I have been at work for five and half hours now and it is 12:30 pm and it has been kind of a slow day so far, don’t get me wrong it is nice to have slow days as the patients have been either sleeping in the day area or doing therapy sessions. At the moment I am on response, which means if the alarms go off or we get a call over a radio to respond I am the one to go to were ever help is needed. I am going to go on my break in about half an hour but then a call comes over the radio,

‘Urgent assistants needed by the main entrance, we have a patient going AWOL’.

I respond over the radio,

‘Willow ward responding’.

I stop what I am doing, which was playing cards with a patient and call over to the nurse in charge (NIC) and let them know that I am responding to an urgent call. I quickly rush off the ward and head to the reception area to leave, this is where I leave my keys and grab a mobile just in case I have to call in information. I run off towards the main entrance of the hospital and on the way I come across about another five staff, men and women running the same way I am. Some of the staff look as if they are going to collapse already, which makes me smirk. As we reach the main entrance there is security standing there watching down the road and it has taken us five minutes to reach the main entrance running. The security team inform us that a patient has run off towards town and give us a description of 5ft 10, long brown scruffy hair going bold on top, blue t-shirt, baggy black jeans and black trainers. The information passed over to us is basic and his name in Carl, he has the potential to be aggressive and a possibility could be a danger to the public if they intervene as well to us if we stop him. So we get the permission to use force if needed to protect ourselves or the public.  This just means we may have to restrain him in public if needed and we have to make sure we have our I.D’s on us, this is just to show the public or police if we have to restrain him. We are divided into three teams of two staff. I am teamed up with a nurse who is qualified named Darren who knows the patient that has gone AWOL (absent without leave), which makes it easier if we find him. We head off to the main road which is up a side street and a five minute walk. On the main road is a load of different shops but also ends at the beginning of town.

Hitting the main road we come across an off licence and we go in and have a look around the shop. I turn to the shop keeper we are looking for a man and give him the details of his description.

‘I haven’t seen him, but give me a number to call just in case he comes in’.

I let him know that he is not to be served alcohol if possible as it can make him aggressive and delusional with his medication, plus I hand over the number of the mobile I picked up from work. Then at this point Darren and I leave the shop and head right off into town. As we walk towards town we pass a mini supermarket and pop in there and have a look. Darren speaks to the shopkeeper this time and gives a description of who we are looking for and I have a look around the store, I turn back to Darren and shake my head to let him know that the patient is not here. After this we head towards town after a lengthy twenty five minute search up the main round and in some shops and hit town. Darren radios through to let the others know that we have reached town and found nothing on the main road.

‘Copy that’

Comes over the radio five times and once from security. To be fair why the hell are security joining us in the search?

As we both head down towards the main drag of town we walk into a little news agents and have a scout around but no sign of him in there. So Darren and I walk out the news agents and follow the street further into town.

Darren starts to let me know that as he knows this patient, Carl is the sort of patient to head to an off licence and bye some booze and get drunk, not just to run and go nowhere and just abscond. So we head off to find shops that sell booze and check them out. So off we head to the next store that sells alcohol, to which I asked Darren to radio to the others to head to any shop that sells alcohol,

‘All responding teams go to any shop that sells alcohol, this is where you are more likely to find Carl’.

‘Roger that’

Comes the reply over the radio. Then after about an hour of searching shops in town, the mobile I picked up in reception rings. It is the first shop Darren and I searched, a voice answers

‘Hello is this the nurse that is looking for a patient?’

‘Yes’

‘I have just seen a man that looks like the one you described walking pass my shop’

‘Ok thank you, which way is he heading’?

‘Away from town and he has a bottle of something that looks like vodka in his hand’

‘Ok thank you we are on our way’

I put the phone down and call over the radio,

‘All teams head towards the main road leading away from town (Colling road) and head towards the main off licence by Francis Street’.

