Thursday, December 30, 2010

Mouth, meet foot

Note to self:
When describing your desire to work with the local jail inmate population and do more health education and health promotion activities with them at the multi-department staff meeting (which includes all of your supervisors and their supervisors) avoid using the phrase "they're a captive audience."

Tuesday, December 28, 2010

Brains are squishy

Helmets are good. Not only does wearing one (gasp!) protect your head from severe injury, but it can even protect other people's heads from severe injury. (By modeling good behavior and convincing them to wear helmets...)

I was recently trying to explain this to Mr. Skateboard. Between multiple traumatic brain injuries and organic brain damage from before he got sober, Mr. Skateboard's memory is somewhat impaired. (He didn't come see us for three months because he forgot where our office was.)

"Are you wearing a helmet when you're out skateboarding with the kids? Because a bonk on the head can really scramble your brains," I said.
"Nah, I been bonked on the head a lot and I'm fine!"

Friday, December 24, 2010

This is why I don't talk about politics at Christmas

Chart check quote of the week:

"Client has persecutory delusions involving RCMH employees and some national political figures, as evidenced by statements like "Sarah Palin is so evil even the aliens don't want anything to with her."

Tuesday, December 21, 2010

Drug-seeking voice mail of the day

As I checked my voice mail yesterday, there was the following message:

"Hi, I just got out of the hospital and I really need something for anxiety. They gave me something good there, you can check my records if you like. It's called lorazepam. L-o-r-a-z-e-p-a-m. So if you could get Dr. Analytic to prescribe it for me, that would be great." [click]

Buddy, it's great that you took the time and effort to think about what drug you wanted the doc to give you, and even spelled out its name for us. While it's pretty unlikely that he'd prescribe one of the most-abused medications to you without seeing you himself in an office visit, at least you gave it a good shot. But since you didn't give us your name and phone number, it's not going to do you any good!

Wednesday, December 15, 2010

One of the lesser-known saints

We have a new psychologist at work. As we were introducing ourselves, he asked what I did as a nurse for the mental health department.

"I arrange for medications to be delivered to our office for the clients who pick them up here. I also telephone doctor's offices to coordinate care of complex patients. There's about fifteen people who come by every week for their injections--"

Comprehension dawned in his eyes. "So you're the Risperdal lady!"
Sure, Mac. Just call me "Our Lady of Antipsychotics." You thought nuns whacking you with rulers was bad--I'll do them one better!

Monday, December 13, 2010

On being part of a community

One of my middle-aged patients has suddenly taken up skateboarding. Not many people suddenly decide to do that at age 45, so I asked him why he'd decided on that hobby.

"I wanted to do more stuff with the neighbor kids. I mean, I known 'em since they were babies and I was runnin' the meth house, but I'm sober now and I thought it could be fun. They always looked up to me and I thought it'd be nice to be be a good influence for once."

Friday, December 10, 2010

Support from supervisors... or not

We had a meeting recently to discuss what to do about a subpoena we'd all received regarding a client. For several of us, it was our first supbpoena, so the meeting was very helpful at allaying our fears regarding being in court.

One of the case managers who's been there for a decade or so admitted to being very nervous about the upcoming court date. "I'll look over my charting and I'll follow our policy, but I'm pretty worried about it. I've never been subpoened before, and it's freaking me out."

"You'll do great. And if the stress gets too bad, you can always call the crisis hotline," I told him.

"But please call Adjacent County Mental Health's crisis hotline!" our boss suggested.

Monday, December 6, 2010

Patient quote of the week

"I've got PTSD, but I was in the Army and served in Desert Storm, Bosnia, Kosovo, and Afghanistan, so I come by it honestly."

Thursday, November 25, 2010

That was a pleasant surprise

Mrs. Worried is one of my favorite patients. She's intelligent, polite, and very involved in her care. She's been on the same medications for years, and we don't mess with them. She's also very forthright with us when she has concerns about the medications.
She called last week about her Xanax prescription. "I know you guys had to reschedule my appointment with Dr. Warmnfuzzy for about three months out because you're so busy. And that's fine, but I've only got three or four days left on my Xanax, and I don't have any refills and I wanted to make sure Dr. Warmnfuzzy did something about that before I see her, because I don't think I can be off it for three months!"
I reassured her that I'd talk to Dr. Warmnfuzzy and get her the necessary prescription. "But she's pretty busy and it will probably be at least three or four hours before I can get this done," I warned her.
She laughed. "Honey, I've got fifteen pills left. If I go through all of them before this afternoon, I don't deserve to be on Xanax!"

