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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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I am a psychiatric nursing instructor. I take sophomore nursing

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I am a psychiatric nursing instructor. I take sophomore nursing students to an inpatient chemical dependency unit. There is an alcohol counselor who is part of the staff meeting. I have been shocked by his comments. Example: "I don't even know why we should bother to admit him. He gets detoxed and then goes back to drinking." A student shared with me that he had drawn mustaches and "horns" on patient pictures on the carded and then laughs about it. Nobody ever says anything to him. I spoke with the psychiatrist and he says he's just blowing off steam. I'm discouraged. It is disrespectful to the patients. Any guidance? Thank you for your input.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Mark replied 1 year ago.

Hi! I'll be glad to be of help with this issue.

I can imagine how frustrating this situation must be for you. You are clearly a caring as well as competent instructor. It is so important in my eyes that you continue to be idealistic and enthusiastic and principled. Your students need this very, very much in our society which is becoming very cynical and self serving.

I'm therefore so concerned here because there is no perfect answer. There are only imperfect answers. Being principled is not a matter of giving up everything to stand up to any injustice. Being principled is a matter of doing the best you can to promote the values and principles that you know you need to live by within your capabilities.

Okay, why that preamble?

Because I want to make it clear that in my view, your retaining your position and you not having a complaint filed against you is going to be equal in principle in my answer as is how to deal with this counselor. Because this counselor's behavior affects people's treatment and their lives. But your being an instructor also affects people's lives. Okay?

There is a fine line between letting off steam and burnout. Well, not such a fine line. The psychiatrist is rationalizing the counselor's burnout. The counselor's behavior is almost textbook burnout behavior: blaming patients, stereotyping patients, creating separating walls between himself and patients through belittling and mocking, etc.

There is no objective timeline for burnout. Some health/mental health workers can experience it after months, others after decades. So his tenure in this position is not an indication; his behavior is.

I am assuming that the psychiatrist is his supervisor who you have access to. And that speaking with department heads or other officials there would be looked at by the psychiatrist as a breach of his authority, that you went over his head. If not, then I think you have the duty to speak with these officials. And doing so in terms of your concern that the counselor is acting/speaking in ways that make you concerned about burnout that is detrimental to patient care and intake is the best, XXXXX XXXXX If the psychiatrist is in the way, then perhaps he would listen to a second talk saying you want to reopen the discussion; because you've considered the possibility that this is letting off steam only and that you want to alert the psychiatrist that this seems to be clearly more severe, etc. and what does he think would help in remedying the problem for the patients?

Again, you can't be too pushy because doctors often have turf they feel they must defend. And you have your own job you must defend as well. Thus, this would be the approach I would recommend.

Okay, I wish you the very best!

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Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5170
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

When I talked with the psychiatrist, I did suggest it was burnout. He assured me, "He's not burned out. Just letting off steam." The man does not "look" burned out. He generally is joking--often at someone else's expense.


 


I do not think the psychiatrist is his supervisor. I'm not sure who it is. Someone in CD. I wondered about personally saying something to him about his impact on the students but I'm not sure that I am brave enough to do it or that it might cause conflict with our school position using it as an agency. My husband suggested I speak with the that agency CEO I know who is also a nurse. If I were to do that, I would check it out with our dean at the School of Nursing. I did appreciate your information. You are right, there is no perfect answer!

Expert:  Dr. Mark replied 1 year ago.
I want to add one thing:


If you suspect this is NOT burnout, then you are in effect talking about a characterological problem. That is as polite as I can say it...


If this is the case, then talking to him directly is not a good course of action. He will become defensive and/or aggressive and may consider you an opponent/enemy. That's on one side. On the other side? I don't see any discernible upside when we're talking about an adult who draws horns, etc. as someone; will he have an ah-ha moment because someone is telling him he's behaving badly? I haven't seen that happen...


All the very best to you,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5170
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you

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