{{color c="blue"text="Wednesday June 14th: Orientation at the Buffalo Psychiatric Center:Total Hours: 2 1/2"}}

To apply to and volunteer at the Buffalo Psychiatric Center, I recieved a folder with important information about the center, (volunteer responsibilities, etc.). I had to fill out a number of worksheets which required some personal information, and I filled out a "Help to get to know you form". One of the requirements was to get a TB test, a physical, and a statement that I was in good health from my doctor. In addition, I had to sign an Authorization for release of information form. After I completed these requirements, I set up an appointment for orientation with Sue Joffe who is the head of volunteer services at BPC. I came in at 1:00 pm for the oreintation on June 14th. The first thing I did for orientation was watch a video on the BPC center. This video intruduced some of the staff of BPC, their jobs, and the purpose of the programs at BPC;BPC is very patient centered and believes in patients having choices in their recovery. It also explained the function of each building on the BPC campus as well. Furthemore, the video explained what mental illness was, patient's rights, rules for emergencies, security measures, and volunteer/staff responsibilities. During the video I answered some questions on a worksheet, which was then collected. Next, I watched a video on HIPPA which dealt with patient confedentiality and security(which was pretty heavy). After watching this video I had to sign a worksheet multiple times to show that I understood what HIPPA was all about. The assistant there after took my picture for my volunteer badge, and gave me a parking pass. After doing so, I had an interview with Sue Joffe. She discussed some aspects of the first video and what it would be like to work at BPC. We worked out what days I would work and what site I would work at. Most likely I would be working at the Strozzi treament mall. The treatment mall consists of patients with limited privileges who need to be in a structured environment.
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{{color c="blue"text="Tuesday June 27th: First day at the BPC:Total Hours:4 9:00am-11:00am & 1:00pm to 3:00pm always"}}

Today was my first day as a volunteer at BPC. Sue Joffe met me downstairs in the Strozzi building and gave me my volunteer badge (to be worn at all times on campus). I was shown where to sign in and out, and I was told about volunteer keys. I did not recieve the volunteer keys today but they will be in my possesion next time I volunteer on the BPC campus. The keys are used to lock and unlock doorways in the halls and for the stairs and bathrooms. This is done so patients can not wander or enter restricted areas. Sue Joffe took me to the third floor, which is the treatment mall. There I met and sat down with my supervisor Dorris Richardson. Dorris Richardson was very kind and she informed me about what activities I would be involved in, while working as a volunteer.

I will have many opprotunities to work with different staff members as well as different groups of individuals. These groups consist of young males, young-adult females, and senior citizens. My suprovisor intruduced me to many of the staff memebers (unfortunately I can't remember all of their names). My supervisor introduced me to one female staff member who is part of the education program whom I will have a chance to work with. I will be mainly working in the treament mall which has patients with limited privileges and need structure in thier environtment. These patients are here for rehab and recovery. Here they can work on their social skills, learn, work, be self-aware of themselves and their environment, develop skills, health maintenance, and self esteem. BPC also incorporates vocational and lesiure activities to help the patients.

Today, I worked with Anne West (my supervisor introduced me to her). Anne West is a counsler at BPC. Anne West and I went to the 5th floor to living unit 65. This unit consisted of senior citizen patients who are 65 and up. Most of these patients had both, physicall and mental disabilities. Many of them had walkers, a few were in wheelchairs, and some were even in beds. The first activity I did with Ann West, was have a meeting for recreation and excercise. In this meeting, a handful of the patients sat in a circle around the room. Attendance was taken and drinks were given to the patients (many of them have trouble eating right or drinking enough liquids). Anne West talked to the patients about health and keeping one's body clean and eating properly. I was introduced to all of the patients and had a chance to interact with them. The patients sometimes made their own discussions and asked me some simple questions. A majority of them seemed to be intrested in seeing a new face and did not mind my presence.

During this session I also participated in a work out with the patients. We moved are arms and legs, while listening to jazz music. Some of the senior patients sleep often and fall asleep quickly. 1 or 2 fell asleep during the session. Shortly after I went to lunch. When I came back I had a chance to work with Dr. Donazzi, a neuropsychologist. Dr. Donazzi along with Dr.Lee held a session with living unit 65. Some of the patients were in the last session I joined in, some were new faces. This session dealt with "Life after BPC". Dr. Donazzi usually has a lesson plan for each meeting. The purpose of his session is to inform, educate, and bring about awarness of the world and Buffalo (life outside BPC). His sessions are to help the senior patients prepare for and make decisions about their options for living outside of BPC. Even though that is the purpose of the program, many of the senior patients do not want to leave(even though some have the ability to) or they are too old/near death. Dr. Donazzi also did a relaxation exercise at the end of the session, and I joined in. We did a muscle relaxtion exercise in which we tightened and relaxed muscles and did deep breathing. Dr. Donazzi invited me to join in the sessions next time and said I could gather some material on Buffalo (updates,news,etc.) to talk about during the sessions. I was very excited about this and I was happy to be invited to join in on more sessions. Lastly I met back up with Anne West for vocational recreation. I observed, while the senior patients answered trivia. One patient in particular was quite bright. She knew all of the answers, I don't think she missed one! After that I signed out and went home. I am anxious to see where they will place me on Thurs.
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{{color c="blue"text="Thursday June 29th: BPC Treatment Mall:Total Hours: 4"}}

Today was a slow, but relaxing day for both the patients and I. I got my first set of volunteer keys and got to lock and unlock the doors in the building (I was extra careful to make sure everything was locked). My first activity for the day was a program called Artistic Enrichment, in which I assisted Anne West (therapist/counsler). This program was made so that the patients can find a leisure activity they like and stick to it (the counslers encourage them to take up a leisure activity). The group that came in for this program consisted of mostly females (ages ranged greatly) and 3 or 4 males. The group was fairly large, consisting of a diverse group of individuals with a range or mental disorders (some more severe than others). There were coloring books, wood blocks to paint, knitting tools, nail polish, beads and string (to create necklaces), flower pots to decorate, cards, and the list goes on. I went around to each patient and introduced myself. I got paper and glue and anything else the patients needed as well as encouraged and assited in their artistic activities. I worked with one male patient for the majority of the time, and I found it interesting that he once owned his own pizzaria (his level of functioning has decreased greatly since then, additionally he was in a wheelchair). Working with him was a pleasure though, unfortunately, some of the patients did not respond as well. About 5 of the patients did not want to participate at all and just sat in their chairs. Two of them were new though, and I was informed that new patients often shut down and are unwilling to do anything at first.
One of the pateints was a real character. He could never sit down for longer than 2 minutes, literally! He played cards with me but cheated and claimed he won, then walked away! He mouthed off to the therapist a couple of times and he would repeat phrases that either I, the therapist, or other patients would say. After the Artistic Enrichment program I grabbed some lunch and then did leisure activities (games) with the patients. I can't remember the name of the counsler I worked with but he was very nice. There was only a small group of patients (mostly males) and I spent my time with one of the males playing Scrabble. He had a chance to work on his spelling and worked on counting (Scrabble points). I also had a discussion about academic degrees and how to treat the patients with the male counsler that I worked with. I hope to work with one of the doctors again next week, but we will see.
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{{color c="blue"text="Monday July 3rd: BPC Treatment Mall:Total Hours: 4"}}

