My plain life

trying something different

Day One After the Incident — March 30, 2016

Day One After the Incident

Once Carl was secluded and the paper work for the seclusion was filled out Tim had been taken by the paramedics which had to attend and the ward manage went with him, they took him off to A&E. I was asked to do the incident report on what had happened. I went into the office and there must have been about five staff in the office and asked the other nurse in charge,

‘If you want me to do this report you will have to get the staff in the office to come into the day area while I do this’

She looked around and confidently got three staff to go into the day area for the next ten to fifteen minutes. As some of them walked out you could see the looks on their faces as if they had just been asked to do something terrible. As they walk off into the day area I notice that I get a few funny looks as I sit down at the desk to do the report.

‘Really, What’

I mouth to the staff staring in my direction. As soon as they see me mouthing they look away as if they had just been shamed. I spend the next ten minutes typing away on the computer what had happened, to who, when and where everything had happened and the threats to life made by Carl during the incident. After this was done I had to inform Carl’s social worker and the lead consultant for Carl and of course the local police officer as a serious assault had just happened. Once all this was done I took a look in the diary to see what was happening today, such as patients going into the community, cinema trip or family visits. There was something in the diary for a patient called Mark, he was going into town to buy some clothes if he wanted to buy anything but he just needed a little bit of support. I asked the nurse in charge if it was ok for me to take Mark into town for a change.

‘I don’t get to go out that much with the guys, so could I go?’

‘I don’t see why not I’ll mark you down to go’ said the nurse in charge.

I go back into the day area and see that one member of staff was serving breakfast to the patients and Mark was sitting smiling, just like he did most mornings, Now let me tell you Mark is one of those rare patients you think to yourself why is he here?, he did not disturb anything or anyone on the ward for at least four weeks. Then one day a patient tried to take some of his property and as a result of this Mark beat up the patient but luckily only manged to hit him twice before staff intervened and stopped him. Mark had a bit of a temper from here on in and he had told staff that he was trying his best to hold it together but the voices had got the better of him.  This must have been the worst incident that Mark had since he was with us, he usually kept it together well but occasionally came to staff for some support. So for someone who had been with us for about six to seven months and only ever had two or three big incidents, not bad going I say.

Mark had finished his breakfast and taken his stuff back to the kitchen for the staff to clean and asked for another coffee,

‘Strong coffee no sugar milk please’

In his rough gravel pit voice, he got this through years of smoking and when he went into hospital years ago he had a health scare of possible cancer but it was caught in time. I went over to him and sat with him.

‘You want a coffee too?’ said Mark

‘Please, same as you’ I replied.

We went and sat together at the dining table and Mark had ask if I was ok after seeing that incident earlier. This was always a great thing to hear especially from a patient, it kind of made the job feel more worthwhile to me. I let him know that I was ok and that it was unfortunately part and parcel of the job at times. But never mind and quickly changed the topic of conversation.

‘I’m taking you into town today, so you can maybe buy some new clothes’

‘Cool that’s going to be great, when we going?’ asked Mark.

I let him know that we would be leaving in about an hour which would make it around 10:45 am, once breakfast was finished and I would have done the paper work for him to leave the building to go into the community. The hour soon past getting everything done such as section 17 for leave and checking in Marks notes that it was up to date and if there was any restrictions on his section17. I got the nurse in charge to ring the reception to let them know that Mark was going out with staff for a few hours into town.  Once Mark was ready and paper work filled out Mark and myself walked off towards the reception area through three lots of locked doors and then one more set of doors to enter reception. Once the receptionist pressed a button on her desk which was behind a thick glass window, just like her own little office. Once the button was pressed a light above the door turned green and that meant we could go through the door. Mark swung the door open with it crashing against the wall and making us both laugh as it made the receptionist jump. I shut the door behind us both and handed to the receptionist Marks hospital I.D card which she kept until he returned and I handed in my keys and personal alarm, which every member of staff had to have on them. The receptionist pressed another button and held it and this turned another light above the outside door green so we could go through this door to the outside of the building.

‘I’LL open the door this time Mark’ giving him a cocky smile.

Mark looked at me with a smirk and walked out of the air lock and turned left out of the building.  We headed for five minutes’ walk up the road until we reach Clare Street, once we got there we turned down Clare Street and walked for another ten minutes, this was the main road into town from the hospital. Once we both got to town Mark suggested we go to Costa or another coffee shop. We walk down the main street to the first coffee shop and walk in, it only has one or two customers sitting down drinking whatever coffee they have ordered. Mark confidently walks up to the counter and then with a quiet voice orders his coffee and turns and asks,

‘What you want?’