Wednesday, November 24, 2010

Time to chart veeery carefully...

Because it's not like I wasn't paranoid about my personal safety before I started this job....

Tee shirts with bizarre slogans are very popular among our clients. I've seen people wearing shirts that said everything from "Can't sleep... clowns will eat me!" to "If sex is a pain in the @$$, you're doing it wrong." The thoughts expressed may not be "appropriate," but they're usually good for a few laughs and conversation starters.

But tell me what I'm supposed to say to a wild-eyed, disheveled gentleman who reeks of stale sweat, vomit and booze wearing a shirt that says "I like you--I'll kill you last!"

Monday, November 22, 2010

We have standards?

Our electronic charting system annoys me regularly, but it has one very useful feature: the "pop-up reminder." There's a lot of stuff that we need to keep track of that doesn't need to be part of the "permanent medical record:" what pharmacy patients are currently using, who their primary care practitioner is, when does their probation supervision expire, etc. The pop-up function is very handy for noting these things.
I was checking charts last week and found the following pop-up in a patient's chart: "Not allowed to contact LuAnn for any reason. Do not put through to her voice mail either!" LuAnn is one of our social workers, so this was odd. When I had time, I asked her about it.
"Yeah, he was wildly inappropriate the last time I saw him. I mean, even by my admittedly low standards, he was really inappropriate."

Friday, November 19, 2010

Pot, meet Kettle. Kettle, Pot.

I received a warning from Dr. Analytic yesterday that my writing style in my recent office correspondence was "a bit sarcastic and maybe you could watch that."
And that's a pretty good point. I'm a bit crabby by nature and while I like to blame excessively bitchy days on a lack of coffee, there's a very good chance that this may just be my personality. (Oh how I wish I had the balls to wear this shirt to work some day!)
Then I realized that Dr. Analytic's automatic e-mail signature said "putting the 'fun' in dysfunctional!"

Punctuation matters more than you think

There are days at work when I'm on top of everything. Yesterday was not one of those days. I realized this as I was reading the crisis log from the night before. The log follows the time-honored format of listing the patient, the hospital at which they were seen by the crisis department, and what problem drove them to seek crisis services.
"John Doe. Random County Hospital. Delusional, found by police intoxicated, naked and directing traffic. Indigent."
"Jane Doe. Our Lady of the Wilderness Medical Center. Suicidal cobra."
I read this and had a grand old WTF moment. Not at John's plight, mind you. If ever there were a good reason for the sheriff to take one on an unexpected trip to the ER of the local psych hospital, that would be it.
But Jane's predicament was a different story. I mean, what the heck does a suicidal cobra have to do with calling our county's crisis hot line? Is it even legal to own a cobra in this state? If it doesn't talk and doesn't have movable eyelids, how do you know the snake's emotional state?
After I got done pondering these things aloud with the crisis workers, one of them politely pointed out that the crisis log's format had changed. It now had room for the client's insurance information. Jane was suicidal. With COBRA insurance.

Tuesday, November 16, 2010

Patient Tee-Shirt of the Day

I saw a patient wearing a shirt that said "I don't listen to the voices all the time, but they have some pretty good ideas."

Wednesday, November 10, 2010

Words you don't want to see in a chart, part 2

I was doing a routine chart review last week, and I ran across this entry in one of the doctor's notes:

"Abuse history:
She says she experienced domestic violence from her first husband, but then she went out and bought herself a nice baseball bat and after that he was very good to her until the day he died."

I'm glad it worked for her, but wow.

You deserve to be treated with love, respect, and dignity. If you are experiencing domestic violence and feel you're in immediate danger, please call 911. If you just need to talk to someone, call 1-800-799-SAFE or visit the National Domestic Violence Hotline for more information.

Monday, November 8, 2010

Toys You Won't See at Sears

I received a subpoena at work last month. Because many of our clients are "involved with" law enforcement, DHS, or other legal entities, this is pretty normal. You sign it, schedule the court date on your calendar, send a copy to the risk manager, and go on with the rest of your day.

But that got me thinking: My First Subpoena! That's a toy Fisher Price will (hopefully) never put on the market.

What about My First Flesh Wound! (Complete with itemized ER bill which charges $15.00 per tablet of ibuprofen, "MRSA and You" pamphlet, and "Gun Safety Means Using Both Hands" bumper sticker.)