‘On way’

As Darren and I head off towards Colling road and start to run down the road a police car passes by and we wave them down and immediately they pull over. I run over to them and say that we are from the St Mary’s Hospital and we are looking for a patient gone AWOL. The police officer, who looks like he is in his early twenties explains he has been drawn into the search due to the risk. I give him a detail of the look of the patient and he asks us to jump in, I call Darren over and we jump in the police car shouting

‘Shot gun’

Laughing at my childish call out we jump in the police car and ask the police office not to put sirens on as it will make the patient aware of us all, plus he does not like police. The police officer turns on the blues and pulls out into the traffic, but as usual there are a few drives that don’t pay attention to the horn and the lights of the police car. The police car goes to turn down a side street to spin round and heads down the road towards Francis Street. Sitting in the front of the police car going fast with the lights on is quite exciting and adrenalin pumping too.  As we reach the off licence the shop keeper is standing outside pointing towards the side street, Francis Street. I lower the window and the shop keeper shouts out as the police car slows on Darren’s request

‘He’s gone down Francis Street’

I wave just to acknowledge the shout out and the shop keeper waves back. The police office waves as well and then slows down and turns down Francis Street. In front of us on the right is a man walking and staggering down the road with a bottle in his hand. A woman passes by but as she passes he says something to her and she turns round and says something back. He stops and slowly staggers towards her. The woman starts to look a little worried as he raises his arm holding the bottle and goes towards her. The police officer turns the sirens on and skids to a stop beside him. Darren and myself jump out of the car and charge at Carl. The police officer takes the woman and leads her off to the car for safety. Darren and I reach Carl and Darren calls and demands Carl to drop the bottle.

‘Carl drop the bottle now, you’re going to hurt someone’

Carl kind of stalls and stands there holding the bottle over his head and looks at the both of us, Darren repeats the commands to Carl

‘Drop the bottle’

‘Why the hell should I’

‘If you don’t the police will press charges and we will get the lady to press charges as well and this could lead to your section being changed to a 37/41which will lead to a longer and more secure placement for you’

As we are talking to Carl I notice the police officer walking round to the back of Carl, with the woman safe in the police car. We continue talking to Carl, mainly Darren. All of a sudden Carl smashes the bottle of the side of a front garden wall and raises it towards Carl and I but he still does not notice the police officer. The officer calls out

‘Taser, Taser’

And the red dot hits Carl in the side by the ribs, and at this point the rest of the search team joins us on Francis Street and all of a sudden a mighty scream comes from Carl and the police officer fired his Taser at Carl because he ran at Darren with a broken bottle shouting out

‘I’m going to kill you bastards’

‘Aww’

Calls out Carl as he collapses to the floor with wires sticking out of him. Then myself and Darren rush over to him and take away the bottle and restrain him with the wires sticking out of him.

‘We have to take him to hospital to get the pins removed from him’

As we restrain the patient, the police officer calls over the radio for medical assistance. We sit there holding Carl but by this time as Darren and I are holding him and talking to him to try and relax him, he calms down and starts to cry. Then he starts to say

‘I’m sorry, the voices told me she was a bad person, and she likes to hurt people’

Darren and I keeps hold and explains to Carl that it is the voices in his head telling him this and how would he know this of the innocent woman. Carl cries out in response,

‘I know, I know but the voices are loud in my head’.

‘But that’s because of the alcohol you have drunk, it makes the voices louder’.

After about five minutes the paramedics pull up and the police officer hands over to them what has happened and this is all out of ear shot of Carl. Carl looks at the police officer and says

‘He’s talking about me’

‘Yes he is, he is just handing over to the paramedics what has happened so they can treat you better’.

As the paramedic approaches he smiles at Carl and introduces himself as Ian. Carl smiles back and lets the paramedic remove the pins from the Taser from his side, while we still hold him. After the paramedic has removed the pins he does a check over on Carl and lets us know,

‘He should be ok but just keep an eye on him for the next twenty four hours’

‘Ok we will when he is back on the ward’.