‘Oh thanks, I’ll have a flat white, cheers’

‘One flat white with an extra shot please’ Mark says to the person making the coffee.

With his smile on his face Mark takes both coffees and sits by the window. Mark asks

‘Do you mind sitting here by the window to drink the coffee?’

‘Not at all I reply’ and smile to make him at ease.

We sit down and Mark is not much of a talker he often likes to sit there with his coffee and just watch people pass by. Sounds familiar, just like me. We sit there drinking our coffees and Mark looks over at me and tries to pull off a smile and says this is nice just sitting and chilling, to be fair Mark is right it is nice just to sit and chill like this. After about ten to fifteen minutes we finish the coffees and Mark takes the cups back up to the counter and says thank you to the person working behind the counter. I thank Mark for the coffee and we head out of the coffee shop and turn right out the shop and slowly walk up the high street looking in shop windows. Mark walks a few feet in front of me, as sometimes he does, just to make himself feel more confident and independent. Once Mark comes to a clothes shop he turns into it but quickly looking back to make sure I know where he is going and I give him a gentle nod and a smile to acknowledge this. Mark wonders slowly around the shop picking up T-shirts and folding them back up neatly, then looks at some trousers and picks out some combat trousers that are a dark blue but nearly look black. Mark wraps them over his arm and heads back to the T-shirts, after looking at the T-shirts for a while Mark picks out at least three polo shirts, white, grey and green and puts them over his arm with the trousers. I turn back to the door and pick up a basket for Mark and hand it to him.  Mark smiles and says,

‘Cheers’

Then continues shopping for clothes. Mark wonders off to the jackets and takes his time browsing while I just look and think about what I would buy, but I’m not here for myself it’s Marks time. Mark decides on a black jacket which is about waist length and has two pockets on the waist and two pockets on the chest area. It appears to be made from a denim material, but looks smart but casual as well. We head off to the cash desk and Mark is looking a little nervous, he sometimes struggles in confidence when it comes to paying for things. I let him know that I’ll walk up to the cash desk with him if he likes and place my hand on his shoulder for that reassurance feeling I think he needs. At this moment we walk up the young lady behind the desk smiles at Mark and greats him and Mark sighs as he places his clothes on the desk.

‘Would you like the hangers with these?’ she asks Mark.

‘No thanks’ is Marks reply.

Mark stairs down at the floor while the cashier puts everything through the till. The young lady lets Mark know that the total cost is £65.55 and Mark hands over £80as he only has twenty pound notes. Mark waits for his change and then we walk off together and off out the shop. Mark turns and says to me,

‘Dam that was difficult’

‘Why?’ I ask.

‘Don’t know, just was’ says Mark

‘Well you managed it with no problem, be pleased’

‘I am I suppose’ and Mark smiles.

Whilst walking slowly down the street looking in shop windows, Mark decides that he wants to go to a book shop and get a couple of books to read for when he has nothing to do or at bed time. So we head off to the local book shop that everyone seems to go to as it is cheap and cheerful. Once in the shop I ask to hold Marks bags so it would free his hands to look at books. Mark hands over the book and says

‘Thanks matey, glad you came’ said with a smirk.

Mark is looking in the self-help books and how to control your anger. He picks a thin book out and it’s by some doctor and Mark reads the back of it then reads one or two pages and decides this book seems to be ok. Then we head over to the fictional section and I stand there watching Mark gaze through the books and after about ten minutes Mark picks a thick book out and it is about some alien coming to earth and taking a woman to his planet where she becomes his queen, Some Sci-fi story.  Marks heads of to the cash desk and puts the two books down on the counter and says to the cashier

‘I’ll take just these two please’

‘That will be £13 pound altogether please’ says the cashier’

Mark hands over a £20 note and waits for the change, then Mark turns and walks to my direction. We must have been shopping for about an hour and Mark says

‘Let’s get another coffee to walk back with’

‘Ok, my treat this time ok’ I say

‘Yer right’ says Mark and walks back to the coffee shop.

