, there are doctors,
00:08:00.106 -->
00:08:04.046there's lawyers. We've had lawyers, we've had professors. Teachers. Yep.
00:08:04.514 -->
00:08:08.074All walks of life and they're high functioning because they are my compliant
00:08:08.074 -->
00:08:11.334and they get admitted, you know, because of these acute reasons.
00:08:11.654 -->
00:08:17.294And it's, they operate just like any, any other normal quote unquote human does.
00:08:17.454 -->
00:08:21.274And so I, I honestly think that, that when I first started psych,
00:08:21.494 -->
00:08:25.014that was a shocker for me because it's almost implied that their thought process
00:08:25.014 -->
00:08:28.014or their insight is not where it should be.
00:08:28.154 -->
00:08:31.254But in reality, it's, it's, what is that delusion, what
00:08:31.254 -->
00:08:34.334is the delusion that's causing them to maybe spiral yeah
00:08:34.334 -->
00:08:37.054it's necessarily you know everything else might be aligned with
00:08:37.054 -->
00:08:42.574what is correct for you and i but that that site that one delusion maybe what
00:08:42.574 -->
00:08:49.214is causing them to spiral exactly what advice do you have for someone who is
00:08:49.214 -->
00:08:54.334looking to start a career in this field like someone who has no exposure to
00:08:54.334 -->
00:08:55.954this population and they're like you.
00:08:57.474 -->
00:09:00.654I want to get into this field and I want to, I want to help people. So,
00:09:00.834 -->
00:09:07.634which I think all of us kind of had some idea to some degree of helping people
00:09:07.634 -->
00:09:13.334with mental illness or just emotional struggles or whatever.
00:09:13.534 -->
00:09:16.794And then when you get into it, it's a little bit different. What advice would
00:09:16.794 -->
00:09:22.214you give to someone who maybe thinks that they know what they're getting themselves into,
00:09:22.214 -->
00:09:25.414but they don't well you
00:09:25.414 -->
00:09:28.134know i think it's true when people say
00:09:28.134 -->
00:09:31.134that people who work in psych have some sort of
00:09:31.134 -->
00:09:34.074psych diagnosis themselves right there's
00:09:34.074 -->
00:09:36.794something within your life that has caused you
00:09:36.794 -->
00:09:39.714to reach this point and more often than not it's because you've
00:09:39.714 -->
00:09:43.594lived it yes i think that a lot of times when we walk into this
00:09:43.594 -->
00:09:46.434psych world we are under the impression that
00:09:46.434 -->
00:09:49.074a lot of these people are high functioning people who are
00:09:49.074 -->
00:09:52.174just like you and i right who deal with everyday stressors
00:09:52.174 -->
00:09:55.634of life and maybe one day you're just unable to handle it whether
00:09:55.634 -->
00:09:58.454that maybe you need to call out use a mental health day whatever it is
00:09:58.454 -->
00:10:01.214we are under the impression that that's the way
00:10:01.214 -->
00:10:05.294the world operates right and in reality these psych diagnosis which you and
00:10:05.294 -->
00:10:10.194i we know firsthand is that they are truly limited with their ability to take
00:10:10.194 -->
00:10:15.234care of themselves right and they struggle every day in and out to do the things
00:10:15.234 -->
00:10:18.594that we would normally do without being asked to do, persuade to do.
00:10:18.894 -->
00:10:21.934These aren't things that we find to be difficult, right? Like I wake up every
00:10:21.934 -->
00:10:24.094day and brush my teeth. That's not something that's hard for me.
00:10:24.574 -->
00:10:28.374Some people wake up and they find that to be difficult, that task in itself.
00:10:28.994 -->
00:10:30.554Those are the true struggles.
00:10:31.334 -->
00:10:36.014That's truly the difference between what makes me and our patients,
00:10:36.014 -->
00:10:38.594what differentiates us.
00:10:39.574 -->
00:10:40.514I think that,
00:10:41.090 -->
00:10:47.870Understanding and knowing that no two patients are the same is probably one
00:10:47.870 -->
00:10:51.190of the best advices that I ever got as a nurse.
00:10:51.570 -->
00:10:56.830That and also the ability to build good camaraderie and build a good team, right?
00:10:57.070 -->
00:11:01.050Anywhere you go to work, if you're struggling within your department to find
00:11:01.050 -->
00:11:05.470people to lean on and find people to give you ideas and find people to kind
00:11:05.470 -->
00:11:09.810of push you to keep going forward with your ideas, then that's where you kind of like fall flat.
00:11:09.810 -->
00:11:12.690And you don't you don't ever move. You don't ever go anywhere.
00:11:12.990 -->
00:11:18.310And I think that one of the biggest successors behind my career has been that
00:11:18.310 -->
00:11:24.130I kind of found a place where it kind of aligned with my ideas and my thought processes.
00:11:24.370 -->
00:11:29.230And I was able to kind of park myself and integrate my roots and kind of truly
00:11:29.230 -->
00:11:33.450expand my knowledge and my ability to learn and understand that,
00:11:33.550 -->
00:11:34.690you know, I don't know everything.
00:11:34.690 -->
00:11:37.510Right we all believe that we know everything we know what
00:11:37.510 -->
00:11:40.450mental health is right yeah you and i have dealt with depression so we know
00:11:40.450 -->
00:11:43.530what depression is depression looks very different for different people yeah
00:11:43.530 -->
00:11:46.490i dealt with depression but i didn't stop brushing my teeth
00:11:46.490 -->
00:11:49.310exactly someone else who deals with depression they stop
00:11:49.310 -->
00:11:52.830brushing their hair and brushing their teeth that's just that's that's
00:11:52.830 -->
00:11:55.850their version of what that depression looks like and i
00:11:55.850 -->
00:12:01.610being able to say you know what i understand to be my psych concerns or issues
00:12:01.610 -->
00:12:06.570isn't going to mimic the person next to So basically just like having an open
00:12:06.570 -->
00:12:13.550mind and knowing that every patient that comes into our facility or into,
00:12:13.550 -->
00:12:14.590you know, into treatment,
00:12:14.830 -->
00:12:17.370they do, they, they present differently.
00:12:17.550 -->
00:12:21.310And there's a, there's such a gray, a gray area.
00:12:21.490 -->
00:12:29.490And I think, yeah, like just having an open mind and trying to empathize with
00:12:29.490 -->
00:12:32.410maybe whatever it is that they're, they're going through.
00:12:32.410 -->
00:12:40.530It's like we try so hard to put tools in place and and diagnostics in place to like.
00:12:41.090 -->
00:12:44.750Try to implement a standardized black
00:12:44.750 -->
00:12:48.010and white care and that's just
00:12:48.010 -->
00:12:50.930like it's not realistic right it isn't it isn't
00:12:50.930 -->
00:12:53.850and it goes back to what i was saying earlier how like you know put 10
00:12:53.850 -->
00:12:56.550schizophrenics in front of you your symptoms aren't going
00:12:56.550 -->
00:12:59.270to be aligned with one another one person may
00:12:59.270 -->
00:13:02.470have the illusion of snakes and the other person has the illusion of a murderer right
00:13:02.470 -->
00:13:05.310and it presents it kind of manifests itself in
00:13:05.310 -->
00:13:08.110it in its own way and i think that's the most unique part about
00:13:08.110 -->
00:13:11.590psych is like not only are you identifying well this
00:13:11.590 -->
00:13:14.490delusion that has to do with snakes what type
00:13:14.490 -->
00:13:17.530of delusion is this right right is this delusion triggered
00:13:17.530 -->
00:13:20.390by a tv show that they just saw or
00:13:20.390 -->
00:13:25.390is this uh delusion that was you know presented on on mission right these are
00:13:25.390 -->
00:13:29.790the things that we really have to like look at and kind of divulge and and separate
00:13:29.790 -->
00:13:33.350between what's happening right now what has happened what is going to happen
00:13:33.350 -->
00:13:37.770and not every two people look the same And that's the hardest part.
00:13:37.930 -->
00:13:39.270That is the hardest part.
00:13:39.450 -->
00:13:43.950It is. And like you said, like going back to the ADL care type,
00:13:44.070 -->
00:13:45.850like brushing your teeth and stuff like that.
00:13:45.950 -->
00:13:50.750I mean, for a lot of our patients, some of their delusions, that might just
00:13:50.750 -->
00:13:52.950be baseline for them, you know, that might not go away.
00:13:53.110 -->
00:13:57.610So sometimes just even the brushing the teeth and like looking presentable and
00:13:57.610 -->
00:13:58.710looking clean and stuff like that.
00:13:58.910 -->
00:14:03.150Sometimes that is the best thing we can offer them. And I think sometimes we...
00:14:03.704 -->
00:14:07.904We forget that. I follow a lot of like psych pages and things like that on social
00:14:07.904 -->
00:14:12.924media and reels and things like that to help me better understand and empathize
00:14:12.924 -->
00:14:14.564with the population that we care for.
00:14:14.844 -->
00:14:20.984And I think it definitely helps to kind of keep me out of that box of you have
00:14:20.984 -->
00:14:25.264delusions and we need to fix them or you have depression and we need to fix that.
00:14:25.364 -->
00:14:28.904We kind of almost get jaded, I feel like. You do. sometimes because or
00:14:28.904 -->
00:14:32.004frustrated really is the right word because recently i
00:14:32.004 -->
00:14:34.844dealt with a patient who had a delusion of right right
00:14:34.844 -->
00:14:38.144that she was being raped she was being abused and so my point
00:14:38.144 -->
00:14:41.164of frustration isn't that the patient has this active delusion
00:14:41.164 -->
00:14:44.104it's i don't want her to believe this delusion yeah you know i don't
00:14:44.104 -->
00:14:47.504want her to have to go through her life in the moment it's like just it's offering
00:14:47.504 -->
00:14:50.104them distraction or comfort right you're not
00:14:50.104 -->
00:14:53.204going to clear that delusion in that moment right and you
00:14:53.204 -->
00:14:56.084can't this is a delusion that's been a work in progress over
00:14:56.084 -->
00:14:59.164many years it developed it it developed
00:14:59.164 -->
00:15:02.184because of an event that took place right my job now
00:15:02.184 -->
00:15:05.124is to identify the event identify the delusion
00:15:05.124 -->
00:15:07.804and fix the delusion right so what we do is we
00:15:07.804 -->
00:15:11.264orient to reality that's a majority part of
00:15:11.264 -->
00:15:14.104our job really every day is to show these patients you know the delusion
00:15:14.104 -->
00:15:16.924that you believe i believe i i understand that you believe it
00:15:16.924 -->
00:15:20.104to be true but it's not right exactly exactly
00:15:20.104 -->
00:15:23.064and how do you do that without making them feel like they're
00:15:23.064 -->
00:15:26.184less than or and i think sometimes that's
00:15:26.184 -->
00:15:29.064where maybe some of the health
00:15:29.064 -->
00:15:35.884care our mental health workers maybe kind of maybe miss the the mark a little
00:15:35.884 -->
00:15:41.644bit is like we're so focused on trying to get them into reality and not realizing
00:15:41.644 -->
00:15:46.384that this is their reality this is their reality yeah and it's not as it's just
00:15:46.384 -->
00:15:48.124not as simple to just say hey.