Or My First Jailhouse Tattoo! (Comes with a syringe, your choice of three ballpoint pen ink colors, two stencils (skull or swastika) and a voucher for a free hepatitis C test at the local laboratory.)

I shared this idea with my husband. "What about Lego's "My First Meth Lab?" They could include a couple of the SWAT team Lego men, breakaway doors, and interchangeable heads that go from normal to unhealthy to a skull for the meth users!"

Friday, November 5, 2010

Overheard at work

Secretary: "I'm sorry sir, but Sherri Socialworker is in a meeting. You can leave a voice mail if you like."
[pause, listening to client talk]
"No, you can't talk to her right now. She's in a meeting. Would you like to talk to a crisis worker instead?"
[pause, with angry voice coming out of the phone handset so lound I can hear it even ten feet away]
"I don't like you swearing at me like that, so I'm going to hang up on you now." Click.

Thursday, October 28, 2010

Mutually assured destruction?

As I was sitting in the break room by myself at work last week, I heard a loud voice speaking down the hall:
"The secretaries are out to get me and enjoy making my life hell, but you get used to it. "
It turned out to be one of the social workers giving a building tour to an intern!
When he got to the break room and saw that it was just me and my Top Ramen, he said, "Darn! I was hoping June or someone would be in here so I could give them a hard time."

Tuesday, October 19, 2010

Do I look like I give out drugs for fun?

Mr. Methhead is one of our "regulars." People tell me that when he's sober and stable on his medications, he's a pretty cool guy. Since I've never had the pleasure of encountering him in either of those states, I'll take their word for it.
Monday, I got to field the following telephone call from him, several hours after I'd given him his regularly scheduled antispychotic injection:
Mr. Methhead: "Hey, I've got the worst headache today! Do you think it could be from that shot you gave me this morning?"
Me: "Maybe, but I wouldn't bet on it. Skipping caffeine can cause bad headaches, though. Did you have your coffee this morning?"
MM: "No, but I had some black tar heroin over the weekend. Would that do it?"
Me: "Yes it would. Heroin withdrawl will really make you feel like crap. How's the diarrhea and vomiting today?"
MM: "I'm not puking, but the @%#s are bad. Do you have any heroin?"
Me, very thankful it's a phone conversation so I don't have to try so hard to keep a professional facial expression: "No, sir, I do not have any heroin."
MM: "Oh, then do you think the doc would prescribe me some OxyContin?"
After the usual reminders to him that we're a mental health office and DON'T prescribe pain medication (We don't do this under any circumstances. Your arm could fall off in our waiting room, and we still wouldn't. We firmly believe in "not feeding the bears.") , drink lots of clear fluids, call 911 if you can't breathe, etc, I managed to somehow gracefully disengage from the phone conversation only to look over and see the interns gathered at my door with their best nonchalant expressions plastered on their faces. You know, the ones that say "No, I haven't been eavesdropping even though my eyes are the size of saucers."
"What's up?" I asked, trying to keep a straight face.
One of the braver ones spoke up. "Our supervisor told us you'd give us tetanus shots as part of the new hire process..."

Parenting FAIL

A lot of my patients "self-medicate" their psychiatric symptoms with assorted illegal substances. Marijuana is far and away the most popular choice. Because it comes from a plant, people generally are a lot more defensive about their cannabis usage than their use of meth or coke. Like Dan Sickles, who told us "Pot's harmless, man. I mean, I've been smoking it since I was six, and look at me, I'm fine."

Tuesday, October 12, 2010

Either I work in mental health or I've got very strange hobbies

Yesterday, I checked through my "favorites" tab on the Internet at work. It's been a bit since I updated it, and I wasn't sure exactly what I'd bookmarked. I found links to:

Local Hospital Consortium's Physician Finder site

Ginormous Local Clinic's Physician Finder site

Needy Meds (a clearinghouse for patient assistance/free medication programs)

Assorted community resources (hospitals, free dental clinics, food banks, etc)

and the Random County online jail roster, complete with mugshots!

Thursday, September 30, 2010

Staff quote of the week

“I don’t know if it is an ethical conflict to go to a patient’s funeral. To be honest, all I really remember from the ethics manual is “don’t have sex with patients”—not like you’d want to with our patient population!”

Wednesday, September 29, 2010

Vacation woes

Dr. Warmnfuzzy went on vacation recently. As is our policy when a doc is on vacation, all requests for medication refills on her patients were referred to Dr. Analytic. And as is his policy, he filled the prescriptions with only enough pills to get the person through until their next visit with Dr. Warmnfuzzy.