Once in the coffee shop I order a skinny flat white and Mark asks for a regular flat white with an extra shot in it. Once we have the coffees I manage to pay this time just before Mark gets his money out. It took Mark longer as his hands are full with his shopping bags. We head out of the coffee shop and slowly walk back to the hospital and it must take us about 20 minutes to half an hour this time round as we are not in any hurry to get back. Once we are nearly back I chuck my coffee cup in a bin but Mark wants to keep his so he has his own cup on the ward for a while. I don’t know why he didn’t buy himself one when he was out in town. Coming back to the hospital we stand at the airlock door and wait for the light to turn green. Once green I push the door open and we both walk into the airlock and let the door shut. Once the receptionist hands over my keys and alarm and I attach them to my belt she presses the button to turn the light green and unlocks the door. Mark and I walk back to the ward. Once on the ward Mark hands over the two bags with the clothes and books as they have to be written down on his property list. I give Mark a search as per policy when anyone goes out they have to be searched and then let him into the day area.  Once Mark is in the day area he heads off to the toilet. I sit in the office and look for the property sheets to write the things Mark has brought. For a change there is only the nurse in charge sitting in the office. Once I have written everything down I take the things out of the bags and throw away the bags and hand over the clothes and book back to Mark.  Marks comes over and takes them from me and says,

‘Thanks for taking me I enjoyed it’

‘Me too’ I replied.

I head back into the office and enter a detailed entry in Marks notes about his visit into town, how his behaviour was, his interaction and whether there was any risk behaviours while out. This took me about 45 minutes to write the whole thing down on the computer.  Once this was done I signed off the computer and then the nurse in charge says

‘It’s not far from 1 o’clock why don’t you go home now, I’ll log you out on the system for 13:45’

‘I’m on a long day’ I reply

‘You ask need to take some of the time owing so we decided you could take some of it today’

‘OK’ I happily replied.

I get my stuff and head off back out of the building and walk home.

I know the ending is different from part one but you can pick which ending it could have. I just thought I’d try something different and have two endings for the day.

 

 

 

 

 

 

People Watching — March 29, 2016

People Watching

I’m sitting here in a coffee shop with my skinny flat white, not very adventurous coffee I know but I like simple coffee, none of this fancy flavoured coffee. But one thing I don’t mind is simple coffee with cinnamon in it, just to take the sharpness of the coffee away. I have decided to sit by one of the big panel windows in the coffee shop which is close to the entrance, so I can observe people passing me by but not actually seeing me. To be fair about 90% of us people watch but how many of us take things in and wonder ‘why?’ You can observe a lot of things if you just only take the time to do so and it can be very entertaining. I mean that you can watch people and imagine what they do for a living, what they do for fun or what type of person they could be.

Outside the shop the sun is trying to break through the clouds and you can see it is just a little bit breezy outside as well. Some of the people outside with long hair appear to have their hair blowing in the breeze. At certain points you can see the sun breaking out through the clouds and hitting the shop windows making it a bit dazzling in the reflection. But to be honest how nice is it to have the sun out and to enjoy it after such a bad winter and autumn.

Whilst I sit here looking outside I start to take note of the different people walking past the shop where I am sitting with my coffee. I see a young lad dressed in what appears to be dark grey track bottoms, white Nike high tops and a baggy black Adidas T-shirt, this appears to have a few stains on it. I think to myself he must have been hungry when he ate and spilt his food down him. He is walking down the street with a few friends and he walks as if he is very cock sure of himself, you know, confident. As he walks he talks very loud and constantly swearing and shoving his friends, the only thing I find wrong with this picture is that he walking down the street with his left hand down the front of his track bottoms. There is about three of them walking like this, what is this all about? Surely if their hands are cold put them in your pockets, just a thought. As I sit there looking one of the lads points over to what I think is my direction. They turn and head towards the coffee shop and stare in my general direction. I look down at my coffee and take a sip or two and think to myself, here comes trouble. But as they approach the coffee shop they then change direction and walk past. I put my coffee back down but still have hold of it whilst I continue to watch people.