On Monday, July 3rd, I had a chance to work with someone new. This morning I sat in on a lesson about medications and side effects. Mike Bailey, who has a background in nursing and education, reviewed the importance of taking one's meds to the patients. He explained to the small group how they should always take their medication and KNOW what meds. they are taking. He asked each patient if they thought they were mentally ill; all said yes but one. He made it a point that the first step to recovery is recognizing that you have an illness. There was an emphasis on always taking your meds., and if you should experience any side/adverse effects you should inform your doctor/nurse. Mike Bailey made it loud and clear that the patients should not stop taking their meds until their doctor/nurse tells them to do so (despite the adverse effects). Mike informed me later that patients who were discharged sometimes discontinue their medication, causing their return to the BPC. In addition, Mike explained some of the adverse symptoms patients could have from their medication. He wrote the technical terms on the board, some of the terms were drug induced parkisonism, and tardive dyskinesia, akathisia, and the list goes on. I did not know half of the terms, so I was learning along with the patients!
After the lesson was done I took a lunch break then headed back for "Communication Skills" with Jerry (can't remember his full name). There were a handful of patients in the room. Jerry went over good communication skills and the types of communication. There is passive, aggresive, and assertive. Jerry informed the patients that communicating in an assertive manner is the best way to get your message across and get what you want (being respectful at the same time). He gave examples of boundaries to communication and got the patients involved as well as me. He used examples and asked me questions (involving me in teaching the patients correct communication). The patients really absorbed the information well. I enjoyed being with Mike and Jerry today. They both had great interactive skills with the patients (especially Jerry) and they kept them involved.
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{{color c="blue"text="Tuesday July 4th: BPC Total Hours: 0"}}


Today was a holiday for most of the BPC staff. There was nothing scheduled for me at BPC, so my supervisor (Doris Richardson) let me take a day off. I will resume my volunteer work this Thursday.
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{{color c="blue"text="Thursday July 6th: BPC Treatment Mall:Total Hours: 4"}}

For today I worked with Anne West and helped run Artistic Enrichment. I worked with an older woman and helped her make a beaded necklace, bracelet, and ring. She had some trouble at first (stringing the beads) but I encouraged her to keep trying and she eventually got the hang of it. She was so happy with her self-made jewlery, she was all smiles (she also thanked me for helping her). In addition, I played cards with an older man, who never sits down for a whole game, but somehow I got him to cooperate. He seemed like he was having fun, and kept saying I was doing well in the card game. I felt like I made a connection with the two patients today, and it gave me a good feeling. Later on, (after lunch) I worked with Jerry (counselor) and played some games with a number of patients. I was supposed to work with the young males today, but they decided to give me more time before I do so. The males can get rowdy, so they want to wait before putting me in that type of situation.
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{{color c="blue"text="Monday July 10th: BPC Treatment Mall/Crossroads/Family Dollar:Total Hours: 4"}}

This has been my most intresting day yet. When I arrived at the Treatment Mall today Doris (my supervisor) set me up to work in the same room as the dental hygenist. The dental hygenists name was Kirsten; this was her first day in the treament mall (she was fairly new). It was nice to speak to someone who was closer to my age. Doris sent us to one of the doctors (I forgot her name unfortunately) for medication management with the patients. While I sat in the lecture, Kirsten brought the patients up one by one to the sink so they could brush their teeth (encourging good hygeine). Only two of the four female patients cooperated. The doctor talked about taking medicine, admitting that you have an illness (this was a repeat for me) etc. After this the patients left for a break, a new set of all female patients came in about 15 minutes later. With this group, the doctor discussed stress and managing stress. She handed out a worksheet, which defined stress and the symptoms of stress. In addition, the doctor handed out an article from the paper which discussed the study of relaxation lowering one's risk of heart disease. The patients were very receptive and openly discussed what stresses them or events that seemed stressful to them.

Following the lesson on stress, I took a lunch break. After the lunch break I went on an outting with 6-7 middle aged female patients, Mary (therapist), and Dr. Reynolds (clinical counsler), and Ann who was a grad from Canisius College. It was good to see someone one graduated from Canisius; we had a thorough discussion about psychology and therapy and social work (she was very nice and informative). We went out in a white van; our first stop was Crossroads. Our purpose for going to Crossroads was to let the patients view and tour the treament center and possibly consider it as an option when they become outpatients. Crossroads is an outpatient facility that offers social groups and a variety of leisure activities and treatment accomodated for each individual's needs. The man who gave us the tour of Crossroads was Ray. He handed out schedules of daily activities to the patients and went through them. Ray also explained the purpose of some of the programs that were offered. Some of these programs included, "Solutions for Wellness", "What do you Want", "Keep Building you Self-esteem", "Basic Living Skills", "Excercise/Walk", and many more. Some of the patients liked the facility others dismissed it. After Crossroads we traveled to a flower shop, but none of the patients wanted to look at the flowers. Mary went in to purchase some; I believe she will start a planting group soon for the patients.

Our final destination was Family Dollar, which eventually became the circus. All of the patients have a limited amount of money, which most have earned. Ann, Mary, and myself went into the store with the patients and watched over them (to make sure they didn't steal anything). One patient in particular was very loud and demanding, and kept getting in and out of line at the cash register to get new things. Mary had to get stern with her to get her to stay in line, buy her merchandise, and go back to the van. This one patient tried to climb up a ladder to get a watch, instead of asking one of the clerks! Another one of the patients after seeing this display tried to do the same thing, to get the same exact watch! The patients' behavior should have been better. After we all left Family Dollar, Mary and Dr. Reynolds talked about making arrangements for another class in store etiquette and social skills. The patients knew better, but took advantage of the situation in spite. When we returned back to BPC and got all the patients back to their living unit I had a nice discussion with Mary. Mary discussed setting me up with the inpatient and outpatient social workers and some of the counslers to shadow. She also wanted me to do some work in the other buildings at BPC. She hopes to set up a calendar with a schedule for me, which will allow me to cover a variety of experience. I am very excited to get started with her tomorrow.
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{{color c="blue"text="Tuesday July 11th: BPC Empire Enterprises/Treatment Mall:Hours: 4"}}

I finally got a chance to visit another building on the BPC campus today. Bob and Mary (both recreational therapists), along with 7 female patients and 1 male patient, and myself, went to Empire Enterprises. Empire Enterprises is like a stepping stone for patients. It has a vocational program which allows patients to do work tasks such as quality control. Some patients were there working, inspecting magic erasers (Mr. Clean product), putting the good ones in one bag and leaving the bad ones out so they can be shipped back to the company. The patients have a selection of other jobs to perform similar to this, and get paid according to how much they produce (the pay is low though, its more for experience). If a patient shows potential, when they become outpatients, the people from Empire set them up with a job in the workforce. The outpatient's progress at their job is monitered every couple of months. This information was broken down to the visiting patients by one of the workers at Empire. After the discussion we were all taken on a tour of the building and the work grounds and were shown standard procedure for when a patient comes in to work. Following, there was a 5 minute refreshment break. Right there after, the visiting patients were put to work for 30 minutes doing quality control. Many of the patients were happy to be on their feet working and wanted to come back and start as soon as possible (which they will). Soon after, I took a lunch break and came back to the Treament Mall to do Artistic Enrichment with a large group of patients. I worked with Noreen and another staff personel. I helped motivate some of the less engaged patients to actually take up an activity.
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{{color c="blue"text="Thursday July 13th: BPC Treatment Mall:Hours: 4"}}

