By I swipe my badge at 1859, one minute early, not bad. I cheerfully smile at the tired faces of my coworkers all scrambling to see who they are passing their patients off to. I’m a few cups of coffee in and ready for the long haul. I don’t sit, I quickly write my room numbers down, so I can get my day shift friends home to their families. I look up medications, check orders and make my plan of attack for the night. A few day shifters stay late charting and the hustle and bustle that we call shift change has subsided, that is until we hear the staff emergency siren go off overhead, it’s 1945. We rush down the hall to discover a suicidal patient trying to escape.
“Mary” is fifteen years old, a good five inches taller than me and well over two hundred pounds. She is screaming that she’s “ready to go”. Mary’s been on our unit for weeks now, has broken two beds, been restrained daily, and rejected by all the psychiatric facilities in the area. My mind quickly shifts my two-month-old patient having seizures down the hall, and I wonder if the bolus of Keppra from the pharmacy has arrived. I attempt to focus on the task at hand, helping Mary safely get back in her room unharmed. We try redirection and bargaining with little success. We call security again, no one comes. Mary defiantly walks back into her room, sits in her recliner and begins to tear at her toe nail yelling that she’s going to rip it off. While trying to console her, I get a call that my new admission has arrived, my 5th patient. No seizures, please little guy, don’t seize. We have no choice but to carry Mary from the chair to her bed, the only way to keep everyone safe is to restrain her. Third call to security, no answer. Our arms are red from Mary’s pinching and grabbing. We dodge her attack, each secure a limb, count, and on three lift her from the chair to the bed, we restrain and give emergency meds. Fourth call to security, they finally answer and arrive just in time for us to lock the restrains. I wish I could say this wasn’t a daily or weekly occurrence but that wouldn’t be true. Just another day at the office.
