The Way it Works; This is the Way it is Supposed to Work

I did too much last night.  After work, I fed the cats, took out trash, did chores and housework, went to the pool and did a PT routine, came home, did more housework while I started dinner, and had a late dinner, then worked on the computer for a while, transferring information from my old computer to my new computer.  The files do not transfer directly, so I have to embed the information in an email and send it to the new computer. I will not have to re-type everything, my other option, although I will have to transfer it to word file formats and re-format everything. 

I must have stayed up later than I realized.  I could not get up this morning, so I called in.  I was feeling like crap! Even the cats knew I did not feel well, and did not wake me up, asking for breakfast! Amazing! But, I forced myself to get up and go in, if nothing else, to prepare the materials for the early morning group I am doing on Wednesday. I was not concerned, my boss is supportive, I have plenty of leave, and most importantly, I get my work done.  I got to work about 9:30. Had I rushed, I could have gotten there at 9 AM, but I could not force myself to rush. I had forgotten about a treatment team meeting at 9 AM, but it was cancelled for reasons not related to my absence!

I was on one of my wards late this afternoon for a session with a patient. My plan was to review his treatment plan, which usually takes less than 10 minutes. I would then return to my office, do the paperwork involved, and leave about 5 PM.  And claim sick leave due to my late arrival.

The patient's plan was to discuss his therapy materials.  He had been a patient years ago, when we had groups and counseling and he was disappointed he did not have access to the same this time.  When we first met, I told him I was not a counselor, but I was available to talk to him about his issues and family. This was only our second meeting, and he was going to talk about the therapy materials he had worked on. Very soon, he decided he needed to talk about the family situation that lead him to seek help from psychiatric services most recently.

So, the session extended longer than I had anticipated, but that was okay.  When that session ended, I was told another offender was having a crisis and wanted to speak to me.

This person is a long term patient who has used external coping mechanisms: work, school, day room time, to help him. He has resisted learning and using internal coping mechanisms: relaxation skills, meditation, changing his thinking, changing his perspectives and expectations, working on his self-talk, self-image. 

We had a very intense session.  Much of it revolved around his intense emotions, his intense reactions, and his inability to handle these with the coping mechanisms he uses. He ended up asking for some written information on relaxation exercises. He changed from very, very angry, to mollified but not happy or content. But not at risk of acting out on his anger. And not at risk of being so disgusted that he will be non-compliant with his medication.  This is why I go to work!

This session ended close to 5:45 PM. By the time I documented these sessions, it was about 6:40 PM. If I had showed up at or about 8 AM as I normally do, I would have put in a 10 and a half hour day, or more.  I would have still done it. If I have a personal commitment after work, I will not necessarily stay late to take care of patients.  But I did not have a plan for after work, and in fact, my plan was to go home and chill at 5 PM, and use leave.

But more importantly, if I had arrived at work at 8 AM, starting a patient session shortly before 5 PM would have been very difficult for me.  For years, I have known that I cannot start difficult patient sessions in the late afternoon, because I am drained emotionally and physically, and it does not usually go well. But it was not that late into my work day.  It helped that this is a patient with whom I have a good rapport. The session was productive, and felt like I helped this patient.

So, I was supposed to go to work late this morning. Years ago, I used to sometimes say I should listen to my internal messages, because when I did not, something went awry.  One of my early supervisors used to tell me to listen to those messages, even if it meant calling in late to work, leaving work early, calling in sick for a day, rescheduling my day to start late and work late, or whatever.  I did not accept her lead, and until I got to my current job, did not have the flexibility to do so in my other jobs (except to call in sick for the day.)  The longer I work at this job, the more comfortable I feel about doing just that: Flexing my day based on Karma. 

This is the way it works; this is the way it is supposed to work.