Week Seven

"Traits of a Social Worker..."

February 17th, 2008 - February 23rd, 2008

ACTIVITIES:

• Attend group on Cognitive Distortions with Michael Kura
• Attend meeting with mental health clinic liason and patient V
• Admit patient C

REFLECTION:

Last week, I was almost shocked by our newly admitted patient V. I'm getting to know her a little bit better now, and am putting my generalist social work practices into play. I warm up to here by creating small talk, and egaging her. I let her share as much or as little as she would like, and I actively listen to what is on her mind. When she has questions, comments, or concerns for the nurses or for Dr. Perez, I let him know. I had the opportunity of sitting in on a liasion meeting with patient V and her liason from Midtown Mental Health Clinic. I knew right away that patient V recognized, respected, and valued her relationship with her liason (or case manager). Basically, the liason's job was to check up on V to make sure she had been admitted OK, the transition was moving smoothly, and she understood why she was there, and what her goals were this time around. It was all very interesting, but sad at the same time. Tears were shed, and plans were made. The entire meeting lasted about 30 minutes, then it was time to go. I appreciated seeing V's liason focusing on her strengths. It helped me also focus on her existing strengths and actively search for new strengths I might be able to point out to her.

After attending the liason meeting, another new admit had arrived. Again, Floy and I attended the treatment team meeting to hear his story, where he came from, how he ended up here. Then we went back to her office to complete a psychosocial history over the phone with the patients mother. She was so nice! Her voice was comforting, she had such a positive attitude, and you could tell by talking with her how much she truely loved and supported her ill son. Toward the end of the conversation, we began asking her about her own life. Yep. She's a social worker... pretty cool, huh?

INTEGRATION QUESTION:

Research/micro: What has research shown to be the traits a social worker needs to have to engage with a client?

In my own experience, I would say there are many “pre-requisite” personality traits one must hold in order to be an effective social worker. Everything I have read about in previous class work supports my theories, and some recent internet research backs me up as well.

Social workers need to be patient... The people talking to social workers usually have a history of the problem they bring to the social worker. It took them a long time to “build” this problem they have now. It may have taken them a long time to decide to come see a social worker. Why would a social worker expect to solve the problem over time. It can take weeks, months, even years to find effective solutions to some problems. Some patients will move more quickly through treatment plans than others. Social workers must be patient people, always trying to move toward the goal, but never angry if it takes longer than planned.

Social workers should be empathetic… This is not to be confused with sympathetic. We, as social workers should not feel the need to feel sorry for our patients. Rather, we need to empathize, or put ourselves in their shoes, try to see things from their perspective. Patients should not want to be felt sorry for, they should want to be understood.

Social workers need to be open-minded… We do not choose our clients. And our clients don’t choose their problems. As social workers, we must remain open-minded and respectful toward all walks of life we may encounter on the job (color, creed, gender, age, orientation, etc.). When patients/clients have backgrounds different than our own, we must learn to accept and adapt to whatever that background may be.

References

Miley, K., O'Melia, M., & DuBois, B. (2007). Generalist Social Work Practice: An Empowering Approach. Boston: Pearson.

Web slides per Dr. Ouelette’s S332 Online Course


Weekly Hours: 20
Hours to Date: 85.5

Schizophrenia

sChiZophReNia

Growing up, I had never heard of anyone having this disease they call schizophrenia. In psychology class we breifly studied it. I began to understand the disease as, "total loss of reality." This definition was fine for the moment, but in hindsight, I kind of just shrugged my shoulders and understood schizophrenia as a politically correct way to call someone crazy.

When I signed up for this practicum, with mental health in mind, I thought I would be dealing with autism, downs syndrome, and other developmental disabilities (an area I am very comfortable with). When I got to the hospital and saw people who looked and seem to act just like me, I knew I was in for a huge learning opportunity. Many patients at Larue suffer from schizophrenia and schizo-affective disorder, and I needed to know a little something about it.

