Looking from the inside out

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  • Journal of the American Psychiatric Nurses Association

    158 APNA Web site: www.apna.org Vol. 6, No. 5

    Looking Fromthe Inside Out

    Thomas J. McGarry, RN, C, BSN

    They looked to be in their 70s.Frustration and helplessnesswas apparent in every crease ontheir faces and in their weary,slouched posture. As they talkedwith the treatment team, they con-fessed hopelessness with theresponsibility associated with 4decades of providing care to theirmentally ill son. Asked for input

    can be. First, I determined the NAMIschedule of meetings and started toattend one of the support groupsfor families on a regular basis. I letthe group know I was there as afriend and that my professionalbackground might be of help. SoonI was coaching families on copingmechanisms, symptom manage-ment, and legislative involvement. Ihelped to pull together referencesto provide education, generateideas for vocational rehabilitation,and identify local resources. Thegroup discussed current legislativeissues and worked to help thegroup members identify their ownpersonal support needs.

    I was gratified by the response Ireceived. The feedback was gener-ous and positive. Group membersstated that my presence in thegroup was helpful to them in theircontinuous battle with understand-ing and living with chronic mentalillness. Written responses includedaccolades such as You have beenan inspiration to many of us copingwith family members suffering frommental illness. Thank you so muchfor your commitment, and Weneed more psychiatric nurses in ourgroups. They need to talk to us so

    Thomas J. McGarry, RN, C, BSN, is thesystem coordinator at Healthcare forHomeless Veterans.

    Reprint requests: Thomas J. McGarry,RN, C, BSN, Healthcare for HomelessVeterans, 1002 NW 23rd Ave.,Gainesville, FL 32609.

    J Am Psychiatr Nurses Assoc (2000). 6,158-159.

    Copyright 2000 by the AmericanPsychiatric Nurses Association.

    1078-3903/2000/$12.00 + 066/1/109880

    doi:10.1067/mpn.2000.109880

    into the discharge plan, they plead-ed, Visits with the doctor or thera-pist and medications are notenough. We need more support forthe day to day problems we are fac-ing.

    Other families of the mentally illhave expressed similar needs forvalidation of their experience andacknowledgement of the effect theillness has on them. Larsen (1998)reported chronic fatigue, anger,depression, stress, family conflicts,and excessive financial burdens incaregivers of the chronically mental-ly ill. These family members oftenare older adults whose personalenergy and financial resources arealready strained.

    Outside help is scarce. Budgets donot allow and insurance does notpay for badly needed assistance.Through the local chapters of theNational Alliance for the Mentally Ill(NAMI), psychiatric nurses, as volun-teers, can provide valuable servicesto family caregivers in the communi-ty. Psychiatric nurses have theknowledge and ability to educatefamily members about symptoms,ways to manage illness crises, andhow to recognize signs of relapse.They can offer empathy, support,and sometimes just help in under-standing what all of this psychobabble really means. Psychiatricnurses can coach family members inhow to take care of themselves andprevent caregiver burnout.

    I discovered just how rewardingand helpful an hour or two a week

    Professional Progress Notes

    Professional Progress Notes reportsinnovations, ideas, and insights rele-vant to the advancement of psychi-atric nursing.Readers are encouragedto contribute their observations aboutfront line issues, new approaches tocare, and other related matters forinclusion in this regular feature. Ourguest writer this issue submitted thesethoughts about volunteer work withthe mentally ill and their family care-givers in the community.

    Psychiatric nurses can coachfamily members in how totake care of themselves andprevent caregiver burnout.

  • Journal of the American Psychiatric Nurses Association McGarry

    October 2000 APNA Web site: www.apna.org 159

    we can understand what all of thismental illness stuff is all about.Another family member comment-ed, The group benefits from thestimulation and the evidence thatsomeone else is interested andunderstands their concerns. Youhave shared your time and knowl-edge of persons with mental illness.You are appreciated. Thank you.

    Encouraged by these responses, Iinvestigated the possibility of start-ing a Schizophrenics Anonymous(SA) group in my area. The goal ofSA is to create self-help supportgroups for consumers afflicted withschizophrenia and related disorders.SA encourages group members tocooperate with all mental healthprofessionals to maintain treatmentand continue on the road to recov-ery. SA views hospitalization as asetback but not as a negative event.This viewpoint keeps the con-sumers mental illness as a chal-lenge and encourages group mem-bers to higher levels of functioning.SA groups offer fellowship andcompanionship through a step-by-step path of recovery. These groupsare consumer led and are successfulbecause of the groups self-determi-nation (John, 1992). Preconceivedideas that people with schizophre-nia are too confused, unpredictable,and unruly to form a self-help

    group is counteracted by the suc-cess of this program.

    In developing the SA group, thefirst step was to locate a meetingsite. The local Burger King provid-ed space in their conference room,and we were able to advertise thegroup in the local media. Tolaunch the group, I assisted ascoleader while strongly encourag-ing the group to become indepen-dent and function without outsidehelp. I provided support to thegroup for a defined period of timeand then monitored it periodicallyto assure that it was being ledaccording to SA standards. This SAgroup is currently managed by theconsumers themselves and has anactive attendance of six to eightmembers. SA group membersreport that they have learned moreabout schizophrenia and are betterprepared to stay on medications,manage illness symptoms, andimprove their social life. Typicalresponses include Group sharing

    and feedback; they help me stayon my medications even when Ithink I dont need them any morebecause I feel better, and Peoplein the group understand and knowfirsthand what psychosis andschizophrenia is like. It feels goodto be among people who know.Before long the group membersstarted socializing outside the reg-ular meetings. For many of themthese were their first social activi-ties outside their families.

    As psychiatric nurses, we havethe background and the skills toprovide an invaluable volunteer ser-vice in our communities. Workingwith these two groups requiredonly 2 to 3 hours each week. Forme, this small investment paid off inprofessional and personal satisfac-tion and validated my belief that justa little assistance from a nurse vol-unteer can produce meaningfulsupport to mentally ill consumersand their families.

    REFERENCESJohn, P. (1992). Schizophrenics anonymous.

    In J. A. Malone (Ed.), Schizophreniahandbook for clinical care (pp. 32-38).Thorofare, NJ: Slack.

    Larsen, L. S. (1998). Effectiveness of a coun-seling intervention to assist family care-givers of chronically ill relatives. Journalof Psychosocial Nursing and MentalHealth Services, 36(8), 26-32.

    As psychiatric nurses, wehave the background and theskills to provide an invaluablevolunteer service in our com-munities.

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