I notice a man and a woman walking by and they appear to be in their late twenties to early thirties holding hands, both smiling at each other while they talk to each other. To me this makes me think Love does exist but you don’t see it that often, I mean true happiness and love together. The young woman must be about 5ft 5, medium build and long brown curly hair and quite pretty and he is about 5ft10 muscular build and very close cut hair and appears to be happy in her company. They walk close together holding hands and arms looking as if they are nearly intertwining. They appear to of been clothes shopping as she is carrying River Island bags and he is carrying a Burtons bag. As they walk along he bends over a little and kisses her straight on the lips and mutters something to her which makes her smile, my thought is that he must of kissed her and said something on the lines of ‘I love you’ but that’s just a guess. As they carry on walking the head off round the corner down another street and out of view. But as they disappear a woman comes storming round the corner like she is on a mission and she has no time for anything or anyone. As she comes round the corner holding her handbag inn her left hand and holding he mobile to her ear in the other hand and not watching where she is going. She walks straight into a young woman who probably in her early twenties. You can see that the woman in a rush drops her phone but just manages to catch it before it hits the floor. You can see that the two women must have exchanged a few words as both of them are pointing and shouting but to be fair the elder lady that was in a rush should have been paying attention to where she was rushing to. The younger lady that was walked into was looking in a shop window minding her own business. This just shows that if you are in a hurry just pay attention to how and where you are going to get there.

I must have been sitting in the coffee shop for about forty minutes now and decide to order another coffee, same as before, skinny flat white. I continue watching people pass by and wonder about them, where are they going, some in a rush and some appear to be taking their time. Some people look like that they are not in a hurry to get anywhere. Some people are dressed smart in a suit or a dress suit, some with briefcases and some with shoulder bags. There are a few people standing outside the coffee shop smoking and some sitting at tables for the shop smoking and drinking coffee. Some people look like they are late for work and some look like they are not going to work but just on a day out. There are one or two groups of people sitting in the coffee shop and having what appears to be a meetings, in these small groups one or two people have computers out working and typing when the people are talking in the small groups. As I look back out into the street I observe a very scruffy man that appears to be in his fifties but it is hard to tell as he appears to be dirty scruffy and not shaven in about four months or so. He appears to be drinking something out of a brown paper bag to which I can only thing is a whisky bottle as it is a smallish bottle. He appears to be a little unsteady on his feet but not too bad, that could be that he has had time to build up a tolerance for the alcohol but that’s just a guess really. As people are passing him by one or two appear to give him some money after he has said something them.

I have just picked up my second coffee and drank the last little bit off and took it back to the counter and thanked them for the coffee. I smile at the shop workers and head for the door, as I walk through the door a woman wearing sunglasses and a woolly beany hat barges through the door and nocks into me as I am already walking through. The lady tuts as she barges past and I respond to her,

‘I think the word is excuse me’

And with that she turns and says in reply,

‘Excuse me, what did you say?’

‘You heard’

And then just turn around and head out the door with a bit of a cocky smile on my face and head up the street. To be fair that lady did barge past as if she had the right of way. Some people are just rude in manors thinking the world owes them.  Some people are funny in the way they act in public and some just want to get on with life and not worry about others. So next time you have some free time just sit in a coffee shop and sit by the window and watch people pass by and turn their lives into something from your imagination.

Day One — March 28, 2016

Day One

I wake up and realise it is Sunday morning and I must of set my alarm for 05:30 as I am at work this morning,

‘Oh yer I’m working this morning’

So I lay there for about ten minutes trying to wake up, it’s not easy as last night I was out having one or two drinks with friends at my local. I’m lying there playing a game on my phone then decide to get up and have a shower. Good job I set the heating to come on at 05:00 last night because it feels bloody cold outside as I left the window open all night, ‘stupid’. I eventually get out of bed and stagger over to the bathroom and put the shower on just so to warm it up. After spending ten minutes washing and letting the hot water rush down over me I slip a little getting out of the shower but luckily I did not hurt myself for a change. I’m a little clumsy like that, as I chuckle to myself. I head back to the bedroom and decide to wear black combat trousers and a black and white Lonsdale T-shirt. Once I am dressed I walk down to the kitchen and make breakfast and decide to make porridge with brown sugar on top, a glass of pomegranate juice and a coffee.

