Dangerous, continued.

image taken from http://www.ariven.com/store/ariven/crazy

I am a psych tech.

I work in a Senior Behavioral Health Unit. For short, we call it Gero-psych (short for Geriatric Psychiatric).

Basically, I work with old, crazy people.
In a locked down unit.
That is an adventure, in and of itself.
I've grown a large amount of patience by working this job for the past 10 months.
Everyday I encounter something new/funny/gross/interesting.
I promised to tell the story of what happened to my finger.

Long story short: A patient did not want to come out of a place he shouldn't have been. He and I had a tussle. He sprained my finger. I got pissed. Someone FINALLY came to my rescue. He got shot. Apparently, I deserved what happened to me. The end.

Wanna hear the short story long version?
Here goes.

April 8, 2011

All was well at work. I had managed to get someone to cover the last half of my shift (from 1pm to 7pm) so I could hang out with my mom and sibs while they were in town. 5 minutes to 1pm, I heard a bed-ridden patient (we'll call him Henry) down the hall calling out for help (his yelling out wasn't a usual occurrence. We have had patients before that yell out "Help me!" at least every 15 seconds. If not more frequently. I am not exaggerating whatsoever. I promise.), which broke through my consciousness. I stepped out of the nurses station and headed down the hall to check out what was going on.

The only reason for Henry yelling that I could see was because another male patient had entered his room (We will call him Herbert). Some things you should know: Herbert has dementia, so some days are good, some are bad. The day before he had been a model patient-helpful, happy and kind. This day had started out bad, and he had gotten more ornery as the day went on. I stood at the doorway and tried coaxing him out of Henry's room (Henry had MRSA in his lungs and was on isolation precautions-we had to put on face masks, gloves, and ugly yellow gowns to enter the room). Henry became frantic when Herbert wouldn't leave. I took a deep breath for patience and entered the room.

There is something you should know about me here. I like to think I'm usually a nice person. But, when I walk through those locked doors to work, I am someone different. I become forceful, gruff and hard-hearted with a will like steel.

Determined to remove Herbert from the room, I told him he had 2 choices-he could either take himself out of the room, or he could be helped out of the room. With a sneer on his face he flippantly told me "You'll have to help me out." So, I moved to do just that (he is just a couple inches taller than me, and probably about 70 pounds heavier).

I began by trying to link arms with him. He didn't like that and proceeded to try and toss a cup of ice water on me, which I deflected toward the floor. I started calling out for my coworkers to come help by that time.

Nobody responded.

So, I continued to try and get him to walk with me out of the room. We had a bit of a tussle-me trying to grab and guide him out of the room safely over the icy puddle we were now standing in, while he was trying to grab my hands. All the while, I was yelling-any nurse name I could think of.

Nobody responded.

I finally realized that we were in a dangerous spot when he got hold of my right hand in both of his. He was holding on to my thumb and first 3 fingers in one hand, and the pinkie in the other. Slow motion. I watched him pull them apart. In quick succession I heard my hand go Pop! Pop! CRACK!

That was the moment I lost my patience.

I started screaming for help at the top of my lungs.

I lost control the moment I let myself feel anger. Pissed that I was in the room without personal protective equipment (a face mask, most especially). Pissed that I let him grab onto my fingers (number one rule when dealing with a dementia patient-keep your hands to yourself!). And, most especially, pissed that NOBODY seemed to hear me, no matter how much I screamed.

At that point, I let him push me against a wall. Repeatedly. Realizing nobody was going to come to my rescue anytime soon, I gathered my wits and assessed what I could do. I most certainly couldn't drag him out now. I didn't know what damage had been done to my finger. Adrenaline and anger had kicked in, so I couldn't feel it hurting yet. Then there was the problem of the wet tile floor. As ticked off as I was at Henry's behavior, I couldn't just let him (or I) slip and crack a head or hip on the floor. So, I did the next best thing. I let him smash me one more time, and used the force as he drew back to throw him into a straddling/seated position on the empty foot board of the bed next to us.

And I held him there. And screamed. Told him very angrily that he better STAY THERE! Screamed some more.

And nobody came.

The whole situation from starting til now happened within minutes.

I had probably been screaming for help for a good 3 or 4 minutes before someone came. Finally. I looked at the nurse and immediately said "You deal with him. He got a hold on my finger. I have no more patience-I'm going to strangle him if I stay here another second!" Then I walked away. Probably not the safest thing I had done, but I really had no patience left.

I walked across the hall into the dining room, and proceeded to wash my hands. Every movement and touch of my right pinkie evoked pain. I began to cry-not so much because of the hurt, but because I was stunned. "Did that really just happen?" I let cold water run over it for a few minutes, hoping it would subside.

Coworkers came in and out asking how I was, of course I replied "fine" with tears in my eyes (why is it that strong emotions seem to always produce tears?) and after telling the story to the nurses and the APRN's, it was decided that I had to get it checked out in the ER (Worker's Comp stuff). It was just after 1pm by this time (so much for getting off early-I knew I'd be in the ER a few hours at least) and I sat in the nursing station collecting myself back together.

Want to know something kinda funny?

The nurse apparently thought she succeeded in talking him down out of his anger after she had gotten him out of the room, and let him roam the hall. This was fine and dandy till he pushed a patient in a wheelchair into a small, dark room across from the nursing station, turned the chair around and began yanking on her braid (she has waist length hair), almost to the point of tipping her over. She yelled out, everyone responded, and he was promptly held down and given a healthy shot of Ativan in the hip. Then he was shoved into the "seclusion" room (a tiny room with 4 walls, a twin bed, and a security camera) to calm down.

Revenge was finally mine. Though, I was not the one to exact it, I felt satisfaction.
(Just kidding. I'm not that vindictive. But it did make me feel just a teensy bit better about my situation.)

Ironically, when asked by the psychiatrist about the incident a few days later, Herbert recalled that it had happened, and proceeded to tell him that he did it because "she deserved it."

RUDE! hahaha

The final decision on my finger? Just a sprain or a strain. I had to splint it for 2 weeks, miss a couple days work, etc. All I ended up seeing was a swollen hand with bruising on the back of my hand and a silver dollar sized bruise on my palm. Not too shabby. Its pretty much back to normal now...3 weeks later. Yay!

And that, my friends, is why working with the elderly is dangerous. Always make sure you watch your back (and your fingers!) when around them. :)

And just for a random FYI: no, we do not use strait jackets. Someone asked me that the other day.