00:15:48.860 -->
00:15:51.840That's not real you know what i mean so and then like
00:15:51.840 -->
00:15:55.500again you're looking at higher functioning people and
00:15:55.500 -->
00:15:58.080maybe they are able to rationalize a little
00:15:58.080 -->
00:16:01.140bit maybe they are and and other people that aren't
00:16:01.140 -->
00:16:06.920like so for instance i actually just saw this reel the other day and it was
00:16:06.920 -->
00:16:13.240a parent talking about his son going in in and out of psych hospitals and how
00:16:13.240 -->
00:16:19.320his son was discharged in the same dirty clothes that he went in with and having
00:16:19.320 -->
00:16:20.560just really poor hygiene.
00:16:20.560 -->
00:16:23.600He basically said to my son, he stunk to high heavens.
00:16:23.860 -->
00:16:28.380But he was acknowledging that the discharge was probably appropriate considering
00:16:28.380 -->
00:16:32.820that he was at his baseline, right? You know, his thought process and all that stuff.
00:16:33.040 -->
00:16:38.880The one thing though that really bothered him was that nobody seemed to focus
00:16:38.880 -->
00:16:44.000on maybe he needs a little bit of help with his clothes and taking a shower.
00:16:44.380 -->
00:16:48.840I think we struggle sometimes, patients who adamantly refuse to take a shower
00:16:48.840 -->
00:16:50.200and take care of their hygiene.
00:16:50.620 -->
00:16:55.000But like for this dad, this parent who was talking about this,
00:16:55.180 -->
00:16:59.560he was just saying, my son isn't someone who would refuse.
00:17:00.380 -->
00:17:04.820He's just someone who needs a little bit of coaxing, a little bit of prompting.
00:17:04.820 -->
00:17:08.580So when I watch things like that, I think to myself, you know what?
00:17:09.120 -->
00:17:14.920Yeah, you're right. I think about all the patients that we discharge and they're a little unkempt.
00:17:15.080 -->
00:17:18.520And what could we have done that's a little bit better? We definitely focus
00:17:18.520 -->
00:17:22.340a lot on independence and you need to be able to take care of yourself.
00:17:22.340 -->
00:17:24.220And that's part of discharge and blah, blah, blah.
00:17:24.440 -->
00:17:30.040And in our facility, at least we don't typically do laundry for the patients.
00:17:30.200 -->
00:17:32.460We encourage them to do their own.
00:17:32.660 -->
00:17:36.360So we, like, I love that you're talking about this because we admit patients
00:17:36.360 -->
00:17:37.900who can take care of themselves, right?
00:17:38.020 -->
00:17:40.920So, like, whenever we receive these referrals, one of the things we're looking
00:17:40.920 -->
00:17:43.740for is that this patient can conduct their own ADLs.
00:17:43.960 -->
00:17:47.360And they might need a little bit of prompt, and that's okay. Yeah.
00:17:48.347 -->
00:17:52.647I do think, you know, and it's interesting because I talk about this a lot during
00:17:52.647 -->
00:17:56.687my training at work, whereas, you know, I like to say inpatient psychiatric
00:17:56.687 -->
00:18:00.307units, a lot of them operate like an ICU, like a psych ICU, right?
00:18:00.447 -->
00:18:04.287So our job is to, we receive these patients, we receive them when they're very
00:18:04.287 -->
00:18:06.367acute, we stabilize them and we send them out.
00:18:06.507 -->
00:18:10.187What does stabilization look like? What does that look like to you? Right, right. Right?
00:18:10.547 -->
00:18:14.387So you may see this person leave and they look very disorganized,
00:18:14.407 -->
00:18:17.027but what we're not understanding is that this is their baseline.
00:18:17.247 -->
00:18:19.867Yeah. This is how they operate in their everyday life.
00:18:20.247 -->
00:18:25.587And so if we can get them, help them reach a minuscule what that may look like,
00:18:25.707 -->
00:18:29.007ideally though, that is discharge ready, right?
00:18:29.187 -->
00:18:33.067That is discharge ready. Because although we have not solved all of their symptoms,
00:18:33.067 -->
00:18:37.687we have not solved all of their delusions, we've gotten them to a point where
00:18:37.687 -->
00:18:39.407they can do the rest of their work on their own.
00:18:39.627 -->
00:18:43.287And that's really our job, right? Our job isn't to necessarily fix,
00:18:43.327 -->
00:18:48.147it is to stabilize. And so once they're stable, once we can confidently look
00:18:48.147 -->
00:18:50.567at each other and say, okay, this patient, they can go now.
00:18:50.707 -->
00:18:53.947They can take care of the things that they were doing before. They can do those now.
00:18:54.267 -->
00:18:58.247That's our job. There's so many components, so many things to look at,
00:18:58.527 -->
00:19:02.227which makes, I think, the psych world so interesting.
00:19:02.627 -->
00:19:10.047Yeah, for sure. So let's get into some crazy stories that were submitted from patients. Oh, boy.
00:19:10.267 -->
00:19:12.267It's going to be true or false. Oh, boy. All right.
00:19:13.307 -->
00:19:18.007So I'm going to read them. And then Kevin, you're going to guess the true or false. Okay.
00:19:18.547 -->
00:19:23.087So this is from, this is supposedly directly from a patient.
00:19:24.023 -->
00:19:27.963I didn't want to take medications because of the side effects.
00:19:28.403 -->
00:19:33.903Doctors kept telling me that the side effects are minimal. So I agreed to take the medication.
00:19:34.103 -->
00:19:39.863But I would purposely cheat the meds and then put them in the staff's coffee
00:19:39.863 -->
00:19:42.383cups when they were not looking.
00:19:42.763 -->
00:19:49.403Within a week or so, the staff were either lactating or falling asleep behind the desk.
00:19:52.183 -->
00:19:55.843This sounds like a J.C.O. patient. this
00:19:55.843 -->
00:19:58.863sounds like a story jaco goes around telling telling
00:19:58.863 -->
00:20:01.583staff so they stop leaving open containers at the nursing
00:20:01.583 -->
00:20:04.803station i'm gonna have to go with false but
00:20:04.803 -->
00:20:09.583okay but but some of it does seem believable yeah why would you say it's false
00:20:09.583 -->
00:20:13.763i would say false because how how how would they know that the that the staff's
00:20:13.763 -->
00:20:18.363lactating like other than right you know what i mean like i mean i mean being
00:20:18.363 -->
00:20:23.103over sedated i think that's that's obviously a side effect from psych meds but,
00:20:23.923 -->
00:20:27.783we i mean we all also know that's like let's take three to four weeks in order
00:20:27.783 -->
00:20:31.903to have a therapeutic effect so like how soon after did you start seeing this
00:20:31.903 -->
00:20:39.963or day right exactly so apparently this is true oh shit this is true so whoever's
00:20:39.963 -->
00:20:42.243listening please don't take you know,
00:20:43.023 -->
00:20:48.463don't use this as well we can look at this either way like nurses listening
00:20:48.463 -->
00:20:53.783to this this is why jaco and DPH and all that stuff, CMS, get your,
00:20:53.943 -->
00:20:56.583you can't have open. Exactly.
00:20:57.023 -->
00:20:59.883Put your Diet Cooks away. Put everything away. Okay.
00:21:00.689 -->
00:21:04.549I know a lot of staff are like, why can't we have our drinks?
00:21:04.709 -->
00:21:06.269Well, you know what? This is
00:21:06.269 -->
00:21:08.389probably the reason. Well, because you might start lactating. That's why.
00:21:08.649 -->
00:21:10.669You might start lactating because one of your psych patients might just be like
00:21:10.669 -->
00:21:13.829slipping their meds. Yep. Here's your how, though, actually.
00:21:14.729 -->
00:21:23.589So, I mean, to say that it's true that this patient knew that staff were lactating,
00:21:23.649 -->
00:21:24.349I don't know if that's true.
00:21:24.449 -->
00:21:26.609But I could totally see like them maybe notice a difference.
00:21:26.609 -->
00:21:34.529And I think what happened, the reason why this might be true or is true is because this was a report.
00:21:35.189 -->
00:21:39.129This was reported from the staff. Like the staff were saying,
00:21:39.309 -->
00:21:42.049hell, yeah, I'm feeling. All right. Next one.
00:21:42.849 -->
00:21:45.689I don't know if I'm going to be able to get through this one. So just bear with me.
00:21:46.829 -->
00:21:49.749So this was in an emergency room.
00:21:50.169 -->
00:21:54.129A patient was having a panic attack. When asked what helps her,
00:21:54.369 -->
00:22:00.229she said, I need my husband to pull apart his butt cheeks and let out a fart.
00:22:03.449 -->
00:22:08.569The nurse felt that this was a delusion or like an inappropriate attention seeking
00:22:08.569 -->
00:22:12.809behavior. So she did not entertain it. Obviously, I would hope so.
00:22:13.389 -->
00:22:20.109The patient continued to escalate until the husband arrived and stated, this is gross.
00:22:20.109 -->
00:22:23.289But it's the only thing that helps her and proceeded
00:22:23.289 -->
00:22:27.329to pull his butt cheeks apart and i just i
00:22:27.329 -->
00:22:30.249didn't know what she was doing
00:22:30.249 -->
00:22:33.449i need to know what happens when someone
00:22:33.449 -->
00:22:37.809does not fart in front of her that's what i need to know like what great charting
00:22:37.809 -->
00:22:41.789by the way on the nurse's behalf because it definitely was it was definitely
00:22:41.789 -->
00:22:49.149was seeking behaviors right but but why what what What is happening?
00:22:49.369 -->
00:22:50.529I'm going to have to say false.
00:22:52.416 -->
00:22:57.136Well, you're wrong. This is true. Holy shit. This is true.
00:22:58.336 -->
00:23:02.196So, yeah, I don't know. I mean, I've heard of Aisha. What a story.
00:23:02.336 -->
00:23:04.036It is a story. What a story.
00:23:04.276 -->
00:23:09.656This is like, this is why we love psych though, right? Like this is really like deep down. This is why.
00:23:09.996 -->
00:23:13.076Because you just never know. You don't. You never know. You don't.
00:23:13.216 -->
00:23:16.376It doesn't shock me. I'll say that much. I'm not shocked by this.
00:23:16.676 -->
00:23:19.296There's a lot of, you know, people that are addicted to meth.
00:23:19.456 -->
00:23:22.036But then there's some people that are addicted to meth fame.
00:23:22.416 -->
00:23:29.616Nothing yeah yeah i guess so make sure no light it was like she immediately calmed down yeah,
00:23:30.216 -->
00:23:35.296i want to know what behavior was on calm like what was that she was like tearing
00:23:35.296 -->
00:23:38.536everything apart and the husband comes in he's like just farts the same day
00:23:38.536 -->
00:23:44.976don't worry about it and then she could just stand back she's like i was on
00:23:44.976 -->
00:23:48.936a business trip and she lost control i haven't been a little fart in her face in weeks.
00:23:48.936 -->
00:23:52.896Oh my God. Okay. Next one.
00:23:53.176 -->
00:23:55.576Okay. Another emergency room nurse.
