Returns

The worst part about my job is not what you would expect, or what I expected when I started working there. It's not the biting, kicking, yelling, threats, aggression, or anything like that. It's not staring at a room of girls and boys so young and already wanting to give up on life. It's not tensing slightly when a patient who's in for attempting to kill their parents walks by you. It's seeing them come back.

Some patients, we know they'll be back; the only reason they left in the first place was because their insurance ran out or they learned how to lie. But others, well, we really never want to see them again. We want to believe that they are living a happy life somewhere out in the world.

At least four times in the past month alone, I have had favorite patients of mine, those who I really thought may make it, come back. Some are optimistic, saying they just need a little more help, and then they'll be okay. Those are the ones who usually commit themselves. Others stare up at you with sad, huge, lost eyes, wondering why they're here again, why they can't break their habits. They are the ones that suffered breakdowns, and simply snapped. It's tragic.

Unlike a lot of patients, these children are sweet, kind, and considerate. They know the rules and respect them; they remember the staff and are kind to us. They try hard in groups, talk to us when they're feeling suicidal or when they want to harm themselves, and generally do anything in their power to understand what went wrong.

These boys and girls, they want help. They want to get better, and they want to make a difference. Interestingly enough, they are the ones who tell me that someday they want to do my work. If they can win these battles, I tell them, they will make fantastic staff.

I keep a mental list of these girls. I pray for them whenever I'm reminded of that list. I keep the notes they write to me up on my walls, and pray for them whenever I see them. The way I figure, they can use all the support they can get.

And, after all, a little prayer never hurt a soul.

Aggression

It occurred to me today that almost all my posts are about our suicidal/depressed/self-injuring patients. I don't really know why that is; I suppose it may be because they are the ones that I think need so much support and love. But they are only half of the residents.

They other half, they are aggressors.

These are the children that , when they are first admitted, will kick you, then wait. They will yank your hair, and wait. They will slap, spit, yell, curse, threaten......and wait. They wait to see what you will do, how you will react. They are testing the waters. They want to know how much they can get away with before you lost your temper. They run hot or cold; either these patients will flare up with fury, or wait, spreading hatred like ice across a lake, slowly but deadly.

These are the children who will toss racial slurs at their peers, make death threats, even attack them for no reason. They keep us on our toes, and they make the other patients, the ones who would never harm anyone but themselves, nervous.

These boys and girls are, quite frankly, nasty. They are admitted for burning down their homes, attacking their family members, even bringing guns to school. They are angry, and they want to spread their anger.

Unfortunately for them, we've seen it all before.

The Achilles Heel of these children is not punishment or negative reinforcement, it is kindness. When someone kicks you, kicks you hard, you want to kick them back. But that is what they want. What they can't stand is a disappointed look and a gentle voice asking them why they would disrespect someone who is trying to help them. To see if it's genuine, often a few more vulgar insults have been thrown into the air. A reminder that you are not disrespecting them, but they are most certainly disrespecting you, will make them feel ashamed. Any human in the world hates that feeling.

Some will try to hide their shame by acting out more, and when more patience, more kindness, is offered, they will simply throw up their hands and storm off to sulk. Others will apologize. Some will suddenly decide they like you, and then the aggression is pointed elsewhere.

These children are far more complicated than those who hurt themselves, but I believe that most, if not all, of them loathe themselves so much that they turn their anger outward, a shield against the world. Some have been heavily abused; others are the abusers. All of them are still children.

Kill them with kindness, I think as I stare at my bruises. Kill them with kindness.

And hide your surprise when they greet you with a smile and a hug on your next shift.

And maybe be sure they aren't holding a shank.

Challenges

It's easy to let one day slide into the next working here. The faces become blurred, the stories run together, and even the staff begin to all look the same. Since I last wrote a post, I have done three physical managements, worked with probably a good 50 girls, and counted the minutes till shift change God-only-knows how often.

I love my job, I love the girls I've worked with and continue to work with, and I enjoy most of the staff. But even chaos becomes mundane after a while.

Today was what we call challenging and what non-staff would call flat-out impossible. Even our longest veterans agreed it was in the top 5 for crazy days. Every 10 minutes or so, someone else would go off. Chairs were thrown, tables tipped, windows and walls punched. A challenging day.

I admit, it got to me after a while. My girls could not go to bed because some of the other patients down the bedroom halls were making the entire area unsafe. It felt like I had one girl crammed in each corner, hands over their ears or mouths, eyes wide, hunched into little balls, and I could do nothing to help them because I had to help with the patients who were the threats. Challenging.

And yet, at the end of the day, I go home knowing we did good. The threats were dealt with, the children comforted and asleep, the group rooms tidied and the nurse's desk organized. Some will probably go out for a drink; I will go home to a book. I like books. They are like alcohol for the soul, sweet, addicting, and diverting.

And I will gather the strength to face the challenges of tomorrow.

Existence

Sometimes, on good days, I will sit my girls in a circle, and for an hour we will talk. It is rare to get them to go for that long; they are so guarded, so suspicious. But today was not one of those days. Today, we talked, and talked, and talked. We talked about secrets, about regrets, about things that they blame themselves for that really aren't their fault. And, eventually, we talked about memories buried so deep that they'd nearly convinced themselves it was just a dream.

I had three girls share about stories of molestations that they had never told a soul. Their faces pale, struggling to find words, they managed, phrase by phrase, to tell their stories. And we all listened.

To have earned the trust of these suspicious and weary young women is a great honor. To listen to their tales is difficult, but rewarding. This is how I can make a difference. And, for those girls who have not experienced this horror, it opens their eyes to the cruel reality of other lives. It makes them think, to realize how wrong it is that so many of the the girls that they consider their friends have suffered incredible injustices in silence.

Sometimes, I am fortunate to have a patient who understands this, who encourages others to share, who is open and patient and, honestly, they do more good than some of the staff. But those girls, as wonderful as they are, worry me too. They are so focused on encouraging others that they forget about their own problems, or shove them aside, deeming them “not that important.” But their feelings are so important; they are the ones who will encourage the world, but until they learn to take time for themselves too, they will burn out.

I try to pull these children (and adults) aside and talk to them, to share this. Sometimes they listen, sometimes they ignore me. But I hope that one day, maybe when they're a little older or a little wiser, they'll remember what I said.

And maybe then they'll turn off their phones, shut off the computer, go outside, and simply be.