Thursday, March 15, 2012

The Other Side

I've written about my love for nursing a million times on this blog, reflected on how much
I love my job and the way I am able to nurture and help those in need.  I've shared
stories about patients who have touched my heart and changed me in ways I will
never forget.  It's not often that I discuss the more difficult parts of my job: the long
hours, the stress, my struggles with leaving work at work.
It's not often I tell the other side.
Last week I was sent out to a remote part of town to admit a psychiatric patient.
This particular patient attends a psychiatric day center Monday through Friday but is
eligible for home health care because he also has high blood pressure and problems
with Diabetes.  I arrived at his home to find him sitting on the sofa, staring blankly into
space.  I instantly felt a weird vibe, a gut feeling.  I ignored it, telling myself I was just
being paranoid.
The patient was polite but extremely agitated, his body language was a ball of nerves as
he tapped hit feet on the floor, wringing his hands as his eyes anxiously darted around
the room.  I introduced myself, told him why I was there, had him sign the consent for
giving me his permission for the visit.  Within minutes, he was a mess of run on sentences
as he told me, "I haven't taken any of my meds in weeks, I don't know where they are,
I really don't understand what's going on, I've been hallucinating and the voices inside
my head are so loud I can barely hear myself think, I see people everywhere and I
know what my doctor is trying to do he is trying to kill me!!!".
Shit.  My gut feeling has now erupted into full on fight or flight mode.  My spirit guides
are telling me loud and clear, "Get out.  This is wrong.  You shouldn't be here".  
"Wait, who are you?  Are you here to put the implant inside my arm?  That's why they
sent you, right?" the patient says.  
"No, no, I'm the nurse from the home health.  I'm here to help you" I calmly reply.  
"Wait here, I'm going to get something" he answers, and then gets up and walks to the back
of the house.  I reach inside my bag, grab my keys, holding them in my fist with the
sharp edges pointing out.  Just as I am about to walk out, the patient's room mate storms
in, wreaking of alcohol, stumbling his way inside.  The patient walks back into the room
and he and the room mate instantly start arguing, their voices rising as I announce that I
am going out to my car to "call the doctor".
I walk swiftly to my car and call the home health office.  I quickly tell my case manager
what is happening: I am stuck inside a house in the middle of nowhere with a
paranoid, hallucinating Schizophrenic and his drunk, angry room mate.  She tells me to
get inside my car, lock the doors, and get the hell out of there.  One problem, I left my
bag inside the house.  I run back up to the house.  The patient and his room mate are
still arguing loudly.  They both turn to stare at me as I reach down, grab my bag, and
tell them I will come back later.  "Oh no, don't leave" says the drunk room mate.  "We need
to talk to you".  I back out, remaining calm on the outside, and tell them not to worry, I will
be back later.
I get into my car as quickly as I can, lock the doors, and drive out of there.  I realize I
haven't taken a breathe in a while, I am sweating and tears are pushing their way through
my throat.  I was so scared, completely shaken up, imagining all the things that could
have happened.  I was alone and defenseless, just trying to do a job and help someone.
But this particular patient was out of my league.  He suffered from several
different psychiatric disorders and was not taking his meds, making him irrational
and unpredictable.  There was nothing I could do for him, I had to protect myself.
I realize now that I made several mistakes during this interaction.  I should have listened
to my gut from the beginning, should have been more prepared.  I should have taken my
bag with me when I left instead of going back inside.  I should have left FIRST and
THEN called the office, protecting myself before waiting for permission to leave.  The
entire experience showed me that I have to be smarter when putting myself in
these situations.  I have to react and think fast, protecting myself over my job.
Lessons learned and nerves settled, I know now more than ever that I was NOT born to be
a psych nurse.  Shawn promptly put a can of pepper spray in my bag and let me practice
my right hook on his arm.  Who knew nursing could be so adventurous?
Never a dull moment...

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Sarbear said...

Liv, my goodness! I'm so glad you made it out okay and were able to think on your feet and make the smart moves. My brother-in-law works in psychiatric care and my sister always hates when he tells stories about it. Maybe I'm starting to understand a little more as to why.