I get my I.D for entrance to work in my knee pocket and my little black book for any incidents that may happen on the ward, for times dates who, what and where, oh yer and my mobile just so I can keep up to dates with news, Facebook and Twitter, in my break only of course. I finish breakfast and wash up as any good husband would after food. Put on my coat and unlock the door and quietly shut and lock the door, so not to wake my sleeping wife who is off today. Then I head down the street where I live and look around and notice how quiet it is apart from the humming of a police helicopter hovering above but over to the left a little. The helicopter must be on the lookout for a criminal, hopefully not a missing child or vulnerable adult. After another fifteen minutes of walking I am in town going to Costa coffee for a skinny flat white and of course I collect my points with them lol. In town I watch people as I walk slowly through town watching people, some staggering, must have had a good night as they are dressed the way you would of if you went into town. Some of them are young and some are older maybe in their late twenties to middle thirties, must have been a heavy night for them. I walk round the back of some pubs and shops to head for work and there I can smell things like you would in a night club toilet. I sniff and the smell that waffs through my nose is the nasty sting of stale urine and drying vomit. Over to the left between a back end of a pub and another alley is some poor bloke bending over making strange retching noises while his body shakes, then all of a sudden you can hear liquid hitting the floor and splatting. Just hope that the vomit does not rebound and spray over his shoes as he will regret this later. As I pass him by all I can hear him say is

‘Oh shit, that tastes shit’

I continue drinking my coffee as nothing bothers me with drinking or eating my food, years of experience. I walk down the main road and see young lads about in their twenties must be about four of them walking towards me acting like tough guys swearing and shouting at passing motorists. I do the sensible thing and cross the road. They then look at me and mutter amongst themselves and cross the road as well. I say to myself

‘Here we go’

My senses heighten as in my job it calls for you to be aware of possible problems and incidents. I stand tall and act as I am confident but inside I am thinking ‘shit, shit fight time’ and as the lads approach the cocky smaller lad, think he must have small man syndrome and says to me

‘Give me a fucking fag’

‘Excuse me’ I reply.

‘I said give me a fucking fag’ he repeats.

At this point his mates start to space out as if to intimidate me, at this point I am ready for one of three senses, Fight, Flight or Fight. I stand tall and said to the cocky little sod,

‘I don’t smoke’

I start to walk past him and he steps in front of me smiling like a wonabe gangster. Then her says again’

‘Give me a fuckin fag’

‘Ok’ I reply

‘Do you really want to do this, I told you I don’t smoke’

I look around at the others two look as if I don’t want to be here and one taller drunk looking lad looks like he wants to take on the world. The lad that wants to smoke stands there with a cocky smile on his face that any rational person would love to smack off his face. At this point I say to him

‘Please don’t do this’

But all he does is laugh, then he grabs me round the front of my collar and pulls me towards him, then he demandingly says to me in what he tries to make a hard voice

‘Give me a fucking fag’

At this point I look around and two of his friends turn their backs and step away and the other looks on with excitement in his face. I have two choices, one is to look frightened and the other is defend myself as he has touched me without my consent so this means he has assaulted my and I am aloud to defend myself. I look at the other friend that looks excited and flip the lid off my coffee and chuck it at him in his face, he turns and shouts out what only I can describe as a feminine girly cry. At this point I take hold of the aggressor’s wrist and lock it in to my chest where he has grabbed and rotate it which locks his arm out and then kick him, not too hard in the stomach as he bends over. I keep hold of his wrist locking his arm and look around at his mates. Two hold their hands up as if to say I don’t want to have any part of this, and the other kneeling on the pavement crying. I slowly let go asking the one in a little of pain,

‘Is this the end of this’

‘Yes, let go, it hurts, I’m sorry’

I let go and slowly let go and walk away but I don’t turn my back on them as they could get up and attack again. I walk backwards for about five to ten paces then carry on my way but every so often I still look back until I can’t see them anymore. What a bunch of idiots , why do we have to have people in the world like this?, why can’t we all just get along no matter what we look like, whatever religion and no matter who we are?.

I get to work at about 07:15 and walk into the reception and hand in my I.D and collect my keys and head off to the ward I am working on. I walk into the ward and head to the nurse in charge office for hand over. There must be three staff there two I usually work with and one I don’t know, but that doesn’t matter as we are always grateful no matter who they are, as long as they will pull their weight when working. What I mean by this is as long as they TRY and communicate or interact with the patients is all we ask.

After handover I am put on an eyesight enhanced nursing with a patient that has urges to attack patients and self-harms. The overly paid doctors say that they are more risk to other patients and attacking them. This only happens when they are due to be taken off enhanced nursing. The nursing team wants this patient to be taken off enhanced nursing and we will deal with whatever happens. The doctors say different and they call most of the shots when they are about, what can I say?