00:23:56.890 -->
00:23:59.650Said that a patient had
00:23:59.650 -->
00:24:03.010stared them down so intensely that they
00:24:03.010 -->
00:24:06.890thought they were quote unquote murdered and they
00:24:06.890 -->
00:24:09.990blacked out and when they came to
00:24:09.990 -->
00:24:17.730kept repeating please don't kill me please don't kill me all right i all right
00:24:17.730 -->
00:24:21.830you want to hear a funny story when i first started working in psych i maybe
00:24:21.830 -->
00:24:27.390i probably was a month in and i was working overnight shift at the out right now.
00:24:27.890 -->
00:24:31.050And I had three patients who were going off one day at the same time.
00:24:31.170 -->
00:24:33.490And one of them was an MME catch fighter.
00:24:34.270 -->
00:24:39.110The other person was a collegiate football player. And the third patient was an ex Navy veteran.
00:24:39.690 -->
00:24:43.350And I remember thinking, I'm going to fucking die tonight. Tonight's the night.
00:24:43.930 -->
00:24:49.070Tonight's the night. I'm going to die. And I remember when they finally called the code, right?
00:24:49.230 -->
00:24:53.210Because every hospital has that intercom system where we call codes whenever
00:24:53.210 -->
00:24:55.010we need help, that code got called.
00:24:55.190 -->
00:24:57.510And I remember seeing the first person run through the doors,
00:24:57.650 -->
00:24:59.370which is Didi. She's one of our coworkers.
00:24:59.870 -->
00:25:04.750And I thought I saw an angel. I thought I saw my life flash before my eyes.
00:25:04.850 -->
00:25:06.910I saw my savior. I thought this is it.
00:25:07.130 -->
00:25:09.950Because I truly, in that moment, I remember thinking, I'm going to die here.
00:25:10.030 -->
00:25:11.350This is how I'm going to die.
00:25:11.710 -->
00:25:14.650No one's going to come and save me. It's like in that moment,
00:25:14.730 -->
00:25:17.510I forgot that police exists, that more people in the hospital.
00:25:17.850 -->
00:25:21.490I'm one unit in an entire hospital, and I'm over here thinking I'm going to die.
00:25:22.286 -->
00:25:26.446I do think that fear does exist still, especially for brand new staff.
00:25:26.666 -->
00:25:30.906Yeah. So I might have to say true on this one. So yes, this one is apparently true.
00:25:31.186 -->
00:25:34.706Wow. Yeah. I see it. I wrote it. I submitted it. That was you.
00:25:34.866 -->
00:25:36.306I know. That's actually where I got it from.
00:25:38.826 -->
00:25:41.666I pulled it from our old reports. Shit.
00:25:43.546 -->
00:25:47.626It's about you. No, I'm just kidding. All right. And so last but not least,
00:25:47.886 -->
00:25:56.426the most effective reduction in restraints is a nice warm glass of Shasta ginger ale.
00:25:56.726 -->
00:26:00.186True. Yeah, witch. True. I didn't have to read the rest. True.
00:26:00.746 -->
00:26:05.886You know, it's so funny because on our restraint paperwork. It asks halt, right? Yes.
00:26:06.586 -->
00:26:10.986One of the first questions it asks is, did you offer something to eat or drink? Yes.
00:26:11.266 -->
00:26:15.026Because believe it or not, literature supports it. That is one of the biggest
00:26:15.026 -->
00:26:18.026de-escalating skills is offering food, believe it or not.
00:26:18.506 -->
00:26:22.966So I find that to be true. I myself have applied that and have seen it be effective.
00:26:23.486 -->
00:26:27.446I mean, I definitely didn't get that data from anywhere but my own brain.
00:26:30.286 -->
00:26:33.326Oh, my goodness. Okay. So...
00:26:34.079 -->
00:26:40.199Let's get into some more questions. Okay. Why do you think there is such a high
00:26:40.199 -->
00:26:42.359mental health crisis now?
00:26:43.279 -->
00:26:48.859I definitely think that a lot of it has to do with social media.
00:26:49.379 -->
00:26:52.939And I don't think that necessarily within the last couple of years,
00:26:52.959 -->
00:26:54.059our numbers have increased.
00:26:54.439 -->
00:26:59.279I think that in the last couple of years, there's been a lot of tools that have
00:26:59.279 -->
00:27:02.259been developed to identify people in crisis and mental health crisis.
00:27:02.259 -->
00:27:06.879And I think that what that data has done is kind of show us what we've been
00:27:06.879 -->
00:27:11.979ignoring, which is it exists and it's here and it needs to be resolved and it needs to be addressed.
00:27:12.299 -->
00:27:17.079I think that there's a lot of resources now that exists out there that identify
00:27:17.079 -->
00:27:18.179people in mental health crisis.
00:27:18.339 -->
00:27:20.579So it's not necessarily that like it wasn't there.
00:27:20.799 -->
00:27:23.999It's just there was no one there to identify it. There was no tools that existed
00:27:23.999 -->
00:27:29.339or existed or processes that existed that help identify who these people were in our community.
00:27:29.339 -->
00:27:32.619And now it exists and it's part of our everyday assessment
00:27:32.619 -->
00:27:36.299and i think that like if you go meet your doctor about a
00:27:36.299 -->
00:27:39.979foot ache yeah your mental health still gets
00:27:39.979 -->
00:27:42.819questioned that part of all the time that part still gets
00:27:42.819 -->
00:27:47.299assessed it still gets questioned and i think that because we've
00:27:47.299 -->
00:27:50.039had such increases you know in school shootings we've had
00:27:50.039 -->
00:27:53.019an increase in assault on these random attacks
00:27:53.019 -->
00:27:56.159on people and it really causes a need
00:27:56.159 -->
00:27:59.299to have more dialogue and when people start talking you know
00:27:59.299 -->
00:28:02.359more of these these concerns come to light and i think that that's truly
00:28:02.359 -->
00:28:05.159what has caused there to be an increase in what we or
00:28:05.159 -->
00:28:08.999what we would call an increase in mental health crisis where really it isn't
00:28:08.999 -->
00:28:14.479a it isn't an increase it's always existed right it's just never been identified
00:28:14.479 -->
00:28:22.399for what it is exactly so yeah and and most of what this podcast is about is we talk about.
00:28:23.259 -->
00:28:28.319Murders and crime and stuff like that, that happens and how it kind of correlates,
00:28:28.399 -->
00:28:30.619I guess, with mental health. So...
00:28:31.478 -->
00:28:37.798And a lot of that is, yes, trying to kind of like mitigate like those risks.
00:28:37.818 -->
00:28:42.338But it's almost like it feels almost counterproductive almost because we're
00:28:42.338 -->
00:28:43.918bringing more awareness. Right.
00:28:44.318 -->
00:28:47.398But it's almost like we're causing more fear. We're causing more stigma.
00:28:47.678 -->
00:28:48.658We're causing more stigma.
00:28:49.218 -->
00:28:52.958And the goal is to actually get rid of stigma. Right.
00:28:54.058 -->
00:28:57.818And I think a lot of that has to do with the fact that like and I talk about
00:28:57.818 -->
00:29:01.418depression and anxiety a lot because that's really where this conversation first started.
00:29:01.478 -->
00:29:04.478In in america yeah and that stigma
00:29:04.478 -->
00:29:07.418i think a lot of it has to do with the fact that depression anxiety
00:29:07.418 -->
00:29:10.198is not measurable measurable disease right so
00:29:10.198 -->
00:29:13.318like you you go to the doctors and you have let's just
00:29:13.318 -->
00:29:17.178say diabetes right or you have a serious case of dka
00:29:17.178 -->
00:29:20.178right diabetes ketoacidosis and the
00:29:20.178 -->
00:29:22.918doctor says to you you know this isn't we can't resolve this right
00:29:22.918 -->
00:29:25.598now you have a week left to life right that's a
00:29:25.598 -->
00:29:28.358measurable thing you're measurable it's been measured you know
00:29:28.358 -->
00:29:31.678this is this is the outcome this is what we're really what you're
00:29:31.678 -->
00:29:34.878leading towards whereas our patients who are presenting with
00:29:34.878 -->
00:29:37.778depression anxiety there's no measurable tool there's
00:29:37.778 -->
00:29:42.798no tool that i can clarify to them where they land on yeah i can tell them your
00:29:42.798 -->
00:29:46.678symptoms align with this aligns with that but like we identified earlier our
00:29:46.678 -->
00:29:50.158symptoms can all look different so where do you think that line is though like
00:29:50.158 -->
00:29:55.498and i think that's again a lot to do with this podcast is like,
00:29:55.618 -->
00:29:58.678where is that line of,
00:29:58.878 -->
00:30:01.578okay, so you're struggling and you're mentally ill.
00:30:02.678 -->
00:30:08.578And what can we do, I guess, as a community and as mental health care workers,
00:30:08.878 -->
00:30:15.398as police force, all that stuff to like, I guess, prevent it from crossing that
00:30:15.398 -->
00:30:19.098line to serious harm, serious crime, serious murder.
00:30:19.958 -->
00:30:27.578Do you think that we can get to a point where we could actually see numbers
00:30:27.578 -->
00:30:29.878where that is, that statistic is.
00:30:30.857 -->
00:30:33.617Is decreased i guess i think
00:30:33.617 -->
00:30:36.277that a lot of that in and you know
00:30:36.277 -->
00:30:39.157historically like on your podcast you guys talk a lot about like
00:30:39.157 -->
00:30:41.877murderers and i think that a lot of the times one thing
00:30:41.877 -->
00:30:44.537that that a lot of these people have in common is that they lack a
00:30:44.537 -->
00:30:47.737support system in the lack of support system from early
00:30:47.737 -->
00:30:50.597on what do i mean by that right so like
00:30:50.597 -->
00:30:53.477a lot of these patients a lot of these people i call them patients but
00:30:53.477 -->
00:30:57.997yes they are but a lot of these people you collect
00:30:57.997 -->
00:31:01.037a history and you figure out very quickly that
00:31:01.037 -->
00:31:04.377they had they struggled making friends they struggled to
00:31:04.377 -->
00:31:07.477have a community that supported them they struggled to
00:31:07.477 -->
00:31:10.537find a person that they identify as someone they could trust and divulge
00:31:10.537 -->
00:31:13.657and share things that they would not normally share right a lot
00:31:13.657 -->
00:31:16.657of these people feel like they're outcasts and so what ends up what ends
00:31:16.657 -->
00:31:20.197up happening is that that feeling of outcast then develops
00:31:20.197 -->
00:31:23.837into a more complicated more
00:31:23.837 -->
00:31:27.377rough around the edges exterior and
00:31:27.377 -->
00:31:30.397what they end up becoming which is you know not active members
00:31:30.397 -->
00:31:33.517of their society right people who cause harm who don't
00:31:33.517 -->
00:31:37.777necessarily like maladaptive like coping mechanisms exactly
00:31:37.777 -->
00:31:40.417and addiction and all that stuff yeah and for
00:31:40.417 -->
00:31:43.137them that's just their way of managing getting through life and it's
00:31:43.137 -->
00:31:46.977not necessarily that it's a bad or good thing but when they measure that tool
00:31:46.977 -->
00:31:49.597compared to everything else in their life there's nothing to measure it too
00:31:49.597 -->
00:31:54.057right so like you think of someone with no support system and they find it they
00:31:54.057 -->
00:31:56.917have nothing to measure that tool with because they never had people who stepped
00:31:56.917 -->
00:32:00.497up when they when just because they were who they were and because they loved them.
