Low functioning male who bites and spits

So we have had this patient with us for over a week now and he has been so hard to deal with. I will call him Matt. Matt is about 20 years old, 4 foot 10 inches, overweight and of Hispanic descent. He is also extremely low functioning, he functions at about a 5 year old’s level. He was admitted the night I was working and when he walked in and was being asked to sign some papers my co-worker had to tell him to take his hands out of his pants. This is something that has never ended, he always has his hands down his pants. Gross I know. That night he went to bed quickly and slept throughout the night. Oh and he was brought in because he had attacked his brother in a fight and had been biting his brother’s ankles. Anyways Matt slept the whole night and woke up at exactly 6:00am the next morning right when I was about to go home. He walked up to the nurses station and said, ” I need to go to school, I’m going to miss my bus.” I was tired and didn’t feel like coming up with some fake answer so I simply said, ” You’re not going to school today.” He looked at me like I had just told him the worst news of his life, yet… I continued. ” Your going to be staying here for a few days.” This time his eyes grew even wider and tears began to swell up in his eyes and then came the screaming. The long stretched out wail of Matt that we have grown to dread. He began screaming at the top of lungs, ” I hate you!! Let me out!!!” staring at me of course. He grabbed onto the nursing station door and began shaking it with all his might while he screamed at the top of his lungs. His face went completely red and he screamed directing it at me. I tried telling him that it wasn’t me keeping him there, that it was the doctor but that did absolutely nothing, he was too low functioning to understand what I was saying. I left a little traumatized from the yelling but got over it before I got home.

I knew I would have to see him the next time I worked. Since then he’s been with us for a little over a week and he wakes up every morning thinking he’s going to be leaving that day…and freaks out all over again. The worst that happened with Matt was the last time I worked when he attacked a few of my co-workers. He randomly charged my male co-worker and began chasing him. While chasing my co-worker he even turned over the coffee table in the dayroom. Sadly the other patient sitting at the table was a man who is suffering with PTSD from serving in Iraq and that traumatized him even more. Anyways, my co-worker ran back into the safety of the nurses station and we called for more help, and began drawing up a shot. It took 3 male co-workers and 2 female to get him into his room, to hold him down to give him 3 shots. I didn’t participate in the take down but I watched as he attacked my co-workers, punching, kicking, biting and spitting at them. At one point he was on the ground holding on and biting on of their legs. He also bit his own lip so that he bled and then began spitting blood at them, blood landing on my co-workers face.  Throughout all of this he is screaming at the top of his lungs. The take down took over an hour until he was knocked out for the night. During all of this I gave attention to the other patients. Of course the PTSD patient was being triggered and so I let him close his door and stay in bed. The other one’s turned up the T.V to try to block out the yelling. I went around and took their vitals and almost everyone’s blood pressure was skyrocketing. I felt bad for them and tried to talk to them to distract to them and be happy for them. Eventually I just took them out to the patio to get them away from it. Thankfully Matt knocked out for the rest of the night and it was a great rest of the night. The next morning just as I was about to leave, on queue he woke up and came to the nurses station. I awaited an outburst, but instead he just said, ” Good morning, what time is it?” I told him the time and he said, ” Ok, I’m going to go back to bed.” It was as though he had forgotten about everything that had happened only hours before. Oh well! At least I could just go home…

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