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2005-12-26 - 12:04 p.m.
fugue in me minor (Parts 1,2,3)
dang, I am still a day behind... and still have work to do on the few entries left in the entries in progress folder... well, no sense in crying over spilled time, so here's today's (or yesterday's) entry with multiple prologues and three part disharmony... me me me (throat clearing or redundant egocentric narcisism?... ah, you can choose for yourself... read on Garth)...
and now, to perhaps give you a little more insight into my psyche (as if you really wanted a tour of a madhouse), or maybe just to fill in some space and start this entry off (am I that transparent?) and whine (grumble?) a bit if only to prove that I might actually be human and imperfect, contrary to my ego and ego-fans opinions (oh no, he's not gonna shoot himself in the foot again, is he?), this entry starts off with a touch of the positivity that was yesterday (yeah, go read that, that was much less selfish than this one) and takes a look around my immediate environments (home and work) with my rose colored glasses off (well, I suppose you've been warned, eh?)...
so this was the PS (as in Post Script, not Public School) to the email in the previous entry, an email that, with a few altered pronouns, was a little more personal at first )and is much more worth reading than this entry, posterity says so with a grin):
PS... geesh I gush, don't I?... I am such a dichotomy... as vulnerable and open as I expose myself in words, the fact is I have yet to actually let someone else be strong in this life... I am always the strong one, the cool one, the together one who is helping others... maybe that is why I am alone at this relatively late date... maybe I must learn to let someone else be strong, even at my weakest worst possible moments...
wait a minute... I've always said that and yet, I remember a few times when I let go, when I gave complete control to another person and let them make the decisions to guide our lives and it ended very badly... perhaps I chose the wrong people (perhaps?... oh, let's not get into it all now)... quite simply, from my personal experience with the few people I've trusted unconditionally with the reigns of life, I learned that they sure didn't want to take care of me even though I took care of them happily first...
on the other hand, I've always picked up the pieces myself after people I tried to depend on dropped the ball... and somewhere in my head I hear myself telling myself that it was because I am the stronger personality and the natural balance was for me to take care of those around me and when we found roles reversed they did not want to see me in need so they screwed up so they could be rid of me...
on the other hand, maybe I just picked the wrong people...
so why am I laughing?...
anyway, I interrupted that PS I was including as the start of this entry (in case you forgot where we were) so I'll get back to it for who knows what odd thoughts or self-analysis might come from such a casual inclusion of a PS after the fact...
I feel like I should post the words above the PS as an entry somewhere... hopefully that's not just ego begging for attention (gotta keep myself honest)... I think there are a lot of people caught between the pain of loss and the moment of starting again (who me?) and maybe these words will mean something beyond myself, beyond this email to you... maybe this could help someone start living and sharing their love in the real daily life world again...
maybe we're all caught between loss and wanting to try again, except for a few lucky folk who never lost and those who've not yet fallen in love (ah, to be a kid again with no lost loves, painful deaths, or relationship mistakes, just starting out)... eventually I think everyone experiences a profound loss, a death, a disappointment, a betrayal, an end of the world as we know it and has to come to terms with it, deal with it, and decide what to do about it...
some die, give up, close up shut, and blend into the woodwork at work or in front of the TV or computer and accept failure of sorts, a solitary life... maybe it's a self-esteem engine that won't get started (or never did) or maybe it's mistrust that will not be forgiven, but it's the end of hope and dreams...
I hope I never get there...
and wonder if I already did...
some live on the edge or on the surface, numb and sort of immune to hurt because they no longer invest themselves deeply in a relationship (even though they may pretend to or even say they want to)... the are seldom alone, often seem quite happy, but deep down are missing something and are seldom alone because they fear facing themselves...
I doubt these people write diaries...
or maybe the are the most popular ones...
and I ask myself, am I alone because I avoid people?... I think I welcome people fairly easily into my world... and I ask myself, am I not in a relationship because I am avoiding one?... I think I'd welcome on with open arms... and we come to the crux (there oughta be a crux, don't you think?), I am alone because I trust myself and my instincts and my chamistry and those I've known and loved who I chose (that'd be two, possibly three) ended up leaving me for one reason or another and those I've known and loved who chose me (that be one, really, but there are others who were not given the chance because I was not attracted to them) were too much of a compromise for me so I left them...
all I really want is honesty and adorableness (that is the natural product of genuine self-love, altruism, self-esteem, humility, independence, and a craving to be one with me), is that too much to ask?...
so far, I suppose it is...
but there's always hope (I hope) J
and so it is Chanukah... and Boxing Day... and Kwanza too... and Minnie's birthday, which is my first celebration for this date... not Minnie Mouse, but my little girl (who's all grown up), who's dubbed Minnie for the purposes of identification in this diary... I mentioned her before, we adopted each other (I'm the Daddy person) years ago, went up to Chattanooga to give her away for her wedding, and of course, I send money... she keeps in touch, understands my lack of reaching out, and reminds me when it's time to send money (ah, I jest, we love each other more than money)... anyway, I actually woke upo and called today, on time for her birthday, the first time in years (she usually calls me and tells me what day it is)... I should have out cigars...
