Here's a deal. I'll tell the story, you do the research and gather the statistics. I have been challenged to blog about what I care about. I care about a lot of things. First, I care about children. Next I care about humanity. Then mental illness/mental health.
It's hard for to me write in a scholarly format. Determining the significance of something by gathering statistics. Experimental Studies' Results that show correlations or lack of correlations between two distinctly different sources of stimulation in order to conclusively prove that a caused b, etc.
I care about what I care about. I have dedicated my life to it. I don't volunteer as much as I should, but I have made my career out of my passions.
Trying to be progressive about something like suicide is difficult. I have seen it discussed on this site. so that is enough of a reason to share what I know about it. I can't bring myself to study it's relevance or prevalence. I know it happens. I have seen it happen. I don't need statistics to tell me it deserves attention. The same goes for child abuse.
Determining causes? I am not in a position to pretend it is so simple. The causes are as incomprehensible in number as are the number of hairs on my head, if you want to define cause as a precipitating event.
I get my information first hand, from the inside.
Today i met a 13 year old boy. I read his chart before I met him. He has 5 brothers and 6 sisters who are spread throughout the county in various foster placements. His father sexually abused him and is in prison. His mother has given up all parental rights. He lived in foster care until he was five, and was abused by multiple foster caregivers. He now lives at a group home, which has a solid reputation and he has been at for 2 years. That's a record in this state.
His chart also says that he has an unspecified neurological disorder.
Before I met him I read his handwritten biography. We have a "Phase" program which allows kids to gain privileges for role model behavior. Part of that program asks kids to write an autobiography, and share it in front of the rest of the kids. His was written in cursive, in very large, jerky letters. Some major misspellings, but correct sentence structure. He tells about being diagnosed with schizophrenia when he was 5.
He was at a foster home. He was having a nightmare that he was being scratched. He woke up, screaming, to his foster mother hitting him. He told her there was a monster in the closet. He managed to communicate that it scratched him. She made him take his shirt off and saw the scratches on his back, and freaked out. He went to a psychiatrist and was told he was schizophrenic.
That was his version of the story. Today I saw him sitting in a chair, twitching. I called his name several times. He just kept twitching. It seemed liked his eyes were rolling around under his closed eyelids. Another staff member was with me. He happened to be another "sensitive." "Sensitive" is the word I choose to describe that ability to reach into a diseased, lonely soul, connect, and extract a positive response.
This boy wasn't responding to me, but I was softly coaxing him with my voice, asking him to let me in. My actual words are something like,"'A----,' my name is 'R------. I am your nurse today. I would like to talk with you. I know you are sad right now. Would you please look at me?" I say it all very slowly. My partner nods, notices, as I do, the slight shift in his posture, and the slight turn in my direction. We are both studying him. His movements appear to be a combination of psychosis, a response to internal stimuli, and seizure activity.
I sense his distrust of me, look my partner in the eye, we exchange a knowing glance, I move away, my partner closes in. He is kneeling on the floor beneath the kid, looking up into his face, speaking very quietly. I don't pay attention to the words. The boy starts to blink, like waking up from a sleep, and locks eyes with my partner. He begins to answer with clear "Yes" and "No" to questions. He shares that the voices are telling him to hurt himself. He starts twitching, but is gesturing as if he needs to scratch himself. He quickly sits on his hands in effort to contain them. He still has nystagmus.
I called the doctor and get an order for Haldol. He already got Ativan, and it wasn't working. He needed something for the voices. He took it, it took 2 hours to take effect. We kept him in line of sight until he relaxed. I noticed he was more calm, and approached him. I asked him about the voices. He said they torture him. He said they tell him he's mean and he needs to die.
I tell him, "I don't think you're mean." His eyes bugged out of his skull. He said, "You don't?" I said, "No, you told me the voices told you to do bad things, and you didn't. You've been sitting on your hands so you wouldn't do anything bad. That tells me you're good, and you don't want to hurt anyone." He said, "Really?"