00:32:00.677 -->
00:32:04.537Right. That's really important. And I think that we we tend to forget that,
00:32:04.557 -->
00:32:09.657that my experience of having a mom and dad is your it's different for you of having a mom and dad.
00:32:09.797 -->
00:32:12.977My experiences of having friends is different from you from having friends.
00:32:13.177 -->
00:32:16.337And so that ends up developing really our character.
00:32:16.759 -->
00:32:19.839And so it starts from a very, very young age.
00:32:20.059 -->
00:32:23.259And like I said, one thing that you'll find in common with all these people
00:32:23.259 -->
00:32:27.099is that they did not have the support system. They did not have someone they relied on.
00:32:27.579 -->
00:32:30.119A lot of people, you know, a lot of people say they were closed off.
00:32:30.259 -->
00:32:32.859Well, they were taught to be that way. They did not know how to open up.
00:32:33.039 -->
00:32:34.459They didn't find it in someone.
00:32:34.659 -->
00:32:37.159So Julie and I, we talk a lot in our episodes about like, again,
00:32:37.299 -->
00:32:40.339central nervous system and like regulation. And like you're talking about,
00:32:40.419 -->
00:32:43.999it is a lot of upbringing and environmental and all that stuff.
00:32:44.019 -->
00:32:49.839Absolutely. And then you add in, how does that impact your development and your mental health?
00:32:49.979 -->
00:32:53.639It's hard to say what comes first, the chicken or the egg. We don't know.
00:32:53.679 -->
00:32:55.779And I think that's what's so fascinating about psych.
00:32:55.979 -->
00:33:02.719And to be honest, I think that's why I will continue a career in psych because I want to know why.
00:33:02.939 -->
00:33:06.319I want to know why. And you know what? It's funny because someone asked me this
00:33:06.319 -->
00:33:07.079the other day. They were like.
00:33:08.351 -->
00:33:15.071Don't you feel like you are climbing like, like a hill that is never ending?
00:33:15.391 -->
00:33:19.571And at what point do you say, I gotta get off this? You know,
00:33:19.631 -->
00:33:20.651I gotta get off. Absolutely.
00:33:20.991 -->
00:33:26.971I agree with that. I, I, it's true. Like, do I think we will ever find an answer?
00:33:27.391 -->
00:33:29.971No, no, absolutely not. I don't think so.
00:33:30.411 -->
00:33:34.631And, and, and that's just due to the, the organ involved, right? That's our brain.
00:33:34.771 -->
00:33:37.551It is so complex. because there's so much research in our brain
00:33:37.551 -->
00:33:40.251that it's yet to be discovered and i think that that has a lot to do with
00:33:40.251 -->
00:33:43.231it as well but i i agree like
00:33:43.231 -->
00:33:47.211i definitely do think that like a lot of times it's just it's at
00:33:47.211 -->
00:33:51.091what point are we able to identify this
00:33:51.091 -->
00:33:53.991person who does not have a good support system who does
00:33:53.991 -->
00:33:57.211not have a good basis or a good fundamental
00:33:57.211 -->
00:34:01.231or good or or the resources is necessary in
00:34:01.231 -->
00:34:04.131order to become successful they're really
00:34:04.131 -->
00:34:07.311products of our of the government and of our own doing yeah they're
00:34:07.311 -->
00:34:10.271they're a product of the way we like that's like what do we do like
00:34:10.271 -->
00:34:18.271you and i we're part of the change or we are relied on by especially family
00:34:18.271 -->
00:34:26.611there are families who 100 rely on quote-unquote the system they rely on people
00:34:26.611 -->
00:34:29.271like us to make a difference and make the change.
00:34:29.671 -->
00:34:35.431So for me, I know I'm only one person, but it's like collectively,
00:34:35.811 -->
00:34:40.311like if we all had that mindset that, okay, this is, this is on us.
00:34:40.431 -->
00:34:46.671It's up to us to provide a safe community. It's, it's up to us to do everything
00:34:46.671 -->
00:34:51.771that we possibly can to make sure that these mentally ill people are.
00:34:52.301 -->
00:34:56.561They might not be perfect and they might never get to a point where they are
00:34:56.561 -->
00:35:02.461thinking normally, but let's make sure that they don't act out on their delusions.
00:35:02.461 -->
00:35:04.621They don't act out violently.
00:35:05.101 -->
00:35:08.681And I know that's, that's, that's hard. You know, that's, that's like a huge.
00:35:09.161 -->
00:35:12.321It's hard because it looks different for every person, you know,
00:35:12.461 -->
00:35:14.061predict it. We can't not predict.
00:35:14.181 -->
00:35:17.161And so like, I, I've, and I know I've talked about this before too,
00:35:17.301 -->
00:35:20.461where I always say like, so we're a behavioral health hospital in our psych setting.
00:35:20.461 -->
00:35:23.241I always say we're like the ICU of psych where we
00:35:23.241 -->
00:35:26.661receive these patients who are in acute distress and our
00:35:26.661 -->
00:35:29.581job is to get them to a place of stabilization so like
00:35:29.581 -->
00:35:33.001when we're able to identify you know this patient they're not brushing their
00:35:33.001 -->
00:35:35.241teeth but guess what they're showering every day that's better than where they
00:35:35.241 -->
00:35:38.461were when they first showed up that we've accomplished a goal here right we're
00:35:38.461 -->
00:35:43.201accomplishing like goals like reachable reachable obtainable goals yeah and
00:35:43.201 -->
00:35:48.941when those goals are obtained you know our job is to keep pushing the patient to move forward.
00:35:49.201 -->
00:35:53.281And so I explain this a lot to the staff because a lot of my role as a supervisor
00:35:53.281 -->
00:35:55.141is to educate the staff and nurse and staff.
00:35:55.321 -->
00:35:58.481And I will say to them, although this patient in your eyes might not seem like
00:35:58.481 -->
00:36:00.801they're ready for discharge, they are based on their presentation.
00:36:01.041 -->
00:36:05.161Exactly. Because the way they presented, which is what their base or the way
00:36:05.161 -->
00:36:08.201they presented, which is not what their baseline was, but we have a good identification
00:36:08.201 -->
00:36:09.521of what that baseline looks like.
00:36:09.881 -->
00:36:14.221We can then decide, yeah, this is better than what they showed up with.
00:36:14.501 -->
00:36:17.281And our one and only job is to make sure that they're one
00:36:17.281 -->
00:36:20.581step ahead of us it's not to completely solve their
00:36:20.581 -->
00:36:24.501issues it's not to completely have some improvement some improvement improvement
00:36:24.501 -->
00:36:29.021some progress and and that's hard because a lot what we're hoping when we discharge
00:36:29.021 -->
00:36:32.301these patients right because like i i mentioned my job isn't necessarily to
00:36:32.301 -->
00:36:35.881fix them it's to stabilize them and once they're stable they then go out we're
00:36:35.881 -->
00:36:39.801identifying line of risk too though absolutely part of the job is that.
00:36:40.382 -->
00:36:44.222You know, we won't discharge someone that we think is going to go out into the
00:36:44.222 -->
00:36:48.022community and cause reckless behavior or harm or risk.
00:36:48.142 -->
00:36:50.742I mean, I think a lot of people probably think like what we do is,
00:36:50.862 -->
00:36:52.722oh, we take care of people who want to hurt themselves.
00:36:53.642 -->
00:36:59.682I would say a lot of our population is people who, again, they lack that impulse
00:36:59.682 -->
00:37:03.262control and they want to, they act out.
00:37:03.462 -->
00:37:07.022They act outwardly and sometimes that looks violent and looks aggressive.
00:37:07.022 -->
00:37:12.482And it's sometimes these patients that they don't have intent to hurt others,
00:37:12.682 -->
00:37:17.242but they might in in their state of like reckless behavior.
00:37:17.382 -->
00:37:20.282So we have to make sure that, OK, we're discharging this person.
00:37:20.502 -->
00:37:25.702We don't want them to go out into the community and start fighting people.
00:37:25.702 -->
00:37:29.942And we know that that that can turn to murder.
00:37:30.162 -->
00:37:31.962And it does. I mean, it's proven.
00:37:32.242 -->
00:37:36.962I mean, literature proves it. I mean, nursing is led through evidence-based
00:37:36.962 -->
00:37:38.562practice. It's led through literature.
00:37:38.962 -->
00:37:42.322It's led through research. And so a lot of the things that you see nurses do,
00:37:42.442 -->
00:37:45.282and it's not because we just woke up one day and we decided this is the right thing to do.
00:37:45.382 -->
00:37:47.782It's because we were taught through evidence-based practice,
00:37:48.022 -->
00:37:51.862through research and literature, that these are the things that work for these people.
00:37:52.562 -->
00:37:57.642And, you know, all we can do as psych nurses is apply it and hope that the outcome
00:37:57.642 -->
00:37:59.242is the best outcome. Yep.
00:37:59.542 -->
00:38:03.702I guess my question to you is because, so you and I were both in,
00:38:03.762 -->
00:38:05.202we're in leadership, right?
00:38:05.422 -->
00:38:08.362Yep. We didn't start in leadership, right? We did not.
00:38:08.562 -->
00:38:11.402We started on the floor. We learned, you know, we worked our way up.
00:38:11.402 -->
00:38:14.442We did bedside. We did bedside. We did all that stuff. So.
00:38:16.139 -->
00:38:23.399We have, I feel, we have an obligation to ensure that our staff,
00:38:23.419 -->
00:38:28.819they're kind of implementing the same type of care that we gave.
00:38:29.019 -->
00:38:36.679So do you think, do you think that you were naturally drawn to or meant to take
00:38:36.679 -->
00:38:37.619care of this population?
00:38:38.159 -->
00:38:42.339No way that I think that I was naturally meant to take care of this population.
00:38:42.339 -->
00:38:46.659I think that, and I say this very confidently, and I say this about you,
00:38:46.799 -->
00:38:50.639I say this about Julie, I say this about a lot of my mentors.
00:38:50.879 -->
00:38:54.399I am a product of people who poured into my cup. I say that often.
00:38:54.739 -->
00:39:02.259I did not, my thought process, my ability to be compassionate, it didn't come natural.
00:39:02.479 -->
00:39:06.139It was a very, it was taught. But how was that taught? No one sat me down and
00:39:06.139 -->
00:39:08.359said, hey, Kevin, be compassionate.
00:39:08.599 -->
00:39:11.459That's so funny. I led through, it was led through example. You know,
00:39:11.579 -->
00:39:15.819I had people who I had people who were who truly cared about psych,
00:39:15.959 -->
00:39:19.679who truly cared, who truly cared about making a difference.
00:39:19.859 -->
00:39:23.879And that kind of helped me and helped me want to be better. Help me want to,
00:39:23.939 -->
00:39:24.979you know, lead to compassion.
00:39:25.239 -->
00:39:29.119It kind of it made me want to be just like that, just like you, just like Julie.
00:39:29.539 -->
00:39:35.539I love your answer only because I really I love, love, love,
00:39:35.579 -->
00:39:40.959love your answer because I was going to ask because I kind of struggle with this as.
00:39:41.139 -->
00:39:47.099Was a supervisor, like trying to recruit and like hire young individuals that
00:39:47.099 -->
00:39:49.799want to maybe embark on this type of career.