I think it may be a sign that my stolid (what word am I looking for there?) ways might be shifting, that maybe my solitary habits might be changing, that maybe my Ph.D in Hermitology is in jeopardy... oh now, I mean, what kind of job can you get with just a Masters in Hermitology?...
any associations with Psychology are purely for joke purposes...
so anyway, I think I should turn the TV or music on because Raspy and new girlfriend went into the bedroom and she's insatiable, according to Raspy and his back (you know the sex is good when your back comments on it)...
meanwhile, around the casa...
so Raspy comes home (an hour or two ago) from work and his weekend with new girlfriend (he went straight to work about twelve hours ago after a 4+ hour drive), and talks about being hungry, which gets me hungry, so I tell him I'll share something if he orders in... he also tells me that new girlfriend is on her way over and they take off, I suppose for dinner... a half hour later they come back complaining that all the restaurants are backed and now they're eating happily right in front of me and I'm hungrier than ever...
wow, how inconsiderate a new girlfriend can make a guy, huh?...
meanwhile he's confused because still in love with the girl in the Ukraine who he's been writing for for a few years (and visited once) and doesn't know what to do because new girlfriend is quite clingy and wants me to move out so she can move in (and we just signed a new one year lease)... you may recall from a mention in a previous entry that she's the one who was talking engagement after a week of going out and this weekend was meet the family down south... apparently she does not get along with her family though, which made his weekend quite uncomfortable at times... I get the feeling he's happy I'm here so she can't move in because she's trying her best to attach herself to his hip...
but the sex is great (oh, that explains it)...
I probably wouldn't be talking about them in front of their faces like this except that they are eating right in front of me after forgetting that I was hungry too (and have to get ready for work soon) and now I'm gonna get up and move some of the dirty dishes they left from before they went away for the weekend so I can get some food prepared for myself cuz I am trying not to spend money every day on eating out cuz I am trying to change habits back to saving money so I can retire someday...
am I grumbling?...
oh no, I haven't started grumbling yet...
back at work again, the first night I've had time to type a bit in a week or so... I am noticing an increase in the inconsistencies in staffing and in the staff who are here following the behavioral programs and contracts with the kids and that is starting to have detrimental effects on the program (this sort of thing comes and goes and it's frustrating because most of the nurses and administrators (who are, by default, nurses), consistently appear to have no idea what they are doing in terms of the psychology, therapy, or behavioral plans and most seem either afraid to actually interact with the kids, or maybe they are just not interested... most do nothing but sit in the nurses station reading or playing a gameboy all night, on weekends they watch TV or videos (even though all this is against the rules) and they are the supervisors setting the example for patient care...
when the few staff who do most of the work on the night shift speak up about the lack of support and unfair workloads at meetings, usually administration stirs the pot, writes a few people up for random violations of rules (often it's the people speaking out), and then pretend they fixed the problems... it's been like that ever since I started here five years ago...
wow, I've been working here five years...
anyway, some (in administration) are of the attitude that we on the night shift have it easy and they discretely look away, perhaps even get some odd thrill out of hearing that some kids give some night staff a hard time... some staff and most nurses disappear when a kid wakes up and needs something or is having a challenging night... or they'll placate the kid with anything, throw out the behavioral program, just to keep the kid happy or get the kid to go back to bed... we are supposed to be encouraging the kids to feel safe and sleep through the night... we are not supposed to be teaching them that they can get away with anything at night because there are not enough staff to follow the program...
some staff seem to come to the night shift to avoid work and resent the fact that there is a lot of paperwork in a hospital that the night shift keeps track of... some staff seem to come to the night shift to avoid patient interaction...
the thing is we are not staffed for the kids to be awake and the kids know that, so they do not get the same immediate interventions at night that they get during the day or evening... some interventions simply require more staff... so on the night shift, we must take a slightly different approach with most kids, a more caring parental approach... but we still have to follow the doctor's orders and behavioral program because consistency is everything in teaching these kids new habits and safer behaviors...
the problem arises when you get a kid who has the right combination of behavioral issues (oppositional defiant, for instance, which simply is directly opposing any authority) and retarded mental and emotional growth (so the kid wants constant attention and does not have the cognitive skills to understand she is not the center of the universe and must follow rules), kind of like a 2 year old, except these kids are in their teens...
