An experience I won’t ever forget

I’ve always thought that I had a lot of compassion inside of me. I always thought that I was quick to be understanding, always considering that the person ( whoever they are) has had hardships in their life that made them who they are today. I actually had thought that maybe I was too understanding where I would go as far as make excuses for someone, thus allowing them to hurt me continually. I had never had someone test my compassion or my patience as much as this person. I will call her Bailey, a person who has become someone I will most likely never forget, someone who has made a very great impact on me as a person.

The first time I saw Bailey she was asleep on the couch in the day room of the adult high acuity unit. She wasn’t even an adult, she was only 17 years old but the adolescent unit was having so much trouble with her that the CEO decided it would be better if she were put onto the unit with the most difficult patients, the psychotic patients, the homicidal patients, in hopes of scaring her. I was told in report that day that she could get violent, kicking, punching, spitting ext. Then her mom called and they asked me to go wake her up to see if she would take the call. This day was over 2 months ago, she goes down in history at our hospital as one of our few longest patient stays. Why has she been with us for so long? Because nobody wants her. Not her adoptive mother, no other facility, the state hospital, group homes, no one.

I started off having a really good rapport with Bailey. I was proud of myself, I thought I had figured out how to handle her. I thought that I had found a good balance of discipline and giving her freedom at the same time. I thought that I had figured out how to de-escalate her before she had a freak-out. I had clumped her in with another 17 year old girl that I had once worked with, thinking she thought the same way. Weeks went by where she respected me, but would freak-out and attack other staff members. I remember thinking…oh she would NEVER attack me, we have a rapport.

Then one day I was working her unit, it was a busy night, it was phone time and so the phones were ringing off the hook. I was handling the phones for two units, running back and forth managing everyone’s phone calls. Bailey walked up to the glass window and stood there giving me this pouty face that she usually does. Bailey is short in stature, a little pudgy with brown hair that lays on her shoulders. She just stared at me wanting me to give her attention, talk to her. As I am on the phone I mouth to her, “I can’t right now.” I was annoyed. Why did she think everyone should stop what there doing whenever she wanted something? About 10 minutes later when I was done with phone time I stepped outside of the nursing station and asked her what was up. She just stared at me with that look on her face and shoved my shoulder. I couldn’t believe it. I was so shocked. I said, ” Did you just push me?!” She replied, ” Do you want me to really hit you?” She then shoved me again. I then yelled over the glass to my co-worker. She came over and as she was coming up behind her Bailey finished off by kicking me in the leg. My co-worker grabbed her arms behind her back and I went and opened the seclusion room door. We put her in there but before we could close the door she turned around and spit in my co-workers face, twice. This type of behavior began happening routinely. Like everyday. There was another time when I was at the end of the hall doing my rounds on the patients and another patient walked up to me and quietly said, ” Watch out, Bailey just told me she’s going to attack someone and she doesn’t care who it is.” As soon as she was done telling me, I looked up to see Bailey walking towards with me a truly evil look in her eyes. She simply walked up to me and began to try to hit me and kick me in a very fast manner. My instinct was to block her hits and kicks with my clipboard. She didn’t actually get me once haha! I surprised myself  later thinking back on it because when she was trying to hit me and couldn’t, I began taunting her . I was saying, ” What are you bored? Is that why your doing this? Did you not get enough attention? I was smiling too and it made her smile and then I said, ” Oh this is fun for you isn’t ” This all happened in a 30 second period. By then my co-worker walked down the hall and she stopped. I walked back to the nurses station and I watched Bailey push my co-worker as she turned her back for a second. She ended up spitting on her too. She went into seclusion this time for a few hours, where she sits on a cold floor and the walls are cement and we stare at her  through a tiny square window.