Which meant that I got to field the following phone call:

Mrs. Worried: "Hi, I'm a patient of Dr. Warmnfuzzy and I picked up my prescription of Xanax and realized that it was only filled for ten days and I wondered what's going on. I mean, I've never had my medications get eaten by the dog or blown away in a hurricane or something weird happen to them for early refills--does this mean Dr. Warmnfuzzy doesn't trust me anymore?!"

After the myriad daily phone calls from assorted drug seekers, it was very nice to have a call from someone who was less concerned about the quantity of Xanax they'd been prescribed than why they'd been prescribed that amount of Xanax.

Monday, September 27, 2010

A drug is a drug is a drug?

Mr. Methhead is one of our long-term patients. He's been with RCMH for ages. While our chart numbering system is currently at six digits and growing, his medical ID number only has four! Due to his bad decisions on how to finance his drug habit, he takes a break from us regularly to spend quality time with the nice folks at the Random County jail, but he always comes back.

He's out again, and that means he's on my list of clients who come in for regularly scheduled injections of long-acting antipsychotic medication. As I gave him his injection last week, he said "Wow, I got such a rush from that!"
At a loss for words, I just stared at him before finally stammering out "You know, Mr. Methhead, that may be the nicest thing anyone's ever had to say about Prolixin!"

Monday, September 20, 2010

Probably not in my job description

Even though I work as a psychiatric nurse, I do a lot of other things in the course of the average day at work.
Like passing out condoms.
I'm a firm believer in preventative medicine. It's a lot easier to prevent contagious diseases than it is to deal with the consequences once they've taken root in a population. Since most of my patients aren't in the most stable of circumstances to begin with, the last thing they need is a serious infection or an unexpected family member.
As part of this philosophy, I pass out lots of condoms to the therapists, crisis team, caseworkers, etc. I'm much more tactful about this now than I was when I first embarked on this project.
"Sheryl, would you like some condoms to give your patients who may not be making the best lifestyle choices?" is a much better way to initiate the safer sex conversation with a co-worker than:
"Hey Sheryl, want some condoms?"

Friday, September 17, 2010

Overheard at staff meeting

Therapist: "I think Patient Steve is getting a lot better: He was telling me about his kids' mother 'and she told me, 'Steve, which do you love more--the booze or me?' and I told her it was her, but it seems I was wrong.' "

Monday, September 13, 2010

Staff quote of the week

From a buxom female co-worker: “I don’t know what it is that makes men so obsessed with boobs. It’s not like they do anything--they're just there. I even tried to ask a lesbian friend what was so important about them and she just looked at me and said 'I’m not talking about this with you.' ”

Thursday, September 9, 2010

Overheard at staff meeting

Crisis worker: "How old are you--I'm pretty sure I've been sober longer than you've been alive!"

Tuesday, September 7, 2010

Not a FDA-approved appetite suppressant

"Can I check my weight?" He stepped on the scale in my office.
"Mr. Methhead, that's ten pounds less than you were last week!"
He grinned sheepishly. "I just got back from a four day meth binge, so I'm not surprised."
I didn't know what to say, so I settled for "Then I'm glad you're here and on time for your appointment."
A worried look came into his eyes. "Say, I've been having bad anxiety attacks lately. Do you think Dr. Analytic would give me something for that?"
"I'll certainly ask him, but I'd bet good money that he'll say your anxiety attacks are because you're coming down from meth binges."
"@#%! I figured it was worth a try."

Wednesday, September 1, 2010

Don't hit on the nursing staff

I've been a nurse for almost five years now. And in the course of doing my job, I've been kicked, punched, sworn at, spit on, vomited on, and hit on more times than I can count. The last one is particularly difficult to deal with. I realize that one of the hazards of being a woman is that some men make rude remarks.
Nursing seems to amplify this tendency. There's something about the intensely personal nature of the work a nurse does (asking intrusive questions, feeding people, administering medication, wiping backsides, educating people, etc.) that leads some men to over-estimate their own attractiveness (Now that you've told me all about your genital warts, what makes you think I'd like to date you?) and under-estimate my proffessionalism. (Dr. Grumpy tells a hillarious story about this here.)
I used to work for the VA, which has an overwhelmingly male patient population. And the patients who hit on me there fell into three distinct categories: (1) elderly men with dementia, (2)middle-aged to elderly men who thought they were being flattering, (3) and thirtysomething alcoholics going through withdrawl.
And I soon found that three different responses were required for these groups of people: (1) "Dave, I can't go to the movies with you, but do you want to watch sports right now?" (2) "It's nice to see you too, Dave." and (3) "Here's your pills, Dave."
Most of my current patients are very appropriate. However, there's always those few... Throw in a history of mild mental retardation and some organic brain damage caused by years of drug abuse on top of their usual mental health sypmtoms, and I often find myself grasping for an appropriate response.
The first thing "Dave" said to me when he saw me last week was "You've got a real nice shape--I like you!"
What do you say to that? I know he's trying to be nice (even by the most liberal of interpretations, Dave has never been playing with a full deck) and I don't want to hurt his feelings, but I do want to set reasonable limits for his behavior. So I settled for "I like you too! I'm so glad you showed up for your appointment today."

