Hell of a Night at the Psych Ward

          And then there was this assignment in the most acute Psych Unit of the hospital. The first night was unremarkable and that was when I was able to make those 70 chart packs which I mentioned in my previous post. I was surprised when I was assigned there a second night in a row when things didn't go as well. For starters there was a plugged up toilet because the patients in that room were throwing their trash in it. So I donned a pair of gloves and dug out the trash from the bowl but despite my efforts, the toilet was still clogged and it took a few plunger attempts by the maintenance person later to fix it.

         Meanwhile a female patient was awake and laughing all night long for no apparent reason other than whatever funny things was going on in her head. Another patient was retching and throwing up in his room except for one time when he did it on the full length of the hallway. Guess who had to clean that up? 

         An insomniac who had been complaining of being unable to sleep for days finally did so only to be woken up by the loud snoring of a newly admitted roommate. So he got upset and tried to sleep on the toilet floor (no, not the plugged up one) which wasn't any help because it was too hard. Another man was compulsively pressing the call light near his bed and in the bathroom, and also punching in numbers on the exit keypad. Not because he needed anything or was trying to escape but rather a compulsive habit. 

         A woman was trying to talk to staff all night and was demanding and argumentative at times when she didn't like the responses. A newly admitted religiously delusional pregnant woman who was calm when she was being interviewed, suddenly went postal on a male patient whom she thought was going to harm her baby. She said she was going to protect the baby with her life. The surprising thing was that she went from speaking proper English to ghetto English when irate. Unfortunately she couldn't be medicated at that time due to her pregnancy until properly evaluated by her doctor. After resting for a couple of hours and waking up very early in the morning, she underwent another transformation and started bouncing around the room and talking about how blessed and holy her baby was, all the while bowing and praying and lying on the floor.

          The staff were counting the slow minutes until it was time to clock out. It was just another day at the office. Would you believe I was assigned to that unit 4 consecutive nights that I was on duty?! On that fourth night, 3 patients became menacing towards me because I couldn't give them a second cup of coffee in the morning. I had to request the supervisor for a reprieve and assign me to another unit the following night and thankfully, he did.

The Perils of Working in an Asylum

In an unfortunate night at work early Sunday morning, two of my co-workers got hurt by an assaultive patient. A female nurse got kicked in the head while a male mental health worker jammed his right ring finger while trying to get control of the patient's leg. Because of that they had to be examined at the employee injury clinic. I don't know the results yet because the two hardy souls still reported back to work the next night. So far, there wasn't a visible bruise on the nurse's face which we hope stays that way. You should have seen the stunned look on her face after the kick. She just sat with her back against the wall with blank stare until the charge nurse asked her to get the restraints and set them up. The sprain on the mental health worker's finger might take longer to heal and I'm basing that on my own experience.

It was hard to determine what got the patient agitated in the first place but when they are paranoid, any voices they hear in their heads can set them off at any time. That was probably what happened in this case because all of a sudden, the patient started ripping things off the wall and kicking the wall. At this point no amount of verbal intervention helped. In order for us to keep the patient from hurting himself or damaging property, we had no choice but to take him down to the ground. It's the same as what the police call the swarming technique: three to five people each try to grab hold of a limb then put the patient against the wall or on the ground then hang on until the patient tires him or herself. Kinda like riding a bucking bronco. This is reality. In the movies where you see the protagonist beats up a whole bunch of bad guys? Well that just doesn't happen in real life. We try as much as possible to keep the patient from getting injured but as this case shows, the staff can get injured instead because the patient is the aggressor while the staff has to take protective and defensive measures. We of course have to attend annual classes on how to handle assaultive patients. However the role playing being done in class is in slow motion and often not necessarily the same as how the patient acts or moves. We just try our best to apply the techniques taught to us and hope that neither the patient nor we get injured.

These are the perils and risks we take while working in an insane asylum. Fortunately incidents like the one I mentioned above doesn't happen very often on the unit I work in. That, I can be thankful for. Lord knows that I’ve had my share of hits, grabs, hair pulls, bruises and soreness through the years as part of the job.