Back to Work

I possibly mentioned it previously but for the record, I was working all the designated ‘working days’ up to and between Christmas and the New Year (so I had three days off, Christmas Day, Boxing Day and New Year’s Day). I didn’t write much about work during that period and kept things purposely light on personal experiences but now everyone is back at work I thought I’d reflect on some of the ways and events that panned out when the office was running on ’skeleton staff’.

In the run-up to Christmas and the week before we suffered greatly with sickness. That is staff members. In fact on one day, we had all the front line managers off. That also happened to be the day that I had volunteered to be on duty. Volunteered, I say, because I don’t figure on the regular duty or on-call rota. I am the only person in the office who doesn’t and that’s because myself, along with one of the afore-mentioned front-line managers, are the only AMHPs (Approved Mental Health Professionals)  in the team so it is some kind of concession given to me on the basis that I need to prioritise Mental Health Act Assessments when they come up so being on a ’standard’ duty rota would begin to have a more significant impact on my case-work.

So about my ‘volunteering’ over the Christmas period. I genuinely thought it would be a Good Thing. Less people around and these Mental Health Act Assessments are hardly common  – but in the way that fate devises these things, wouldn’t an assessment (and the first one for a few weeks) turn up the day I am on duty doing lots of other things when the manager who is the only other person in the team who could step in for me, is off sick.

Of course, I had to prioritise the assessment which left the next level management doing more of the front-line work. And having a good feeling about some of the pressures we are experiencing. So while it was possibly one of the busier days I’ve had, it wasn’t all bad and everything that needed to be done, was.

I had to carry out another Mental Health Act Assessment to detain someone in hospital between Christmas and the New Year. This was a man who was already in hospital and his section 2 ran out on the Monday after Christmas. His son was away over Christmas and due to return on the Tuesday.

The ward consultant had not referred him to be re-assessed because he had thought that Mr H would ‘get a bit better’ and would not need to be placed on a section 3. He was definitely better than he had been on admission.

Mr H’s son had said, the week before, he wanted to take his dad back to his own house and just see how he managed. It was agreed that a stepped return (as previously his son and his son’s wife had had lots of difficulties managing) would be best advice for a discharge.

And so we were, on the morning that Mr H’s section expires – and the day before he was potentially going to be going to his son, with a man who is suffering from a latter stage dementia  and asking to go home while having  no capacity to make any decisions about where he is and a nearest relative we are unable to get in touch with. Possibly not the best example of ward/community consultation in action.

There are a lot of ‘if onlys’ but I do wish I’d been able to speak to Mr H’s son before, rather than after the decision needed to be made.

Other than that, as far as my own caseload is concerned, I try not to schedule to see too many people at that period. A few, I made a specific appointment to see if I knew that friends/neighbours were not going to be around. There were a few hairy moments, with one man’s wife and carer coming down with a nasty bout of ‘flu and having to take to her bed pretty much and another woman who had a deep and concerning episode of depression.

These are still areas to follow up but it was good to see a more full office yesterday at least.