Sunday, August 29, 2010

Can I see some ID please?

Dr. Troubledyouth, the child psychiatrist I work with, is interesting. He’s probably forty, but he likes to spike his hair, roll up his shirt sleeves just enough to display his wrist tattoos and wanders the office corridors with a perpetual five o’ clock shadow. He looks like a college English professor who has yet to come to terms with the end of his fraternity days.

The first time he asked me to call in a prescription to a pharmacy, I didn’t know who he was (Yes, random guys do ask me to call a pharmacy and order Valium for them quite often. It’s one of the hazards of nursing.) and made him show me his driver’s license!

Friday, August 27, 2010

Patient quote of the week

53 year old woman: "I'm almost sixty, and I can't go 72 hours without sleep!"

Wednesday, August 25, 2010

Overheard at the staff meeting

“Phil Sheridan? Is this "babies in the sewer" Phil Sheridan?” one of the experienced therapists asked on hearing a new client's name.
“Babies in the sewer? What’s that all about?” a newly hired therapists asked.
“About five years ago, he was pounding on Sonny and Cher’s apartment door, screaming that they’d taken his baby and flushed it down the toilet and he was going to get in their house to get into the sewer and rescue it,” she explained.
“So after the cops came, we evaluated him and had him committed to the state hospital until he was stable again. Apparently he just got out of prison for something else and is back in town,” the crisis worker with the most seniority finished.
The new therapist still looked puzzled. “So was there a baby at all?”
The crisis team all started laughing, which is never a good sign. “No, no baby, just crazy Phil.”

Sunday, August 22, 2010

Conspiracy theory of the week

I called the local laboratory to ask them to send us Lillie Langtree's lab results.
“For her medication monitoring?” the lab technician asked.
“Yeah, just like every week.”
“My mother-in-law needs to be on that stuff,” she said.
I should have let the conversation drop right there, but I didn’t. “Oh?”
“Yeah, she keeps telling anyone who will listen that Chinese people are trying to invade the West Coast.”
This is admittedly strange, even by my standards. “What?”
“By going south through Canada, no less! Is that crazy or what?!”
“That’s pretty wild,” I agreed. “If they do, I know some Chinese people in California who’ll hide me.”
“I’ll be able to blend right in—I’m Korean!”

Thursday, August 12, 2010

Words you don't want to read in a chart

Usually medical charting follows a time-honored format: Situation (why they're there to see you) Background information, Assessment information, Recommendations (changes in medications, etc.) It's generally pretty dry stuff, but occasionally things jump at out me as I'm reading through the patient's previous visit notes.

(On a developmentally disabled client who lived in a group home:) "He was fired from work after he destroyed the mail box and ran naked through the streets."

(From a patient complaining of right-sided numbness that started three days earlier:) "I am worried that he has had a small stroke, and I told him he needs to see his PCP ASAP. Although, given his history of heroin abuse, I am also concerned that his condition may be due to peripheral nerve damage after laying on the floor for an extended period of time--essentially comatose."

(Concerning a woman who had a history of asking for early refills on her Xanax, claiming her purse was stolen, pills were lost, etc.:) "Ms. Histrionic seems to be making a full-time career out of requesting early fills on her meds and I told her in no uncertain terms that she needs to do a better job of keeping track of her belongings."

(On a gentleman who'd recently gotten out of jail and was required to seek mental health treatment as a condition of his parole:) "Legal history: Client was arrested at age 8 for possession of methamphetamine. He says he used to smoke it with his mother..."

Tuesday, August 10, 2010

This one's a dud

Recently there was a bomb threat at the Random County Courthouse, about a block away from our offices. Several of the other Random County Health Department offices were evacuated, but not ours.

