At work in 2010… not so good

Ok, so, it’s the second week in February and I’m slowly but surely loosing my last nerves. The BF tells me I’m getting aggressive on the week-ends (is it work, or the influence of a certain American?). I overworked that week and tried to compensate by going to the movies (Avatar – did not brighten my day), hanging out with friends (thanks again for the pancakes, Trevor!) and getting out of town (for lunch with the in-laws…). All the while carnival has started and I cannot stand that season. I’m trying to avoid it all costs, but then Mardi Gras Tuesday comes along and the whole ward is all abuzz with Fasching fever. Since I had to miss out on the Christmas party already, I feel guilty and the others pressure me to come along. So here I am, on a work week Tuesday, at three thirty in the afternoon, dressed up, on the main street with “Jecken” all around, drinking champagne. I also hate champagne and getting disguised this way. Who am I? Where am I? And why the hell am I doing this? Eventually everybody gets drunk and starts singing those horrible songs and I’m guessing this is supposed to be the part where we “bond” as a “team”. One of the nurses who came along was really getting shit-faced and started telling me how she thought I was a naive, white-bread girly girl – but hey, it turns out I’m not all that bad! Why gee, thanks for the compliment! Somehow I still ended up being the only one who wanted to make sure she got home safe (since she could hardly stand anymore), so after I had to watch her pee in public – along a main road and in front of a police station – I finally found a taxi to stick her in. Luckily for me, I only had to be back at work in the afternoon. She was there too and couldn’t remember a thing.

Meanwhile, that week I also had another encounter with the narcissistic asshole known as the chief. I learned at that wonderful carnival evening that apparently it was an open secret that he was also bipolar. Yay. Anyway, I had to meet with him because he’s running a research project and I needed some income. But everyone told me to not go there, since he is the most unorganized and capricious person in the history of all mankind. So I politely declined, with a very fitting excuse that my orphan pension would not allow it. Now I’m guessing that didn’t digest too well with the megalomaniac, who probably never hears a no in his life, because the week after is when all hell broke loose. We had a new patient: turkish woman in her 30’s who can’t breathe – even though everything was medically checked. We would call these panic attacks, but she refuses a psychological model for her problems. I’m supposed to do therapy with her. I manage to squeeze in an hour on Wednesday morning, when I have no office, so we talk in their lunch room. Off the bat she tells me she knows my face, but can’t say from where. She is very dismissive, won’t answer my standard first-encounter questions (“It’s all in the chart!”) and when I try to get some biographical info, she outright tells me I’m asking the wrong questions. I can tell this isn’t going well and I’m running out of time. So I ask to make the next appointment and will try to adapt and somehow build a therapeutic relationship next time.

Every Wednesday the supervision for psychologists in formation at that clinic is at the same time they have the chief rounds at the ward. So I always miss it and have to ask afterwards what happened. This time a nurse tells me, on the sly, that our beloved chief talked to said turkish women, who apparently was not at all happy. She said I was cold and she didn’t like talking to me. What does the chief answer? Maybe something like: well, that was just the first hour, normally there are 5 probationary sessions, give it a try? Or: well, our ward works on a give-and-take basis, not on demand? Nope. He says: “we have another psychologist on ward, you can switch”. Just like that. And this to a patient who thinks we should jump at her request anyway. Nice going, chief.

But wait! That’s not all! Remember the patient I talked about last time, who no one knew how to handle? He has what we call a body dismorphic disorder (google it if you like). I went and got a psychotherapists manual to that disorder and held to it. When the chief asked him what he was doing with me in therapy (nobody thought to ask me, of course), the patient said: just diagnostics. Just diagnostics! When I’m busting my ass to find a way for him to even realize he’s sick and start to question these convictions of ugliness he has! But then: he brings an example. We worked on a lifeline together, where he lists what symptoms he had when in life and what other events occurred. Normally this helps in recognizing connections. What does the chief say? Yes, that’s diagnostics. Fine, mister I-know-nothing-about-therapy-but-I’ll-judge-anyway, leave me to explain that to the patient. As if that wouldn’t hurt the therapeutic relationship and the patient’s esteem of my work enough, chief goes on to say: “it’s not possible to work without a concept like that. If she needs a therapy concept, she should call me”. I will pause now to let that sink in and let your jaws come back up.

What a hoot, right? Him, of all people, wants to give me a concept? Sure, go ahead and try! I’d be really curious to see what turns out. And yet, he goes on to say that psychotherapy is total humbug anyway and it’s only real purpose is to keep the patients off his back. Again, I pause for the full effect… Yes, those pesky patients he actually has to spend a whooping five minutes per week with. Poor you. Never mind he loves to cite reasearch papers for any kind of findings, omitting however that it has been scientifically proven that cognitive behavioral psychotherapy (which is what I do) really does help people – on the long run even better than his beloved meds. Ugh.

That evening I met with The BF to watch “I’m a cyborg, but that’s ok”, which is a movie that plays in a psychiatric ward. Even though it’s made as a satire, I had to hold back tears several times because it reminded me of work. When The BF tried talking to me I felt like stone and apparently looked like it too. I was at the edge of burn-out cliff and looking down into the steep slope of nervous breakdown. I shut down and couldn’t say a thing. This might sound like an overrreaction to some, but I’d like to point out that I never got any feedback on my work until then. Or any direction, for that matter. At least I was meeting up with a friend on Friday, who had worked on the same ward before me. Maybe she could have some insight. Till then I had thought it over enough to be able to talk about it. Then she told me something I didn’t know: that the chief had actually kicked her off the ward. I thought he wasn’t in charge of us, but apparently he can fire us. She had only heard afterwards, over three corners, that he wasn’t happy with her work. She never really heard why.

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