I told him, "You don't have to listen to those voices." That confused him. He asked me 3 different times, "I don't?" I said, "They're not real. They are lying to you." He started to process that. I asked, "Are those voices louder than my voice?" He had to think about it, looking away quickly, then locking eyes with me. He said, "No." I said, "So whenever these voices that tell you lies are bothering you, you can come and talk to us( I nodd toward my partner), so we can tell you the truth." He nodded.
About an hour later he went to sleep in the observation room. I tucked him in, and he said, "Thank you."
This was beautifully written.
I really miss working with the kids at Phoenix Childrens' behavioral health unit. That was probably my favorite rotation out of all the nursing school clinicals.
You are a truly special person for choosing to help these kids as a career. It's pretty clear that you are already having a positive effect on their lives. :-)
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Lovely story!!!!
Haldol is a biggie. Right now one of my clinical clients is on that as well as lithium.
Anyway I just wanted to say every positive influence helps kids learn to cope and truely live.
You and your partner are truely life makers.
Love is like a box of chocolates; if you chose wisely you won’t be disappointed and have to spit it out. ~T
We use the big guns for severe symptoms. If someone takes it routinely they can curb the side effects with Cogentin or Benadryl.
And thanks to everyone who has posted so far. It's not an easy job, and most of the time it feels like I'm banging my head into a brick wall, but every single day I am there I am given an opportunity like this to make just one little tiny crack in the wall these kids hide behind. It seems like a small thing, but it's the small things over time that make a difference.
"Consistency is not a human trait" - Maude, from Harold and Maude
The grand canyon started as a small streaming trickle of water. The effect is hugh.
Love is like a box of chocolates; if you chose wisely you won’t be disappointed and have to spit it out. ~T
"I say it all very slowly."
I don't know if you find this effective, but from reading mentally divergent adults' writing concerning this matter, it seems to actively offend people when you speak to them in this manner, as they are simply mentally imbalanced, and not necessarily slow, per se.
The manner in which I speak to my patients varies from patient to patient. I have to be very sensitive to every twitch and every breath a patient makes in order to read the effect I am having.
I don't assume anything about my patients. I don't even read their diagnoses. i read their histories, and then I read them.
Sometimes I only say one word repeatedly, sometimes I say two words repeatedly, sometimes three.
Sometimes I get in 30 minute long debates about the existence of God and whether or not Emo is cooler than Goth. Sometimes we have a very lucid philosophical debate about whether or not suicide should be legal.
Sometimes I just hold them and whisper, "Shhh" in their ears. Every single patient and every single moment is completely unique, and so are my responses.
I guarantee you, if I made my patients feel stupid, I probably wouldn't be alive right now.
"Consistency is not a human trait" - Maude, from Harold and Maude
He told me when he called me on his break, "I'm on adolescents today." I didn't really process. I was rushing to finish overdue schoolwork.
He's home now, and i asked him to read this blog. He told me, "He was my buddy today!"
My husband didn't know anything about him before going to work today. He also doesn't have the luxury of reading charts before he passes his meds.
My husband is also a "sensitive," sometimes the most sensitive. He has worked at the state Developmental Center for 7 years. He is especially sensitive to seizure antecedents.
My husband keyed in on this kid pretty early. The boy approached my husband, asking him to read his autobiography and sign his Phase Up packet. My husband said he never got the chance to read his packet, but he did sign his packet.
Later in the shift the boy was found with a self inflicted abrasion on his forehead. His nurse approached my husband, and said, "Do you know anything about anime? Apparently this boy loves anime."
My husband was excited. We both love and collect anime. My husband spent much of the day sitting with this boy, drawing characters from Neon Genesis Evangaleon and Trigun. My husband wanted to be a cartoon artist for Disney when he was a kid.
At various intervals the boy would start trembling and acting like he was going to scratch himself. My husband was able to keep him connected to the present moment by drawing attention to their drawings. They connected over a common interest, but the trust had already been established.
It makes me feel good to know that seeds can be planted, and watered, with or without my direct involvement or knowledge.
