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."

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!"

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."

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!

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!

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."

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.

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."