A Day in the Life

I don’t dread the day before it begins, not today anyway. I pull my yoga pants over my bruised legs and pull a shirt on over my sore shoulder muscles. I knot my hair into a ponytail at the top of my head and slip on my running shoes. Today, we are taking the kids to the zoo. Historically, zoo days have been the most fun and the most stressful. It really puts the staff’s de-escalation skills to the test.

I pull up to the Psychiatric Medical Institute for Children (PMIC) and make sure all of my doors are locked and nothing valuable is left in the car before making my way to the side door used for staff entry. As I place my badge over the reader I hear the familiar click of the door unlocking. It is 7 am and we don’t wake up the kids until 8 to get ready, so I have time to enjoy the coffee in my hand and read through the shift notes from the previous shift. I work in the older girl’s unit, ages 12-16. There are four other dorms as well, so it’s a rather large facility. Every kid in the facility has a history of trauma and mental illness that leads to behavioral problems.

One by one, the girls start poking their heads out of their rooms and asking if they can start getting ready for the day. I peek over the computer desk and allow the excitement to fill my voice when I get to reply, “Yes, that’s okay. You can start getting ready. Try to let the other kids keep sleeping though.” It feels like Christmas morning, the air is electric with giddy whispers and excitement. Once all the kids are awake and ready to go, the staff split them into three groups, equaling two staff per group of five kids.

“Okay kiddos and gremlins, who can give me the expectations about off campus adventures?” I ask the group before we get into the van. Reminding them of rules and expectations helps keep them fresh in their brains before we take them into the community. Plus, it seems to help the behaviors off campus if they get to tell me what the rules are, rather than the other way around.

“No running away!” the first kid says with enthusiasm. I laugh, that is always their first answer, and yet there’s always at least one that likes to push that particular limit.

“Good job! Thank you! What’s another rule?” I ask. The kids continue to take turns shouting out the expectations of off campus activities before we all get into the van and make our way to the zoo, about two hours away.

When we arrive, I count heads and make sure my other staff and I have a plan if a crisis occurs while we are at the zoo. We begin walking through the gates, our eyes scanning the crowds, trying to avoid as many triggers as we can for the kids before we have even started. We break off from the other groups and start with the gorillas, an inside enclosure first. A couple of kids press their faces to the glass, their eyes wide with wonder. My heart squeezes, I know this is a first for some of these kids. Some have never been to a zoo before. I watch one girl in particular, trying to read her movements. We have had her in the treatment facility for about four months now and her cues are getting easier to read so we can intervene faster, before her behaviors escalate. She gets stressed easily when there are loud sounds or sudden movements, all of which are present in the area. I use my body to block a group of rowdy adults, as if I alone can keep her from noticing them. She is too busy watching the gorillas eat in front of her, so close to the glass, so close to her.

My heart swells with pride at how well she is regulating herself. I make eye contact with my other staff as my shoulders relax. It is hard to believe, watching her now, that just a week ago she had gotten upset that her peers were hogging the remote, and that the volume was too loud. She had asked her peers to turn it down twice before staff intervened and turned the TV down themselves, but it was too late. She had grabbed a cushion off of the couch and threw it at her peer. I was standing close and managed to intercept it. She then bolted from her seat and lunged for her peer. I and the other staff present moved swiftly to block her target. Another staff member came to escort her peer away, a fluid rotation you would've believed we’d choreographed. As the other staff and I were holding her back, preventing her from attacking her peers, she had opened her jaw and clamped down on my arm. I tried using the protective skills we had been taught to get my arm back, but her jaw remained locked. It ended up in a restraint, which meant we had a lot of teaching and rebuilding of relationships to do after. The skin around my teeth shaped scar tingles at the memory, but I push it away, wanting to hold on to the joy happening in front of me as long as I can.

Next, we move to the cheetah exhibit. So far, so good! I make sure to give verbal praise to them at how well they are doing and how proud I am of them to keep morale up. We are so quick to react when something stressful happens, I like to make sure we acknowledge when the kids are using their skills, too. Once the youngest of the group sees the big wild cats she gasps so loud it sounds like she’s been hurt. My eyes dart to her to make sure the other kids hadn't pushed her or something, then relaxing when I am certain she is excited and not panicked. I smile at her.

“Do you like them?” I ask her.

“Oh yes, yes! Can we keep it? Can we bring it back? Please!?” she exclaims. Her curly hair whips around as she bounces one knee up and then the other, over and over with her hands clasped to her chest. Once again, I am amazed by how well the girls are doing. Her smile is contagious as we watch the cheetahs begin to chase each other around.

“Look! Did you see that?” I pointed excitedly as one of the wild cats jumped over the other, and the girl’s jaw dropped in awe. By distracting her to another cheetah I was able to avoid verbally denying her the chance to take a cheetah home, which would have surely ended in hurt feelings and behaviors at the zoo. Not being able to bring home the cheetah sounds silly and trivial, but may very well have become a domino that could topple the rest of the day.

“I didn’t know they were so big!” she said, and I felt my stomach twist at how sad that one statement made me feel for her. In a perfect world, my job wouldn’t exist. Parents would have everything they need to take care of their children and every kid would be able to go to the zoo at least once a year.

This kid was admitted to us more recently, with nearly nonexistent social skills and a ton of trauma. We were actually worried about bringing her to the zoo today because of it. She’s still so dysregulated and unpredictable, just two days ago she escalated to the point where she was demanding to be restrained and kicking my shins trying to force me into it. I never ended up restraining her, because we don’t use restraints that way. Restraints are only used as a last resort for safety, and it is never used as a power struggle, as this situation was. What she was really needing was tactile pressure, which is more commonly recognized as a hug or a weighted blanket. She didn’t know how to ask for this, and she probably didn’t even realize that’s what she needed, instead she knew that if she was aggressive I would have to put my hands on her and hold her. We have been working on replacing restraints with tactile pressure interventions with her. That night, staff and I had to swap out frequently due to the severity of the bruises she was leaving on staff’s legs from kicking them, but we were eventually successful in getting her to make the connection between what she was needing and how to appropriately get that need met.

Seeing her eyes glow, and awe fill her features, it gives me a sense of purpose for what we are doing. We continue around the zoo, stopping extra long at the giraffes so the girls could take it all in. They loved every moment, and I feel warm all over knowing that I got to give them this experience today. When we get in the car at the end of the day, everyone has grins on their faces and both the staff and the kids can't stop chattering about their favorite parts of the day.

Yes, I have a really difficult job where I have to knot my hair up to keep it from being pulled, wear stretchy pants in case I end up restraining a kid bigger than me, and wear running shoes on the very good chance that I end up chasing a kid through a corn field, but eventually we see the positive change. We see the kid who used to break windows when they were angry turn to crashing into a bean bag instead. We see the kid who kicked shins and demand restraints turn into the kid who loves Pokémon and asks for a hug when she’s feeling upset. We get to teach skills to these kids that they will carry with them for the rest of their life. I wouldn’t trade a day in this field with all my bruises and bite marks for anything. Every single kid is doing the best that they can in the moment they are in with the skills that they have. I’m here to help teach them the skills so the moment they are in can be just a little bit less painful.

I love my job because I get to teach kids what safety is supposed to feel like, what adults in their life are supposed to act like, and how capable they are of taking control of the lives they’ve been given. I often wonder what will happen to them when they go home. Will they fall back into the same familiar toxic patterns or will they remember what we taught them? What happens to them five years from now when they are adults? I could torture myself forever on worrying about them for the rest of their lives, so instead I like to think of happy endings for all of them. They all get their dream job, they all have healthy relationships, and they all remember the time their favorite staff took them to the zoo.