I found out about the bomb threat as I checked my e-mail before the weekly staff meeting. After I finished calling my husband "just because" and made sure my conscience was right with my Maker, I headed to the staff meeting--only to find out that no one else had heard about the bomb threat. What's more, no one was very worried about the bomb threat.

Apparently this sort of thing happens a lot. The head of the crisis department summed it up best when she shrugged and said "If whoever did this isn't already one of our patients, he will be by the time the courts get through with him! And would everyone please park only in the designated employee parking spots..."

Wednesday, August 4, 2010

Glad I'm not a doctor

Dr. Warmnfuzzy just got back from a two week vacation. Here's what awaited her when she returned to us:

  • 10 days worth of e-mails from the crisis department
  • 23 requests from patients for medication adjustment or early refills
  • the minutes from at least six different meetings
  • a missive from the department head saying he'd discovered Twitter and wondered if any of us had heard of it
  • four different people tackling her in the hallway and saying "Fuzzy! You're back! Your patient Mrs. Namewitheld needs...."
  • an e-mail from the big boss casually mentioning that there is a bomb threat one block away, but no need to evacuate our building

"I feel like I need another vacation just to recover from vacation!"

Sunday, August 1, 2010

Drug-seeking fun

As with any medical doctor’s office, there are the occasional patients who come to us hoping that we’ll support their addiction to prescription medications. We generally refer to them (outside their hearing, as insulting them to their faces would be "unprofessional") as "seekers," short for "drug-seekers." We don’t prescribe narcotics, but we do regularly prescribe Valium, Xanax, and Ativan to patients who have legitimate anxiety problems.

Life happens, and people do lose their medications for strange reasons. (My brother used to have a disturbed German Shepherd that liked to snack on bottles of Percocet.) Our clinic's policy is pretty simple: The first mishap is a "freebie," but if you seem to be especially accident-prone, we will start to grow concerned.

This past week was especially noteworthy for lost meds. It seemed like three or four people called each day wanting us to authorize another prescription. After yet another patient telephoned to complain that someone had stolen her Valium (for the second time that month,) SuperNP got annoyed.

“My God, does no one ever steal these people’s blood pressure medication? Why don’t their antibiotics get flushed down the toilet accidentally? Do their dogs just not like to eat cholesterol pills? Why is it that only the entertaining drugs that get lost and need replaced?”

Friday, July 30, 2010

I love the clerical department!

If RCMH is a "well-oiled machine," (and it's usually not) it's the office goddesses are who keep our place up and running. (Don't you dare call them "secretaries"--as I found out to my chagrin on the first day of work.) We couldn't survive without their amazing clerical skills (I'm pretty sure the docs haven't used a fax machine since the Macarena was the new dance craze.) but it's all the "little things" they do that make the day go more smoothly for us all.

Like warning me which pharmacies are hard to deal with, so I'm emotionally prepared before I telephone Overly Expensive Drug to ask why our deliveries haven't arrived. And taking the gazillion Post-It notes that have pharmacy phone and fax numbers scrawled on them and making them into an alphabetized spread sheet!

When I've spent the last twenty minutes on the phone with an insurance agency punching random numbers in the hope of contacting a live person to get a medication pre-authorized, they've even been known to come to my office holding a sign to tell me a patient is waiting to see me.

One of them, June, is a truly formidable woman. She's bilingual, incredibly intelligent, and very good at her job. (I want to be like her when I grow up!) She has worked for RCMH for the last twenty years and doesn't suffer fools lightly. Many patients (and some of the staff) have described her as "scary."

Yesterday the secretary who's in charge of our patient assistance program (making sure people get the medication they need even if they can't afford it) called. She asked many questions about why Vince Lombardi wasn't getting his prescribed medications and could we give him samples until the paperwork went through.

"Sure, we can do that," I said. "But why did Mr. Lombardi call you about this instead of me?"

There was a pause on the other end of the line. "Don't take this the wrong way, but he says he thinks you're scary."


Why do I do this?

I am a psychiatric nurse for the Random County Mental Health department. I work with doctors, nurse practitioners, pharmacies, therapists, social workers, the local crisis hotline staff, and the county parole & probation department. If they're involved in the treatment of our patients, I talk to them!

Most of the time I really enjoy my job. However, there are some days when dealing with the docs, the patients and the pharmacies can make me feel a little crazy myself.

Writing this blog is how I deal with days like that.

HIPPA disclaimer:
No accurate patient information is contained here. If you think you recognize the description of yourself or a friend or family member in these writings, you're mistaken. I'm probably making this stuff up just for my own amusement.