Gathering Nuts While in May

[usuakari]

My month in an acute psych unit is over. This one has proved to be more intellectually and emotionally draining than the last. I’m not ultimately surprised at that, because it’s minds and emotions that we’ve been dealing with so much more than bodies, but still a noticeable thing. This isn’t to say that problematic interfaces between minds and

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[usuakari]

The preceptor in quo was a psych trained nurse (back when that was a direct entry course, rather than the post-grad specialty it is here currently) of considerable general and forensic experience and a robust approach to health care. An older Scottish immigrant who could believed mightily in the power of swear words. I enjoyed my shift with him quite a lot. :)

The patient who was giving me particular grief was young, smart (although not as smart as they thought they were), had a certain brash charm, and was a little shit while they were with us. I strongly suspect that they were also likely to be diagnosed as having a personality disorder (assuming you believe in the concept in the first place) of one sort or another with the infamous Cluster B traits. Along with very manic, charming and clever, went deceptive, intrusive, and manipulative. When I expressed my frustration and difficulties at dealing with them, the preceptor reminded me of a couple more things. One, being manic, they were probably only hearing half of what I was saying, and only remembering the fragments they wanted to; and two the problems with the relationship were mine, not theirs... I actually got back-handedly commended for my own insight on that last bit. When I explained that I'd also gotten to the point that I didn't believe a thing that the patient told me without verification I got reminded of another useful attitude in mental health care: "With some patients, if they say 'Good Morning' to you, then the first thing you do is open a blind and look outside to check."

I imagine working in prisons would somewhat similar. I kept expecting to get to the forensic psych unit for this placement, but it never eventuated. I'm not really upset about that one way or another. I think that I still lack the full set of spoons to work there, but it would have been an amazing experience.