I come on the ward and see that the patients are still down the bed room corridor either in their beds or having a shower attending to their hygiene. I go and sit on the constant I have been signed to and see that he is awake but sitting in bed reading a boot.

‘Morning how are you’? I ask.

‘You on me this morning?’ he asks.

‘Yes I am sorry’

He gives me a smile and continues to read his book. He lets me know that he is reading a book by Chris Ryan and it is his latest book so far. It is about a man from the Special Forces and he has to try and save his girlfriend from some drug dealers that have links to drug lords in Iraq. I sit down and let him know that it sounds interesting, and to let me know how it turns out as in is it worth a buy? I look at the time and it is about 08:15 and the rest of the patients have woken up, some have a shower or bath and some just get dressed and don’t bother with their hygiene. That’s the thing with some patients, they don’t want to attend to their hygiene due to their diagnosis.

We enter the day area and I am following my patient who is known as Carl. He is on enhanced nursing and has to be on eye sight 24/7 due to his aggression to himself and others but mainly others. I enter the day area and see that Carl goes and sits at the dining table and waits for breakfast. I go over and sit with him and ask him about how his night went. Carl tells me he went to his room and had a shower and sat on his bed for a while and read his book. At about 22:15 someone created an incident and most of the nurses went and responded and it looked like a few other nurses responded from other wards. When he told me this I did not react or make a judgement as he is known to twist the truth at times and make complaints to the management staff about the team I am working with. What you got to understand is that this patient is also known for being paranoid. So if people talk quietly near him, he may think that they are talking about him and it could turn aggressive, whether it be to others or himself. Whilst we sit at the table and he eats his breakfast which is toast and a cup of coffee, I notice a patient looking at him and smirking in a malicious way Carl slams his cup down and gives one hell of an evil look and shouts out

‘What the hell did you say?’

Looking frightened the other patient replies,

‘Err, nothing, what the hell you on about?’

Carl stands up nocking his plate off the table and I stand up straight away and stand in front of Carl holding out my right hand saying

‘Carl don’t do this, sit back down’

‘NOW’ as I raise my voice for him to hear I mean business.

Carl looks at me and smiles, at this point I realise that this is about to turn out heavy, and get ready to stop Carl. Other staff stop what they are doing but don’t stand as this may antagonise him into doing something, I look around to look at other staff and two of them give me a nod and a smile as if to say ‘we are ready’. Carl starts to walk round the table and walks to the other patient. At this point the other patient gets up and starts to walk away saying,

‘Keep the fuck away from me, you twat’

One member of staff walks to the patient walking away and tries to guide him to the day area to safety. Myself and Kevin, the other staff member stand tall in front of Carl to block his way. Carl starts to shout out at the patient,

‘I’m going to fucking kill you, you twat’.

Carl suddenly makes a charge at the patient and Kevin grabs Carl by the arm hoping to stop him going for the patient. But at this point Carl stops and looks at Kevin as if he was going to give him a pasting. At this point I reach forward to grab his left arm but Carl is too quick for me and he catches Kevin in the nose. Kevin’s head flicks back as Carl’s fist connects with his nose and the blood splatters everywhere. I feel the blood hit my face and I can taste the blood in my mouth, kind of a metallic taste. I reach round and take hold of Carl by the shoulders and bring him backwards, as I do this he falls backwards to the floor and the rest of the team join in to restrain Carl, to control the possibility of a potential violent situation. Carl screams out,

‘You fucking dick I’m going to kill you when I get free from these twats’.

A nursing assistant that has a good rapport with him tries to talk to him letting him know that the other guy is just trying to wind you up and make you lose your community exposure. After about ten minutes the talking is not working and it is just winding you up. Still the threats are coming from Carl which is unlike him as usually he calms down when he is in restraint. One of the qualified nurses and comes over and says that Carl has not had his medication for the past three to four days and this is why his paranoia is getting the better of him. As the qualified nurse approaches Carl kicks out and kicks him flat point in the knee and the nurse known as Tim collapses to the floor screaming in pain. As this happens it appears that Tim’s leg doubles backwards and we hear a crack or a snap as Carl’s foot connects with Tim’s Knee. I shout out to another member of staff call for a medical emergency. While some staff attend to Tim, myself and Kevin relocate Carl to seclusion, which is a room to take patients that are too aggressive to be on the ward for the time being. Carl I place in the room face down with on the floor with his hands behind his back and we exit the seclusion room shutting the door as we leave the seclusion room. A new member of staff volunteers to observe Carl while he is in seclusion which he was secluded at 09:00.