Lots of love to you my friend.

deanna@delirious-rhapsody said...

wow liv, my heart was actually pounding as i read this. i can only imagine how you were feeling. thank goodness everything turned out ok for you!

Wendy said...

Oh my gosh, that was terrifying! Like a scene is some a movie. I'm so glad you got out okay and that you learned from the experience. What a crazy experience!

Jess said...

Oy..this makes my stomach hurt just reading it. Thank God you got out of there!

Anonymous said...

Quite scary Liv'. I am glad to see you got out ok. I think when we find ourselves in these kind of situations, we tend not to think quite clearly. You know better now.
Take care

Randalin. said...

My goodness - I'm so thankful you got out of there safely. Are there any workplace policies that help protect you in these kind of situations (i.e. visiting in two's when seeing a psych patient)? I'm sending e-hugs your way, mama. You're strong and brave and smart - you handled it better than most would have in your situation.

Indi said...

Definitely scary; thank goodness you made it out safely! I could never be a psych nurse either!

Little Gray Pixel said...

That is scary. It's a good reminder that we should all listen to our gut instincts when we feel something is wrong. It's easy to overrule our intuition when we feel bound by a sense of duty or purpose, but it's not in our best interests to put ourselves in danger. I'm glad you were unharmed!

Kara said...

Holy crap Liv. I am so glad you got out of there and that your spirit told you something was off!!!

Sara Bell said...

Eek, so nerve-wracking. I do home health care for special needs children, but every once in a while I get asked to cover a behavioral modification or mental illness patient. I've never had an issue like this arise but I will definitely be sure to remember your story if I ever do.

Babes Mami said...

I used to work in group homes for adults with special needs, they attended a day center M-F but needed 24 hour care available friday at 3 until monday at 7 to help them shower, dress, cook for them, take them out and stuff like that. We had two houses with very aggressive patients and that was always where I was put and it could get very scary at times. My Dad gifted me with pepper spray, don't be afraid to use it if you have too. I'm glad you are okay.

Cait said...

I came to this post from another blog and I'm deeply troubled by the fact that your entire post and the eleven comments prior to mine are all so one-dimensional in that concern is only expressed for *your* safety and well-being. As valuable as that is, and as important as it is that you were not harmed in this experience, where is the concern or compassion for the very ill man that you left without help or treatment? He is very paranoid, hearing voices, and is at the mercy of his drunk roommate. It seems that both you, and your readers, have written him off as "just another crazy person" and as someone who only poses a threat to your safety, as opposed to another human being, as worthy of compassion and concern as any one of us. Did he receive the help he needed that day? Did you send a more well-trained and prepared health worker to his aid after you left? His health and well-being are kept in my prayers.

Olivia Grace said...

I can assure you that my concern lay mainly with the patient, that's my job as a nurse. I didn't write out the entire experience because it would have been a pretty lengthy post but I promise you I didn't just drive away without making sure this patient was cared for. As soon as I left, I got on the phone with the psychiatric day center who cares for him Mon-Fri. I gave them a full report of the incident, a list of his medications (which they should have already had and ensured that he was taking but for some reason didn't), and then called the police to report the drunken room mate and his erratic and threatening behavior. The patient was readmitted to the hospital the next day to be treated for his exacerbated symptoms and I can only hope that he is feeling better and is placed in a more secure environment once he is discharged.
This post was merely about my own personal experience, my side. My patients mean everything to me and, as a home health nurse, I often go into threatening and unsafe environments. But part of my job is to call the appropriate parties and ensure that these people are taken care of after I leave. I commend you for looking at the big picture and having so much compassion for this man. The world needs more thinkers such as yourself. And I thank the rest of you for your concern, love, and support as well. The blogging world is truly a lovely community.

Sweet Green Tangerine said...

Liv, you are an incredible, compassionate person. You did the right thing. I'm glad you are safe. :)

Lora said...

oh my goodness. i am so glad you're ok! God was definitely with you and sent His angels there to protect you!