Dr. Michael Pisano, who has studied years of psychology at IUPUI, allowed me to sit in on educational groups he led for patients with schizophrenia. In group, patients were given folders, handouts, worksheets, and opportunities to ask Dr. Pisano anything they wanted about their disease. We discussed neurological, biological, and psychological factors of the disease, symptoms, as well as the pros and cons of different types of medications used to treat schizophrenia.

Dr. Pisano could not seem to emphasize more the importance of compliance with doctors medication orders when treating schizophrenia. One of my classmates mentioned the side effects associated with medicines used to treat patients with HIV. The list of common side effects for schizophrenia meds, sadly, is no walk in the park. Side effects range from:

• drowsiness/sleepier than usual/difficulty falling-staying asleep-early waking
• dry lips / dry throat /dehydration
• dry skin / rough texture / skin flakes, sores, bleeding skin cracks
• weight gain- increased appetite
• stomach aches / unusal pains in belly
• constipation / inability to urinate
• muscle agitation / less able to sit still or stand still / fidgeting
• sexual difficulties / impotence or decreased ability to achieve orgasm
• dizziness / feeling faint, lightheaded, loss of balance
• sensitivity to sunlight / skin may burn more easily
• blurred vision
• absence of female menstral cycle
• etc. etc. etc...

HOWEVER, these medicines can drastically improve one's quality of life. Have you ever read all the symptoms on the back of that asprin bottle you carry around in your purse? Do it sometime. You may be quite suprised. All medications have side effects. Sometimes you just have to take the good with the bad. And sometimes, you need to wait it out, talk to the doctors about changing the meds or the dose, or take additional medications to control the side effects. Always keeping in mind that the medication works best when taken exactly as prescribed.

Though no one really knows the exact cause of schizophrenia, it is highly correllated with too much and/or too little of certain brain chemicals. Medications change the amounts of these chemicals and work best for reducing delusions, hallucinations, and agitation. These medications are safe, effective, and non-addictive. They have been known to prevent and/or delay relapses and the need for rehospitalization.

Overall, these medications help patients with schizophrenia feel happier, brighter, and healthier.

Week Six

"I'm a social worker... not a miracle worker..."

February 10th, 2008 - February 16th, 2008

ACTIVITIES:

• Attend weekly treatment team meeting
• Attend Dr. Pisano's group on Schizophrenia
• Admit patient V

REFLECTION:

Well, it's about time for me to be "assigned" a patient (or two) now. Floy and I had discussed me taking charge of the next admission to the unit. That new patient came this Tuesday, and Floy and I agreed that maybe I should wait for a different patient. The patient admitted this week is a returning patient. She is a 43 year old white female who has been hospitalized over 40 times in her lifetime, all due to some kind of self harm/suicide attempt. Looking through her old charts I found a long list of diagnoses: bipolar disorder, borderline personality disorder, schizo-affective disorder, and anorexia nervosa were the main ones. She had an even longer list of medications, ranging from antidepressants, mood stabilizers, antipsychotics, lithium for the bipolar disorder, and many many more. Floy said she remembered patient V very vividly. Last time she had been admitted she had weighed 160 pounds, and was best known for cutting/scratching herself, and using anything she could find around the unit to keep the wound open or prevent it from healing. Since her last discharge, she had set herself on fire, twice, and her weight had dropped to a whopping 91.5 pounds. She looked like a skeleton with grafted and scarred skin stretched out over each of her frail little bones.

As a mere student, I really did not feel I would be the best "social worker" for patient V, and agreed to take the next admission instead. Wow. Things here at the psych hospital are really starting to open my eyes. I had no idea I would be working with such visably mentally ill patients. This was shocking to me. I questioned myself on how badly I really wanted to work in mental health... Was there anything I could do to help this patient? If the 40 some hospital admissions did almost nothing for her, how could I be of any help!?!?

