I have lost all passion for what I do. I don’t even seem to be good at it anymore.

I am feeling strong dislike and annoyance toward my residents.

I spent so much time studying psych, obtaining my degrees, feeling sure in my career goals. Now I’m disillusioned, heartbroken, certain I can never truly make a difference.

I am so sick of direct care.

I’m not sure the point of having this blog any longer when I no longer like what I do.

I was interviewed for a job at the VA last week. I’m resuming my masters with practicum  and practicum seminar next month.

Quick Stop Mental Health

Fast food – cheap grub at a low price that fills you up and is given to you at a rapid pace. It might satisfy for a moment but leaves the body quickly because it isn’t real food and doesn’t provide any real nourishment. Fast food and America’s mental health system have much in common.

Here at the City House, drugs are the answer. To anxiety and psychosis, aggression and even high blood pressure, drugs are always the first response. There’s no attempt to talk about why we’re anxious, and no counselor or psychiatrist will ask what the hallucinations are like. They will ask if the drugs mask it enough to get through another day. When someone comes in for their morning meds and they’re crying, there is very little time to get to the bottom of it because the next person is waiting, and the next, for the “services” in a drive thru line of mental health. If you try to advocate a little harder, if you try to spend more time talking with residents about the reasons for their depression and anxiety, then you’re just working too hard. You will meet resistance from coworkers and bosses and nurses and social workers. Why make anything from scratch when it comes frozen on a truck?

That’s the majority of my day, passing medications. I have to be quick when someone’s in some kind of real distress. I have to be like a fast food worker doling out a quick fix to get them through the next hour, the next day. Every day is a drive thru lane of varying needs and we address them only as quickly as possible and never try to get to root causes, never try to alleviate anything other than day to day symptoms which crop up like a craving for french fries. I’m not a mental health professional, I’m not a skilled nurse dealing with a difficult and complex population, I’m a quick stop on the road to mental health treatment and I can only spare you a little of my time.

We don’t make anything from scratch until someone goes into crisis mode. Not a minute before, even though we see it coming from miles away. Then the only answer is detainment and more drugs. In the hospital a psychiatrist will ask how the meds are working, not about the symptoms themselves. That’s as good as it gets if you’re lucky enough to even go through the drive thru lane of mental health.

I’m back!

SO MUCH has happened since I last posted – first off, I had to call off North Korea. That’s because about a month ago, my house was in the news and I thought, why is my house in the news?? Turned out it and the one next to it were going to be demolished in order to put up a human shelving unit. The landlord to this day still hasn’t told anyone. I got out fast, finding another house and moving my three cats and service dog into it to the tune of 2,000 dollars….that was a very large chunk of my savings. It was what I was going to use to go to North Korea. Now unless I win the lottery or someone sponsors me, I’m staying right here. (Though my new house is awesome because it’s in much better condition than my last house).

I finished another 1,000 dollar nursing course to add to my resume. I have to pass a skills demonstration and written test on the 14th to earn the credential number so I can actually market it.

But the coolest thing to happen so far (besides the move) is I got moved to day shift! During my month off, my boss called to say when I come back to work, I won’t be on nights any longer. This is good, because I couldn’t take it much more. I was being saddled with way more than a nurse should be – 4 floors most nights, almost 100 residents under my care. Every night. The state would have a fit if they were to hear about it. But I’ve already gone into great detail on why my organization can’t seem to retain people and it’s because they don’t pay people. I work days, but am staying late because I need the money so I can fucking feed myself.

I applied for a promotion in the clinic but didn’t get it. Another with less time and experience than me got it. My boss didn’t use the words “bipolar disorder” but when I asked what this person has that I don’t, or what do I need to change, it came down to that.

I’ll start looking for a new job this month. I have my eye on a few places.

North Korea Adventure Plans

(X-posted from another blog)

I’ve been fascinated with North Korea for some time. Their history spans 5000 years, and they worship the Kims as gods. They see us as imperialist aggressors, and they’re not wrong. No country is more imperialist and meddling than America. On that count I agree with them wholeheartedly.

All this time – as I soaked up any little bit of info I could get on North Korea – I just assumed isolationist policies did not allow any room for tourism. They don’t see themselves as subjugated as much as protected from the outside world. But the DPRK (Democratic People’s Republic of Korea as they like to be called) does have a fledgling tourism industry, and about 6,000 visitors a year are invited to the DPRK. Most of these are Chinese, some South Korean. Further, I assumed that because of their fury and hatred toward America, American citizens were banned from ever getting a tourist visa. I was wrong. I will not be the first American to visit and come back with no problems, but it is very likely that while there, I will be the only American in the country.

From the hotel window

From the hotel window

I am beyond thrilled that I will get to see the country for myself, even if it is a pre-packaged tour, carefully arranged and totally supervised by guides employed by the DPRK travel company, a privileged position to be working. I am working with Koryo Tours based in Beijing, the intermediary between foreigners wanting to travel to the DPRK and the DPRK government. There are many steps to the process, but I have already submitted all documentation for the visa and am getting ready to put a deposit down on the tour. The night before we leave, there is a required pre-tour briefing at the Koryo tours offices in Beijing. At that time I can buy traveler’s insurance and even pay for the rest of the tour.

