Stirred And Shaken
I spent much of Monday and Tuesday having meetings with patients around sexual activity, which has suddenly exploded on my unit in the past week. The hospital has no clear policy on the matter, other than to officially “discourage” sex and promulgate a sort of “don’t ask – don’t tell” approach. But it’s been going on, not very discretely, mostly in the bathrooms—with up to three partners in one week for one patient, and more than once each. Potentially very messy.
Anyway I thought I had a pretty good rapport with this fellow, but my attempts to discuss the situation with him have not been well-received, with much cursing and shouting. Last night he started slashing at his arms with broken bit of glass, and again this morning with a staple, leading to a number of sutures and being moved to a different part of the unit. When I went to see him there staff warned me that he was threatening to kill me, and indeed I found him pounding on the windows and screaming not-very-nice things at me. He bashed in a fire extinguisher cabinet with his foot. With four or five staff I met with him in the middle of the unit. He demanded to be discharged. When I told him that didn’t seem like a safe thing to do just then, he lunged and tried to punch me in the face, not quite making it. I moved behind the nursing station, and tried to discuss with him from a safer distance. He grabbed at his sutured wrist and flung out his arm, splashing blood across my shirt with some choice words about my sexuality, reproductive organs, and intellectual capacity.
Things unraveled from there. I’d like to say I handle these incidents with imperturbable aplomb, but that would be a lie. I wind up shaken, pretty well. I think about quitting on the spot.
I retreated into the chart room to catch my breath. I didn’t like having blood on my shirt, so I took a couple Little Mermaid stickers and pasted them over the spots as a temporary fix. Unfortunately, the patient for whom Green Acres buys these stickers as a reward for safe behavior saw them on me as I was leaving the unit, and also began to scream and pound—“Those are my [emphasis] stickers! What are you doing with my stickers, you [kind gentleman] doctor!” As I walked out the door, the guy who had tried to punch me yelled, "YOU'RE NOT GOING TO PRESS CHARGES AGAINST ME, RIGHT?" It hadn't crossed my mind until that point.
Later I walked over to the staff break room of another unit to sit for a minute in a different environment. A mental health aide I’m friendly with was sitting there with a cup of coffee.
“How long have you been here, L.?”, I asked her.
“Eighteen years.”
“Does it get any easier, at some point?”
She considered. “No, it stays about the same. Unfortunately, you get older, and you don’t heal as fast.”
“I hope I don’t get bashed in the head, and wind up here violently brain injured myself”, I speculated.
“If you do,” L. said, “just try very hard to remember: you like me.”
Anyway I thought I had a pretty good rapport with this fellow, but my attempts to discuss the situation with him have not been well-received, with much cursing and shouting. Last night he started slashing at his arms with broken bit of glass, and again this morning with a staple, leading to a number of sutures and being moved to a different part of the unit. When I went to see him there staff warned me that he was threatening to kill me, and indeed I found him pounding on the windows and screaming not-very-nice things at me. He bashed in a fire extinguisher cabinet with his foot. With four or five staff I met with him in the middle of the unit. He demanded to be discharged. When I told him that didn’t seem like a safe thing to do just then, he lunged and tried to punch me in the face, not quite making it. I moved behind the nursing station, and tried to discuss with him from a safer distance. He grabbed at his sutured wrist and flung out his arm, splashing blood across my shirt with some choice words about my sexuality, reproductive organs, and intellectual capacity.
Things unraveled from there. I’d like to say I handle these incidents with imperturbable aplomb, but that would be a lie. I wind up shaken, pretty well. I think about quitting on the spot.
I retreated into the chart room to catch my breath. I didn’t like having blood on my shirt, so I took a couple Little Mermaid stickers and pasted them over the spots as a temporary fix. Unfortunately, the patient for whom Green Acres buys these stickers as a reward for safe behavior saw them on me as I was leaving the unit, and also began to scream and pound—“Those are my [emphasis] stickers! What are you doing with my stickers, you [kind gentleman] doctor!” As I walked out the door, the guy who had tried to punch me yelled, "YOU'RE NOT GOING TO PRESS CHARGES AGAINST ME, RIGHT?" It hadn't crossed my mind until that point.
Later I walked over to the staff break room of another unit to sit for a minute in a different environment. A mental health aide I’m friendly with was sitting there with a cup of coffee.
“How long have you been here, L.?”, I asked her.
“Eighteen years.”
“Does it get any easier, at some point?”
She considered. “No, it stays about the same. Unfortunately, you get older, and you don’t heal as fast.”
“I hope I don’t get bashed in the head, and wind up here violently brain injured myself”, I speculated.
“If you do,” L. said, “just try very hard to remember: you like me.”
posted by Turbo at 7:45 PM
5 Comments:
whaddya talkin 'bout? quit? that describes my household every night
I'll say it for you: WOW...
You've got 'lots of moxie', Turbo. What's the work situation somewhere else? This place sounds like something directly out of One Flew Over the Cuckoos Nest!
Please quit this job and start charging people to read your blog.
M&P: I can't quit this job until you reinstate my trust fund! Please!!
Kat: Did you know that Moxie is the official beverage of the Smallish State? It's true!
BOTW: Interesting, what you point out (here, and on Stay of Ex.) about moon phases.
What research there is on this & psychiatric patients is not very compelling, but many old-timers in the field would swear there's a connection. Couple years ago I called in some favors at Green Acres and got hold of the statistics for all dangerous behavior episodes at the hospital over the course of five or six years. I was going to analyze it for any correllation to lunar phases. But it's a big pile of paper, and I don't have a research assistant...
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