Voices tell him to do it

Matthew is the boy who was walking around trying to strangle people with his bare hands. The voices were telling him to do it and then he would feel bad about it afterwards but then he would try to do it again and again. He attempted to strangle me once and I have to say it was kind of scary for a second there. I was standing in the snack room handing out snacks for snack time. He had come up and I had handed him something and he turned around and sat down to eat it. I then turned around to get something for the next patient who had walked up. But when I turned back around Matthew was right in front of me with his hands up and coming towards my neck. The look in his eyes was incredibly scary. At first I felt afraid and in my head I thought, ” Why? Why would you want to hurt me?” But I responded quickly by putting my arms up and said “No! No No…Go sit back down. The look in his eyes immediately left him and it was like he snapped out of it and he went to go sit down. A little while later he came to me and apologized. I told him that he needs to do something different when the voices start to tell him these things. My co-worker suggested clapping so that he will occupy his hands in another way. At least it would give us a warning too you know…to get away.

Bi-Polar Manic Stage in Denial

 Kimberly was our latest admission. She was being admitted because she made threats to kill herself. She had been looking up on the internet the ” most painless ways to die”. A lot of people do this actually. And so her husband brought her to us and it took hours to get her to the unit. We weren’t able to do an assessment, a skin or clothes check or anything. It was all we could do to get her to the Unit. Once on the unit she sat in the corner of room crying and screaming. One by one we would go in and try to calm her but she just got worse. She finally came up to the nurses station and began telling me that she should be able to leave and that we can’t hold her against her will. I explained to her that we can in fact hold her against her will if there is a reason to be believe that she is a danger to herself or to others. Then her husband showed up at the front door demanding to get her released and saying all of the same things. It’s interesting that so many people come in not understanding how it works. Are they being educated on their way over about this largely important fact. I guess they don’t want to deal with it and figure they will let us handle it once there locked in. Well luckily we gave her some medications and she was asleep for the rest of the night.

A Myriad of Psycholigical Issues

Aimee came in completely psychotic. The doctors think she has schizophrenia and bi-polar. She had just had a baby a couple months prior and they took her away because they felt she was a danger to her child and towards others. When I walked into work a few days ago the first thing I heard was Aimee screaming. I couldn’t see her but I could hear her. She screams a lot, mostly about wanting to leave to go be with her baby and also about how her husband left her for another woman and how much she hates her. I feel sorry for her. She’s extremely manic and very hard to re-direct.  She begins yelling and banging on the nurses station door demanding to be let go, and if I would try to reason with her she would say, ” Shut-up, I don’t want to hear you anymore.” she would see this every time, even when she asked me a question and I was answering it. She also wakes up at 3:00am ready for the day everyday and begins screaming as well. This resulted in waking up other patients and having them run out of their rooms ready to fight someone. When I say she’s yelling I mean blood curdling screaming. I noticed that she kept asking the same questions over and over and over again and at first I thought it was just behavioral but then I realized that she not be understanding. She would say, ” I have Asperger’s!” When one of my co-workers attempted to talk to her she came back and told us that Aimee had been talking about aliens coming from space…so it looks like she may be Bi-Polar, Schizophrenic and have Asperger’s. That’s a hard hand to be dealt. I felt like she was getting a lot better yesterday before I left so hopefully she continues to improve.

Psychosis to its fullest

Janeen is so cute, in the way she is so innocent to everything around her. Janeen is a woman in her late 40’s early 50’s. She always wears her blonde hair in a side braid that sways in front of her as she walks. She has two black eyes and a cut on her nose. She walks with a little limp and she is always carrying around her Holy Bible. Janeen suffers from Schizophrenia, she extremely bad hallucinations and delusions. She calls me Daphne or Princess Daphne consistently. She is one of the most actively delusional patients I have seen in a very long time, one who is completely unaware of her delusions. She truly lives in her own reality. She is constantly “picking up” things off of the ground. She is constantly talking to unseen others. I found her “playing” in her room with her “grandson”. One time I attempted to take the dirty linens from the bed next to hers and she wouldn’t let me because they were “Princess Diana’s.” She has come up to me a couple times with two cups for water or asking for 2 towels to shower, because one is for her friend. I have found her punching someone in the hallway many times. She has come up to me holding her head saying that she had been shot 8 times in the head. She brought me into her room yesterday and asked me to help look for Benjamin Franklin’s dead body and that was why her room smelled so bad. She is in constant conversation with unseen others, it is sometimes hard to get her attention. When I say hello to her she is very polite and asks how I am doing. She is so sweet and nice.

Aggressive and Scary Male

Bobby, Oh Bobby. He’s a scary one. He is African American, 6 foot something, and weighs 200 something. He came from jail because he had done something violent. His family said that he had a sudden psychotic break and they didn’t know why. Turned out he had taken some drugs and became psychotic but also very aggressive. Bobby would stand at the nurses station and demand to leave when he had moments of lucidity. He would punch walls, break chairs, knock over tables. When he was super psychotic he was still mean and aggressive. He would have word salad, putting random words in a sentence, nothing making sense. He was so big that we gave into him a lot more than we normally would. If he wanted a drink from the cafeteria, we got it for him. We would often ask him if he wanted a snack just to redirect him, even if only for a few minutes. Bobby was unusual in that he would go back and forth from being lucid to psychotic a lot. We would think he was “clearing” and doing better but then he would suddenly slip back into psychosis. There were many times that he would stand at the nurses station flipping us off, cursing at us as well as throwing up gang signs. That part scared me a little. So we eventually discharged him when the doctors thought he had gotten the best he was going to get, which in my opinion wasn’t that great. Some of our staff drove him 45 minutes away, to a homeless shelter, let him out of the car and said, ” Look there’s the homeless shelter.” He then walked in the opposite direction and began cursing and threatening a man walking down the street. Our staff drove off. Only hours later did we receive a call from a police department asking why we let him out. They didn’t tell us why they picked him up but we can only guess.    