After this second time I began to hate her. I actually had hate in my heart for her. I cringed every time she said my name or wanted my attention. I was cold to her now. I worked the connecting unit for weeks afterwards to get away from her. She still had freak-outs and I would help but at least I didn’t have to communicate with her or have to look her in the eyes. I hated that I felt this way. I didn’t want to, but I couldn’t help it. I guess I just felt like I couldn’t figure her out. I couldn’t figure out what triggered her or why she acted the way she did. She didn’t seem low-functioning to me, she didn’t seem depressed. It just seemed that she wanted attention or was bored and so she would act out.  Also everyone else in the shopital felt the same way. Everyone had this hate for her when normally my co-workers were very understanding. To make matters worse she wasn’t leaving anytime soon. The attacks were becoming so often and more frequent that our managers were telling us to file a police report against her each time it happened. They thought it would help get rid of her faster. I myself filed twice on her. The police would come right to the hospital and we would file it right then and there.

So this went on for weeks, my anger towards , her continual outbreaks and everyone trying to get rid of her. Then one day I came across an evaluation that what been recently done on her. You see up until this point we didn’t know that much about her. And so I found some things out… She had been severely neglected from birth until age 5. She was sexually abused by her father. She was then put with her grandmother, then her aunt and then into foster care. Someone in foster care sexually abused her. Then at age 13  she was adopted and her adoptive mothers husband sexually abused her. The doctor who evaluated her diagnosed her with PTSD, ODD ( Oppositional Defiance Disorder ) ,RAD ( Reactive Attachment Disorder ) and ADHD. I suddenly understood her so much more. I had more compassion and my heart softened towards her.

The next time I worked with her I was more kind and loving and not as cold as I had been for so long. I didn’t expect her to change just because I viewed her differently but I had changed in my thoughts and feelings towards her.

One night she was on the verge of a freak-out and somehow she didn’t, oh it was because we threatened seclusion, which she had begun to hate. And she asked me if I would take her to the gym  to get her energy out. I ended up taking her and we played around for a little bit. After we were done she asked if we could go to the cafeteria. We got some drinks and I asked her if she wanted to sit down for a little. I could tell she was a little shocked that I didn’t say “Ok lets go back now.”  We began talking. I began asking her questions and she responded like an adult, we had an adult conversation and I couldn’t believe that this was actually happening. I couldn’t believe that I felt safe enough to be alone with her off the unit, totally secluded at 11:00 at night. When we went back that to the unit she asked me if I would tuck her in. The next time I worked we did the same routine. I could tell it meant a lot to her, she told me that she felt like everyone hated her here and how she just wanted to go home to her mom and that she didn’t know why she freaked out all the time. She also said that her biggest reason for wanting to die was so that she wouldn’t have to be sexually abused ever again.

I found myself wondering how could I have ever been so hateful towards someone who have been given one of the crappiest set of cards in life ever… but I hadn’t known that before I guess. So anyways it has been a crazy last 2 and a half months and the end is unknown still. How will things end for her… I wish I knew. Will she be ok?   I have no idea. But what I do know is that I could do better to not judge so quickly, to not hate so quickly, to understand what being in somebody else’s shoes is really like. And love really goes a long way.

Complete Mental Exhaustion

Virginia Oh Virginia – This is one of the most craziest experiences I have ever had with a patient in my 2 and a half years working at the Mental Hospital. Crazy! I hate to even think about it, I feel like I cant go there in my mind again. So I’m going to do my best at getting it all out onto the blog. My first time meeting Virginia I walked into work and I heard screaming. It was a loud, deep, long moan almost. I walked towards it and found 2 of my co-workers with her as she sat on her bed. They were talking to her trying to get her to calm down. That first night with her she slept most of the night and it went fairly well so I didn’t think she was going to be that difficult.

To back track Virginia is in her upper 20’s, only a few years older than me but she appears to be in her 40’s for whatever reason. She is of average height with short brown hair. Virginia is developmentally delayed and also has psychosis, the doctors think its Schizophrenia. She was sexually abused pretty badly as a child and the doctors believe this has a lot to do with her psychosis. It is believed that sexual abuse can bring on psychosis and I have found MANY cases of patients who have psychosis and were sexually abused as a child. I have to believe there is a positive correlation.

Anyways, my next day that I came into work Virginia had gotten much worse. She had begun screaming non-stop, all day and all night. Her voice had become hoarse from screaming for so long. The screaming was also filled with anger and if someone attempted to redirect her or calm her down she would become aggressive and hit you. A doctor actually talked to us all before we went out to work with her telling us to be patient with her because she had had such a terrible life that had made her like this. It was pretty surprising to hear a doctor be that concerned.

