CPN Care

I’ve been promising this post for a little while, before I get engrossed… thanks for my recent comments. It’s nice to know I’m not in cyberspace alone and that these words float out to someone, somewhere and raise a thought.

CPN CARE

I first heard the term CPN on an Internet forum, people were talking their CPN’s down and really dragging their experiences out in the open for all to see. I had to google CPN to see what it meant, realising that it was meant “community psychiatric nurse”, christ I didn’t even know what Bipolar meant until February 2008!

As I am a complete n00b to my Bipolarity, even though the cycle is well embedded. I have started into the system aged 32, will all my defences, flaws and hard headed conceptions. I met my CPN for the first time at my first CMHT (community mental health team) meeting, she was my first point of care and understanding, undertaking my initial assessment and family history. Watching my tears, dechipering my mumbles, listening to some of the shocking and egocentric thoughts I have, along with high behaviours and indicators.

You see I had no idea what the hell would happen once the doctor hit the send button and sent my information off in a referral, I was on the way to the experts. Who tells you what happens next?

No one that’s who, I went fishing on the forums for some reassurances and walked away with some informative and supportive posts, weaved in with the “my Bipolar is harder than yours” posts, I’ve never seen it as a competition, why the hell would you want it to be worse than it is? That’s messy.

At the time of my referral, I was highly anxious, suicidally depressed and starting anti depressants this added some additional weight and paranoia into the daily equation.

Fortunately, I was seen in about six weeks from the referral. The anti depressants were starting to do something, I was high as hell though looking back at the assessment, as above I met my CPN with an open mind. She’s my age exactly, cheeky as hell and quite flippant. This unnerves me for some reason, someone my age making decisions and managing my health, I forget sometimes that I’m actually 32 and not 4.

At this initial meeting, my CPN asked me to identify indicators with her, to show when I’m depressed or high. Allowing her to watch for them, I could barely think of any, some of which I really didn’t want to be discussing with a girl at our first meeting (hyersexuality is a BIG sign). She explained that we would meet once a week and see how things progressed, week one she was sick, so that one hit the skids from the off.

On my next visit, she advised me that I am indeed Bipolar. This freaked me out to high heaven, I have heard that it takes years of assessments and reviews before most people get a diagnosis. I admit, I fell between the medical cracks for twenty five years, but a diagnosis within three months and two CMHT meetings? It was only fair for me to ask how they based this, I was advised that due to my detailed history and very clear exhibeted Bipolar behaviour, I was textbook. Wow, really wasn’t expecting to hear that.

From our first meeting, I think my CPN and I have been like a pair of cats circling each other. We’ve switched venue from the CMHT HQ to my house of a luncthime, making things a little easier. I’m hard headed and really take my time to trust and open up, there are things I’ve done or thought about that I barely admit to myself, that I’ve never told another living soul, how do you express this stuff?

She’s been rather comforting but non-comittal and aloof, a lot of our appointments have changed at the last minute or been cancelled for random reasons. Some of the time I have been involved in other CMHT issues, like seeing the Psychiatrist, being a guest speaker at a training day and we’ve overlapped. On more than one occassion, she’s pulled my leg or said “get over it” in a phone call and I’ve taken offence to it, become sultry and paranoid and subsequently a little withdrawn in our chats. As an expert at covering up, I think I can run rings around her….. but why should I?

After a number of let down’s, upsets, paranoia days and mixed episodes. I didn’t want to be a forum beater as I had read, the only way I could see forward was honesty. People make me laugh when they say they’re honest, when what they mean is they’re rude and obnoxious. Honesty doesn’t have to be like this.

I am an ex-business person, and ex-high flyer. I know how to people manage and when you add this with a bit of people magnetism and charm, this is why I always seem confident to others, I know how to achieve my goals as painlessly as possible… A spoonful of sugar helps the medicine go down.

So in my most recent session (13/06/08), we had the chat, she didn’t know it was coming and afterwards she left thinking she had masterminded it. Excuse me for sounding smug, I am, this is the trait of mine I value the best, it’s like having a silent fart in a lift and it passing undetected, so satisfying although a bit twisted.

I raised all my issues in a motivational way, I explained that I know it may sound selfish, but this is what I need:-

• consistency
• honesty
• time
• structure
• communication

I will return the favour, it means that we can try and get something out of our time together and improve my mental health a little. She was a little saddened by my paranoia confession, but I felt she needed to know the effects of these changes.

Something set me off, as we ended on a big high, she said she didn’t want to leave she was enjoying herself and I then went on to come out (Bipolar) at work!

We’ll see how it goes, next session is tomorrow, I’m hoping things develop.

People online have told me how lucky I am to have a CPN, I’m not quite sure on the take for this one. It’s nice having someone to talk to, but remember, they’re not a friend, they record your conversations and issues. CPN’s are trained as medical staff, not emotional support staff. They’re around to make sure you are taking your tablets, that your medication is working and that you are seeing the right people at the right time, part of this touches on life review, but really this is just for impact analysis.

I reply to these comments fully, it’s nice to know that someone out there is watching your progress, but as much as they can help you they can damage you. They are human and and are unable by their own actions to hold you up, and sort your life out. They’ll miss appointments, they’ll say the wrong thing, sometimes they’ll leave and you’ll wonder why you bothered making the time to meet with them.

As I said, the jury is still out for me, as much as the support is new for me, it’s a bind letting the mask down and explaining your innermost thoughts and fears with someone who scribbles furiously on a notepad.

CPN Round Up

• remember your CPN works for you as well as your trust, explain to them what you need and how you respond to this best. Could you walk into any old office and start working without instruction?
• CPN’s are human, they will miss appointments, screw up and generally have bad days, it’s not always down to you, try and be objective.
• ask questions and set objectives, you’re an adult, you can take care of yourself ask for the services you feel will make a difference, if you get a no, ask for detail.
• listen, as a Bipolar person, I fail at this spectacularly, believing no-one could know better than me. They do though, a CPN’s opinion is a new opinion or insight, use it.
• equip your CPN as much as possible, prep them with charts, diaries and indicators. The more information you provide them with, the better they can work on your behalf.

I’m not sure if I’ve hit the appropriate markers here or not, let me know your thoughts…. I like a bit of debate.

-Beeper-