Written by Anna P.
I park my car, check my make up in the mirror, take a deep breath, grab my newly bought “smart work bag” and step out of the car, this is going to be big, my first day as an Assistant Psychologist.
I’d spent several hours the night before figuring out what to wear, obviously not jeans and a t-shirt, but I didn’t want to overdo it either, I settled on a smart pair of trousers and a pretty but sensible top. However despite this forward planning I’m faced with my first problem before I set foot on the unit; there are 3 different doors into the building and I haven’t a clue which one to knock on! I decide to opt for the one I went through for my interview, thankfully someone answers “Hello, I’m Anna, the new Assistant Psychologist” (oh god that sounds weird!) and I’m led into the manager’s office.
The manager is nice, the patients here show a lot of challenging behaviour but she’d rather work with behavioural intervention than pharmaceutical, she tells me her working relationship with the previous AP was a good one and she relies on the psychology team a lot. This is all good, looks like I’m going to get a really good education here! I get told to spend the day on the floor just observing and meeting staff and patients. It’s a small unit, and patients tend to stay here a long time. All of the patients have learning disability and a lot of my job will be working with the MDT to figure out how best to manage the behaviours we see, the best way to start is to get out there and observe the behaviours first hand, so that’s what I do.
In fact this is most of my work for 2 days. For the most part I chat to people, the staff are really friendly and quickly facilitate me getting to know the patients better. Despite the fact that this is a unit where patients are often physically aggressive, the general feeling in the place is positive. On only 1 occasion did I feel at all worried, this was when a patient asked to talk to me and invited me to see his room, where I used to work this would not be cause for concern, so I started to follow him, but the support worker (pretty much all the patients are on constant observations, so there is always a support worker nearby) quickly whispered in my ear “Do NOT go in his room, stay outside” apparently his room is an incredibly high risk area and where he is most likely to attack, which was a little worrying, but it was nice to know that staff were watching out for me. I also witnessed a couple of full body restraints, which was a new experience for me, the staff were so quick to act and so calm that even though I was close by when the patient went to strike someone I still felt quite safe. All staff, including myself, also carry alarms on their person which are quick to activate, adding another level of reassurance. All in all although I realise I had definitely underestimated the level of behaviour that I was going to be working with, I don’t feel at risk at all.
I quickly realise why so many AP positions require that applicants have had some experience as working in support worker roles, the running of the unit makes a lot more sense to me by drawing on my own experience as a support worker, it also acts as an easy ice breaker when chatting to staff. The same experience proves useful on the second day when I find time to read through care plans, it enables me to understand the difficulties faced by staff in implementing said care plans. Often I find myself reflecting that no matter what the patient group all services seem to face the same basic challenges, and a lot of them lie in staffing levels and the knock on effects this has on activities and staff morale.
The weekend proves useful time to process all I have learned, I make sure I have some fun activities planned for myself so that I don’t end up just sitting in my flat on my own feeling lonely. Whilst it’s nice to finally be making it on my own I’m trying to stay aware of the fact that it can also be really scary and isolating at times, so I’m doing anything I can to protect myself from that aspect of things.
Monday rolls round and I’m off to a different unit, my post is across 2 services. The second unit seems less prepared for my arrival and I’m told to just sit in the office and read care plans. It makes for an interesting read though; similar patient group but this unit is a transition unit, so the goal is to get patients out of residential care. Once I’ve finished working through the care plans I still have a few hours to spare so I head into the living room and get chatting to patients, before I know it the day is done and I get home with minimal getting lost (yay!).
Finally on Tuesday I get to meet the Clinical Psychologist. He’s every bit as friendly as he seemed in the interview and we spend the whole day talking through my job role. He is a great lover of numbers and stats, and I’m assured that my research experience won’t go to waste even in this clinical setting. Much of my job will be presenting behavioural data to the MDT, but I’ll also be providing some of the interventions that we plan because the CP isn’t able to be at the unit very often himself, he covers too many services. Obviously because of this I’m expected to work fairly independently, but I’m not the only AP he supervises, there is another new AP at one of the other services in the same boat as I am, so we are put in touch and told to make sure we talk and support each other. Most reassuringly of all the CP is well aware of the stresses and difficulties faced by a new AP and does his best to prepare me and reassure me about any worries. In among the chatting we even find time to meet with one patient, a young man with LD and recently diagnosed autism. We discuss some teaching on emotions and boundaries, which it turns out I will be providing!
The next day I am finally introduced to the bulk of my work for now; the incident forms. These forms are filled out every time a patient displays challenging behaviour; staff record the behaviour, any potential triggers, and any intervention used. Once a week I will be expected to spend the day sat in my office putting all the data from these into the computer so I can make pretty graphs to take to the MDT. Except that there hasn’t been an AP here since May, so there is quite a stack to get through! I get through the first lot in a couple of days, and just when I think I’m done then the manager says “Oh did you find the ones in so-and-so’s office?” it’s an even bigger pile than the first, I just KNEW that blank section in June wasn’t just a blissful incident free period!
Anna is an Assistant Psychologist working in a private hospital for adults with Learning Disability and complex needs.