My first clinical internship while in graduate school, was as a therapist in training at a hospital.  I worked primarily on the adolescent residential unit with kids who were there for a length of time.  During the internship, I was also hired to work weekends.  After graduating, I worked full time while completing the requirements for licensure.

I loved my job.  I might still be there, except the hospital closed.  But while I was there, I loved being a therapist and working with teenagers in an inpatient setting.  I had already worked a lot with kids in a church setting, and I discovered there were many similarities between church and hospital.  Perhaps the most striking difference was that the kids now lived at the “church”.  They were there 24/7, which meant I got to be present for the best and the worst as teenagers tried to navigate their life (lives).  The teachable moments happened frequently right in front of me.

We’re used to thinking about teachable moments in the lives of children.  We’ve heard a lot about the importance of adults recognizing and taking advantage of those moments as golden opportunities for growth.  Moments when children are more open to learning, more malleable.

Working in that hospital, fresh out of graduate school, taught me that teachable moments aren’t reserved for children.  I was sometimes painfully aware that while the kids on the unit were trying to find themselves and their path, the adults involved were engaged in a parallel learning process.  We were routinely faced with our own teachable moments, often under the instruction of the kids we were responsible for.  Growth was an equal opportunity experience for doctors, nurses, techs, a variety of therapists, unit school teachers, and me.  It was on that adolescent residential unit that I learned the impact of responding vs. reacting.  I began to watch the ways our behavior as staff helped escalate or de-escalate the behavior of the kids on the unit.

One day as I talked with a frustrated colleague, I began to think out loud about the self-management skills that could make or break your work with hospitalized adolescents.  Over time my colleagues began to refer them as Paulann’s Cardinal Rules for working on an adolescent residential unit.  A fellow therapist arrived at the hospital one day with a stack of computer generated “Cardinal Rule” cards for me to hand out to my peers.  It became a running joke grounded in seeds of truth.

When the hospital closed I went on to new jobs, new colleagues, new consumers, and new teachable moments.  I don’t think I realized at the time that the one thing I took with me were those rules.  I discovered they were helpful to remember and to practice, with my children, my colleagues, my clients.  Those rules have been with me for twenty years.  I think I even have one of those original cards in my momento stash. Those rules have served me well.  I would like to say they’ve become second nature to me.  That I do them in my sleep, with one hand tied behind my back.  But in spite of knowing them, there are times I violate every single one.  So maybe they’re better thought of as goals to shoot for.  So, for what it’s worth, Paulann’s…,

Daily Goals To Shoot For

1.  Don’t Forget to Breathe.

2.  Keep Your Sense of Humor

3.  Don’t Take it Personally