My day passed by quickly at BPC today. In the morning I worked in the Treament Mall on the 3rd floor with Mary. We were originally supposed to bring the group of female patients (and one male) to Empire Enterprises, but we were unable to do so. Bob (another recreational therapist) took the day off, and at least 2 people must be present to bring and oversee the patients. As a result, Mary and another staff person, as well as myself brought the patients to the beading room. Here, the patients worked on vocational skills by creating necklaces, earings, etc. out of beads. Each patient's name was written down on a chart and everytime they produced a piece of jewelry they got a tally point next to their name. For each piece of jewelry they produce, they get a set amount of pay. The jewelry is later sold to whomever at BPC. This helps the patients practice and enhance their skills for when they work for Empire Enterprises. I helped and encouraged some of the patients when they were making their jewelry. I also helped to tally up individuals work. Time passed by quickly, before I knew it I was off to lunch. Thereafter, I went back to the 3rd floor of the Treament Mall, where I got to work with the men for the first time in the kitchen. There were about 10 men in the room, one male staff person and Mary. The men seemed very happy to see a new female. Luckily none of the patients tried to touch me, some would make remarks (ex. your a nice looking girl). I was warned about this so it didn't effect me as much, you have to always be on your toes with the men for these reasons.
One of the older male patients was very adament about his dislike of my presence in the group. He thought I was too young and should not be with all older males. He ended up going to the alternative room, but then came back and tolerated my presence. In the kitchen, Mary and I helped the men make cup cakes, and supervised when they cleaned the kitchen up. One of the male patients did extermely well, I think he did a better job than I could have ever done!!! He was the most competent of the group and required little help if at all. After the cupcakes were done, the males got to eat the food they labored over. I think the fact that they knew they were getting dessert at the end of the session helped their attitudes. They behaved better than usual, which is common when they know they will get to eat some treats (Mary and others informed me of this). At the end of my day I spoke to Mary about some of the patients' backgrounds. I am excited that Mary will be showing me some of the patients' charts next week. Mary has been very helpful to me so far and I really appreciate what she si doing for me as well as the rest of the BPC staff.
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{{color c="blue"text="Monday July 17th: BPC Treatment Mall:Hours: 4"}}

I had a chance to work with the men again today. I worked with Mary, and another male staff person. The patients worked on arts and crafts, and the dental hygenist (Kirsten) came in and helped the men brush their teeth one by one. The men seemed pretty cooperative and willing to participate. They are very talkative and will ask you a range of questions, some of which you can not answer (personal information). I helped two of the patients, one with painting and another with drawing. During break time, the male patients were served some cup cakes and juice. Two of the patients (which I happened to be sitting between) started to argue and fuss over the cup cakes. The one patient to my left got up and grabbed a chair as to throw it at the other patient. The patient to my right got up and got into a fighting stance. I quickly jumped back, out of my chair so I would not get harmed in the midst of things. The male staff person quickly apprehended the male who was going to throw the chair, while Mary got the other male patient to sit down. Another male staff person came in the room and escorted the patient who was going to throw the chair out of the room (he was not allowed to return). I wish I could explain the situation better, but I am not allowed to use the patients names or describe them in anyway in which someone would be able to identify the individual. This situation scared me and had me on my toes. It reminded me not to get too relaxed and always be alert for anything. After arts and crafts Mary took me to one of the rooms on the ward that had charts of the patients I worked with. I was interested in looking at one of the patient's charts, and was very interested in his background information that I recieved. It is helpful to see a patient's background and what mental illness they are diagnosed as having. I will have the chance to look at more charts during my stay, and I am very curious as to what I will find. After this unexpected experience, I went out for lunch. When I returned to BPC, I worked with the older women in arts and crafts, and helped them do beading. One thing I noticed about a handful of the male and female patients is that they will laugh for no apparent reason. These same patients also get quiet very quickly (after carrying on a conversation), as well as agitated too.
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{{color c="blue"text="Tuesday July 18th: BPC Treatment Mall/Ward/Beauty Shop:Hours: 4"}}

I had a chance to spend part of my day with Dee, a woman who works on the ward on the 5th floor of the Strozzi building. The 5th floor ward is the only ward with all female patients. Dee monitors the women, takes them to programs, makes sure there is order, etc. She showed me two books that the staff kept for the patients, to mark down violent events or incidents. One book contains the major violations that patients make (hitting staff, etc). The other book consists of minor violations. If a patient commits major or a number of minor violations, their privileges are taken away from them. These violations are also reviewed by each patient’s psychologist/psychiatrist and other members of staff whom it may concern. In addition, there is a bulletin board which lists the patients who have privileges. The privileges are split into categories of escorted I, II, and III, and unescorted I, II. For example, escorted I means that a patient can go to specific programs inside the building with an escort. Unescorted I, means that a patient can go to programs by themselves on campus. After Dee updated me on this information, we took one of the patients to the beauty shop (which is on the first floor of Strozzi). The patient got her hair washed, trimmed and styled. Dee and I then escorted the patient back to her ward.
I then went back to my house for lunch.

When I returned from lunch Dee set me up to sit in on a team meeting. There were approximately 9 people in a conference room in the Strozzi building. The team consisted of psychiatrist Dr. Brown, clinical psychologist Dr. Reynolds (whom I met before), a head nurse, a medical doctor, Norine (recreational therapist) and some other psychologists/psychiatrists. First thing on the agenda was the discussion of new transfers to BPC. Next they discussed specific patient’s privileges and requests for advancement in privileges (ex. going from escorted I to escorted II). Patients can fill out request forms and list the reasons why they deserve or want certain privileges. The members of the team reviewed these requests; most were turned down for legitimate reasons. Following, the team reviewed certain patient goals for treatment and their eligibility for discharge. They discussed patients Axis III medical conditions, their mental symptoms (improvements or lack there of). It was interesting to hear the medical and psychological terms, some of which I learned in class. Lastly, some patients came in (one at a time) to discuss their progress with their treatment goals and any problems they were having. The members of the team gave the patients feedback on their progress. They praised the patients for any improvements that they had made, but also informed them about areas they needed to improve on. For example, one of the patients had trouble controlling her emotional behavior. She was made aware of this and the team gave her a time period to correct the issue, in turn allowing her to progress in her treatment and be eligible to earn certain privileges.
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{{color c="blue"text="Thursday July 20th: BPC Treatment Mall/Strozzi Building:Total Hours: 4"}}

