Personal Service
Coordination Services
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Tim Morrisse, RN--currently works
at the Wellness Center |
Chuck and Tim hanging out in a Village Team
area |
Tim's Story:
AS AN OUTSIDER LOOKING IN
When I was working at the hospital before I started working at the Village I
didn’t understand what the Village was about. We would see a wide variety of
patients at the hospital, but there was something totally different about the
patients that came from the Village. No one else who was admitted to the
hospital had a case worker coming to visit him or advocate for him. Village
psychiatrists would come daily to visit patients and had thorough relationships
with them. Village members would talk to their psychiatrists on a first name
basis. Psychiatrists would spend an hour to an hour and a half with Village
members where as other psychiatrists would spend about 15 minutes with the
patients that they visited. A Village patient would tell me, "would you
call my doctor," or "can you call Mark for me." Mark would say,
"If a member wants to talk to me, please call me." He would not only
visit the members for a long time but he would also encourage them to call him.
Village staff not only supported their members, they supported the hospital
staff as well. One time, I was working with a member that was psychotic all of
the time and took swings at me and would holler at and abuse all of the staff. I
was really frustrated and didn’t want to go to work because he was there. I
called Mark to inform him of staff's frustrations with working with his member,
"nothing was working.". Mark asked me, "How are you doing?"
In the hospital I didn’t have that level of team support that is apparent with
the Village Staff.
As soon as a Village member is admitted to the hospital, there is an
immediate plan of how he or she is going to be discharged. I came to know the
phrase "hospitalization is just an interruption to community living."
When we got a Village member we knew the person would really be in need of a
hospitalization. We also knew the high level of support that a person would get
once they were discharged if he was a Village member. The "revolving
door" problem is eliminated. A hospital can stabilize a person and help
reduce symptoms, but as soon as a person is discharged, his life frequently goes back
downhill, like it was before he came to the hospital, and he would eventually be
back at the hospital. The hospital staff came to see that patients from the Village would
not experience
this problem, which seemed to me to be the crux of the problem.
One man had been in the hospital for several weeks. I wanted to call and find
out how he was doing but I was afraid to cross a therapeutic boundary. I called
Mark to see if it was o.k. Mark told me, "By all means call him."
GOING TO THE VILLAGE FOR THE FIRST TIME
I got a call from a Village staff member, who I got to know from her hospital
visits, and she told me that there was an opening at the Village. I had
never been to the Village before but I thought that it was definitely worth
checking out. I saw an incredible amount of people that I had seen as patients
in the hospital, but they didn’t look the same at all. It was a surreal
experience. I saw one man who was a mess when I saw him in the hospital. He was
working in the Village Bank as the bank teller. He was wearing a suit and
tie. We both did a double take when we saw each other. In my wildest dreams, I
never thought that he would be doing so well. He was not the only Village member
that surprised me that day. So many others looked so good, they were doing so
well.
IN THE BEGINNING
When I started working at the Village, there were only 120 members. I had a
case load of 10 people so we really were able to do a lot of proactive work. I
would go to visit one of my members at a board and care, but he was really
socially isolated. I knew that he used to be more socially active. He used to be
a surfer. I made plans to go surfing with him and another member. I was out in
the ocean and I felt like I was playing hooky. But, it was the best intervention
that I could have given him at the time. After our outing he started surfing
again with his brothers and friends, he just needed a little reminder of how
much he loved to do it.
My favorite activity with members is to take them out in the ocean. The water
holds a special place for me, it really give me a sense of freedom. So many
members have been in institutions their whole lives that wide-open spaces can be
so wonderful. A lot of what we [Village staff] do has to do with introducing
things to members that they have never done before. Even members who are in
their 50s and 60s can still experience new things. It feels special to show
someone something they enjoy doing that they never thought of doing before.
THOUGHTS ON THE VILLAGE STAFF
It is hard to describe the Village staff in general. They have a sense of the
value of a person regardless of labels accumulated during his or her life. They
believe in hope. That belief can translate itself to people who do not have any
hope for themselves. The saying goes, " we believe in members until they
believe in themselves."
We continue to push people if they do not start believing in themselves.
Although we are member driven, we push people past what they expect from
themselves. One of the biggest differences between the Village and the
Medical Model is that there is not as big a difference between us and them,
between patients and professionals. We recognize the human connection.
THOUGHTS ON MEMBERS
When I first meet a member, I ask her, "what do you dream about, what
are your fantasies?" I don’t think there is a person alive who doesn’t
have something to tap into. A member- PSC relationship does not have to always
have to do with accomplishing an agenda, or working on something. We can just
spend time, hang out without an agenda. We can establish a connection without
intention of goal accomplishments. Often times when we do this, goals just
sprout up. I had one member who I couldn’t picture in a board and care, but
everyone including my member saw himself there. He liked to go bike riding, so we
would go together sometimes. When we would pass an apartment with a "For
RENT" sign, I would point out, " I could see you living there."
After a while he could see himself living in an apartment, too. A LOT OF OUR JOB
IS EXPOSING MEMBERS TO LIFE.
THE TEAMS
It is important to create an environment where it is o.k. to talk about
anything. There has been a long time fallacy that mental health professionals
are not affected by the people that we work with. As a team we have to share the
load. Flex time and flexible scheduling are important.
The teams are able to implement creative ideas because of the easy access to
funds. That is a critical aspect to this program. I know that if I have a member
who is paranoid and isolating himself at his house that I can take him out for a
meal and possibly save him from hospitalization without having to jump through
red tape.
We
have a lot of frustration dealing with substance abuse conflicts with staff
goals verses member’s goals. How do you provide support to someone whose life
is falling apart without feeling personal failures along the way. I believe that
this job provides a lot of personal growth. What most people get in a life time
we get in a week.
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