generally speaking, at least in theory, the kids are sorted out into the units of this facility based on primary diagnosis (what's the problem?), readiness for treatment (ready for help?) and cognitive ability (understand what you need to do?)... I usually work the unit where the girls who've been traumatized and are ready for help are placed (as opposed to kids who's primary problem is behaviors and have no interest in getting help, at least not yet)...
in other words, the prerequisite for coming on this unit is being ready for treatment... unfortunately, there are times when kids who are far from ready for treatment are placed here simply because there's no empty bed elsewhere and what usually happens is that one (or sometimes a few) kid(s) disrupt treatment for everyone by taking up most of the staff's time... often other kids who were progressing start regressing because they are reminded of the hostile environment they came from or because they simply need their treatment and staff are too busy to provide it as it should be provided...
the past few weeks has been one of those times... again... it goes in regular cycles... there are two kids who clearly did not belong here from day one and gradually staff attention and energy focuses more and more of those two kids and the overall program suffers...
what makes matters worse is the staff on this unit generally do not have the training or skills to work the behavioral (or conduct disorder) unit where less conversation, less therapy, and much more direct intervention, more hands on intervention is required to maintain a safe and healthy environment... in fact some staff are placed on this unit because they lose control of the situation with more agreesive or confrontational kids... so a violent or oppositional definant kid placed here can get away with a whole lot more with some staff than they could on the unit designed for their specific treatment needs and most of the time even the slowest ones can figure that out eventually...
we come to tonight's partner (we are two to a unit, technically three, but the nurse hides out all night leaving the work for us, so two on the floor), who skips off routinely after taking the rounds sheet (which, I infer, means she's taking the rounds responsibility, but silly me, it appears she just wants to appear to be responsible by keeping the rounds sheet with her, even though rounds do not get made on time... this is the same person who openly admits she will lose her temper and get fired (or, in her words, go to jail) if she has to work with any of these kids during the day or evening when they are awake... she usually disappears to get on the phone or something when we wake the kids up...
and she has a careless work ethic, forcing Berry and I to constantly have to point out to Elpien, who is technically our supervisor, that the files are out of order or something either has not been done or has been done wrong... Berry and I have reached a point of letting it be after we let Elpien know, because we are tired of not only doing the extra work, but of fixing the errors that supervisors and administrators choose to ignore...
and then there's tonight's nurse supervisor who is an excellent nurse, but plays the nurse card, that is, ignores the fact that she is counted in the ratio and does nothing but nursing work, leaving us a staff short in reality even though she is counted on paper... as far as the kids supervision or most of the night shift work, she's not here... and then she, already empowered to get over on the system, does not follow the behavioral contracts (being too motherly is nice, but for manipulative kids who desperately need guidelines and consistent structure, it's undermining to their learning) and providing inconsistent reinforcement in a behavioral program is basically teaching kids that it doesn't matter what they do, they will sometimes get rewarded and sometimes not get rewarded, so there's no incentive to think about changing or learning healthier behaviors...
so lately we have a couple of kids who do not belong on this unit and need much more structured treatment and these kids gets rules broken for them in an attempt to placate them by some staff (especially on weekends) and then those kids get frustrated, angry, even violent with staff who say no to their requests for special privileges or things that are against the rules... the sources of the inconsistent reinforcement are obvious to anyone who understands behavioral programs and works on the units, but the supervisors and administrators look the other way (and are often the source themselves)...
I've been in this field long enough to be able to sigh, wish for better days (if they exist in any program anywhere... wait... I'm not that cynical... I know they do because I've run programs with much more kindness and consistency at it's core... it takes acute vigilence by managers to select staff with the right personalities and skills and to train staff well and to send staff packing when they do not have the right personality or who refuse to learn... but that starts with management who has the right personality, the knowledge, and skilled themselves and who stay closely involved with the program... this is not that place) and roll with the flow while doing my best to be consistent with the kids... in any health care delivery system, sometimes you've just got to ignore what's going wrong above or around you and simply do the best you can do one moment, one kid at a time...
hey, if you missed the Xmas letter, well, it's not actually a Xmas letter, it's a letter and was written and uploaded on Xmas, but it doesn't have a whole lot to do with Xmas, unless, of course, you are reading death and ressurection between the lines in which case you are even wiser than I am cuz I didn't realize I might have put it there until just now... go figure...
anyway, if you missed the not really but maybe Xmas letter, click back an entry...
it's a whole lot more positive and optimistic and uplifting and cheery than this entry and after this grumble, we can all use some cheerfulness, right?...
Merry ho ho, Happy Jewish Xmas (Chanuka), Good Boxing, and Kosher Kwanza (Kool Kwanza?... well anyway, Jovial Mixed Metaphor Season)...
and most important of all, Happy Birthday Minnie...
thanks for loving me and letting me grumble to ya J
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