Let me start by mentioning that I don’t hate my job, and I absolutely enjoy all of my coworkers and the clients. Any frustrations I feel are not directed at specific people, exactly.

These frustrations come from the system as a whole and from within myself. The rules and regulations behind every health-centered organization will generally leave patients and employees feeling a bit disgruntled from time to time because at times they seem unfair.

I was actually pretty excited and eager to finally put my education and knowledge into action with new clients and colleagues. But, alas, the “honeymoon phase” dissipated, and I find myself left with an internal struggle every time I am faced with a situation at work. I just feel conflicted that I am over qualified for my job title, and I also feel like what I can offer to these clients is not being utilized.

As an RRS I am at the facility to help the patients make treatment goals and help them gain the resources to accomplish their goals. Being at a residential facility we only have 4 clients who live here a bit longer term than if they were in the hospital or an inpatient clinic. We help them find housing and gain skills to be able to successfully live on their own, or in the next facility they move to. My job really depends on what each individual needs to remain stable and mentally healthy.

However, it is difficult for me to differentiate my job title from being a counselor. At my internship I had the responsibility of a counselor. I helped people work through serious emotional crises and find healthy coping skills. Here, I have been told we are not allowed to provide counseling, since we are not trained to do so. Which, sort of makes sense I guess? Yet, it is still confusing.

Many of our clients tend to have a sense of entitlement that we must do their bidding and they get very upset toward us if they do not get what they want. We try to be as helpful as possible, but some things cannot be done for them just because they demand it.

When some clients are restricted to certain levels within the facility the employees cannot agree to some demands. For example, if a client is restricted to a level one, then he or she cannot leave the building without staff supervision, and sometimes we are understaffed. The clients are able to work up to a level three, which means they have the freedom to come and go as they please, as long as they notify us beforehand and follow the general rules and guidelines (such as coming back before 8pm).

This sense of entitlement doesn’t just form overnight. Sometimes staff can feel under appreciated or powerless and let patients get away with little things, which eventually turns into the idea that they can expect their demands to be met at that very moment.

Staff does much of the upkeep within the building. We clean regularly, do the grocery shopping for the house, and have been cooking lunch and dinner since our cook quit (yes, they get a cook during the week to prepare meals). Many of the necessities are provided for our clients, and we take the time and effort to take them to the store for their own personal wants and needs. We can only blame ourselves for allowing the clients to have misguided expectations.

I also feel like when our clients really need our guidance that we are very limited in offering help. I was actually informed to not talk to a client about their severe suicidal ideation and self-harm.

Whereas I understand why we don’t go too much in depth about their desire to end their own life, I am still concerned that directing the conversation away from the thoughts can be damaging. I am told to ask certain questions to make sure the client is practicing learned coping skills and to make sure they are not in immediate danger. However, I believe I should be allowed to offer the patient some counseling by functioning as someone who just listens and helps them by being supportive.

I was told not to ask the client where they had self harmed (if they admitted to doing so) and how they had done it. I was also told not to ask them what their specific thoughts and emotions were when they felt like attempting to kill themselves.

Granted I was informed of these guidelines after I had actually mentioned all of these topics to the client (oops). So, I am unsure what kind of support I can be if a client cannot feel like they can get genuine emotional support from me. Directing a person’s thoughts away from getting deeper into the issue (as long as the client is comfortable) gives the impression that I don’t want to hear what they choose to share.

Another issue I have been battling with at my job is feeling that my abilities are highly underestimated. We have a wide variety of staff and we each offer our own ideas and perspectives to this agency.

I view every one of my colleagues as an asset to the team because we all bring something to the table. I can talk about issues I am frustrated with amongst the facility and get a better idea why things are the way they are.

However, I have come across some coworkers who assume that since I am new to the agency, that I don’t have an opinion worth listening to.

This is not to say that I believe I am always right and that my way is the only way, because I do not think that at all. But, when a coworker takes 15 minutes out of my time to explain how to take the trash out, and how to replace the cans with new bags, I am going to get offended.

I want to learn everything I can about how this agency works, and I want to take on as much responsibility as I possibly can, but when people assume you don’t know anything they also tend to assume you can’t handle certain tasks. This will automatically make me slightly bitter, and I don’t want to feel that way toward people I work with on a day to day basis.

Going along with the idea of other coworkers is that I have observed many of my colleagues and how many of us just feel powerless and used. I understand that it is counterproductive to have a power struggle between clients and staff because we are not here to be the authority. We are here to offer resources and guidance in an appropriate, therapeutic way.

Except, when we feel like we cannot actually implement some rules, then we are going to essentially feel powerless. Our facility supposedly has a no smoking policy, but our clients smoke the most I have ever seen a human being smoke. Three out of four of our residents smoke, and two of them smoke at least three packs a day.

In my experience many health-related facilities have implemented tobacco free grounds, designated smoking areas, or have very strict rules in place for smokers (such as one cigarette per hour from 6 a.m. to 10 p.m.).

When I bring up my concerns to fellow staff and my supervisors (because I view the chain smoking as negative coping skills) I am told we actually can’t tell them they are not allowed to smoke, since this is “technically” a volunteer program.

This makes no sense considering plenty of facilities can (and do) restrict tobacco use even as a volunteer program. When I suggest implementing smoking cessation plans, I am told we are not medical professionals and are not trained to help clients with smoking cessation.

As a matter of fact, I am trained and certified to offer smoking cessation help. I am a certified alcohol and substance abuse counselor in training, known as a CASAC-t, (which means I am a counselor but must retake the licensing exam after I have been in the field for a certain number of hours allowing me to become a full CASAC.)

Basically, I can say for certain that I can counsel people on smoking cessation considering it is a drug addiction. I can also counsel individuals who may be at our facility who are recovering addicts (because we do help both demographics).

I want to explain that a lot of the issues are within the state regulations. Since our funding comes from the state we kind of have to just play by their rules. This is not the fault of my coworkers or my supervisors. I know I am going to run into these issues at any mental health/substance abuse facility that I work with. I am just having a difficult time accepting that fact and accepting that the employees here have so much more to offer than glorified babysitting.

I understand we are all going to encounter these obstacles in the work force, whether it is our entry-level job or the full climb up the professional ladder to a higher-level profession, but I feel stuck. I feel like I am being forced to move forward with my education so that my income and job satisfaction can improve. Except, I am not prepared or comfortable with continuing my education at this point in time. It’s terribly frustrating to get out of years worth of schooling, only to realize that 4 years wasn’t enough. Many jobs expect years of experience or a higher-level degree, and honestly I just don’t have the motivation, time, or finances to continue my education into a Master’s program right now.

I am getting unsure of myself and questioning my own abilities, which I sort of thought I was mostly past this point.

I am frustrated that there are people who set the rules, here, that don’t actually spend 40+ hours with these individuals. And, I would like to point out that not every day is a bad day and the clients aren’t terrible people. I enjoy talking to them and find that they are all caring people who have important things to say. It’s really not their fault that they are mentally ill, nobody would choose their lives. But, I can get a bit overwhelmed with the lack of progress they have been making, which is not entirely their fault. We almost keep them stagnant.

You cannot simply look at a diagnosis and a file to know how a person works and know what they need to recover. If my fellow RRS staff and I could be given more say in the treatment plans for our clients and be allowed to implement some better policies, then maybe we could actually promote positive change.