Monday, February 9, 2009


Can I just start off by saying that posting blogs is becoming addicting? (I think it's the false sense of self-importance it creates. Oh well, it's been a good way to get random thoughts off my mind).

Tonight I am "on-call" for work. Right now I am killing time, just waiting for the pager to go off. Can I just say that I HATE waiting for the pager to go off. It makes me anxious and on-edge, the whole not knowing when or if it will go off. I like to act like I can predict the patterns of calls, when I will get several, when I will get none. More often than not on a Monday night I will get at least one call, if not 2 or 3. Tonight so far it's quiet. (When I say that, I feel like I am jinxing myself). My debate is do I try to go to bed now and get some sleep in case I get a call at 2 or 3 am? Do I just stay up and wait?

Being on-call means different things for different professions. Most commonly, you probably have seen medical doctors on-call on shows like ER or Scrubs. (However, I have never been exactly sure what this logistically entails. I should consult my pediatrician friend who lives in California to find out more.) I have even heard of IT guys being on-call and in the middle of the night having to fix important complicated computer-related problematic stuff.

That being said, in my profession as a child/adolescent counselor, I am "on-call" a few days a month to provide "crisis intervention and pre-hospitalization screenings." As my brother-in-law jokes, my job is "talking people off of bridges or buildings." But in reality, I have never talked anyone down from a ledge, a bridge, told anyone to put down a gun or a knife, or anything else within the realm of high-intense drama (which, by all accounts, is a good thing! I am not sure how I would handle it, or how it would affect me). In fact, 95% of the time when the pager goes off, I am going to an emergency room where a kid has ended up after the dramatic precipitating event (such as a threat or gesture of suicide or homicide, extreme aggression, running away, actual psychotic behavior--not to be confused with people mislabeling irrational behaviors as 'psychotic'--), usually after the police or an ambulance brought them there and after they have been waiting in the ER (which I should say that going to an ER feels much safer than going to a suicidal or homicidally raging kid's house in the middle of the night!) Typically, by the time I get to the ER, the doc or social worker there have already decided the kid's fate, that the kid needs to be transferred to a psychiatric unit, and the vast majority of my time is not so much crisis intervention as time spent contacting hospitals and finding an available bed. Oh, and completing an insane amount of paperwork and signature gathering. (Trust me, kids usually refuse to sign papers recommending they go to a psychiatric hospital, and sometimes parents sometimes don't either).

Now, don't get me wrong, very often the kid I see at the ER is one who does need immediate help, who is crying out for help by their words, their actions, their choices. And hopefully I am helping them in some way, but often I leave and drive home feeling exhausted, drained, and not sure how I feel about the outcome. Probably because I don't usually get a "thank you for your help" or any other kind of warm fuzzy response. Usually the kid and their parent are angry and upset with me that they are being transferred to a psych unit (however, only once did a kid yell and curse at me and he did it when I was out of his room and down the hall). In a few cases, I did leave feeling like I really made a difference, usually those atypical ones when I go to a kid's home, maybe because I have felt more in charge of the situation.

Maybe my focus is wrong, because it shouldn't be about how I feel at all.

Meanwhile, I just wait for the damn pager to go off...

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