Today I worked with Mary again;Doris (my supervisor)always meets with me before hand and arranges where I will go for the day. We took over Jerry's group, which were from ward 67. There were a mixture of male and female senior patients. Mary first reviewed coping skills with the patients. She asked the patients what they personally would do, when coping with certain situations (for example one said do deep breathing exercises). After reviewing coping skills Mary and I led an exercise routine. Mostly every patient participated as we worked and stretched our arms, legs, and joints. Mary suggested to me that I can lead or continue to co-lead a workshop/progam, or teach a topic to the patients (I will have to work this out). Following exercise, the patients had a choice to do leisure activities, cook (we were in the kitchen area), or go over another topic. They choose to do leisure activities, some drew, others read magazines, I played board games with two of the patients. Shortly after, lunch rolled around and then I was back at BPC. I met up with Mary and we took 6 patients (5 male) down to the first floor of the Strozzi building where a "Hobbies Fair" was being held. I assisted the one female patient (she uses a walker) the whole time and kept her company. She seemed to really enjoy it as we went to each table and looked at musical instraments, coin collections, and the list goes on. When we were all finished with the fair, Mary and I took the patients up to the second floor kitchen for break/snacks. Some other patients came in (after coming from their programs). I served the patients hot chocolate and Kool Aide. One patient needed "Thick It" in her drink because she chokes easily. There is a list in the kitchen containing the names of patients who are chokers and diabetics. This means that patients on those lists can not drink or eat certain foods, or they need those foods or drinks to be specially prepared. When break was over, it was time to go. Hopefully I will be working with one of the social workers next week.
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{{color c="blue"text="Monday July 24th: BPC Treatment Mall/Strozzi Building:Total Hours: 4 and 55min"}}

This morning, I worked with Mary and Bob (recreational therapists) on the third floor (Treatment Mall). I worked with a group of males, which I have worked with in the kitchen before. The male patients did "work for pay", which is a vocational program (stepping stone). I have worked with some of the women with this a couple of weeks ago. The male patients get paid per product they produce. In this case, the product is jewlery made from beads and wire. One of the male patients got into an argument with Bob, and started cursing along with other inappropriate language. He had to be escorted out of the room. The rest of the patients seemed to be productive to their best abilities. I worked with one of the male patients and made a display board out of felt, cardboard, and duct tape. The patient that I worked with was very proud of our work, and felt that he made an accomplishment. The males cleaned up their work areas, and turned in any jewelry they made around 11:00 am, and I went off to lunch. I returned around one to meet Mary on the second floor of the Strozzi building. We went staright to the arts and crafts room, where Norine (recreational therapist) was also working for the afternoon. The arts and crafts rooms as well as the kitchens on some of the floors were not up to par, and staff was responsible for cleaning up these areas today. I helped clean the tables and organize some of the materials in the art room Norine, Mary, and I were in. When I finished doing my part I played cards with one of the male patients, who often talks non stop and irritates the other patients he is around. Playing cards with him kept him quite for a short period. I then played cards with one of the female patients, she actually taught me how to play spades! Shortly after the fairly large mixed group went back to their wards (most were from 75 I believe). Tomorrow, Mary informed me that I will finally be working with the social worker Mary Lue. It will be a pleasant change from the usuall; I am sure that I will be taking in plenty of information as well as learning a thing or two from Mary Lou.
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{{color c="blue"text="Tuesday July 25th: BPC /Butler Rehab Building/ RCCA and SOCR BPC campus Facilities Treatment Mall:Hours: 4"}}

I finally got to spend the day shadowing Mary Lou, the social worker. I met her in the Strozzi Building on the fifth floor. Mary Lou works on unit 75 which is an all female ward. She has about 27 patients, which she arranges meetings with according to alphabetical order. She usually sees about four patients per week. Mary Lou finds and reviews discharge options for patients which can range from community housing, to family care, or supervised living (in apartments). She also handles the patient's money (any income they recieve), and keeps track of how much they have,spend and gain. The patients have the opprotunity to visit different areas for discharge through Mary Lou, which is supposed to help them in their decision of placement. Mary also reviews the patients therapeutic mental and medical goals set by admissions, when a patient is first enrolled into BPC. These goals are usually general and are later adjusted to the individual through the treament team (consisting of medical doctors, psychiatrists, and a variety of staff). Mary Lou then reviews these adjusted goals with her patients and tries to encourage them and keep them on the right track.
Some steps must be taken for a patient to get dischaged (for most advocates). Inpatients who want to become outpatients must first comply with their treament plan and be on good behavior (also show some signs of independence). When a patient has done all of the above they can make a request out to Mary Lou who will request them to New Beginnings. This program is held in the Butler Rehab Center on the BPC campus. It is for patients who have privileges, allowing them to walk unescorted to the Butler Rehab Center where they can test their independence and show the progress they have made. New Beginnings is a program that offers groups such as education programs, leisure activities such as swimming and bowling, and a weight room. They also have groups such as how to manage one's mood and stress, classes on cooking, etc. The difference between the programs here and the one's in the Strozzi inpatient living unit, is that they are not mandatory. Patients at the Butler Building get to pick and choose what programs they go to. They can eat at a cafe there and they can also work there too. Shopping for clothes is also an option, since they have a thrift store right near the cafe. When the patients make choices like this on their own, and sign up for programs and attend them, it shows their ability to make choices and function independently. If a patient makes progress in this program they can then be reffered to the on campus outpatient facilities. The two facilities are on the BPC campus and are co-ed. One is the Residential Care Center for Adults (RCCA) and the other is the State Operated Community Residence (SOCR).
Mary took me on a tour of all the buildings listed above. At RCCA, I was introduced to Lauren, an Occupational Therapist. She explained to me that there are three floors consisting of both male and female patients. There are two patients assigned to each bedroom. The patients choose there own health care provider. They have a range of time to go to breakfast, lunch, and dinner. They pick the programs they go to and basically have alot more freedom here. These patients usually stay for a year or two and are then discharged to community housing for example. There is a total of 101 patients in this facility. Unlike the RCCA, the SOCR is more comfy (has more of a family setting to it). Tom (I forget his title) who runs the building gave Mary and I a tour. Approximately 24 patients, both male and female live in this facility. Two patients share a bedroom and have a list of chores to do. The patients are also assigned to group chores as well. The patients plan out their day and go to the programs they want to go to. They provide their own means of transportation (usually by bike) some have bus passes though, for off campus activities. The patients do their own laundry and can cook (microwave snacks) in the basement of the facility. The patients have a range of time to attend breakfast, lunch, and dinner. They also may cook in groups for dinner. Patients here are less inhibited (physically and mentally) as those in the RCCA. Patients usually stay from 4 to 24 months, and are then discharged. Of course not all patients who are discharged stay discharged, a considerable amount of patients end up back in the system.
Shortly after my tour I went to lunch and then came back at 1:00pm for a team meeting on the second floor of the Strozzi Building. This was my second time observing a team meeting. The staff that conducted the meeting was the team leader Hal (who just retired and will be leaving after this week) and the temporary team leader who will replace Hal for the time. In addition, Dr. Brown and Dr.Xu who are both psychiatrists were present, as well as Dr. Renyolds the clinical psychologist. Lisa, a psychiatric nurse was there, also Mary Lou, a medical doctor, and a therapy aide were present. The first action was to go over the Cardex for unit 75 (all female ward). The Cardex listed each patient's name, their medical status, behavior, etc. The patients' mental health, behavior, and medical conditions were reviewed one by one. Next, there was an Agenda sheet which consisted of reviewing for patients progress for discharge. Next, request slips made by the patients for privileges (ex. escorted I to escorted II) were either accepted or declined.
Today the staff met with one of the patient's uncles. Originally, the uncle and mother were coming in to have a meeting with the staff and the familial patient to review her progress. The patient cancelled this meeting, but the uncle still came in. Because the patient cancelled the meeting, staff could not give out any information to the uncle. The uncle met with the team and talked about the patient and what home life was like and was given some of the teams numbers to contact. After he left, 2 female patients came in and the team reviewed their progress. The one female was complemented on her good behavior and compliance, but warned about one incident that occured (which they did not mark her down for). They encouraged her that her discharge will come soon if she keeps up the good work (she seemed very chipper after receiving this bit of information). The other patient (who's uncle came in before hand) was warned about not taking her medication. She was told to stick with her medication, and have more hope for herself and her recovery (she didn't have much faith in herself). On thursday I will be going in early (8:30 am) to look over patient charts.
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{{color c="blue"text="Thursday July 27th: BPC Treatment Mall/Strozzi Building:Total Hours: 4 and 30 mins"}}