00:39:49.999 -->
00:39:56.119Like I struggle with, can this type of compassion be taught?
00:39:56.419 -->
00:40:03.099Like, can I inspire someone like I was inspired? And you just kind of answered
00:40:03.099 -->
00:40:06.799that question by saying you think that that's true.
00:40:07.359 -->
00:40:10.619100%. So give me an example, I guess, of.
00:40:11.341 -->
00:40:14.361Maybe was there a time where you felt like this isn't for me,
00:40:14.461 -->
00:40:20.781but then you might have saw an example from like a coworker or a manager or
00:40:20.781 -->
00:40:22.001something where you were like, you know what?
00:40:22.561 -->
00:40:25.721I feel inspired. Like, I kind of want to I want to see this through.
00:40:25.881 -->
00:40:29.621I want to keep going. That happens all the time. I think that happens literally all the time.
00:40:29.941 -->
00:40:35.981And I think that one of the biggest things that happens in like the nursing
00:40:35.981 -->
00:40:38.121world, nursing career is burnout.
00:40:38.361 -->
00:40:40.281That's one of the first things we, you know, burnout on staff.
00:40:40.281 -->
00:40:41.181And we always talk about those
00:40:41.181 -->
00:40:43.801two things right they're the biggest there's not enough nurses in the
00:40:43.801 -->
00:40:46.661world and burnout happens very quickly how do
00:40:46.661 -->
00:40:49.741you kind of come combat yeah that type
00:40:49.741 -->
00:40:56.061that that that feeling well it relies on a support system guys which is really
00:40:56.061 -->
00:40:59.341what i've been centered around support system like in the family but support
00:40:59.341 -->
00:41:03.301system at work too at work too yeah absolutely i can't i can't tell you guys
00:41:03.301 -->
00:41:06.241i've been doing this for 11 years i can't tell you how many times i've been
00:41:06.241 -->
00:41:07.921punched in the face. It probably happens once a year.
00:41:08.881 -->
00:41:14.321I should have quit the first time it happened. Tell the story you got punched in the face. Oh boy.
00:41:14.941 -->
00:41:19.041Ideally, right? But what keeps you go, imagine this, right? You go to work,
00:41:19.101 -->
00:41:21.641you can punch in the face and you go back the very next day. Why?
00:41:22.081 -->
00:41:26.821Think of that. Why? Exactly. Why? And it happens all the time.
00:41:27.041 -->
00:41:31.501If you have any nurses in your life, ask them how many times they've been verbally abused.
00:41:31.821 -->
00:41:35.321Ask them how many times have been physically abused? Ask them those questions.
00:41:35.501 -->
00:41:38.621It happens all the time. Our job is,
00:41:39.113 -->
00:41:43.673It is that, right? It's to cater to our patients, to cater to their needs.
00:41:43.873 -->
00:41:48.193I am adaptive to what you need in this moment because you're the one struggling.
00:41:48.413 -->
00:41:50.313I'm not struggling. I'm here to make your life better.
00:41:51.053 -->
00:41:55.433I think that it's a constant struggle. It's a constant struggle.
00:41:55.713 -->
00:42:00.533And the biggest thing that has supported me through my times of burnout have been my support system.
00:42:00.673 -->
00:42:02.853It's been the people at my job who look at me and are able to say,
00:42:02.993 -->
00:42:06.933you just got punched in the face. That sucks. I'm sorry. How can I help you?
00:42:07.193 -->
00:42:10.593Yeah. That's all it takes. So you think anyone, theoretically,
00:42:11.073 -->
00:42:15.633anyone can come work in our environment or our field.
00:42:15.673 -->
00:42:19.433And as long as they have the right leadership and the right support.
00:42:20.253 -->
00:42:23.573They can make it. I absolutely believe that. That's awesome.
00:42:23.753 -->
00:42:27.273I think that I am a true believer in education.
00:42:28.553 -->
00:42:35.293My dream job to retire in is to teach nursing. I have said this forever since I started this journey.
00:42:35.553 -->
00:42:39.453I think that education is a powerful tool and I think that education can be
00:42:39.453 -->
00:42:41.873provided and given to people without a school setting.
00:42:42.073 -->
00:42:44.853I think that it doesn't take for you to have to go to school to sit down and
00:42:44.853 -->
00:42:46.473become an educated person and learn.
00:42:46.633 -->
00:42:49.673I think all it has to take is to pique your interest and
00:42:49.673 -->
00:42:53.273that's the difference i think that i myself because
00:42:53.273 -->
00:42:56.173when i first started working in psych i was 23 or 22
00:42:56.173 -->
00:42:59.053years old actually i think that what and
00:42:59.053 -->
00:43:01.813think about it right i'm a 22 year old i don't
00:43:01.813 -->
00:43:04.453really care about much other than having fun hanging out with my
00:43:04.453 -->
00:43:07.253friends yeah meeting people i was 23 and i
00:43:07.253 -->
00:43:10.093was like brand new nurse and i i don't
00:43:10.093 -->
00:43:13.193know they like put me in charge and i'm like what why do
00:43:13.193 -->
00:43:16.093you why do you think i'm responsible exactly i charge but like
00:43:16.093 -->
00:43:19.493you know it's like sometimes you get thrown in situations i had
00:43:19.493 -->
00:43:22.173that moment as a supervisor where i think to myself i haven't gone
00:43:22.173 -->
00:43:25.293through enough life experiences to meet people that have who are
00:43:25.293 -->
00:43:28.473experienced 20 plus years more life experiences
00:43:28.473 -->
00:43:31.393than i have but one of the benefits i think
00:43:31.393 -->
00:43:34.393to me specifically in my environment and
00:43:34.393 -->
00:43:37.513the place i work at is my longevity right i've been there 11 years
00:43:37.513 -->
00:43:40.413so i know policies and processes that people
00:43:40.413 -->
00:43:43.653aren't fully aware of i have seen the hospital develop in
00:43:43.653 -->
00:43:46.493and evolve into something that people didn't actually see
00:43:46.493 -->
00:43:49.513just today i was in a meeting about electronic charting and
00:43:49.513 -->
00:43:52.533how i actually saw the facility evolve from paper charting
00:43:52.533 -->
00:43:56.853into electronic charting i saw that happen that's what causes a good leader
00:43:56.853 -->
00:44:01.453experience think about it like what experience being through it yeah i might
00:44:01.453 -->
00:44:08.013not be i might not have have 20 plus years of of nursing experience but i have
00:44:08.013 -->
00:44:09.78311 years of experience in facility.
00:44:10.603 -->
00:44:15.863So you think like a new 22-year-old, for instance, like coming into our work,
00:44:15.963 -->
00:44:18.103like you're interviewing someone, for instance, who's 22.
00:44:19.123 -->
00:44:20.823You think that,
00:44:21.505 -->
00:44:25.445you could model the leadership that you want.
00:44:26.045 -->
00:44:30.105Absolutely. Absolutely. Because all it takes is a willingness to learn.
00:44:30.305 -->
00:44:33.845If you show up to a place, you could be a nurse for 50 plus years.
00:44:34.205 -->
00:44:38.285And if you show up to a place and you're not teachable, you're no longer beneficial
00:44:38.285 -->
00:44:39.565to me. You're not going to be, right? You're not.
00:44:39.885 -->
00:44:43.845Because although you have 50 years plus of experience, and if you've gone to
00:44:43.845 -->
00:44:46.485a point where you feel like you no longer need to learn anymore.
00:44:47.185 -->
00:44:52.145Then you've reached a point where you kind of have to see yourself self-go.
00:44:52.725 -->
00:44:56.685You got to see yourself out. Because if you're not teachable,
00:44:56.845 -->
00:44:59.105if I'm not able to teach you
00:44:59.545 -->
00:45:04.105how to be a better nurse here, how to be beneficial to the facility here and
00:45:04.105 -->
00:45:07.185our patients here, based on your experience from a different facility,
00:45:07.245 -->
00:45:09.305then there's nothing more for you to learn.
00:45:09.485 -->
00:45:12.445That's what you're telling me. You've learned it all and there's nothing more I can teach you.
00:45:13.065 -->
00:45:16.285I learn something every single day, whether it's from staff,
00:45:16.505 -->
00:45:19.225whether it's from directors, whether it's from my own mentors,
00:45:19.505 -->
00:45:21.685people teach me something new constantly.
00:45:21.985 -->
00:45:27.445And what your job is to do as an educator, as a healthcare worker,
00:45:27.465 -->
00:45:32.745is to apply what applies to you, is to apply what applies to you and let go
00:45:32.745 -->
00:45:34.305of what doesn't apply to you.
00:45:34.425 -->
00:45:38.425And that's hard, right? That's the hardest part because sometimes everything
00:45:38.425 -->
00:45:41.465can apply to us and we might not want to hear it, right? But that's the difference
00:45:41.465 -->
00:45:45.045between being teachable and no longer being teachable. Exactly, exactly.
00:45:45.505 -->
00:45:51.725So yeah, I think a lot of the challenge with our mental health and society is
00:45:51.725 -->
00:45:57.465probably that the people that are in charge are taking care of people. Maybe just...
00:45:58.360 -->
00:46:04.060I don't know, maybe they just lack that passion or they don't have good support
00:46:04.060 -->
00:46:05.800or they don't have leadership.
00:46:05.860 -->
00:46:12.880But I feel like you, me, Julie, several other people that we work with,
00:46:13.060 -->
00:46:16.280I think that makes all the difference in the world. You know what I mean? A hundred percent.
00:46:16.500 -->
00:46:20.260You have to teach people, like pass the torch, you know, pass the torch.
00:46:20.460 -->
00:46:23.240And like, I fell into psych by accident.
00:46:23.520 -->
00:46:27.180I applied for a job in Boston and I thought it was a regular hospital.
00:46:27.440 -->
00:46:30.940Like I was like, Oh, I'm going to go to an interview. And remember sit,
00:46:31.040 -->
00:46:33.300I'm like, where the heck is this hospital? Like what's going on?
00:46:33.460 -->
00:46:36.340I was like driving to the interview and pull up and I'm like,
00:46:36.460 -->
00:46:39.760this is a psychiatric hospital. I almost didn't go in.
00:46:39.860 -->
00:46:42.080And then I was like, I was like, what am I doing?
00:46:42.500 -->
00:46:46.820And I sat in front of them. I was like, they were talking to me.
00:46:46.880 -->
00:46:50.500They're like, do you have any experience in psych? And I'm like, not at all.
00:46:50.660 -->
00:46:52.220Like, what are you talking? And I'm like thinking to myself,
00:46:52.340 -->
00:46:53.520like, I'm definitely not taking this job.
00:46:53.900 -->
00:46:56.980But after talking to like the nurse manager who's interviewing me,
00:46:57.060 -->
00:47:00.280I was like, you know what? I should totally give this a chance. And I,
00:47:01.097 -->
00:47:05.577I'm so glad I did. Like, I'm so, so glad I did. Like, I think I found,
00:47:05.777 -->
00:47:07.157definitely found my niche.
00:47:08.077 -->
00:47:11.877I think, too, like, we're passionate about psych, you know?
00:47:12.037 -->
00:47:15.317But that wasn't the... But, like, we fell into it. We fell into it.
