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...