On Thursday I went in early (8:30) to look at some of the patients charts. At 9:00am, I worked with Doris Richardson (my supervisor) on the second floor of the Strozzi Building. She held a music program in which she played tunes on the piano and the patients had to guess what the song was, and who it was composed by. The patients where given instruments such as marracas to play along to the rhythm of each song. I used a pair of sticks to keep rhythm and participate, some patients participated more than others. The group consisted of senior citizens, male and female patients (most from ward 65 and 75). One patient that sat next to me knew almost every song that Doris played!! Another patient on a more disturbing note, made up her own lyrics to many of the songs. These lyrics involved death and violence. This particular patient is very intimidating, and on a daily basis comes off very aggressive. She does not take all of her medication, which would help her mood, but it is against the law to force her (unless court ordered). After this program, I went home for lunch (around 11). I returned to the Strozzi Building at 1:00pm to work with Anne West (occupational therapist) on the third floor with a group of middle aged men.
The name of the program was called "Community Living Skills". Anne discussed with the group certain skills they needed to live outside of BPC. She also explained to the patients that they must posess these skills in oreder to be discharged. She reviewed with each patient what their personal status was as far as discharge and what they need to do to get there. One patient got very involved in the discusion. He talked about his anger issues and a certain incident that pertained to it (in which his priviliges were taken away from him). Whenever a patient is involved in an incident it takes their progress down a level, leaving them with less priviliges (such as going outside with an escort to not going outside at all). The patients then have to work themselves up to that particular level again. I can see how some of the patients can get very frustrated by this or even give up. Anne encouraged the patient to keep his temper under control, and I encouraged him not to give up. He seemed relieved that he let off some steam and expressed a sense of some hope (unlike earlier in the conversation). Following the discussion, the male patients had a snack break. Next they watched a nature movie (leisure) for thirty minutes and the session ended at 3:00pm.
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{{color c="blue"text="Monday July 31st: BPC Treatment Mall/Strozzi Building:Total Hours: 5"}}

I worked in the Treament Mall on the third floor today at 9:00am. I accompanied Trina (mental health therapy aide), and escorted the women from ward 75 to their education program (which was on the third floor). There were two teachers working in the education room. There were a number of computers with learning programs on them. The two teachers had the patients working on algebra and basic math involving rounding, times tables, word problems, and so on. The patients sat at round tables in small groups and worked individually in their work books. The teachers came around to each table and corrected the patients' work. They also helped patients individually when they asked for it. When it was time to leave, the patients got to line up for a piece of candy (positive reinforcement) and I left for lunch around 11:00am. I returned to the second floor of the Strozzi Building where I sat in with the patients from ward 75 and 65 to listen to a guest speaker. The guest speakers name was Amy Upham from the organization "Action for Mental Health". She was an advocate for empowerment in the mental health field. She spoke to the patients how they could go through training (when discharged) and become advocates too, and also run their own groups. For example, former patients who suffered from clinical depression could run their own group with people who were or are suffering with the same diagnosis. The intention ofthe program is to allow the consumers to help themselves as well as others and do what is best for them. Some of the programs that already are up and running are, "Trauma Group for Women and Men", "Women Trauma Survivors", "Panic and Anxiety/ OCD Support Group", and the list goes on. The woman who gave the presentation actually suffers from PTSD and OCD herself, and continues to take medication (she is 27 and was put on mediction since she was 20). A handful of patients seemed interested and took the brochures. Following the guest speaker the patients had cookies and tea for their break, before returning to their living units. I then helped to clean up and straighten some of the file cambinets; shortly after I left at 4:00pm.
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{{color c="blue"text="Tuesday August 1st: BPC Strozzi Building/Empire Enterprises:Total Hours: 5"}}
This morning at 8:00am I attend a meeting with all of the recreation staff in the Strozzi Building. They had a briefing, in which they discussed concerns and issues. Doris (my supervisor and the head of recreation therapy and programs) gave out an article on running programs for those who suffer from cognitive deficits. Along with the article each recreational therapist received updates on incidents that occured with the patients they worked with. These incidents listed, are those that occur after programs (after the recreational staff leaves). Most of the incidents were related to particular patients not taking their medications. Thereafter, I helped to round up a handful of patients to go to Empire Enterprises. Mary and I went to the all male ward to check to see if any of the male patients had the priviliges needed to go to Empire. These patients had to at least be a level three, meaning that they can go outside on BPC grounds if escorted. Unfortunately none of the males had that privilige level. One male that was on the ward on the 8th floor, had the privliges but could not go because he had to be escorted by someone on his ward and no one was available. On the 8th floor the wards are part of the Brite program. It is a social learning program. The patients earn tokens for good behavior. They also have access to a computer room. On the 7th floor we picked up one female patient to go to Empire. Her ward is the only open ward, meaning that none of the doors are locked. After retrieving the one patient we took four more female patients from the second floor (most from ward 75).
Empire Enterprises is like a stepping stone for patients. It has a vocational program which allows patients to do work tasks such as quality control. The female patients signed in when they arrived at Empire and then put some gloves on and went to their work stations. The ladies' job for the day was inspecting magic erasers (Mr. Clean product), putting them in a package (if they were good), and closing up the package. They then put the packaged products in a box which was able to contain 40 packaged products. My job was to help mark the patients down so they could get paid for each box of 40 they produced. I also helped some of the patients package the products. Afterwards I went to lunch then returned to the Strozzi Building to take the same 5 patients plus 6 more female patients back to Empire. The patients did the same work that they did before. I helped one of the patients (who did not work this morning) package the magic eraser properly (she was having trouble). After awhile that particular patient, although moving slowly, got the hang of it and continued to work by herself. At 3:00pm I left the premises.
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{{color c="blue"text="Thursday August 3rd: BPC RCCA:Total Hours:5 Times:8:00am-11:00am and 1:00pm-3:00pm"}}