I return into the dining area to where Tim is still laying on the floor and see that no one has taken him into the nursing office,

‘What the hell, why has no one taken him out the way?’

I attempt to lift Tim up and walk him slowly into the nursing office, as he hops in a lot of pain on each hop. Once in the office Tim sits on a chair with a huge breath of release. After about fifteen minutes the emergency services arrive and ask what has happened. Whilst this is going on I can see one or two staff appear upset as well as some of the patients. The paramedics attempt to put Tim on the stretcher and move him off out of the ward to hospital.

To me this is just another day on the ward, but not with the injury of staff like this. It is a rare occurrence that injuries happen, but maybe that the staff member should not have walked straight on into a situation like this but come in from side on. In any potentially situation staff should never come on front ways always come on from the side or from the back if possible.

At the end of the shift it is about 19:30 and it has been a long day and some of the staff are going to have a beer or two in the local pub. Luckily the pub is on the way home for me and I would pass it driving or walking. So I catch a lift with Sarah who is one of the qualified nurses and ring my wife just to let her know what I am doing. We reach the pub at about 20:00 by the time everyone meets up and I have a Fosters and sit chilling and talking about how the day has gone. After about thirty minutes I walk off to the hospital just to find out how Tim is doing. I walk into the A&E department and head to reception and explain who I am and that I am asking after my colleague who come in by ambulance with a possibly busted knee. After about five minutes waiting the nurse comes back and says that he has gone home with his wife in a cast and it was a broken knee cap.

I return home after about fifty minutes after finishing and let some of the staff know what has happened to Tim. As usual no one texts me back and I chill by talking to my wife about how the day had gone some of it good but some of it bad.

Some days it is good and some days it is bad, the only thing you never know is how it will be but how it could possibly be if the right people are there at the right time, this also depends on the patient and how willing they are to turn it around for them. The job is enjoyable and very rewardable but it has it trials as well, but remember that the people are there for particular reasons. So remember do not judge just be nice and understanding.

World of Madness — March 27, 2016

World of Madness

I have worked in mental Health for over 20 years, from child learning disabilities to elderly mental health, from hospital settings to community based settings and I have come across some good things and some not so good things. One thing people will realise while working in any setting in mental health is that you are always learning. Whether it be on how to deal with people of different abilities from physical to mental abilities or some people’s abilities within poor or high social settings. Unfortunately you will often hear about the bad things that happen but not so much on the great work the nursing, doctors, managers, occupational therapists, physio therapists and social workers can perform. The work (job) is and can be very rewarding, especially when you have a patient (client) moves on to a better placement or back home into the community. I will write about the possibilities of what could happen with in a mental health setting but nothing has actually happened when I have worked. Working as a nurse whether it is as a health care worker or a qualified nurse you will always be going on courses and learning in the work place. Some courses you may come across are basic to advanced life support, first aid, manual handling and lifting and some form of conflict management like Prevention and Management of Violence and Aggression (PMAV) or Control and Restraint. The last two are to teach you how to take control of a potentially aggressive situation and possibly move a violent patient safely for them and others around you. These courses are usually paid for by the company you may work for and usually have no cost to you.

Myself, I have worked mainly in a hospital setting but also in the community. I have worked in this setting for over 20 years and enjoyed near enough every day so far, but there has been days that I have thought ‘why do I do this?’ don’t get me wrong the job is great but it can be very draining on you depending on the setting you work in. If you are thinking of this line of work, the best thing you can do is to make sure you get regular supervision, this means that you will have a regular member of staff usually a qualified nurse but it can be a senior healthcare assistant to off load too. You should have this, usually an hour and talk about what is bothering you, the things you find stressful and also talk about the good things you come across. I have found over the years that the supervision has helped me a lot while working in mental health. Sometimes they will also supply a professional councillor for you to talk to but don’t worry what you talk about in this session usually confidential. The only time the things you talk about get passed forward are if they are detrimental to your work place for colleagues or patients. What you need to remember while working in mental health is that the patients are here for a reason and they need someone that is compassionate, Understanding, someone that will make time for them and also guide them on the right way on how to deal with problems.