After about another ten minutes we help Carl up and escort him in holds to the police car as the police officer takes the lady out of the car and starts to explain the situation. The lady decides not to press charges as she is just suffering from shock. One of the spare staff decides to walk her back home, which is just around the corner and stay with her for a while. On the way back in the back of the police car the patient is starting to sit there and cry to himself and feel sorry for himself. Five minutes later we are nearly back and someone has called for assistance to the entrance of the patients ward and there is about five big staff standing there waiting for us. As we get out of the police car a staff member takes over my holds and says,

‘I’ll take it from here’

Then he just looks sternly at me as, let go, and with Darren walks Carl in holds off into the building, with this the police officer asks me my name and says

‘It’s for my records’

Then follows the staff off into the building. I am left there standing alone and thinking to myself is that it. I head off to the canteen and get a strong coffee and slowly walk out of the canteen back towards my ward. Slowly walking back I think to my self

‘What a good but also bad search that was and how wrong that could have turned out if the police officer was not there. Myself or Carl or even worse the member of public could have got cut or worse. So I reach my ward and walk back in and go and speak to the nurse in charge and explain what has happened. After about fifteen minutes of explaining to him what has happened and another half hour of venting to him, he tells me to go on my break. As I walk off the ward to go on my break, I think to myself how thankful I am for the tight team I work with within the hospital.

I wake up when my alarm starts to bellow out the talking on the radio at 05:50 and think in my head

‘Dam already, feels like I only slept a few hours’

I slowly crawl my ass out of bed and head for the kitchen down stairs to make myself a coffee. Walking there my eyes feel like they are burning as if I have only had about two to three hours sleep and I also feel like I have a hangover. Even though I have had about nine hours sleep and did not drink a drop that night. Once I have made my coffee I sit feeling sorry for myself and think about breakfast but I can’t be arsed to make anything. After ten minutes of feeling sorry for myself and drinking my coffee I head for a shower and stand in the shower letting the water gush over me hoping that the day will be ok and not to tiring. Once I have this sorrowful shower I go get dressed and today I think it is going to be a green Krav Maga T-shirt and black combat trousers with black boots and I look at myself in the mirror and think

‘Sod it the shave can wait for another day’

Once I make my breakfast of eggy bread with slices of ham and burger mustard I go and wash up and think that I need a new job. You will see how busy and stressful the job is as we go through these stories. But what could I do as I don’t have the national standards of a basic C grade in maths and English. Don’t get me wrong I have worked in mental health for about twelve years and I have learnt a lot as in illness, how to deal with situations that others may feel squeamish with and how to deal with confrontations, after a while it does get to you. What I really want is a teaching post as in teaching others how to deal with situations and deescalate people, but how hard are these jobs to come by in today’s job market and without the certificates to prove your worth. Looking at my watch I see it is already 06:50 and I need to be at work for 07:15, I’ll be cutting it fine today but

‘What the hell, I’m usually the first in and one of the few last out’

As I walk onto the ward I enter the office and it looks like they have just started hand over for the previous night and one person says;

‘On time then?’

I reply to this in short term

‘Oh shut the hell up as if you ever on time’

I’m feeling so tired that I cannot be bothered with arrogant shits like him. I take a seat and the night nurse in charge carries on with the hand over. Just to let you readers know on this ward we have a patient who is nursed on a two to one enhanced observation. This means that the patient is too unsettled and for his safety or others he needs two nurses with him within arm’s reach 24/7. This particular particular patient needs two staff with him for his own safety as he has a tendency to start verbally abusing others due to a brain injury and his lack of reality.  I think to myself

‘I know where I am going to be for the shift’

At the end of hand over the nurse in charge askes Carl and myself to be on his constant. To me that’s not too bad as Carl and I can work very well together. As some as you, health care professionals are aware that you and a colleague click and don’t need to verbally communicate, it’s just a look you both give and you both know what to do. So off we both go and take over the two night staff that are sitting outside his room and park our butts on the chairs by his door. Now it is about 07:35 and the patient is still asleep for now and in about ten minutes we will have to wake him but be aware of the other patients in his vicinity, just in case they attack him due to him saying to other patients what he thinks of their behaviour. Don’t get me wrong, some of the time he is right but there is a way of saying it in the right terminology.  It comes to 07:45 and Carl walks in to the patient’s room and gently shakes him on the shoulder calling his name and saying in a soft caring voice

‘Time to wake up, its 7:45, time to get up and showered’.