I worked in RCCA today with Lauren (an Occupational Therapist), who deals with outpatients. RCCA stands for Residential Care Center for Adults . 101 outpatients reside in the 3 floors of the co-ed facility;two patients are assigned to each bedroom. The patients choose there own health care provider. They have a range of time to go to breakfast, lunch, and dinner. They pick the programs they go to and basically have alot more freedom compared to inpatients. Oupatients have to meet with their psychiatrist at least once a month and are encouraged to taked their meds. These patients usually stay for a year or two and are then discharged to places like family care or community housing. Laurens job is to take care of intake of patients, crisis situations, and patients' discharge. She's basiclly thei social worker. Lauren provides options to patients for discharge, she helps them contact family members. In addition, she helps them to get employed in the community. Patients may come to her office and meet with her at random or schedule an appointment. Lauren deals with alot of paperwork as far as patients' medical records, status, their progress at RCCA. She has to file forms for patients to move from RCCA to places like community homes for discharge. Lauren also keeps notes in each of her patients charts (progress, problems, etc.). I had the chance to view one of the patients charts who was the hot topic for the day. This particular patient has had a history of non-compliance with RCCA rules, and has been involved in prohibited and destructive outside activities. As of today she has been gone for a week, and has not checked in with anyone from the RCCA facility. She had until 12:00am to do so or else she would be discharged. Unfortunately, she was discharged and was put into the hands of AOT (Assisted Outpatient Treatment). The staff had to move all her belongings out of her room, while Lauren had to contact the family and look over and edit the documents in the patients chart in case of a psychiatric autopsy. The staff, including Lauren, seemed to be very disturbed by this event. The staff worked harder on the treatment plan than the patients, and in cases such as this there is never any pay off. The patient has to show intrest and be willing to work as hard as the staff for their recovery, sadly this was not the case for this one patient. All afternoon (1:00pm-3:00pm) files, emails, and phone calls were made and reviewed. There is alot of paper work involved in even the smallest of situation, even allowance for patients at the facility. My day with Lauren really help to clarify what it means to be an outpatient and what work is involved in her position.
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{{color c="blue"text="Friday August 4th: BPC Treatment Mall/Court yard:Hours: 5"}}

This morning I attended my second meeting with the recreation staff. They discussed issues with being understaffed and covering groups of patients for one another. The staff is trying to work out a system for when staff takes vacation or is off for a day. Following the meeting, I worked with Anne West (occupational therapist) with ward 66; consisting of male and female senior patients. Anne and I discussed the different types of ways people can communicate to one another. The patients got involved in the discussion and participated quite well (ward 66 can often be hard to work with). In the afternoon from 1:00pm-3:00pm, Anne, Mike (rehab therapist/nurse), Jodi (therapy aid), Doris (head of recreation), and myself took ward 75 and 66 outside in the court yard. The court yard is outside and is a gated in section of the Strozzi Building. There are benches outside as well as 2 shelters for shade. At hand was a water fountain and two grills as well. The patients had a chance to relax and socialize in this setting. Everyone was cooperative, some patients played card games, some read magizines, others colored or did crossword puzzles. Many of the patients had a chance to work on their social skills and cooperate with others. The patients were also provided with drinks and some had the privilige to smoke. Everyone (staff included), embraced the warm weather and the cool breeze. I enjoyed being outside, especially with the patients.
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{{color c="blue"text="Monday August 7th: BPC Treatment Mall/Court yard:Total Hours: 5"}}

This morning, at 8:00am I attended the meeting with the recreation staff. At, 9:00am I worked with Mary (recreational therapist) on the second floor of the Strozzi Building. We worked with ward 66, which consists of an older co-ed crowd which can be unmotivated at times. This group normally is ran by Jerry (recreational therapist) but he was on leave. Understaffing can often cause difficulties with placing patients into unscheduled groups, or finding someone to take over their group. Mary and I were placed in the arts and crafts room. I helped one female patient apply make-up, other patients painted or colored. Shortly after arts and crafts I took a lunch break and returned to work with Mary again at 1:00pm. Mary ran Jerry's group again, working with ward 66 and some patients from ward 75. The name of the group was called "Coping with Stress". Mary asked the patients what problems they often placed, and how they cope, or could cope with them. Some of the patients had very delusional ides, and went off topic. One patient in particular was very delusional. She asked Mary "I don't know why (name) said I killed your son but I didn't do it". This patient created this senario in her head, and believed what she was saying. Situations such as this have occured often with a great deal of patients that I have worked with (a good portion being schizophrenic). In addition to the discussion, Mary put in an exercise tape for the patients to follow along with. The tape showed stretching exercises created by monks. Mary and I followed the exercises and encouraged the patients to join in. Only a few patients did not participate. In contrast, the patients who did join in seemed to enjoy themselves (felt relaxed). Thereafter, I escorted the patients to the kitchen to get some refreshments. Following the refreshments, Mary and I took the patients from the group who had privliges (about 5 or so) out to the court yard. In the court yard they enjoyed some fresh air and did some leisure activities. I noticed that most of the patients seem happier and more social when they are permitted to go outside. I left the building at 3:00pm, and I will be working 8:00am-11:00am and 1:00pm-3:00pm everyday this week.
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{{color c="blue"text="Tuesday August 8th: BPC Strozzi Building:Treatment Mall: Total Hours:5"}}

As usual, for this week I attended the morning meeting. I then worked with Mary in arts and crafts, or "Artistic Enrichment". There was a large blend of patients consisting of wards 65,66, and 75. One of the patients had a nose bleeding incident and had to be escorted to the nurse. Some of the patients, most from 66, were unmotivated and did not participate well in the activities. The other patients either colored, painted, or did basket weaving (which was a hit for today). When it was time for break we escorted the patients into the kitchen for some coffee/tea and applesauce. The patients then continued working on their projects back in the art room. I had some difficulties with one patient who can be very stubborn at times while trying to escort her back to the art room. I convinced her that is wasn't fair for the other patients to have to go back, while she stays in the kitchen. After that being said she walked over to the art room. Following this program I went to lunch and returned for a team meeting at 1:00pm. The team meatng members included Dr. Reynolds (clinical psychologist), a therapy aid, Dr. Brown and Dr. Xu (psychiatrists), Mary (occupational therapist), and myself. A list was passed out that consisted of the agenda for the meeting. First, the team reviewed "Developmental and Status Reports", which dealt with issues such as patients moving to different units on the ward or for discharge. Secondly, the team reviewed a cardex for ward 75 (all female ward consisting of many borderline patients). The team reviewed each patient one by one on their progress, problems, and compliance with treatment. Thereafter Dr. Reynolds went over requests made by patients for specific priviliges or passes to see family/go out. The team as a unit either decided to grant, turn down, or delay the priviliges requested by each patient. Lastly, patient interviews were held off until late (ran out of time), and the meeting came to a close at 3:00pm.
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{{color c="blue"text="Wensday August 9th: BPC Strozzi Building:Treatment Mall/Action for Mental Health/Annex Total Hours:6 and 30min"}}

