I am having to learn how to be a DMHP all over again.  And it is exhausting.  (read: the person who acts as an arm of the superior court to make decisions as to involuntarily detaining patients to psychiatric beds.)

A week before my wedding in 2012,  literally the week before my wedding, I was at a DMHP week long training in the city.  And then I went back to the community in which I was working, and the coursework did not transfer over to any practical skills.  O, how I just dreaded, dreaded, dreaded crisis work in the previous community.

For propriety's sake (and o, my word, is it difficult to be in a place where I observe any propriety), I'll refrain from going into why they skills did not transfer over.  That county just did things that county's way.

So now, while I am building up my child and family caseload at the New Clinic, I am being trained again in DMHP work, because I will be expected to take crisis shifts 3 to 4 nights a month.  There is always a sliver of worry that pierces my spine when the crisis calls come - hard and sharp and automatic.

I am slowly learning that the New Clinic's way of doing crisis is so different from the Old Clinic (and we're talking the job before my last one, folks.  Two jobs ago) that it shouldn't even have the same name.  I'm learning.  Learning how to trust my clinical skills.  Learning to trust that help will actually be there.  Learning that I *can* make sound clinical decisions that serve my patients' best interests.

Slowly learning that crisis calls don't have to be spears of fear.

I'm grateful for that.  It's a slow gratefulness, but gratefulness none the less.

The head crisis worker at the New Clinic has been training me carefully.  He is a quiet, gentle, seasoned veteran, and he continually asks me quietly, "What do you make of this?"  "What do you think about (something)?" "What could this be from?"  And then when I hesitate or apologize for thoughts he quietly says, "I like your line of thinking" or "Go on with that thought a little further."

And this is where we get all Mufasa lifting Simba to the sun.

My MIL was a clinical psychologist in the area for years.  Head of mental health, retired now for a bit.  Next state over, but the same geographical region as where we all live now.  The Head Crisis Worker at the New Agency actually worked under my MIL for a long time.  (That's how it goes in small towns.)  Today Head Crisis Worker and I responded to a particularly sticky crisis call at the ICU.

As he was writing his final documentation (and we had been there for hours, my stomach grumbling and my head swimming from information), he started chuckling, looked up at me over his glasses and said,  "I find it ironic that as I'm writing this, I'm very much remembering things I learned from (my MIL)."

It's all in the family, I guess.

Look, folks.  All I really want to do is get back to providing child and family therapy.  But if this is what has to happen as part of this package deal, as long as it looks like this and has this type of support, and as long as I'm surrounded by clinicians who are in this for the patient's best interest, I think I can stick this out.  Being an Every Person with Other Duties As Assigned is part of working rural community outpatient health.  I wasn't prepared for that at first.  I think I'm getting closer to that point.


  1. Andrea on July 21, 2014 at 11:24 AM

    Hoping this new clinic will truly re-define crisis calls for you, and the experiences will be supportive and confidence building!

  2. Sylvia Hastiti on July 24, 2014 at 9:57 AM

    work is the trust that must be done well, I think you go round a very responsible

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