The Day for Choking

Its been a pretty good crowd except for 1 thing. We have got a lot of choking going on. Today when I came into work my shift report went as such : ” So last night Bobby freaked out, began breaking things and then started choking Terry. Terry didn’t like that, grabbed his throat back and began choking him. And then Matt ( who I mentioned in my previous post) didn’t try to strangle me but did attempt to strangle Karen ( another patient).” My co-worker smiled as she said this. I looked at her and replied, ” Why are you smiling?” Her reply was, ” I am SO tired.” 

As you can probably guess I was a little hesitant to leave the safety of the nurses station but I didn’t really have a choice and so I began the shift. A few times some of the other male patients would walk near me and watch to make sure Bobby didn’t hurt me. It really is comforting knowing that someone would have my back if I needed someone. It can be scary because we don’t have security or anyone who would even hear me yelling. I have 3 other co-workers but 2 of them are in the med room getting medications ready and the other one is on the other unit.  

Anyways the shift went really well. Matt didn’t attempt to strangle anyone and Bobby was agitated off and on, sometimes lucid and could hold a conversation and other times not at all. He would slam his hands against the nurses station glass and knock things over but he would pretty quickly calm down and then go lie down for awhile. The fact that we gave him a lot of medicine to help keep him calm helped a lot I’m sure. So yeah good night you could say. 

This past weekend

This past weekend was pretty good. I work three 12’s in a row which sometimes can be extremely exhausting if they are super busy nights, but thankfully they were all pretty chill and slow nights. But there a few patients that caught my attention as interesting so I thought I’d share!

First there is Harry, he is in his 40’s and is a return patient. He is extremely intelligent, a computer programmer actually but his psychosis has gotten the worst of him and he can no longer function on his own. He has extreme paranoia and is extremely delusional. Random things can trigger Harry into a full blown freak-out. Its really sad because he is such a nice person who suffers deeply. For example he can be watching T.V and he will see or hear something come from the T.V that is not really there or he will hear something and think that is really happening in real life in our world. ( Ex: watching a movie about zombies or an apocalypse)  This then spirals into him yelling that he doesn’t want to live in a world like this and wants to be euthanized. He fortunately has the ability to calm himself down rather quickly. But it is so sad to see the look of desperation and hopelessness in his eyes. After a week on a different medication he is doing much better. He told me that he feels like his mind is  more clear and that he feels like he could “live like this”. It really made me happy to hear that.

The next patient is Matt, this patient is a much younger guy, probably around 23 years old. He is a little bit lower functioning and is so sweet and innocent. He has to be prompted to do things. He worries that he will do something wrong. Matt suffers with auditory hallucinations. His voices tell him 1 thing and that thing is to choke people. He doesn’t want to do it but he feels like he has to so we will all be sitting around watching T.V and Matt will randomly walk over to someone whether it is a staff member or another patient and put his hands around their neck to choke them. Luckily he does it in a very non-aggressive manner and so it is very easy to pull him off of the person and he doesn’t fight back in the least. Its sad to see him so sad about it. I know that sounds strange but he is truly a kind innocent person who is just tormented by these voices and he feels very bad about it afterwards every time. I told him yesterday that if he starts to hear the voices to come and tell me and that I will help him get through it. He agreed that he would.

Another patient that sticks out to me is Zachary. This patient is in his early 40’s and this is his 6th or 7th visit with us now. I have no idea why he has not been sent to the State Hospital at this point because he has shown the state that he is not capable of functioning on his own and being safe but… I don’t know.  First of all Zachary abuses Meth. He is an avid drug user and has been for years. Zachary also has psychosis so he hears voices. And last but not least he has extremely bad diabetes that he doesn’t take care of at all. He is homeless as well. He is a mess, and every time he comes in he comes with his extremely dirty bag of clothes that smell so badly of smoke that we wash his clothes at least 3 times before giving to him to wear. He is always coming down off of Meth when he comes and his blood sugar is either 44 or 450 and so as you can imagine he is not a happy camper. With those two combined he is extremely irritable, yelling at us and being uncooperative. He is also not hygienic and is found walking around with food in his full grown beard and because of the meds we give him he is often drooling into his beard. Gross I know. But anyways he can be very hard to deal with. Last night I attempted to wake him up to get his blood sugar ( which was 44 by the way) and he batted me away grunting at me and then gave me and my co-worker the middle finger.

The last patient that I had the pleasure of working with this past weekend was Tim. Tim is a man in his 40’s. He is extremely small in stature and very skinny. He has a shaved head and stayed in bed for 3 days straight pretending that he couldn’t hear us so that he could stay in bed. No body had heard him say a word for 3 days. On my last time of doing rounds on my last night of working three nights in a row I went to check on him and he was awake and said Hello to me. He seemed very nice and I said Hi back. As I then began checking on the room across from him I heard him ask me a question but I thought I hadn’t heard him right, I turned around and said, ” What?” and he repeated himself, ” Would you like to have sex ma’am?” Shocked but then kind of not at the same time I responded, ” No thank you.” and walked away. And then thankfully I went home.

So yeah I would say all in all a good weekend. It was actually extremely calm and non stressful. Good times.