Shadowing Dr. Reynolds gave me further insight into the role of a clinical psychologist and what title I would like to pursue in the mental health field. I started my day in Dr.Reynolds office on the fifth floor south ward of the Strozzi Building. This is the only all female ward in the building. Dr. Reynolds discussed his education, his role in the hospital, and what I could/should do in terms of becoming a Clinical Psychologist. Our first event of the day was working with a handfull of women from group 75 in the Treatment Mall. Dr. Reynolds along with Doris Richardson (Recreational therapist/my supervisor) ran a group called Emotional balancing. They passed out worksheets to the patients on emotional balancing, self-love, mutual relationships, meaningful work, and goals and visions for the future. The worksheets defined these terms; in addition one worksheet had a self survey dealing with the mind, body, and spirit, and taking care of the three. It contained questions such as "when was the last time you exercised for 30 minutes". The purpose of this discussion was to encourage the ladies to have goals, want to live life, and take care of themselves emotionally. Dr. Reynolds made sure to ask every patient what their goals were, and to involve them in the discussion. Two patients fell asleep, even after Dr. Reynolds attempts to get them involved and talking (it happens at times).
In addition to emotional balancing, Dr. Reynolds held another discussion about relationships that can interfere with one's goals. Many of the female patients have been in abusive relationships with significant others. Therefore it was important for Dr. Reynolds to emphasize how these types of toxic relationships can become barriers and prevent the patients from reaching their goals. He also explained that having children, or our peers can sometimes change or get in the way of our goals. Thereafter, Dr. Reynolds took me to a "Training Committee Meeting". The meeting was held by Dr. DiNezza (whom I worked with before). There were two 3 other psychologists present besides Dr. Reynolds. There is only one female clinical psychologist at BPC. The committee discussed upcoming grad students and the training that will be provided for their internships at BPC. Three of the incoming students were female, and Dr. DiNezza wanted to bring in another female psychologist (since there is only one) for the female students. He felt that there was not enough diversity and some of the issues the female students might be faced with would be better dealt with one of the female psychologists. He even asked me my opinion on the ordeal!! They then went on to discuss seminars that were to be held for the students and who would be presenting at these seminars. Following the meeting, Dr. Reynolds and I went to rent a van from the campus to take three of the females from ward 75 over to Action for Mental Health on Kenmore Ave. A therapy aid came along named Dianna. The three women attended a group at Action for Mental Health called Trauma Survivors. The women did not discuss their specific trauma experiences in this group. Instead, for the day, the women created and decorated binders to keep a daily journal in. After the program was finished we took the female patients back to the ward and returned the van.
Dr. Reynolds and I then attended a Trauma Awareness group in the Strozzi Building. Dr. Reynolds, Amy (Social Worker), and two fully recovered patients, and I were asked to review a tape that discussed trauma. This tape was to be used for training for incoming students. We all watched the 15 minute movie in the Annex, which held training classrooms for incoming students and staff. All of the group members though the video was inappropriate and was geared more towards alcohol and drug abuse instead of trauma. The video did make one good valid point about trauma. The video explained that sometimes the person that caused the victim trauma can have trauma from that within itself. I never thought about how a person who caused others trauma could suffer and be traumatized by their guilt, regret, and behavior, and harm they caused to others. When I left it was 4:00pm. I was very thankful for this experience I had with Dr. Reynolds today.
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{{color c="blue"text="Thursday August 10th: BPC Strozzi Building:Treatment Mall/Empire Enterprises: Total Hours:5"}}

This morning I attended the recreational staff meeting and was assigned by Doris to work with Bob (recreational therapist). We went to the 7th and 2nd floor of Strozzi to round up qualified patients to go over to Empire Enterprises. Bob had to fill out some paper work and get it signed in order to bring the patients over to Empire (common process because of liabilities). We took 8 female patients and one male patient over to Empire. Here, the patients made some money boxing the Mr. CLean Magic Erasers. One patient stamped the box covers instead, and I chipped in to help. All of the patients worked hard, were motivated to get money, and none of them quit in the middle of the job. Around 11:00 Bob and I escorted the patients back to the wards and I left for lunch. At 1:00 pm I helped out Brenda the nurse, along with two other therapy aids, watch over some patients as they smoked in front of the Strozzi Building. One of the patients who is autistic actually started (what I considered )a conversation, and for him that was good compared to his normal behavior. He did not repeat my words when I answered him or asked him a question, and he even made an observation and comment about the weather on his own. He wasn't jittery or loud, which was exactly the opposite of what I expected. Following, I headed to the art room on the 2nd floor (Treament Mall). I helped Sandy, a recreational therapist watch over and help the patients work on their hobbies. It was a small and easy to manage group consisting of mostly patients from ward 65.
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{{color c="blue"text="Friday August 11th: BPC Strozzi Building:Treatment Mall/Court yard:Total Hours:5"}}

This morning I met the TTL (team treament leader) of the recreational therapists in the 8:00 meeting. The TTL's name was Renne. She addressed some issues with the rest of the therapists (seemed very stern). After the meeting I paired up with Anne West (Occupational therapist). We worked in the arts and crafts room with ward 65, which consists of senior citizen male and female patients. One of the men was acting out today. I believe he is autistic, he repeats people often and blurts out sentences. One of the other patients was getting very agitated by the other patients behavior. The male patient usually goes home on weekends, and every time he is about to go home he gets very anxious. When he is anxious his condition is not as controlled so he becomes very vocal and antsy. Anne and myself had to tell him several times to stop harassing the other patients and to lower his voice/have some quiet time. I played cards with this particular patient a couple of times so he would settle down some but at the end of the program it didn't to seem to make much of a difference. The other patients were well behaved and they painted, colored, and did beading. One of the older male patients is very skilled at drawing. He painted a picture of Jesus and gave it to me. Many of the patients have made religious art, and are religious themselves. They often have strong feelings about their religious beliefs. Almost all of the patients have mini bibles and rosarys. This afternoon Anne, Mike (Rehab Counsler), and I took the patients from 65 and 75 out to the Court yard so they could smoke, socialize, play board games, and read. It is always a pleasent gathering when the patients get to go outside. There were few problems with the patients and many cooperated with each other to play games and socialize. I personally played UNO and Connect four with two of the patients. I actually had fun playing the board games with them since I haven't played them in 12 years practically!
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{{color c="blue"text="Friday August 12th: BPC Strozzi Building:Treatment Mall/Friendship Clubhouse/Hannah's Ice Cream:Time: 8:00am-11:00am & 1:00pm-3:00pm:Total Hours:5"}}

I attended the morning meeting, in which staff discussed room cleaning deligations and what groups particular patients would be going to for the day. I was assigned to help Mary and Bob (recreational therapists) with the men on the third floor of Strozzi. The men were brought to the work for pay room. Most of them were from ward 76; there were about 11 men in attendance. Here, they packed Mr.Clean Magic Erasers/sponges (as some of the patients have done beforehand at Empire Enterprises). The male patients were very productive, and the packaging kept them busy. All the patients, whether it be male of female, participate more when there is money involved. I helped to watch over the men as they worked. On male patient stamped the boxes the sponges were to be put into. I helped to organize those boxes and distribute them to the males who ran out of them (after packing a number of sponges). In every program there is an attendance sheet and each patient is rated on their participation. They are rated on a scale from zero (no participation) to 4 (high participation). Following working with Bob and Mary I went off to lunch and was lucky enough to go on a community outing with Dr. Reynolds and Donna (nurse).