I was sent a long instruction packet about the DPRK. At the top it said DO NOT bring this to North Korea. In it was extensive information about the country, about what you can and cannot bring, information about the hotel we’ll be staying at, and some debunked myths. For example, it is not illegal to talk to locals or for them to talk to you. There may be a language barrier, however. Another fascinating thing I learned is that American money is accepted there! Apparently the dollar has great value; one dollar there can feed a family for two days. I will need three forms of currency – RMB (Chinese, for while I’m Beijing for a day and a night) euro, and American dollars. There were repeated warnings to never wander off on your own, and especially to not leave your hotel room at night. Further warnings included bibles – do not bring them. There is an American over there detained still who purposely “forgot” a bible in a restroom. Just yesterday, North Korea publicly executed 80 for owning bibles. All in all, my pre-tour instruction packet is a fascinating document and included information about the DPRK you just can’t get unless you declare intentions to go there. An entire page was dedicated to essentials for packing, and included gifts for the guides. The top four items? Chocolate, apples, face cream, cigarettes. The first three items are exceptionally rare in the DPRK. My state is drowning in apples so I’ll bring a whole bag.

I haven’t decided yet if I’ll bring my laptop. I want it for the long flight to Beijing and back, and the DPRK does not confiscate laptops or cell phones since 2013. They may, however, want to search the contents of a laptop which I don’t want. While there it’ll be useless to me. I will be totally cut off from the rest of the world – there is no internet, no cell phones. You can get SIM cards for smart phones in Beijing to make international calls, but these are expensive, and I don’t even have a smartphone. In the hotel there are phones capable of international calls.

I will turn 30 in Pyongyang! My birthday falls right in the middle of the tour. I timed it in August because I want to see the Mass Games. There aren’t any actual games, but think Olympics opening ceremony on steroids. Over 100,000 performers put on a spectacle of a show. Very few westerners have seen it live and in person.

mass games

The DPRK is more liberal with photography than people think. I have been told I will take more pictures than I expect, so bring lots of memory cards because they are not available in the DPRK. The exception is when visiting the Mausoleum with the embalmed bodies of Kim Il-Sung and Kim Jong-Il – photography is strictly forbidden. This place is extremely important to the North Korean people and you won’t be allowed in unless formally dressed. You are also required to lay flowers and bow like everyone else. And I will do it. I intend to totally immerse myself in the culture as much as possible, to be as open-minded and respectful as possible. I feel this is absolutely essential for things to go well, and to get along well with the guides.

If you want to take pictures of the Great Leaders (their pictures and statues are all over the capital) that’s also fine but it has to be all of them, no part cut off. The guides will check. You must also be careful not to fold newspapers with their pictures the wrong way – their faces cannot be creased, and under no circumstances can you throw the paper away. I am excited to see the English language Pyongyang Times. What a souvenir that will be!

I will post more as more happens. It’s time to give Koryo tours my down payment.

Some More Venting

When I took this job, I took a pay cut. Many have done so, either because there was no choice, because they foresaw better opportunities in the future by doing so, or simply because they preferred the work compared to other work. It’s been three years, and my wages still lag behind what I used to make. Furthermore, I’m expected to pull miracles out of my ass when stuck on four floors with nearly 100 residents to look after. Neglect is definitely happening, because it’s simply too much for one person.

And yet they ask for still more. For example, the two residents we have in hoyers, Jake and Raymond. Jake is much easier because he doesn’t scream and yell, hasn’t had multiple strokes, and he’s much lighter. To me it is no problem getting him in the hoyer and taking him to the bathroom and then back to bed. It’s not even hard for me to get the sling under him when he’s in his chair to put him to bed. I only need a second person when he’s getting up for the day – someone needs to lift him while the other yanks the sling out and pulls his pants up.Yet they demand two staff be present whenever we operate a hoyer. For “safety.” To me this is ludicrous. At a time when all shifts are working with a skeleton crew, they want another staff standing there just so I can wipe Jake’s ass?

There is better work out there – work that pays much more and does not expect miracles from me. But I am stuck because of the tuition program I used – I must stay till June to avoid paying any of it back. Fine, I will do it. In the meantime, during my time off, I will take a nursing certification course which will elevate me from being registered to being certified, and thereby able to work in hospitals or skilled nursing settings. My boss once said the work is much harder in these places (think nursing homes) and I promptly told her she was very wrong because no home would ask me to look after 100 people. And at such a pittance! I only realized how poorly I was being compensated when I started looking into other work. Whether it’s at a nursing home, hospital, a skilled nursing facility (much like a hospital) or another group home, they all pay 3-5 dollars more an hour than I make now. There are other psychiatric settings like this, if I want to stay in mental health (as I do). I could be a tech for any of the psychiatric stabilization centers in the area, especially with my extensive knowledge of psychotropics and medications in general. Or I could wipe ass at a nursing home – I don’t care. Either way, I would work with 10-15 residents at 15 an hour or more.

The City House has taken steps to secure more staff, including a 1000 dollar sign on bonus. They have taken steps to get current staff to work more, including 35 dollar bonuses for each extra shift worked, and all the overtime one could want. What flabbergasts me is they will do this but not increase wages, which is much cheaper than paying out all this overtime and bonuses. Don’t they see? How is it the reasons people are fleeing the City House are not obvious to them? Because it’s happening, staff are dropping like flies as they find better work that pays more and does not expect miracles. Two have quit in a month, one stopped showing up because she was too overwhelmed, and another told me this morning she plans to leave to work at the state psychiatric hospital – they offered her a job similar to the one she has now at 17 an hour!

My therapist says this is the nature of non-profits, that they always pay notoriously low relative to places that are not owned by non-profits. The City House will get itself shut down if it doesn’t pay up in an attempt to retain people, I know it will. I’ve seen it before. No one will come work for us, no matter how bad the recession. Not when everyone else like us pays more for less work.

But I do love and care for my residents a great deal. It breaks my heart because they are the ones who truly suffer in all this, not us overworked and frustrated staff. They are held hostage by case managers, doctors, the mental health system, LRAs (least restrictive alternative) and a non-profit that does not appreciate the good staff it has to look after them.

My next post will be about my preparations for my trip to North Korea, or as they say, the Democratic People’s Republic of Korea.