Welcome to Social Work Stories, a podcast exploring social work practice through stories and critical reflection.
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But for now, on with the episode.
Welcome to the Social Work Stories podcast.
My name is Liz Murphy and I am joined here today by my lovely co-host, Dr.
Mim Fox. Hello, Mim. Hi, Liz.
Hi, everyone. Welcome back.
Welcome back. Yes. Yeah, yeah, yeah.
It's been a busy summer.
It's been a good summer.
Time to get into it. Let's get into it.
I just want to get into this one straight away because it's a practice piece.
I know. It's a practice piece, but it's a practice piece set in a really busy setting, Liz, right?
Mm-hmm. Like it's fast paced this one.
And I'm chuckling because I think you just have to listen to the way in which this wonderful social worker tells his story.
It is, like, it's very fast paced.
Yeah, you know when we talk about embodied environments where you can tell about an environment because of the sounds, the smells, the vibe, the feeling, this is one of those stories where the social worker is actually telling you the story of being in an emergency department, but telling it with the feeling and further of energy that happens when you're working in an emergency department.
And the pace. Oh, yeah. The fast pace.
When I was working in emergency and I would take students in with me, I used to have to say to them, you've got to pick up your pace in walking and talking.
Yeah. And it took about a week for that to happen, but I reckon this is a great piece for people to listen to because this is a normal pace for an ED health worker.
But I also want to reassure listeners we're going to trans have a transcription too because there's so much that is telling us in relation to working in the psychiatric or the mental health space.
Yeah. And this is a night shift as well.
And this is quite an unusual environment for social workers to work in.
So it's really special.
We don't see that as much in New South Wales Health.
This is set in Victoria.
And so there are some very fundamental differences that we'll pull out, me, in our post story discussion, but it is a special one.
You know Liz, I've always felt that my time working in emergency departments, I felt really comfortable in that space.
And I think people always say to me that I talk really fast.
You were built for ED work.
Yeah, I think maybe that's why I felt so comfortable because actually I do move really quickly.
I was one of those kids where my mum would have to stop me at the side of the road physically with her arm across me because I would walk out onto the road really fast.
So I think the emergency space, it's a special one, right?
Yes. Yeah. Look, this recording as well, we want to do a shout out to Felix.
He was a student with us through those really hard lockdowns that Victoria had that went on for a really long time.
And he did this recording at that point in time, which I think is true credit to him, right?
Because actually we've had some amazing stories come out of that period.
Thanks, Felix. Let's listen to it now, me.
Sounds good. I was working a night shift.
Night shifts are funny.
The first lesson I learned on night shift with his doctor telling me that when there was a whole heap of sweets in the middle of the room that apparently there's no calories if you eat on night shift, I learned quickly that is inaccurate despite the fact that a doctor said it.
So I don't eat so much now.
Night shift can replace that with fruit, which no one may care about, but it does give you a sense that night shift is a little bit different.
And it is often busier. The peak time for mental health presentations in emergency departments is generally about eight o'clock in the evening and to start a night shift, you start at nine thirty in the evening and you work through till about eight thirty the next morning.
And there's a lot less people on.
It's basically you as the mental health clinician there.
And I guess at the end of the day, my job is about risk and assessing risk.
But also I say to people that I teach and I train that every risk needs a plan.
So when someone is talking about what issue is going on and what the risks are, we need to be mindful of that and putting something in place that can support them.
So there are a lot of risks that come down and people generally just think it might be the suicide risk or the self harm risk or the aggression risk.
And those are predominantly what we often deal with, unfortunately and sadly for the people for that experience it.
But there's a whole range of other risks that we have to consider when we're meeting with people and supporting them like employment and housing, family and social, all those, we're social beings and as a social worker, we have to pay, you know, great importance to those things.
And those can be burdened by people that might have long-term illnesses for example.
Also things like sexual safety risks, driving risks.
There's so many more that I won't go through in great detail.
But we have to support people through that and try to put in a plan.
So night shift, the story I'd like to talk about is a person that has a history of experiencing bipolar affective disorder.
And I just guess to set the scene, night shift is an interesting beast.
It's kind of quiet at about three in the morning because we're trying to get people to sleep.
We turn off as many lights as we can.
But it's often interspersed with loud noise.
If you've ever spent a night in emergency department, you know it can be very difficult to sleep.
Whatever you're there for and imagine having a mental health problem on top of that, you're probably on a hard cubicle bed.
There might be lights around.
There's nurses coming in taking OBS.
There might be someone doing tests on you.
Doctors can come in. People can come in at all sorts of hours.
Just got to sleep and they want to ask a question or ask another question.
You hear the phone ring.
You might hear people in staff base having a bit of a laugh or a talk or a conversation and things like that.
You might wonder are they laughing at me, especially those that are experiencing mental health problem.
You might see your clinician in there.
That's the nature of emergency.
I guess you need to, as a worker, get through those night shifts and get through those roles and have a conversation with your colleagues.
But as a person that's in emergency, that's kind of the atmosphere that you might be experiencing.
A little bit of a low at times.
Then sometimes interdispers with a very loud crisis.
Someone might be coming in with a mental health disorder, which is quite disturbing for them and those around them.
You might get intoxicated persons coming in late in the evening as well.
You might have some that is having a stroke or a heart attack and a lot of distress to people and a lot of loud machines going off and beep, beep, beep, beep, beep, and all those sorts of noises of equipment and trolleys being wheeled around.
That's kind of night shift.
It's a bit of an interesting beast.
I was in the process of supporting another person that had come down feeling, you know, sadly quite suicidal.
And whilst I was assessing that person, there was quite a commotion just behind me.
So I was in a cubicle and about probably 30 meters from where I was.
We have what is called the ambulance bay.
So there's a back door where people can come through ambulance and police rather than going through the front triage area, which is where people see the triage nurse and the Australasian triage scale gives them a triage category and they either wait in the emergency department waiting room or they come through.
But because police and ambulance obviously have a demanding role, we have a separate process for them.
So they came in and I looked across and there was a middle aged female dressed in a red two piece bikini with about six police and very distressed.
But you know, quite unfortunate, quite sad for her very angry about being brought into emergency department, very angry about the imposition of having mostly male police bring her in.
And how would you feel about being dragged into emergency when you don't want to come in?
It's just not no one wants to go to emergency generally to begin with.
So imagine being brought in when you're thinking that you're going about your own business.
So I noticed that and I don't know if I mentioned it was in July.
So it's kind of like the smack bang in the middle of winter at about three in the morning.
It's not really conducive to being in a red two piece bikini.
So I noticed that and I finished supporting the person that I was assessing.
And then the next thing I do and there's a lot of background that'll happen before you go and assess or support someone and that is to get the background information.
I think that a lot of people don't realise how much behind the scenes information can go into supporting a person and coming up with as much of a thorough assessment as you can.
So the first thing I do is obviously is my mental state and my visual observations were to look and put two and two together.
Police, two piece bikini, middle of the night in winter.
Police, quite obviously raising some alarm bells for safety for me.
