Liberal Artist in the Ambulance

They call me “counselor.”

…But I’m not.

But I am…

Confused? Let me explain.

I had a good day at work the other day. I work in a psychiatric hospital and my title is “counselor.” But I have no (zero, zilch, nada) training in counseling. That usually requires at least a master’s degree in counseling, whereas I only have a bachelor’s degree in psychology. Sure, I may know a thing or two about many of the different illnesses that my patients are diagnosed with and maybe a couple of the medications that they’re prescribed, but nothing whatsoever about counseling.

But what would you expect if you were a patient in a psych hospital and someone worked there was called “counselor”? You’d probably expect them to be someone trained in counseling techniques who’s job it is to listen to your problems and help you fix them. That’s why when patients need someone to talk to, they ask for the counselor on duty instead of talking to other staff. That happened the other night. It was strange because my counseling skills were really put to the test (remember, I have no training for this), but it was also really nice because I was able to connect with my patients in a way that I never had before.

I like spending time with my patients. I spend my shifts walking around outside, tossing a frisbee in the small courtyard right outside my unit, playing cards, painting the windows on the unit, coloring, watching tv, or just sitting and talking with patients (when I’m not doing charting and paperwork). I like getting to know them, but I also like to think it’s therapeutic for them too—it helps them develop coping skills to deal with their issues and also reminds them that I am in no way above them just because I am staff.

That night, I was coloring with some patients during snack time when another patient said she needed a counselor to talk to. I thought, “Oh great.” This patient is particularly needy—a frequent flyer at the hospital. I thought that she was summoning me only because I happened to be talking with another patient at the time and no one was paying attention to her. But I squeezed every bit of professionalism I had in me to the surface, put on my best counselor face, and sat down at her table. What started out as her usual sob story of “nobody likes me, everybody hates me, wah wah wah” turned into something a lot deeper than that—by then two peers had sat down at the table too and were sharing their feelings with me, and before I know it, I’ve got everyone sobbing loudly as they open up to me and share things with me that they’ve never shared with anyone before, not even the treatment team! I gotta say, I never saw that one coming…

I sat there with them for two hours listening to their stories. Life on the res is tough. These people’s families really do tend to treat them like crap. I’m not going to pretend that I understand the historical, cultural, and social complexities of the situation on the reservations, but I do know that that night, two patients whom I viewed as overly needy and annoying transformed into two people who have had very difficult lives and who have a lot of problems they need to work on. And I wish I could help them. But that is way beyond my “scope of practice” as a counselor, so to speak. It’s probably way beyond anyone’s—the counselors, the nurses, the social worker, and the psychiatrist can only do so much alone. Until there is somewhere else for the patient to go instead of right back into the same shitty situation that brought her to us in the first place, I think she will continue to end up back with us again and again.

And while my heart is bleeding all over the floor for these people, everyone who has worked there longer than me—counselors, nurses, and aides alike—are all rolling their eyes. They say, “Katie, you can’t believe everything a patient tells you.” But that’s my job isn’t it? I’m not going to be the one to “fix” them—I just listen to them because they have no one else to talk to. I don’t care what they tell me—I know that a lot of people lie and try to manipulate you—but it’s my job to listen and to be supportive, not to judge them. Sometimes all people need is someone to believe them. So I do.

I may not deserve the title of “counselor” but that’s what I am, and I take my job very seriously, thank you very much.

Aaaaand the next day it was like nothing had happened. They were back to their rude, demanding, obnoxious ways overnight. The girl even called me a bitch because I’m “supposed to be there to help her and I never do anything for her.” Say whaaaa?

*sigh* Such is life, I suppose…

=)