"Consistency is not a human trait" - Maude, from Harold and Maude
Are the seizures due to medications or a neurological disorder? I have a seizure disorder, and even a few minutes of anime can set me off later that day. Just curious.
I'm glad that kid is doing so well there. Congrats for opening a door.
-Sonja :)
"I'M AS MAD AS HELL, AND I'M NOT GOING TO TAKE THIS ANYMORE!" ~ Peter Finch as Howard Beale, 1976, "Network"
it's probably not the anime, because this boy hasn't seen any in over 2 years. Drawing pictures isn't going to provide the same stimulation as watching it.
Not the medications, because he has been this way his whole life. Meds didn't come into the picture until he was 5 or older.
I don't know if they are seizures either. i think they are part of it, but the psychosis is pretty strong. People don't typically scratch themselves repeatedly while drawing blood during a seizure.
"Consistency is not a human trait" - Maude, from Harold and Maude
That's a pretty incredible story. Schizophrenia is such a scary disorder...the move "Beautiful Mind" gives an excellent example of that. The part where his baby nearly drowns in the bathtub is especially scary. You can't help but feel bad for these people and wish there was more you could do to help. That's SO awesome that you're being able to help like that! God bless your work!!!
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"It is poverty to decide that a child must die so that you may live as you wish."
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Beautifully written. My step-father was schizophrenic and was on Haldol.~angi~
is a pretty big challenge. Have you blogged about your step-father?
"Consistency is not a human trait" - Maude, from Harold and Maude
My husband was there again today. He told me that our boy had reached Phase 2 and working on Phase 3 (the highest phase we have, which gives privileges to take walks off grounds and to receive outside food).
My husband said he was really focused and stressed about it. He said that at one point the boy was begging him to know if he would get to Phase Up. The kids are the ones who actually decide. The patient reads their essay in front of the group and the kids decide if the kid should phase up. We take a vote by raise of hands with the patient absent from the room. Anyone who doesn't vote in favor has to state their reasoning if they want their vote to count.
Phase 2 requires an autobiography, and Phase 3 is an essay about what a role model is and how the child perceives him/herself as a role model.
There was more to this encounter than I am going to post, but the thing that struck me the hardest was my husband quoting him as saying,
"I just want to know what it feels like to be a leader. I'm going back to my group home soon, and I'll never have the chance to be a leader ever again!"
"Consistency is not a human trait" - Maude, from Harold and Maude
Nice work. I see you're good at writing these personal stories. This was an amazing show of empathy and affection for another person. I definitely think you're in the right profession. :)
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Mind Control is Easier Than You Think
that this boy went back to his group home today, and he did make it to Phase 3 before he left. I'm pretty sure I will see him again. I know we didn't cure him, but we did help to stabilize him.
He can use all the prayers he can get, so if you are so moved, please pray for him. He is one in particular that really touched my heart. I honestly don't know even know if I believe that schizophrenia is his real problem.
I can't help but think that if it weren't for the abuse and abandonment he suffered, he wouldn't have these terrible voices.
It's easy to think that from his autobiography, what might actually have happened is that he was having nightmares and flashbacks that distressed him. Others misinterpreted his behavior and gave a diagnosis, a label. None of the psychiatrists I work with believe that a 5 year old can be schizophrenic. Magical thinking is a very important part of childhood. How can we judge their reality as false?
If I am correct, then as soon as he received this label, and attention, he had no reason to fight his nightmares. They made people pay attention to him and want to help him. Also, he is developmentally delayed, and more than likely he is just still in that magical thinking stage, and his nightmares just don't go away.
I don't know, but I know that my job is to promote healthy behavior and to stabilize kids in crisis. He is not in crisis now, but his nightmares will continue.
"Consistency is not a human trait" - Maude, from Harold and Maude
First of all, thank you for your kind words regarding my blog. Second, thank you for sharing this heartbreaking, yet inspiring, story. I don't know what to say other than I am deeply moved by your compassion and professionalism. I look forward to reading more of your writing. Regards, JBuitron.
Speechless....just pure beauty.