00:47:15.377 -->
00:47:21.317It wasn't just born into, like, I didn't just, it wasn't in me when I first started this journey.
00:47:21.457 -->
00:47:25.237I think that really what led me to this point was people who were passionate
00:47:25.237 -->
00:47:29.057about psych, who share their passion, were able to have conversations with me,
00:47:29.117 -->
00:47:30.297and my willingness to listen.
00:47:30.297 -->
00:47:33.437Really I wanted to learn I wanted to I
00:47:33.437 -->
00:47:36.477was a sponge and I just wanted to take in as much as I could and so no
00:47:36.477 -->
00:47:39.277one could say anything to me that I didn't want to hear I wanted to hear
00:47:39.277 -->
00:47:42.117everything yeah because I thought in that moment I remember being
00:47:42.117 -->
00:47:45.177so young and thinking this is gonna make all the difference I was
00:47:45.177 -->
00:47:47.95722 years old when I started working at our facility and I
00:47:47.957 -->
00:47:51.177was the youngest BHA you were yeah I was the youngest BHA
00:47:51.177 -->
00:47:54.157and now I'm I am a superior
00:47:54.157 -->
00:47:56.857people look up to me and they look up to my advice and the things I have
00:47:56.857 -->
00:47:59.617to say and so those things I have to really so you
00:47:59.617 -->
00:48:02.537do you have to pass like i said pass it on right and
00:48:02.537 -->
00:48:05.577i and i choose my words wisely because what i want to develop
00:48:05.577 -->
00:48:08.397what i want to see what i want to cultivate is what
00:48:08.397 -->
00:48:13.117i had what i received and what i got which was support was which leaders people
00:48:13.117 -->
00:48:18.777who saw something in me do i think i was the best employee the all-star no absolutely
00:48:18.777 -->
00:48:23.577not i think i was a work in progress but it took for someone to see he can become
00:48:23.577 -->
00:48:28.117what we want him to be yes versus someone who saw he's annoying and asking a lot of questions.
00:48:28.517 -->
00:48:30.357Right, exactly. You know, because I did have people who said,
00:48:30.517 -->
00:48:33.377You have loose lips. Be quiet. You have loose lips. Be quiet, right?
00:48:33.637 -->
00:48:36.337But then I had people who said, Actually, you have great ideas.
00:48:36.497 -->
00:48:39.037I have great ideas. You have great ideas. You're not a nurse yet, but that's your goal.
00:48:39.137 -->
00:48:43.077And I think that one day when you have that degree, those extra letters behind
00:48:43.077 -->
00:48:45.877your name, that BSNRN, people will start listening.
00:48:45.957 -->
00:48:48.797And it wasn't until I had those letters and I did have these good ideas,
00:48:48.917 -->
00:48:52.837but I was also coached into becoming who I became that I was able to say,
00:48:52.997 -->
00:48:55.417Okay, I can confidently talk and know what I'm talking about.
00:48:55.477 -->
00:48:57.117So I think like, so like what, Thank you.
00:48:57.353 -->
00:49:00.453Kevin and I are talking about right now is that I think in order to kind of
00:49:00.453 -->
00:49:07.153mitigate or even decrease just this, the crises, I think, in our society and
00:49:07.153 -->
00:49:10.613the violence and all of that stuff, I mean,
00:49:10.833 -->
00:49:15.753the only way to really get a handle on it is really to, I think.
00:49:16.693 -->
00:49:23.053Cultivate like a community of people like our healthcare workers that really do actually care.
00:49:23.233 -->
00:49:26.813They really care about the population. They want to actually see them get well.
00:49:27.333 -->
00:49:32.753They do think outside of the box. They think further than, okay,
00:49:32.873 -->
00:49:35.273this person's at their baseline. We got them on their meds.
00:49:35.453 -->
00:49:40.513It's no, like maybe discharging them home to their parents who are,
00:49:41.022 -->
00:49:44.082obviously know their child. They know what their baseline is.
00:49:44.182 -->
00:49:46.382They know when they need a med adjustment.
00:49:46.602 -->
00:49:51.762Okay, great. But their biggest thing was, geez, like, could you have given them a shower?
00:49:51.922 -->
00:49:54.362Could you have done this stuff? I just think that makes, it does,
00:49:54.482 -->
00:49:55.242it makes all the difference.
00:49:55.582 -->
00:50:00.042I don't know. It does. And it, and it sometimes all it takes is a quick second of compassion, right?
00:50:00.182 -->
00:50:04.162And again, guys, and I say this and I say this and I'll say this, don't blue in the face.
00:50:04.862 -->
00:50:07.702Everyone deals with mental illness. We all struggle with it at some
00:50:07.702 -->
00:50:10.562point in our lives whether we identify or not that's our
00:50:10.562 -->
00:50:13.822own business right kevin's the most mentally ill person i've ever i am so mentally
00:50:13.822 -->
00:50:18.162ill i love him but i'm an active member of my society guys i love him so much
00:50:18.162 -->
00:50:27.322look at him he's a lady i'm fucking crazy no i just think i just think you know
00:50:27.322 -->
00:50:30.322like in laughter that's so important oh my god that's,
00:50:30.842 -->
00:50:36.862comedy like finding you know i it's not hard to tell that i'm gay and a lot of times.
00:50:40.102 -->
00:50:46.522And I think that a lot of times, you know, like the patients loved me.
00:50:46.722 -->
00:50:50.702I'm so disappointed. That will be one of their first, that would be that.
00:50:50.762 -->
00:50:53.342That's one of their first insults, right? You're, you're, you're a,
00:50:53.502 -->
00:50:54.602you're a this, you're that you're gay.
00:50:54.782 -->
00:51:00.002You're, you're, I have no ass. The first thing patients say is fuck you, you flat ass.
00:51:00.302 -->
00:51:04.402You have no ass. Great. Thanks a lot. Like they just point out whatever they
00:51:04.402 -->
00:51:07.862can, whatever they can, whatever they, whatever Whatever physical insecurity
00:51:07.862 -->
00:51:11.702that they can see in their eyes, they will say to you, but you know,
00:51:11.802 -->
00:51:14.502at the same time, like I'll turn around and be like, they didn't call me ugly though.
00:51:14.822 -->
00:51:17.802They just said, they called me gay, but they didn't call me ugly.
00:51:17.902 -->
00:51:21.162Things like that. And I think that that's what, that's what ends up,
00:51:21.282 -->
00:51:23.162you know, cultivating a positive work environment.
00:51:23.382 -->
00:51:25.562It's being able to laugh at yourself. Like being able to say,
00:51:25.662 -->
00:51:26.862guys, listen, it wasn't personal.
00:51:27.022 -->
00:51:30.122I understand that. So like one of my questions, it isn't, but like,
00:51:30.242 -->
00:51:33.582so one of my, one of my questions, because I want kind of wrapping this up,
00:51:33.582 -->
00:51:35.562we'll do some a little bit funny, but yeah.
00:51:35.747 -->
00:51:38.607I was going to say, what's the funniest thing a patient ever said to you?
00:51:38.867 -->
00:51:40.047Oh, my God. You guys want to hear this?
00:51:40.347 -->
00:51:43.807This is one of the scariest and funniest things a patient's ever fucking said to me.
00:51:44.007 -->
00:51:46.967I was an overnight BHA, right? A behavioral health technician.
00:51:47.167 -->
00:51:50.207And part of the psych world is we have patients. So they get checked on every
00:51:50.207 -->
00:51:52.487five minutes or every 15 minutes.
00:51:52.587 -->
00:51:57.007Or they're on a one-to-one, which is constant observation. So these are level of observation.
00:51:57.807 -->
00:52:00.647If a patient's on 15-minute checks, you check on them every 15 minutes.
00:52:00.727 -->
00:52:03.187If a patient's on five-minute checks, you check on them every five minutes.
00:52:03.187 -->
00:52:07.207If a patient's on a one-to-one, then they get an assigned staff person that
00:52:07.207 -->
00:52:08.487just stays with them at all times.
00:52:08.667 -->
00:52:11.207So that would be someone who's like a high suicide risk.
00:52:11.487 -->
00:52:15.347We would be with them at all times. Or high assault risk. Or high assault risk, right?
00:52:16.087 -->
00:52:19.107They're randomly attacking random people, so they would be on a one-to-one because
00:52:19.107 -->
00:52:21.107we need eyes on them at all times.
00:52:21.947 -->
00:52:25.167Well, I was a BHA at the time, and I had a patient who was on a 15-minute check.
00:52:25.267 -->
00:52:27.107So I just had a check on her every 15 minutes.
00:52:28.187 -->
00:52:30.787And I will never forget this lady because I won't say her name.
00:52:30.907 -->
00:52:33.807Well, actually, I'll call her Mary. I like that name, Mary. Mary? Okay.
00:52:35.167 -->
00:52:39.287Mary had a – she was sectioned from her job, which was Dunkin' Donuts.
00:52:40.127 -->
00:52:42.927And when she arrived at the hospital, she arrived in her Dunkin' Donuts uniform.
00:52:42.967 -->
00:52:46.327That's just what she had on. That's just what she kept on. She had no other clothes.
00:52:46.447 -->
00:52:48.767She didn't care. Did she have her little headpiece earphones on?
00:52:49.127 -->
00:52:52.867No, she didn't have the headpiece on. She must have not been working the drive-thru
00:52:52.867 -->
00:52:53.707that day. Yeah, maybe not.
00:52:55.027 -->
00:52:58.807But she arrived. She was in her Dunkin' Donuts outfit. She was in her room.
00:52:59.107 -->
00:53:02.207And at this time, this was many, many years ago, the patients,
00:53:02.487 -->
00:53:05.407and they still can. If they want a Bible, we'll give them a Bible.
00:53:05.867 -->
00:53:09.487Back in the day, they were able to have pens. So we had black pens and red ink
00:53:09.487 -->
00:53:13.347pens. And so this specific patient had a red ink pen on her.
00:53:13.607 -->
00:53:16.387Now they're unallowed. Those are only allowed the golf pencils,
00:53:16.547 -->
00:53:20.087which are like the mini pencils, because they're a lot less.
00:53:20.087 -->
00:53:24.247There's a lot less risk with those but she had a red pen and i was doing my
00:53:24.247 -->
00:53:27.507checks and she was at the end of the hall the hall was dark because this was
00:53:27.507 -->
00:53:29.307an overnight trip it was completely dark,
00:53:30.027 -->
00:53:35.167and i remember walking down the hall and i opened her door and i said mary is
00:53:35.167 -->
00:53:39.227everything okay and she was sitting on the floor in between both beds because
00:53:39.227 -->
00:53:42.947each room has two beds and she was in a room by herself i remember this because
00:53:42.947 -->
00:53:45.067she was sitting on the floor between both beds
00:53:45.487 -->
00:53:48.127she had all the lights on and she had the bible open in front
00:53:48.127 -->
00:53:53.207of her and she was just writing on the bible and reading yeah and i was like
00:53:53.207 -->
00:53:56.687that's sacrilegious in itself like let alone whatever she's about to say to
00:53:56.687 -->
00:54:00.207me yeah and i was like mary is everything okay and she looks up at me and she
00:54:00.207 -->
00:54:06.347said the devil's here and i said and i said god bless and i closed the door and i ran.
