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.    

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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.

Work as of lately

Work has been pretty good lately in that it hasn’t been super busy. I’ve had only 8 patients on average at a time. But about 3 of them somehow made it feel like so much more. I tried to figure out what exactly it was that they were doing that consumed my time and drained me mentally so quickly. I figured it out…A million questions, a million requests, a million complaints. Can you do this for me? Can I have this? Your doing this wrong…One of these three patients would literally follow me around wherever I went.  I finally asked her, ” Is there something you need?!” I felt cluster phobic! I just wanted to scream, stop asking me questions. Stop asking me to do things for you every second. Cant you see I am doing something already? that I am busy? I was amazed at the ignorance of how they were acting wasn’t bothering somebody. But they couldn’t see it. It seemed that they were sitting around just thinking of something they could ask me to do next or a question they could ask so that they have interaction with me, so that they could have attention. In the hospital we call these types of people needy and attention seeking. They are constantly seeking contact with us, parking themselves at the nurses station even if they can only just watch us work. Even when we tell them they cant stand there they don’t feel offended or embarrassed enough to leave. They need and want human interaction even if it means annoying somebody. I’m not going to put needy and attention seeking into only 1 category but the “diagnosis” that I find these traits in the most are the Borderline Personality Disorders. These people are manipulative as well or they lie to get their way and often get offended by us quite easily. But yeah anyways… It was a crazy few days there where I was extremely exhausted mentally by these few patients. My job can draining! But it really just depends on the day 🙂

Suicidality

So I know that I post mostly about how I work with people who suffer from psychosis whether it is Schizophrenia, Bi-Polar ext…but in our hospital we also have a Unit for patients who are considering suicide or have already made an attempt at taking their own life. I realized that I never post about that and that I do have some things to say about it and so here it goes. We actually have two Units for patients that come in because they are not safe from themselves, one is the Adolescent so 12-17 and then the other is 18 and up. These people are in the ward against their will because they are not deemed safe. Someone in authority whether it was a doctor or a police officer found them not safe from harming themselves or sometimes others. Most of the people that come in attempted to overdose on medication. That is the most common suicidal attempt we see. Some other ones we see are running out into the middle of traffic, putting a gun to their head, hanging themselves and stabbing themselves in the stomach with a knife. Something that I have found surprising is that a lot of patients when asked, ” How would you kill yourself if you could?” answer that they would drive their car off a cliff.

 Another common thing we see among this population of patients is self-harm, where people will use razors or other sharp objects to cut their arms and legs until they bleed. We see this among our Borderline Personality Disorder patients of whom are mostly women.

Now I know that those of you who have never experienced severe depression before are probably reading and saying, ” This is crazy. Who thinks like this? Who talks like this? Who could ever even think of doing these things?”

It is crazy, your right but when a person is not in the right state of mind, is not thinking clearly and truly feels like there is no hope or happiness in their future, the idea of never waking up again sounds so wonderful.

You may also be wondering , ” Well who are these people? What could be so terrible in their lives that they would consider doing something like this?”

Well most of these people have had a difficult upbringing with sexual and or physical abuse, divorce or their parents were drug addicts ext…. So in turn they turned to drugs or alcohol and the cycle continued. A lot of the patients have dysfunctional relationships, are financially stressed, some had to give up their children, they have low-paying jobs.  Basically when they are so many life stressors and not a lot of “good” life stressors going on depression is prevalent. I have noticed quite a large number of patients that come in because their significant other left them and they saw no point in living.

With depression I believe that it can be situational and biological. It can be because something traumatic has happened but it will pass in time. But I do believe that depression can also be caused by an imbalance of chemicals in the brain. I know this to be true because I suffer with this. And I know how it feels to feel completely empty and hopeless and to feel like someone is literally stabbing you in the chest with a knife to where it is physically painful. I know what it feels like to not want to wake up. I know what it feels to literally feel no joy in something that I used to find joy in. I don’t think there is anything worse than not being able to feel happy. But I was blessed to find a medication that works for me and helps my brain function right. I can feel happy again and I hope that others find this too for themselves. I believe that I still have to provide myself with a good “situation.” But I want anyone who suffers with depression to understand that it is not normal to live like how I described, you can get help and please not feel ashamed. It is ok to need help.

Like we say in the hospital, ” If you had appendicitis you would get surgery right?” So please if you have depression or even think you may have it go to your doctor and ask for help. You can feel happier, it is possible!

Schizophrenia: Will it ever go away?

I came into work to find a repeat patient, someone who had been with us before. I will call him Gary. At first glance most people would be frightened of Gary, he is an older man in his 50’s very large in stature. He has brown hair that is beginning to gray that he pulls back in a pony tail and most of his face is completely covered in facial hair. His mustache literally curls into his mouth if that helps. He has absolutely no bottom teeth, just black holes where his teeth used to be.

