Crisis Intervention

Today I was assigned to the crisis team in the emergency room. This is a group of psychologists and social workers who handle all the counseling aspects of acute crisis. If their is a trauma that requires talking with the family of the victim, any violence, death, suicide ideations, drug intoxications, rape etc, the crisis team handles all the counseling. I was assigned as their medical / psychiatric consultant. My responsibility was to evaluate the patients from a medical perspective and handle all the medication management. I had an emergency medicine attending doctor to report to but he basically let me run my own show. 

We had a busy night. I had 2 panic attack patients, 1 drunk driving accident, 2 suicide attempts, 2 drug / alcohol over doses (not intentional) and a couple traumas. I love the emergency room. It is fast paced, go, go, go! The time goes by quickly and you feel like you are making a big impact on patients' lives in a very vulnerable time. I had to call family members to report bad news. A couple of the patients I ended up admitting into the psych ward and my psychiatry attending doctor was on call so these patients will be mine to follow in the inpatient unit as well. This will provide great continuity of care. 

One thing I notice in the emergency room and in the hospital in general is that there is a ton of dysfunction in the world. These patients are often on drugs, in abusive environments, lonely and out of control. They often have no guidance in their lives and very little education. They bring a lot of disaster into their lives through the choices they make and often these choices land them in the hospital. It is sad to see all the dysfunction and miserable individuals suffering. It is especially difficult when a young child is exposed to their parents chaos and end up being a victim. The dysfunction grows and is often passed from generation to generation. 

The question is; how do you help one of these patients break the cycle of dysfunction?