Today was very busy…4 evals and a census of 12 + 1…all mine…lol. I had NINE people in my first group….yep, nine. Me and 9 psych patients. In that group was a combination of people with psychotic features, mood disorders, major depressive disorder, and dementia……and two monopolizers. Ack. I keep marveling at the idea that I'm running these groups.

first group on self-awareness, second group on coping skills for depression. What irritated me is some pheblotomist or something came in during group and while I didn't mind that she obviously needed to do her patients, I minded that she ACKNOWLEDGED it was group and that I was doing it, yet stayed and talked to the patients in the room at a normal level. Either take them out of the room or at the very least, talk quietly! I was like WHY LADY WHY. Then she came up with the great idea of us getting a van so we could take the patients to an animal shelter to cuddle them. I was thinking…..these people are here like a WEEK with ACUTE issues….most of them combative/aggressive when confused…no way are group community outings appropriate for this population during this type of hospitalization. Anyway, I was rather surprised at her level of obliviousness in terms of being quiet even though she knew I was doing group and was actively loudly talking over her. My OT told me I should have asked her to be quiet, but I don't think that would have gone over well with her, seeing as how she was an employee.

One patient spoke up and told me I was a great speaker and she enjoyed group and I was like aw, thanks! Then the lady next to her was like “You said that to the last lady too!” and I was like….oh man, deflate my balloon or whatever.

One monopolizing lady with lots of pain issues was like “I have pain, I should go lie down…but I think Satan is the one trying to get me to do this. Satan, I rebuke thee in the name of the Lord! I'm going to stay.” …..several times she rebuked Satan. I was like ummmmmmmmmmmmm. lol. She reminded me SO much of the lady on Trading Spouses or whatever, the Christian lady who went crazy and said THE EXACT same thing  (I rebukee thee…) as she screamed at cameramen in her house.

What else…..during an eval today a lady with hallucinations who was perfectly sweet and appropriate said “Oh, there she is waving at me, I hope she realizes I'm busy”….and yet it was just her and me in the room. It was one of those “Am I crazy or did she just say that?” blink-and-you-missed-it kinda moments. You know how we blink and miss it? What happens when we miss it with our ears, since ears don't blink? Hmm, earblinks.

WHAT ELSE……..we were listing coping skills for depression and one lady said “eat a lot!” and snickered. Her normal answer is “smoke” so I guess that's a slightly better response. She cracks me up.

Um…..one patient went down on the floor today and they went and got a Hoyer lift to get him back up..at the same time another patient vomited, and another patient who requires 2 people for help, needed to use the bathroom that was currently being mopped…lol. Chaos.

I got 29 units again today….had to write FIFTEEN notes for group alone lol…and have to type out objectives/goals for EACH one since their systems are so old/DOS-based there is no copy/paste!!!!!!!!!

Um, a patient got agitated today and grabbed onto the unit clerk….they verbally took her hands off the clerk, then redirected her verbally….and they casually mentioned she got agitated around this time each day. That is an occupational therapy mystery as to what sets that lady off then. Hmmm. My guess is she had some kind of errand or chore she did around that time previously, and/or that having more than a few hours of down-time with no entertainment, agitates her….since the last group of day is rec therapy from 1 to 130.

Oh….one last backtrack…I did an eval on a lady Friday in another unit than my normal one…..the unit is connected to the acutely psychotic unit. I went into the nursing station which is enclosed in something like Plexiglass and encloses both units. Some guy started banging on the window and yelling and pointing at me. I was like AUGH!!! Luckily my lady was not in that part since no way was I going through there. This lady was WHACKED OUT….young but not a lot of teeth and she got a SIX out of THIRTY, scoring in the SEVERE dementia range…I'd ask her questions like, what month is it? and she'd take like five minutes to ponder it….”Oh…gee whiz….oh….brother….I don't know….”

I think the “What floor are we on?” question is really stupid. If you are in a psych hospital and all messed up, the last thing you remember is what elevator floor button got pushed as you were taken to your floor….”AUGH THE SCORPIONS ARE EATING MY BRAIN OH LOOK FOURTH FLOOR” lol….maybe I don't get the point and I write this in ignorance. It wouldn't be the first time.

Okay….I know this is too long and most people didn't read it all…but now it's all out of my head and I can go to sleep. I gotta figure out my groups for tomorrow though. I'm thinking a social bingo game to work on social interaction, and then maybe a relaxation group….with a mini array of possibilities….I could read one guided meditation, play one flute relaxing music, discuss deep breathing, and maybe do a few basic chair yoga like things. I dunno. Hmm.

Feb 03, 2009 | Category: Occupational Therapy | Comments: none