The patient wakes up and tells Carl to

‘Fuck off and leave me alone’

As I am standing in the door way watching Carl’s back I laugh to myself as Carl turns to me with that Dam look on his face. As Carl walks out and gives him time to wake up, the patient slowly comes around and surprisingly apologises to Carl for swearing at him. Carl lets him know that he should not worry about it as Carl is a little grumpy shit when he wakes up. We walk the patient to the shower and spend five to ten minutes waiting outside the shower until he is done and follow him back to his room and he neatly puts his night wear away and his toiletries away. This patient is a nice bloke, don’t get me wrong but due to his injury he tends to tell people how it is in his mind which makes him very vulnerable towards others. After his shower and tidying his clothes and room it is about 08:00 and we all head down stairs to the day area for breakfast. This can be a challenging time as this particular patient does not have a lot of patience for waiting. Today must be a good day for this patient as he waits and tolerates the others taking their time. Once everyone is sitting down we stay sitting with him until he is called up for ordering his breakfast. Myself and Carl let the patient go up on his own but keeping a sharp eye on his body language and his tone of language. The patient returns and sit’s with us both and asks if we would like some of his breakfast. We both decline the offer but tell him to enjoy what he has. This in my eyes is a moment to remember. I f you work in this line of work you will understand.

The patient asks to go in to the quiet room and watch a DVD as it is a bank holiday and there is no sessions on today. In the quiet room is a three seater sofa and a TV DVD player. The patient decides to watch a film called Total Recall, which is an action film that is fairly easy watching, it’s the one with Collin Farrell in it. Carl and I sit there for about an hour and half watching this film and when it finishes, the patient wants a cup of tea. So off we go back into the day area so the patient can go and have a cup of tea. Whilst sitting there Carl notices a patient pacing nearby and looks at me and nods, this is to make me aware of the other patient pacing. I look at Carl and smile to give him the recognition that I am aware. Carl shouts out, I only assume to myself and the patient

‘MOVE’

The patient dives out the way and Carl and myself stand to attention and manage to stop this other patient getting to the patient we are looking after. Immediately another staff member steps up and covers me with the constant and I deal with the aggressive patient. We take hold of the patient using a conflict management known as PMAV and immediately relocate this patient to what is known as seclusion. Once in the seclusion room we stand there with the patient and the nurse in charge (NIC) tries to talk to the patient. The patient explains that he is sick to death of the patient saying what he says. The nurse explains that due to his injury he cannot help says what he says, it’s part of his condition.  This patient starts to put a struggle while we are holding him. We both lock our holds and move in tighter to control the situation and the patient starts swearing and trying to push us both around the room. Due to our training we both have a tight lock on our holds and with what’s coming out of the patient’s mouth we both nod at each other and the patient drops to his knees. The staff member and myself drop to our knees then down to a laying position and hold the patient on the floor face down. He is screaming and shouting

‘Get the fuck off me you bastards’

I activate the emergency alarms and we both wait for staff to respond to us. Once staff enter one staff member takes hold of the patients head and the other staff member takes hold of the patient’s legs as he is trying to kick and knee us in the back. Once we take hold the NIC tries to speak to the patient and deescalate him. All that is coming out of his mouth is swear words and threats of aggression, threats to kill the patient and anyone that gets in his way. The NIC yet again asks him to try and take some medication to help him calm him down, but yet he still refuses to take anything.  Whilst we are holding him face down the patient is beginning to become highly resistive and during this time the nurse that has the best rapport tries to speak to him, with no effect. The NIC walks off and goes to get some medication to inject into him, which will have a faster effect once it gets into his system. After about five minutes the NIC returns with a bowl that has a syringe of some sort of liquid in it and a plaster in it.  The nurse gently pulls his trouser down a little just to reveal his butt cheek and injects the needle into the muscle in his backside.  After the nurse disappears we all continue holding on to the patient and start to talk to him again after the swearing and threats have stopped. The team decide to turn him over onto his back, just so there is no pressure on his chest and he can breathe easier. This will be a well-timed and easy thing to do if you have the right people with you. Whilst he is on his back a staff member starts to talk to the patient and tries to deescalate him which has a very good effect. It has been about ten minutes since the injection has been given and with the nurse talking to the patient and the medication working we all start having a little bit of a giggle. The problem with this patient is that he suffers from paranoia and this turns out why he went for the patient is was with. The patient starts to relax a little and the nurse chatting to him asks if he wants to sit up and the person on his legs can get off.

