(This is the third installment of my position as a psych tech on an adolescent crisis unit.)
I was working with “N.” A brilliant young adult who was a senior in high school. He had obtained his piolet’s license and was set for an ivy league school the following fall. “N” had been on the unit with us three times before. “N.” suffered from severe depression. He was nearing the end of his 4th stay with us and was doing incredibly well. That afternoon he was in good mood, and he asked if we could play a game of scrabble later in the evening with two other patients. He would be getting released tomorrow so I happily agreed! “N” had been my patient 3 of the 4 times he was with us. (One of my favorites.)
I was working on my paperwork when I heard a float nurse arguing with a female patient named “A”. This patient, “A,” was extremely violent, she came to us because she had ‘knifed’ another female for ‘flirting’ with her boyfriend. Her boyfriend was a well-known skinhead and had attempted to ‘break her out’ twice. I gotta give the guy props for attempting, but we were a lock-down treatment facility. It was harder to get in then get out.
The flu was going around, and we were short staffed, so we were running at about 50% regular staff the rest were ‘float staff’ from an on-call temp agency. The nurse who was arguing with “A” was 8 months pregnant, she was an in your face kind of gal which may work on other units but not on a crisis unit and definitely not with “A.” I got in between them.
I got “A’s” attention, told her to go chill out in her room, please and thank you. I said quietly to the nurse to lock herself in the staff room, now! Then it was just “A” and me. She had walked towards her room, but she hadn’t gone in it. Standing by her door, she asked me if I thought she could break down that office door because she wanted to kick that nurse in the stomach and kill her baby.
(Shit! Kim, just look bored and non-threatening, show no emotion… giver her room, all the other patients are in music therapy and safe…)
I leaned against the wall about 10 feet from her, I looked at the office door, never letting “A” out of my line of sight, then I focused my attention on “A” and said,
“Naw, that door is reinforced, you’d be wasting your time.”
“What if I beat you up?”
“Why? Isn’t there something else you can do since everyone else is in class?”
“I want to do my laundry.” (This was a big privilege for positive behavior… I wasn’t going to let her do that especially since she was refusing therapy and threatening a pregnant nurse.)
“Well, head to your room and take 15, we will talk about it more after you take your 15.”
(This meant she’d be on room restriction for 15 minutes.)
At that exact moment, one of my fellow techs came around the corner, and I said, “Hello, I think I’d like to see Dr. Green.” He went to call a code, and “A” came at me. I put her on the ground and restrained her, but she was fighting hard! Thankfully the other tech was immediately on her legs, and we held her there. Then like music to my ears;
“Dr. Green Crisis Unit, Dr. Green, Crisis Unit.”
Within two minutes we had all the help we needed, and I lead a safe six-point restraint.
Restraint completed, patient unharmed, safe and secure. All staff involved in 6 point restraint procedure, unharmed. Procedure sheet signed and dated, return to respective units.
This little incident meant a massive amount of paperwork for me… and I was extremely ticked off that staffing had a pregnant nurse floating to the crisis unit. Out of all the units to put her on, they decided the crisis unit would be the best option? Even regular staff worked other units once they learned they were pregnant. It was just too risky. Our kids were too violent and way too unpredictable. I spoke with the unit director, wrote out a statement and made sure this would never, ever be accepted protocol again. That was putting not only the nurse in danger but her baby in danger as well.
I had promised “N” a scrabble game and I wasn’t going to go back on my word. We got a group together and had a pleasant evening playing scrabble. I decided to work a double as there was no way I would get all my paperwork done. It was a viable option because the flu short staffed us! Little did I know that in the next two weeks I’d begin receiving death threats and that “N” would commit suicide. It would be the most emotionally difficult two weeks I would have while working as a psych tech.
(To be continued…)