00:54:08.987 -->
00:54:13.307I said see ya i said see the devil could be any way he wants to be but he's
00:54:13.307 -->
00:54:14.747not going to be near me and I ran.
00:54:15.007 -->
00:54:17.167I was out of there. Oh my god.
00:54:18.202 -->
00:54:23.842Oh my God. All right. Last question. Have you ever been convinced of a patient's
00:54:23.842 -->
00:54:26.242delusion before? Oh my God. Mary. Yeah.
00:54:26.602 -->
00:54:31.962I believe her. So I, I literally, I'm not joking. Like I had had conversations.
00:54:32.122 -->
00:54:34.202My sister also works in healthcare. Her name's Anna.
00:54:34.482 -->
00:54:38.522And I had had conversations with Anna about patients who show up with delusions
00:54:38.522 -->
00:54:40.762are specific to religion. Yes.
00:54:41.122 -->
00:54:44.422And I was saying to Anna, I remember around this time we had a conversation
00:54:44.422 -->
00:54:48.642about this because she had brought a patient to a hospital and the patient was
00:54:48.642 -->
00:54:52.542very religiously occupied and the family had believed that this patient was
00:54:52.542 -->
00:54:54.162demonically possessed.
00:54:54.502 -->
00:54:58.402They believed in demonic possessions. They believed in Christianity.
00:54:58.402 -->
00:55:00.562They truly believed that this was demonic possession.
00:55:00.742 -->
00:55:02.942They did not believe that this patient needed medicine.
00:55:03.142 -->
00:55:07.002They believed that they needed a plane ride back to their country where they
00:55:07.002 -->
00:55:11.242could be dealt with with remedies and all these other things.
00:55:11.602 -->
00:55:15.482And, you know, I remember Having this conversation with my sister and saying,
00:55:15.962 -->
00:55:18.482I truly believe that these people Are sometimes.
00:55:19.301 -->
00:55:22.561Possessed like there's no like an exorcism like some
00:55:22.561 -->
00:55:25.261something along those lines i'm like yeah these people who are
00:55:25.261 -->
00:55:28.381truly yeah their delusions are aligned
00:55:28.381 -->
00:55:31.421with religion and possession yeah play the part
00:55:31.421 -->
00:55:35.881yeah like what you see in a movie oh yeah i'm seeing in real life i i agree
00:55:35.881 -->
00:55:39.761with you and i i honestly believe that there's i've been assaulted i've seen
00:55:39.761 -->
00:55:44.581assaults i've seen people get hurt i've seen all sorts of things but this demonic
00:55:44.581 -->
00:55:48.681possession this christianity talk like this religion preoccupation,
00:55:49.841 -->
00:55:50.601it's scary.
00:55:50.841 -->
00:55:53.401That is the scariest thing. Especially when you have a patient that comes in
00:55:53.401 -->
00:55:57.781and they have no history. Right. No history of any, like, psych or anything.
00:55:58.881 -->
00:56:02.141Right, because you and I know that, like, psych diagnoses, they usually get
00:56:02.141 -->
00:56:03.381diagnosed very early on.
00:56:04.041 -->
00:56:11.081Early 20s, mid-20s. That's when you'll see these diagnoses develop and they truly, truly come out.
00:56:11.581 -->
00:56:16.141Yeah. Early, late teens, early teens, you see a little bit, my psych professor,
00:56:16.761 -->
00:56:19.561her name was dawn i loved her she used to always say
00:56:19.561 -->
00:56:22.241a lot of times you'll think your son's talking on the
00:56:22.241 -->
00:56:25.201phone and he's talking to himself but you walk by the room the door's closing
00:56:25.201 -->
00:56:28.521you think he's on the phone yeah but he's having a full-blown conversation
00:56:28.521 -->
00:56:31.541with himself yeah that was like like
00:56:31.541 -->
00:56:34.421that was in itself like i'm like really like i would never
00:56:34.421 -->
00:56:37.301how many times did my mom walk by and hear me talk on the phone and think oh
00:56:37.301 -->
00:56:40.101he's just talking to someone and i could have full-blown been talking to myself
00:56:40.101 -->
00:56:45.681no one would have known so my experience i guess with like patients like sometimes
00:56:45.681 -->
00:56:52.361every every so often I'm listening to them and they sound wildly like delusional and,
00:56:53.121 -->
00:56:56.681there is there's a part of me sometimes where I'm like I kind of believe them
00:56:56.681 -->
00:57:00.861like I kind of absolutely I mean it's weird because it's definitely like it's
00:57:00.861 -->
00:57:03.821like I don't know it's spiritual it's existential it's all this other stuff
00:57:03.821 -->
00:57:06.541and I'm not like a religious person like at all but,
00:57:07.238 -->
00:57:12.138There's just, there's a certain criteria of psych, I think, where you're like,
00:57:12.258 -->
00:57:13.518oh yeah, this is clear delusion.
00:57:14.358 -->
00:57:17.498And then there's another where you're listening to someone and it's like,
00:57:17.658 -->
00:57:19.758I think this is their experience.
00:57:20.258 -->
00:57:23.878I mean, you talk, so like Julie and I, we had another, we had an episode where
00:57:23.878 -->
00:57:27.818we talk about people who have a higher level of intelligence,
00:57:28.038 -->
00:57:34.058high IQs and things like that, where they're more susceptible to mental illness.
00:57:34.058 -->
00:57:37.398But then there's also I've talked about quantum physics before,
00:57:37.578 -->
00:57:42.158too, which there are scientists out there that will prove like there are different
00:57:42.158 -->
00:57:47.518dimensions. There are different, you know, realities and realms and things like that.
00:57:47.658 -->
00:57:51.038And so, like when we get like a highly intelligent, like, like patient,
00:57:51.058 -->
00:57:52.658which happens, it happens every once in a while.
00:57:52.778 -->
00:57:58.718We'll get one who's extremely, extremely, very intelligent, knowledgeable, even even in medicine.
00:57:58.958 -->
00:58:02.158Right. We get that often where they know medicine, but they're so.
00:58:02.158 -->
00:58:04.938But they're like talking to you and they're like no i'm telling you
00:58:04.938 -->
00:58:07.758like this is what's going to happen yeah or even like some
00:58:07.758 -->
00:58:11.898patients that are like like clairvoyant almost
00:58:11.898 -->
00:58:14.718and i'm just like oh my god so like for instance like
00:58:14.718 -->
00:58:19.058way back way way way back in the day when i was working a different psych hospital
00:58:19.058 -->
00:58:25.198and i would have occasionally i would have patients that would know that i was
00:58:25.198 -->
00:58:30.598a twin now that that's weird right because yeah and i didn't work together We
00:58:30.598 -->
00:58:33.638didn't start working together until, what, like seven years ago?
00:58:33.898 -->
00:58:40.118And so this one experience I had, a patient had, you know, come up to me and
00:58:40.118 -->
00:58:40.998they were like, hey, Julie.
00:58:42.095 -->
00:58:45.775And I looked and I said, hi. And they were like, oh my gosh,
00:58:46.215 -->
00:58:50.815I don't know why I called you Julie. You look like a Julie.
00:58:51.075 -->
00:58:56.755So in my mind, I'm thinking, okay, so Julie, she's a nurse and we work like in the Boston area.
00:58:56.775 -->
00:59:01.235So I'm like, it's possible that she's treated this person before and they're just confused.
00:59:02.015 -->
00:59:05.815So, but this one particular patient, she just kept, she was so fixated on me.
00:59:05.915 -->
00:59:08.855And she was like, you just look like, and there's a HIPAA.
00:59:08.975 -->
00:59:12.795I can't be like, oh, did, were you at this hospital? because my sister works there.
00:59:13.275 -->
00:59:18.235But this one patient, finally, I just was like, I can ask these questions without getting into too much.
00:59:18.375 -->
00:59:20.875And it's like, have you ever been here before? Have you ever been there?
00:59:20.955 -->
00:59:25.695Have you ever been blah, blah, blah? And they're like, no, I'm from Kentucky or something like that.
00:59:26.015 -->
00:59:29.115And they're like, no, I just moved here like two weeks ago. And it's like,
00:59:29.575 -->
00:59:34.595so there's no way in hell that you ever came across my sister,
00:59:35.115 -->
00:59:39.755my twin sister named Julie, and you for some reason feel like you know me.
00:59:39.755 -->
00:59:42.715Or are you so like that to me was just
00:59:42.715 -->
00:59:45.955like okay they're on some different realm and
00:59:45.955 -->
00:59:49.075then also when i was pregnant i was
00:59:49.075 -->
00:59:52.255just gonna say i wasn't i remember you being pregnant you
00:59:52.255 -->
00:59:55.595remember that right yes that you this really really
00:59:55.595 -->
00:59:58.495highly intensely patient who has been
00:59:58.495 -->
01:00:01.695she's been a repeat patient of ours you know who i'm talking about um
01:00:01.695 -->
01:00:05.135hippa guys but she was
01:00:05.135 -->
01:00:08.895really fixated on being pregnant she always
01:00:08.895 -->
01:00:11.675had a delusion that she was pregnant and every time she'd come to us she'd
01:00:11.675 -->
01:00:15.035be like take my urine i know i'm pregnant and it was just kind of one of those
01:00:15.035 -->
01:00:21.895things oh sorry guys kevin just got assaulted by a fucking tree i get assaulted
01:00:21.895 -->
01:00:27.675at work i get assaulted i get assaulted filming so she was kind of dangerous
01:00:27.675 -->
01:00:30.435though in a sense like she wanted to hurt people who.
01:00:31.211 -->
01:00:34.091Like, if you were visibly pregnant, she was probably going to assault you.
01:00:34.271 -->
01:00:37.291So I'm, like, two minutes pregnant. Like, I'm not even kidding.
01:00:38.571 -->
01:00:41.991Like, just conceived, like, an hour ago. So how many was that?
01:00:44.991 -->
01:00:47.391Oh, boy. It's not the parking lot line.
01:00:49.451 -->
01:00:55.311Oh, boy. So she was so anxiated on me. She was like, you're pregnant. You're pregnant.
01:00:55.471 -->
01:00:59.931You're pregnant. And I'm looking at her, like, what is she talking about? And she was right.
01:00:59.931 -->
01:01:04.051Like, so it's like patients like that, that I'm like, yeah, how,
01:01:04.311 -->
01:01:11.111and it's not like she was saying it to everybody, like plenty of women, my age in her presence.
01:01:11.351 -->
01:01:16.571And she would pick me out out of everybody lined up and be like, she is pregnant.
01:01:16.971 -->
01:01:21.491And she has my, I mean, the delusions were like, but I had, I was holding her
01:01:21.491 -->
01:01:24.291baby and I was all this other stuff either way though.
01:01:24.491 -->
01:01:28.931It was really strange. Like she could smell the hormones or something. I don't know.
01:01:29.131 -->
01:01:33.531But so. And I think that's pretty. And I think that's actually pretty normal
01:01:33.531 -->
01:01:37.051for most healthcare workers that work in the psych setting.
01:01:37.111 -->
01:01:39.751Because I don't know if you've noticed this, Laurie.
01:01:39.911 -->
01:01:43.391But like I've seen people that, you know, I obviously know their personal life.
01:01:43.391 -->
01:01:44.931I know that they have kids and they don't.