His physical appearance may cause a person to fear him at first but after talking to him a person would see how extremely kind hearted and loving he is. He actually has a wife at home for whom he loves dearly and wishes to go home to soon. The past two times I worked I spent a lot of time talking with him. He would ask me if he could talk with me and we would sit at the end of the hallway and chat for as long as I could get away for. Gary would say to me, ” The voices tell me to go kill and rape people and  I cant live like this anymore. I just want to kill myself.” He then asked me, ” Do you think If I killed myself I would go to hell?” and then ” Do you think I’ll always be like this?” “What should I do? The meds don’t help.”

It broke my heart to give unfair answers such as, ” You will most likely suffer with this for the rest of your life.” And ” I don’t know what can help you.” I hated how there was no good answer to give him. In the psychiatric world their only fix is meds, but as someone who works in this field I can tell you that meds do not help these people, maybe for moments when it puts them to sleep but when they wake up its right back to where they started. Its a constant battle and it always will be. I have never seen a person with Schizophrenia permanently get rid of the voices. Ever.

I find myself racked with these questions constantly… Why cant there be more help for people with schizophrenia? Why does this disease even have to exist? Why does someone have to suffer with this their entire life? I keep asking myself these questions hoping that one day I’ll have a good answer for myself and I just cant come up with anything better than, ” Well that’s just their trial for this life.”

But I just can’t help but think that its not fair when I’m sitting in front of someone who says, ” Why me? Why is this happening to me?”

Count your blessings. I’ll say it again and again. If you have your mind and your body you’ve got everything. There has not been a day that has gone by since I began working at this Psych Hospital that I don’t walk out of those doors at 6:30am, look up at the sky and say “Thank you God, for I know how great I have it and please don’t ever let me forget it. I have it good and I want to always be grateful for all that I have, for I have the capacity to live a life so great that these people will never have the chance to do.”

So to Gary and to anyone else who goes through a trial like this I commend you, truly, for you are a lost and forgotten people who suffer more than most humans could ever imagine.

That’s all.

Demon inside him

I don’t ever take things like this lightly so I want whomever reads this to understand that I am not making this up just for a good story. I truly believe what I am about to say.

A couple of weeks ago I went into work and was introduced to all of my patients. One in particular stuck out to me. The nurse giving me report said that he had just come onto the unit and he was lying in his bed catatonic, staring into space unresponsive. She said he had a psychotic break and would most likely come out of it soon. I thought nothing of it since this is quite common. I began doing my rounds, introducing myself to everyone and getting everyone’s vitals. At one point I passed by his room and as I did I saw his entire body come up off the bed in one large motion and then come back down hitting the bed. He was lying on his side when this happened and this happened twice in a row very fast. I really didn’t think much of it since I see patients do strange things all the time. I actually thought that maybe he was doing it for attention. I walked away and went to the nurses station for awhile. Soon after I heard a blood curdling scream coming from his room. It was a loud strong long scream. It sounded as though he was screaming at somebody or something. All of the other patients looked at me as if saying ” Make it stop, he is scaring us!” I walked down to his room and found him curled up, with his knees pulled to his chest, rocking back and forth. He was staring at “something” completely terrified. He could see something bad and this was not psychological. The second I entered the room I could feel something terrible, absolutely terrible. He finally looked at me and I said, ” It’s ok. It’s ok.” Then he literally growled at me, it came from the bottom of his throat, it did not sound human. When he screamed and growled it was not his own voice. Even though this was the first time I met him I knew he had something evil inside of him and that it was not his voice. It was the deepest scariest voice I had ever heard. I left pretty quickly. There was such a tangible feeling near his room.

Even the other patients could feel that something was wrong. You see we have this patient who believes he is a cowboy. He speaks with an Australian accent ( he has never even been to Australia) who thinks he is a navy seal and has been shot 6 times and the reason he is with us is because he beat up a man on the street because he was trying to hurt his wife and three kids that don’t exist. Even this guy would walk over to this patients door and say religious rants to rid the evil spirits from him. It was crazy. The most sick crazy dirty scary feeling I have ever felt.

Eventually he stopped screaming and laid down on his bed completely naked for the rest of the night. Of course I had to my rounds on all the patients for the rest of the night and when I would come to him I would dread having to open the door to see him. Not only because he was naked but because of the sick tangible evil feeling that would come over me. I almost made it through the night but my very last round on him I opened the door and with the room completely dark I could see his eyes somehow lit up, they looked like a cat in the night searing right through me and he had a half crooked smile on his face. I shut the door so quickly and I felt shivers go right through my body. I wanted to get out of that hospital as quick as possible. I could feel the evil seeping through my body.

I went back to work a few days later hoping that he would be gone but knowing full well that he wouldn’t be. When it was time to go check on him I gathered up the courage and walked into his room. I knew instantly that whatever had gone inside of him was gone. The feeling that once was there was completely gone. He was just lying there and he responded when talked to, he knew where he was and he was most definitely not growling, rocking back and forth or screaming bloody murder. He had completely been given his body back.

Before I left the room I asked him, ” Do you remember your first day here?” He suddenly had a confused look on his face as if he hadn’t thought about that before. He finally answered ” No, I don’t.” I just said in response, ” That’s what I thought.”