One thing you should try to understand is that you will come across many different patients and people with in the services but try not to take anything personally. Some patients my hear or see hallucinations which could be upsetting for them and sometimes if you disturb this event they could become verbally hostile, upset or even on some occasion aggressive. Sometimes these hallucinations could be telling them to hurt themselves and telling them that they are worthless. Telling them bad things such as people are out to get them, hurt them or the government is spying on them making them very paranoid. So if you come across a patient that may be verbally aggressive or physically aggressive, what you need to try and remember is  why are they aggressive is it due to the hallucinations, they could see something bad in you like past abuser or something evil. So if this does happen remember to try and be companionate towards the patient. If the aggression does occur this does not mean that the patient needs to be secluded ( locked in a room for safety) try to control the situation and try talking to the patient and discover what is going on but mainly have a lot of patience in the situation. Speak gently and do not use long complicated words or long sentences. TAKE YOUR TIME this is very important, you will usually find that the patient is usually frightened of what is happening and does not usually mean any harm.

You may come across patients but mainly females but sometimes some males also that have an urge to hurt themselves. This can come in many forms such as cutting themselves with sharp objects as broken plastic, razors or glass just to name a few things. Some patients may rip items of clothing and tie what is known as ligatures around their necks or a limb, usually if it is around their neck and they are serious you may not know they have done it at first until you check on them and find they have tied something around their neck. If you ever come across this it is not a nice thing to witness but try and remain calm and call for assistance. Some patients may tie it around their wrists, legs or fingers just to name a few. It could be a cry for help as they do not know how to ask for help whether it be for thoughts and they are struggling with these thoughts. If a patient is cutting themselves it could be due to pressurising thoughts and seeing blood or feeling the pain is the only release from the pressure that they know at the minute how to deal with this. Sometimes it could be due to voices in their heads telling them to hurt themselves, probably saying to them that they deserve to be hurting or they are not worthy and this is their punishment. What you need to do as a staff member is be understanding and whatever you do, DO NOT JUDGE no matter what they do or say to you.

Once in a while you will come across a patient that will build a therapeutic relationship with you and starts to build up trust. Do not overstep the boundaries on this. They may feel ok to open up to you and talk about past events, if you feel comfortable with this let the patient speak but never put words in the patients mouth or direct the topic of conversation. At points of the conversation you may find that the patient could become emotional or stop talking for a while, this is when you should be compassionate and understanding and give them time. If you ever find yourself in this situation, after wards please go and talk to the nurse in charge (NIC) and let them know what has been spoken about in the conversation. Then after wards you should enter a detailed entry in the patient’s notes whether it be electrical or paper. Then after this try and see if you can talk to your supervisor or a senior member of staff and just talk about what was said to you and how it may of affected you and don’t take the stresses of this home with you. You may be told some good things from their past but also some bad things about their past and at times you may come across some patients that may possibly make things up but always take this information and speak to the nurse in charge.

I have in my time have attended some sessions within a patient setting and enjoyed nearly all of them. One session I have enjoyed attending is physical activities, education, ward rounds and coping skills just to name a few. Whether it be with working with adults, learning disabilities or adolescents, there are many sessions staff can join in with and support the patients. In the community I have taken clients (patients) to college and attended art. This was fun as the staff I worked with were looking after clients with learning and physical disabilities. One time we took the clients to college and painted pictures that the teacher had already drawn, this was to get the clients hand and eye coordination working better and faster. We sat helping the clients to pick the colours they wanted and to paint the pictures. We have taken clients out for birthday meals and made it into a huge deal for them and their families, Gone out to restaurants for meals and a drink non-alcoholic as some alcohol can affect their medication and their mental health. We have gone for days in the local parks and taken a picnic with us and also on a few occasions taken them on holiday to other countries or places around England which could be fun for both parties.

What you got to realise in this line of work it is not for the money it is because you have a devotion to caring and want to help people. You should never judge the patients no matter what they tell you, or how they treat you and it is never personal. You will always be learning on the job on how to deal with situations such as upsetting times, confrontations verbal or aggressive, how to deal with gratitude and how to deal with loving families loving and not so caring. You may also find patients that don’t like hearing the word NO and at times you may come across complaints made about you but don’t worry if you remember to always talk the truth. It is a wonderful job to be in and educational job as well and you will meet a very wide verity of people in this line of work. You are there to help them learn ways to cope with thoughts and feelings and deal with their emotions. You are the nurse and they are a patient so always remember that and never cross these boundaries and you will always do well.