Once sitting up myself and another staff member keep hold of his arms while the nurse that was holding his head moves round to where his is facing and continues talking to him. The patient starts to apologise to staff with tears in his eyes and asks if he could say sorry to the other patient, which to be fair seems like an ok thing at the time. After another ten minutes we decide to let go of our holds on this patient as we appear to be relaxing and deescalating him well and he goes to sit on the chair in the seclusion room with us. The patient asks if it would be ok for him to remain in this room for a while as he says he does not feel 100% safer to be on the ward but just wants time to relax. So myself and this other staff sit there chatting to him and he talks about that he was feeling paranoid this morning and while I was chatting quietly to the other patient he thought I was chatting about him and that’s why he attacked him. It’s about fifteen minutes and we all decide to go out into the day area and remain with the patient until he appears to be settled. As we walk out into the day area the patient that I was originally looking after decides to stand up and start shouting at the other patient giving him a lot of abuse. The nurse with him take hold of him and demand that he stops and sits down, surprisingly he listens and does as he is asked and sits down.

I walk with the patient that has just come out of the seclusion room and go and sit on one of the sofas. We start to watch a movie that is on the TV as there is no sessions on for today and it appears to be an action film Bourne Ultimatum, which appears to be a good action film. We sit for a while and I look round at the patient and realise that he has fallen asleep while watching the film.  I gently stand up and walk away from him and at the same time he puts his legs up on the sofa and gets comfy with his eyes closed. Once I see that he is still appears to be asleep I walk off into the nursing office and handover what has happened, it appears that the other staff member has already started to fill out the incident form for what has happened. Not bad for team work, team to restrain and one taking notes as the incident goes on. Now that’s what I call team work.

This is how a team is supposed to be working together in a job like this. We all muck in together, one leads, one takes details and the other does the notes of the patient in relation to the incident. It does not matter what position or grade you are anyone can take the lead and anyone can take notes or writes the notes. As long as you get all the details and don’t write their own personal opinions in the notes everything should work like clockwork.

Like I said these are just stories of possibilities and nothing is true fact. If you work in mental health of any sorts you will recognise situations and potential in what I write.

Introduction

What you will read about in these stories are what could possibly happen whilst working as a health care professional with in the wide range of mental health. Nothing in the stories are true fact. I have worked with in Mental Health for a good many years. I have come across many things with in my job(s), so good things and some not so good and also some emotional situations. The situations will range from young adolescents to elderly patients within s hospital setting and also in the community.

There are so many different subjects that could be covered in mental health, to many to cover but such thing like Schizophrenia, Depression, Personality Disorder, obsessive-compulsive disorder (OCD), self-harm and Post-Traumatic stress disorder; just to name a few. Some of these will be covered as you go through the stories.

Few too many people truly understand what it is like to live with these condition but just because you have a diagnosis does not mean that you are different or that you should be locked away. The person with a mental health diagnosis can quite easily be the person sitting or standing next to you in the shop or the lift. It does not mean that you have to be afraid of them just be considerate towards them and be an ear or friend and just listen to them.

It amazes mean that people only hear about the bad things in mental health such as stories hitting the news. Such stories as patient escaping from hospital, nurse getting assaulted by patient or patients coursing a riot on a wing. You never hear about the great work patients do with the help from health care assistants, qualified nurses, Occupational therapists, Teachers, Doctors and social workers. Let’s not forget the families that sometimes have a lot of input into their family members care.

People come into hospital for all sorts of reasons. Adolescents for example could be problems due to past abuse, whether it be physical, or sexual, neglect or forced isolation. There has been some cases of people being kept in cages and forced to fight others and if they do not they are beaten. Basically slaves to fighting. There are also people that could have inherited mental health problems from family members, mental health due to major stresses such as war, jobs and even people preparing for exams have caused forms of mental health problems. It could also be that someone has just moved from adolescent services to adult services and have not moved on as yet. It could also be due to a brain injury they have acquired from an injury or illness as in infection.

So from what I have written so far I don’t want to scare anyone but it’s a matter of care and think and do not judge the people under care whether it is in the community or hospital.