After pondering these thoughts for a few days, I began to regain hope. I sat down one day and talked with patient V. She was suprisingly casual with her words, and seemed to be very bright, and willing to talk. We even cracked a couple jokes. I have not lost hope for her (or for myself for that matter). Maybe I won't be able to "save the world" as a social worker... Maybe I can't "save" everyone from themselves... But I CAN talk to and listen to patients who need me. And sometimes, being locked away in a hospital unit, a good laugh can be the best medicine of all.

GROUP WORK:

I attended Dr. Pisano's group on schizophrenia this week. The information was very interesting. We talked about recognizing and coping with the symptoms of schizophrenia, the different medicines and their importance in living a functional life with schizophrenia, and also the neurological, biological, and hereditarial basis of the disease. Dr. Pisano seems very knowledgeable on this subject, and I was able to stay after to ask my own personal questions about the illness.

I think it is very important for anyone working and any field to have a deep understanding of the psyche of the patients, clients, consumers, (whatever you want to call them), that he or she serve. If I were the head chef of a fine restaurant, I would want to know exactly what foods tastes good with what sides, and what wine is best to serve with what meals. Same is true for people-professions. If I'm working with a client population affected by schizophrenia, I want to know what "meal" they are hungry for. Or, what is the goal of their stay here at the hospital. What "sides" or treatments do they need (what meds), and what kind of "wine" (therapy) would compliment that meal and side dish the best. Pardon the abstract anaolgy. I must be getting very hungry... I guess my point here is that I want to be knowledgeable of my clients status. If they are going through something I have never encountered before in my personal life, I want a crash course on the subject to prepare me to help them to the best of my ability.

INTEGRATION QUESTION:

There are no integration questions listed for week 6... Just reflections. :)

Weekly Hours: 21.5

Hours to Date: 65.5

Diversity Lunch

DIVERSITY LUNCH

I was lucky enough to be invited down to the annual Larue Carter Memorial Celebrates Diversity luncheon. Members of the staff were asked to bring in traditional dishes from their own heritage. I had never seen so many types of food on one table! I filled my plate with worldly goodness and sat down to eat a wonderful lunch with my co-people.

I would have liked to have an awesome blog about this luncheon, but after reading David Kearby's practica blog (we are practicing at the same agency), I've got nothing! I think he summed it up perfectly by stating that other than a wide variety of platters to choose from, diversity ceased to be the topic of discussion at most tables. Which in my opinion (and sounds like David's too), is a wonderful thing. Diversity should be expected and celebrated year round! I think everyone had a great time just socializing as equals and sharing the amazing food.

Week Five (LEAD)

"Two! Four! Six! Eight!

Social Workers Advocate!"

February 3rd, 2008 - February 9th, 2008

ACTIVITIES:

• Participate in LEAD
• Write letter to legislature
• Attend Cognitive Distortion Group w/ Michael Kura
  

REFLECTION:

LEAD was pretty cool (I'll mention this more in the integration questions).

INTEGRATION QUESTION:

Policy/macro: What was your experience at LEAD? What was most valuable? How could your learning experience have been improved?

I had a great time at LEAD this year. Upon arrival at the hotel, we were directed to the basement, where LEAD was being held. We listened as speakers explained what social work meant to them, and why social work was such an important field. I went to LEAD last year, too. I thought this one was pretty repetitive, but equally as valuable. I learned a lot in the breakout session about discrimination and current bills being reviewed deal directly with discrimination issues.

I thought the most valuable information gained this time around was the scavenger hunt. Last year, I went and visited the statehouse, but never really found out where (or what) anything was. The scavenger hunt gave me a much wider perspective of what really goes on over there.

My learning experience could have been improved. I feel like next year, seating should be clearly marked so that schools can sit together. (David and I ended up in an entirely different section than our classmates...). I also think there should be MORE (or different) break out sessions added.

Overall, good day.

Weekly Hours: 15
Hours to Date: 44