Community outings allow patients to take field trips, explore the city, other areas providing treament, and teaches them social skills and proper etiquette when they are out in the community. Dr. Reynolds, Donna, and I rented a van and took 7 females from ward 75 to the Friendship Clubhouse. This building is off the BPC campus, located off of Main St. This was a drop-in center for former patients. It provides food, a place to shop for clothes, a recreation center and some social groups. The patients were provided with a tour and got a chance to buy some candy from their snack shop and shop in the small clothing store. This facility is open through the majority of the day, but it does not provide a place to sleep over night. The former patients get to cook their own meal as a group and are assigned cleaning chores through the day. All of the female patients got a warm feeling from the facility and wanted to come back again. In addition to the Friendship Clubhouse, Dr. Reynolds and Donna took us to Hannah's Ice Cream on Colvin. I believe this was the highlight of the female patients day (also seeing men in cars and on the street). Donna paid for one ice cream cone per patient. The patients got to pick what type of ice cream they wanted. Two of the patients got second helpings (they payed with their own money though). When all the patients were finished, we headed back in the van and returned to BPC. Dr. Reynolds and Donna escorted the female patients back to the ward and I returned my keys, signed out, and went home (must do this everytime I leave).
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{{color c="blue"text="Monday August 21st: BPC Treatment Mall:Total Hours: 5"}}

We were short staffed today in the Strozzi Building's Treatment Mall (as I saw for myself in our 8:00am morning meeting). I looked over the binder containing sheets of patients who either refused medication, were involved in an incedent, or wwere being moved to another ward (all occuring from the night before). I also (since we were short staffed) made changes to the bulletin board containing info. about which patients went to which program. I worked with the older patients from ward 65 with Anne (Occupational therapist), on the 5th floor of Strozzi today. Originally Anne was running a program called "Healthy Living Styles", we ended up having an open discussion instead. One of the male patients actually ran away for two days and took a Greyhound bus to Cleveland. They retrieved him from the city mission there. Anne discussed how she was suprised by his street smarts and was happy he was able to coordinate a trip such as this. On the other hand she warned him that it wasn't the right thing to do. She explained that if he wants to make arrangements to go off the BPC campus he must speak to his social worker. I'm not sure how this move will effect his discharge and privliges but I'm sure it will have some impact on it. The patient showed very little understanding of the repercussions of his actions.

Another male patient whom I worked with and been in program with before said something that surprised me today. This male is usually kind but gets short tempered when he does not receive what he wants when he wants it. He is very into and knowledgable of art, and he has drawn over half the staff (including myself) at BPC. At one point in our session he asked me how much longer I would be staying here and what my purpose at BPC was. After I answered him, he said "Do you know what they do to you here? They take a big roll of toilet paper, the size of a football, wet it, then shove it down your throat". I explained to him that I didn't think they would do such a thing here, and that I never heard of that happening before but he believed different. Another female patient was anxious, and worried all of the program that no one would take her to the hair dresser this afternoon. Anne told her in the beginning of program that she would, but the patient asked that same question over and over all through program. In addition, one female patient kept asking me and Anne if her brother was dead. Her brother had died a long time ago. She would ask if he was dead and then say he was dead and died a long time ago, then proceeded to say he died recently. When Anne and I corrected her she called us liars and then said she never lied in her life. Following, she continued to ask if her brother was dead again. These particular patients were very delusional and paranoid.

Later in the day at 1:00pm I returned to the same room, with the same patients, and Anne. The patients did leisure activities. Two females did their nails, two other female patients played rummy. One man worked on coloring a picture, while another read magazines. One of the female patients did not participate and was verbally aggressive and loud in the beginning of program (she calmed down midway through program). I played cards with one of the male patients who lost his short term memory due to alcohol abuse. We played the game "War"; I had to remind him here and there how to play in certain situations in the game. At 3:00pm, I signed out and left BPC.

{{color c="blue"text="Tuesday August 22nd: BPC Treatment Mall:Total Hours: 5"}}

I attended the morning meeting as usual and updated the board on the third floor again. Once more, I worked with Anne on the 5th floor of the Strozzi building 9:00am-11:00am. We held an exercise group consisting of the senior patients from ward 65. Most of the patients participated as they stretched their limbs and listened to the sounds of Tuxedo Junction and Elvis. Many of the older patients have problems with their feet and hands (arthritis) and things of that nature. Exercise is a good way for the elder patients to keep their physical health intact which in turn, will have them feeling good mentally. Towards the end of the program Anne spent sometime reminiscing about childhood/teenage activities. The older patients always enjoy these conversations. I returned to BPC at 1:00pm and sat in on a team treatment meeting. The treatment team was present (Bob), as well as the psychiatrists Dr. Brown and Dr. Xu. Dr. Reynolds (Clinical Psychologist), a medical doctor, a nurse, and a therapy aide were present, as well as Mary Lou the social worker. The Agenda was passed out along with the Cardex at the beginning of the meeting. At the top of the agenda was to have a debriefing with a particular female patient from ward 75. This patient came in and was disciplined by the treatment team leader. This patient was on a restricted diet and she bought some chips (which she is not supposed to have). She has very little teeth and can choke easily. Staff tried to explain this to her at the time and they had to restrain her in the end because she was acting out. The team leader Bob asked her about the situation and she put the blame on staff. She lied about her diet and said that the staff was being cruel to her and she didn't act out in any way. Bob reminded her that she is on a restricted diet, but she claimed she can chew fine. They offered her the option of dentures so she could change her diet but she refused. She also refused to sign a slip stating that she had this conversation with the treatment team (which would be put in her chart).
Following the debriefing, the team discussed a possible transfer of a patient to BPC, changes in the Cardex format, and privilege and policy structure. Dr. Jones Brown then reviewed ward 75's Cardex. The team discussed each patient from ward 75 one at a time on their progress and wrote notes, or made changes to their treament plans. After Dr. Brown wrapped up the Cardex, a young female's parents came in to discuss their daughter's discharge. The team explained to the parents that they want the female patient to go to assisted care before she could live with the father. The father understood and agreed with making that move. The team also explained to the parents that their daughter needs to participate more in programs and show that she is knowledgable of, and can perform, basic living skills. The female patient was brought into the room, shortly after the team spoke to the parents. The team had the father explain to his daughter the situation and what she would have to do to come back home. The female patient (daughter) got very emotional, the conversation was intense, but she smiled at the end. The parents were escorted out the room along with the female patient after the father daughter conversation. The team was hoping that this conversation would help motivate the female patient to participate more so she could eventually be discharged. The problem with this particular patient is that she only does what she wants. She posesses the skills she needs to be discharged but refuses to show the staff otherwise (staff is aware of this). Overall, that point in the meeting was very intense for me. I saw how the job could take an emotional toll on you. Towards the end of the meeting Dr. Reynolds went over privilege requests from patients and the team went over patients who would be getting discharged soon. The meeting then came to an end at 3:00pm and I returned home. Tomorrow is my last day, and I can honestly say that I will miss being around the patients. Time really does fly.

{{color c="blue"text="Wednesday August 23rd: BPC Treatment Mall:Total Hours: 5"}}

Today was my last day of my internship at BPC. I attended this mornings 8:00am recreation staff meeting. I also gave out thank you cards to the staff members I worked with. Doris appointed me to work with Anne today who was running the recreation program in the kitchen of the Treatment Mall. Anne and I were to work with all of the patients from ward 66 (mixture of males and females). The kitchen was filled to capacity with all of the patients from ward 66. The patients from this ward can be unmotivated at times; a handful of the patients never picked up an activity throughout program time. Patients who did participate played board games in groups of two and three while others either colored or read magazines. I taught one of the older female patients how to play checkers. She enjoyed the game even after the fact that she lost to me. Directly after the game I got her a poster to color (she loves to color). One of the male patients who has many psychological problems walked around the room the whole time saying odd and bizzare things. He even laid down on the floor at one point and started rubbing his head, continuing with saying bizzare things. Staff had to tell him multiple times to get up off the floor. Despite his behavior, that particular patient stayed in the room for program the whole time period which doesn't happen often. The recreation program ended at 11:00am and I returned back to BPC at 1:00pm. I went to the volunteer office to fill out my exit interview and turn in my badge. After doing so, I left the facility. I hope to be back on holidays/vacations and next summer. I already miss being there.




PracticumExperiences




















PracticumExperiences