01:01:45.031 -->
01:01:49.051And I will hear a patient like verbally assault them and be like,
01:01:49.151 -->
01:01:51.031your son's a drug dealer or something.
01:01:51.311 -->
01:01:54.631And see these people get actually bothered by it.
01:01:54.631 -->
01:01:57.591Not necessarily because it's true but because
01:01:57.591 -->
01:02:00.531they picked up on something that correlates with their actual life
01:02:00.531 -->
01:02:03.531and so it's interesting because if
01:02:03.531 -->
01:02:06.651it's almost like if you can if a patient insinuates
01:02:06.651 -->
01:02:10.951something that can kind of like it lands close to home and that reaction piece
01:02:10.951 -->
01:02:16.671it's it's scary it's scary because do you think like psych like people i don't
01:02:16.671 -->
01:02:22.171say psych patients but just people that are i guess severely mentally ill do
01:02:22.171 -->
01:02:26.631you think they have maybe like a higher level of maybe...
01:02:27.836 -->
01:02:30.676Emotional or or even just like they're able to
01:02:30.676 -->
01:02:34.176read maybe paravirables like
01:02:34.176 -->
01:02:36.936i don't know i almost feel like sometimes they can
01:02:36.936 -->
01:02:40.036pick up on maybe you're emitting some
01:02:40.036 -->
01:02:42.996type of energy energy or something and
01:02:42.996 -->
01:02:46.096they pick up on it because it is we it is true like i've seen
01:02:46.096 -->
01:02:48.736patients go off yeah another on a
01:02:48.736 -->
01:02:51.476staff and there's no way that they would know their
01:02:51.476 -->
01:02:54.316history and they would just be like you're just
01:02:54.316 -->
01:02:57.716upset because your daughter sucks and
01:02:57.716 -->
01:03:01.156she's a drug addict and she's a whore she's a prostitute and
01:03:01.156 -->
01:03:03.936deep down we know like oh that's actually true but
01:03:03.936 -->
01:03:07.236right right and we're just like watching it in real time like how the
01:03:07.236 -->
01:03:10.076frig do they know that and it's
01:03:10.076 -->
01:03:12.916whether whether it's true or not that i don't
01:03:12.916 -->
01:03:15.996know but it happens often it happens
01:03:15.996 -->
01:03:18.916so often and i can tell you from experience that
01:03:18.916 -->
01:03:25.816when it does happen it's intimidating it it causes you to stutter and stop parent
01:03:25.816 -->
01:03:28.916you almost get paranoid yeah you turn paranoid like how the hell do they know
01:03:28.916 -->
01:03:32.616this and then you start looking at your co-workers like did somebody tell someone
01:03:32.616 -->
01:03:35.336tell this patient yep someone tell this patient about me and then it's like
01:03:35.336 -->
01:03:37.976nope no actually no just read you,
01:03:38.576 -->
01:03:43.916they just yeah they looked you up and down and just knew story yeah yeah it's
01:03:43.916 -->
01:03:45.776scary but it happens often it
01:03:45.776 -->
01:03:49.576happens often gosh all right so let's wrap this up a little bit all right.
01:03:50.336 -->
01:03:53.756How do you want to end this um i don't
01:03:53.756 -->
01:03:56.476know was this
01:03:56.476 -->
01:03:59.176fun i guess no this was a great time i'm so
01:03:59.176 -->
01:04:02.256passionate about psych and i love talking about psych and i have no problem
01:04:02.256 -->
01:04:06.216talking about psych and i think that the psych world is one of those things
01:04:06.216 -->
01:04:10.956that if we put a little bit more time and energy into we would see a lot of
01:04:10.956 -->
01:04:15.316issues resolved on their own i think that a lot of the problems in our world
01:04:15.316 -->
01:04:19.196right now really do point back to mental illness and what we can do.
01:04:19.396 -->
01:04:23.376And honestly, our job, our everyday job, especially as nurses,
01:04:23.796 -->
01:04:26.856is to, you know, always assess what we can do
01:04:27.125 -->
01:04:35.765Always do your own good and do your best within your ability to take care of
01:04:35.765 -->
01:04:37.225our patients the best way we could, right?
01:04:37.285 -->
01:04:40.685Listen to them, right? And if you think about it, right, like I talk about this
01:04:40.685 -->
01:04:43.125a lot, and especially when I was going through nursing school,
01:04:43.345 -->
01:04:47.105a big component of our curriculum was patient advocacy.
01:04:47.425 -->
01:04:50.885And so when you think of that word, right, patient advocacy, why? Why?
01:04:51.665 -->
01:04:55.205That exists the most in a psych setting.
01:04:55.205 -->
01:05:00.325Yeah that is patient advocacy don't don't do the bare minimum don't ever do the don't clock
01:05:00.365 -->
01:05:03.325into work and go i'm gonna do the bare minimum i'm gonna oh this person has
01:05:03.325 -->
01:05:08.305a disposition issue i guess they need a they need a bed somewhere right go and
01:05:08.305 -->
01:05:12.745you contact maybe two places because that's all you have time exactly go the
01:05:12.745 -->
01:05:14.525extra mile it's within our ability to do
01:05:14.845 -->
01:05:17.965those extra steps and extra things i'm a psych nurse at heart i've been doing
01:05:17.965 -->
01:05:21.185this for 11 years and i think that i don't ever really envision myself doing
01:05:21.185 -->
01:05:23.165anything different other than probably teaching.
01:05:23.485 -->
01:05:26.005Yeah. But I do think that it's important to,
01:05:26.557 -->
01:05:29.597talk about these things. It's important to bring light to these things because.
01:05:30.357 -->
01:05:33.877They're stigmatized because they were kept behind closed doors for so long.
01:05:34.437 -->
01:05:39.337And so although it may seem like this is huge increase in mental health crises
01:05:39.337 -->
01:05:43.857and no, this all existed for many, many, many years. And it has been around
01:05:43.857 -->
01:05:45.757us. It's your neighbor, it's your friend, it's your family.
01:05:46.257 -->
01:05:50.797Our job is to just do the best that we can. It's to do right by our patients.
01:05:51.237 -->
01:05:54.097And it's to identify, you know if if you're
01:05:54.097 -->
01:05:57.057working in a psych setting and you know that's not for you then it's
01:05:57.057 -->
01:05:59.917your job to remove yourself and find find a better
01:05:59.917 -->
01:06:03.797setting find something different to do i've worked in just detoxes and
01:06:03.797 -->
01:06:06.517i've identified within myself that i lose some
01:06:06.517 -->
01:06:09.357of my compassion over time so i need to figure out something different
01:06:09.357 -->
01:06:14.777i found my niche it's like it's it's psych nursing and so i have learned that
01:06:14.777 -->
01:06:19.277over time that is what i'm good at that's my within my wheelhouse it's within
01:06:19.277 -->
01:06:23.397my realm it's within my ability of as a nurse and so i don't see myself doing
01:06:23.397 -->
01:06:24.937anything anything other than
01:06:24.937 -->
01:06:29.117that so we need more we need more people like that i think to actually see.
01:06:29.957 -->
01:06:34.097I think a difference yeah you want to keep learning that is the best advice
01:06:34.097 -->
01:06:37.477i can ever give anyone is to just always want to keep learning because when
01:06:37.477 -->
01:06:41.497you're no longer teachable you're no longer necessity and try not to get annoyed
01:06:41.497 -->
01:06:44.977do not get that's the hardest part it's so hard. We're human.
01:06:45.957 -->
01:06:52.877You know, psych patients tend to have, yes, they have behaviors that are very
01:06:52.877 -->
01:06:56.597draining and very much like, oh my gosh, I have to deal with this.
01:06:56.917 -->
01:07:00.757Sometimes it's just reminding yourself that, you know what, they wouldn't be
01:07:00.757 -->
01:07:03.837here if they didn't need to be. They wouldn't be.
01:07:04.177 -->
01:07:07.897Regardless, and then we talk too about like, oh, this person's malingering and
01:07:07.897 -->
01:07:10.237they're here for like, you know, three hots.
01:07:10.457 -->
01:07:14.597And even still, even still, just Sometimes just.
01:07:15.350 -->
01:07:21.670I don't know, reframing the way that you are thinking about their disposition, their circumstance.
01:07:21.950 -->
01:07:23.830It's just, it would make all the difference.
01:07:24.170 -->
01:07:26.730This is the hardest part, which is to put yourself in their shoes.
01:07:26.890 -->
01:07:29.890But I truly do live by that standard, right?
01:07:30.010 -->
01:07:32.310So like many of our patients are homeless people.
01:07:32.470 -->
01:07:35.390And I always say to the BHAs who deal with their belongings,
01:07:35.590 -->
01:07:38.750I always say to them, you want to handle it with the utmost respect and care
01:07:38.750 -->
01:07:40.370because this is all they have.
01:07:40.490 -->
01:07:44.030This is all they have. Think of all the stuff you have and you think it's very
01:07:44.030 -->
01:07:46.690little, but it's important. to you, they have a lot less.
01:07:46.930 -->
01:07:49.630Right. When a patient's like yelling at you and they're like, you did it.
01:07:50.050 -->
01:07:53.030Right. Like in that moment, instead of getting defensive and being like,
01:07:53.170 -->
01:07:56.710oh my God, another entitled patient, blah, blah, blah.
01:07:56.870 -->
01:07:58.750Think about how you would act in that moment though. Exactly.
01:07:58.790 -->
01:08:01.590You know what I mean? And it's kind of like, I think when you can give yourself
01:08:01.590 -->
01:08:06.790that perspective, you can definitely meet them where they're at. Exactly.
01:08:06.970 -->
01:08:10.070Right. Okay. So we can end this. Thank you, Kevin.
01:08:10.430 -->
01:08:13.610No problem. Thank you for having me, Laurie. I miss Julie. Where the hell are
01:08:13.610 -->
01:08:15.570you? I know, Julie. She's at work right now. I know.
01:08:15.870 -->
01:08:21.590I actually gave Julie a report and then left work and came right to Laurie's
01:08:21.590 -->
01:08:23.670house. So I saw Julie today.
01:08:24.090 -->
01:08:27.030Poor Julie. And I handed the keys to the hospital to her and said, good luck.
01:08:27.230 -->
01:08:30.830I texted Julie and I said, hey, can you send me a text recording or something?
01:08:30.950 -->
01:08:33.650Well, before I went, she was like, yeah, maybe a little bit later,
01:08:33.730 -->
01:08:35.050though, in the middle of a restraint.
01:08:36.090 -->
01:08:40.750Don't touch her. Good luck, Julie. Someone got assaulted. I have to write all
01:08:40.750 -->
01:08:43.030the paper. I said, okay, yep. There you go.
01:08:44.210 -->
01:08:47.070All right guys thank you so much for having me all right
01:08:47.070 -->
01:08:50.430yeah thank you for coming on have a good one guys bye bye
01:08:50.430 -->
01:08:57.130hey i'm just here to remind you that when life isn't horrible it's actually
01:08:57.130 -->
01:09:01.310pretty good so if you just don't think about how horrible it is and think about
01:09:01.310 -->
01:09:05.950how good it is then then it gets it gets better even though horrible stuff still
01:09:05.950 -->
01:09:08.550happening there's still a lot of good stuff.