So this was my first of 3 nights in a row to be working. The next 3 nights were extremely difficult. The screaming became unbearable, not only for us but for the patients. It was traumatizing actually. I couldn’t do it anymore but I had to. We couldn’t get through to her, there was no light in her eyes. It was as though she were looking right through me, as if I wasn’t there. She would take her clothes off, go into other peoples rooms. We gave her food to eat and she would have it dripping off of out of her mouth. My co-worker and I did manage to bathe her after about 30 minutes of coaxing and I washed all of her clothes since they were soaked in urine.

The second of the 3rd night was the absolute worst. The screaming somehow escalated. I was telling everyone to go to their rooms and close their doors. Amazingly so other patients would be standing there asking me a question like, ” when is phonecall time?” as Virginia is screaming about the devil and being raped at the top of her lungs. It made me so angry. I wanted to say, ” Really? Can’t you see what is happening here right now?” It was so weird and inconsiderate to me but then I remember that they themselves are not completely there either.

The night of the second day was so bad that our CEO came in. He rarely, if ever comes in and one of the doctors must have called him. We had given her everything possible to knock her out and nothing was working. Our doctor told us that she had talked to her ” Peers” and no one had an answer. It was so crazy! So anyways, the CEO came in, walked her to a different hallway and let her pace up and down hall yelling. We could still hear the yelling but at least it wasn’t so close to us anymore. So when she yells it sounds like a bunch of gibberish, and only rarely will you understand a word or two. Some of my co-workers were a lot better at understanding her and would tell me she would talk about sexual abuse and the Devil. When she was yelling, it was all angry yelling. She never smiled and you could tell she was responding to internal stimuli.

So our CEO took her for about 3 hours into that hallway and it was such a blessing. We were able to get other work done, the patients were able to sleep and we were able to have a mental break from it all. He would come out from time to time and he looked absolutely exhausted. He couldn’t believe the amount of energy she had and that she never stopped yelling! We said, ” Yes, we know.” I had an extremely bad headache that wouldn’t go away.

She never went to sleep that night. In the morning they found an office room, emptied it out, took a bed in there and she had her own personal room. We would have 1 staff member with her there at all times watching her. I went home that morning and I felt like I couldn’t function. I felt like I couldn’t talk or listen to anyone else talk. I felt sort of traumatized. I couldn’t feel emotion either. I woke up feeling the same way and I had to go back to work again. The thought made me want to cry.

I went back in and she was still in her personal room and luckily another co-worker offered to go stay with her. I was so grateful. She didn’t get better that day or the next day but about 4 days later I went and saw her and she was happy and smiling, talking a lot but not yelling. She had a light in her eyes. She could see me this time. I couldn’t believe it.

 

 

 

Confusion, Psychosis and Internal Stimuli

 Spencer is so cute and young. He is a sad case. We don’t quite know why he is having psychosis but here’s a little bit about him. He is probably in his early 20’s, he is average height and has dark brown hair. He wears the same clothes everyday and despite his constant showering his hair appears very greasy sticking to the top of his forehead. When he came in they said that he appears to have some OCD tendencies, but I feel a little differently. He is constantly responding to internal stimuli and he rarely talks unless he is asking for food. He lays in his bed a lot, he sits in the dayroom rocking back and forth staring at the floor. He is constantly asking for food even when I have told him No multiple times. He is also always asking to take a shower but I have a suspicion that he doesn’t wash his hair or use soap. He will stand in his shower for an hour straight with the lights turned out. When I ask him ” How ya doing?” To urge him to get out he responds with a , ” Good, How are you?” He is literally the only patient who has ever done that. Kind of funny actually. Eventually I have to tell him to get out, because if he not who knows how long he will stay in there. The most interesting thing that he has been doing is retracing his steps when he walks. He will literally walk 3 steps forward and then turn around and walk back 4 steps, stop turn around and walk forward again. So going anywhere takes a little while. I feel sorry for him. I don’t know what his exact diagnosis is, it may be drug induced psychosis or just genetic, but either way it is sad because he is so young, so confused and so sweet. He is one of the few patients who actually asks me how I am doing and seems to mean it!

 

 

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.