My plain life

trying something different

Gruesome — July 16, 2016

Gruesome

Day Six

On arriving on the ward, Jack thought to himself that it is such a beautiful afternoon, why do I have to be coming into work? Why can’t I be at home chilling in the garden with his wife, having a cold beer?

Today Jack is working in a hospital south of Birmingham, working on a ward that is for female adult admissions, with a number of different diagnoses. It could range from things like eating disorders, alcoholism, hearing voices, just to name a few things on the ward. The ward is called The Firns, Acute Emergency Admissions.  Jack has in the past worked here before, but it has been a while, it must have been about three to four months. Since Jack has worked here the last time, things have changed a little. As in change, it is just the staffing has changed for a younger bunch of people. It appears that some of the older staff are no longer around. It could be, they have left for better things, moved wards or even retired. In environments like this, a staff change around can go one of two ways. A good way, as in the patients find it good, or a bad way as in it could unsettle the patients as some cannot deal with change.

Back to the story. With Jack walking onto the Firns, he sees the staff room and unlocks the door with his keys he collected from the receptionist. The door is heavy to push open as it is a thick fire door. Dropping off his bag off in the staff room he notices a free locker with a key in the lock. Jack places his wallet and mobile phone in the locker for safe keeping, as mobiles are not allowed in the clinical area. As he locks away his belongings he scans around the room. Jack notices a cheap coffee dispenser, chocolate machine, to the left of him is about four two seater sofas that look like they were saved from the 70’s. Also, there is a few cupboards basic white and a not so nice sink. Jack checks himself out in the mirror just before he goes in the office. Thinking to himself “looking presentable” he turns right and heads out the door. Opening the office door Jack walks in and greets the staff members sitting at the computers typing away madly. The staff swivel around in their chairs and greet Jack with a smile and the nurse furthest away asks

“Are you Jack”?

“Indeed, nice to meet you” replies Jack.

“Nice to have you here, I’m Sara, one of the nurses in charge”

Jack sits down while Sara is talking, giving Jack a detailed handover about the four patients they have on the ward. Three of the other patients have gone home on leave and may even get discharged when they come back. So they have a four relatively new patients. The one Jack has to pay attention to is a patient called Tabitha, known as Tabi. She is being nursed on a 1:1 nursing care plan due to her aggressive behaviour towards others. Tabi is an 18-year-old girl that has had a rough upbringing due to her mum and dad.

Tabi was subjected to witnessing lots of violent behaviour from her father and her mum. Then witnessing her mum stab, the father, a number of times on numerous occasions over a period of four to five years. The father had made Tabi kick and beat her mum after he had given her mum a real beating. He would brag Tabi by the arm roughly leaving bruises and drag her to her mum and demand, screaming at the top of his voice to kick her hard, stamp on her and punch her in the face. On the chance that Tabi did not obey her father’s commands he would take off his belt and whip Tabi with it.

There was one occasion when Tabi was sitting at the top of the stairs when she saw her mum came flying through the lounge door. Her mum had landed on her back with what looked like a mask of red paint on her face. Suddenly Tabi realised it was blood coming from a cut above her eye and nose, she had got from when her dad had punched her with his fist. Tabi saw her dad come bounding through the doorway over to her mum laying on the floor and then put his boot in a couple of times in the chest and stomach. As he continued to kick and then stamp on her, Tabi suddenly stood up while at the top of the stairs and had a huge smile on her face but still looking evil. The father noticed that Tabi smiling at the top of the stairs and demanded that Tabi should come down the stairs and do what he is doing. With this the father said

“You never know Tabi you may enjoy it”.

While saying this to Tabi, he grabbed his belt as if to gest as if he would beat her with it. Tabi stood there at the top of the stairs looking vacant and glassy eyed but still smiling. Tabi suddenly could not hear his father demanding and shouting at Tabi as she stares at her mum as she screams in agony every time the father’s foot connects with the mum’s body. Tabi starts to walk down the stairs vacantly, firstly looking at the father while he screams at Tabi, but still not actually hearing his voice. Then Tabi looks over at her mum who is now curled up on her left side screaming at every kick. As Tabi is walking down the stairs, it feels like the whole world has suddenly gone into slow motion. Once Tabi reaches the bottom of the stairs the father grabs hold of Tabi by the scruff of her neck who is standing in front of her mum, but still remaining deaf to his screams. The father raises his hand above her and brings it down slapping her around the back of her head.

Feeling her head shake Tabi now hears her mum scream and cry

“Tabi, what have you done? You killed him”

Tabi then realises she had blanked out while standing there and sees her mum crouching over the father and he had collapsed on the floor and lays on his side. The mum moves and Tabi sees a small metal object sticking out of his stomach oozing blood. Tabi just stands there watching the blood spill out onto the wooden floor.

Tabi says “He had it coming anyway, if not me it would be someone else” in a hardened deep voice.

Suddenly Tabi realises that she had no recollection of what had just happened to her dad. She had lost about five to ten minutes and could not account for anything. Tabi started thinking to herself,

“What happened”? And with that, she drops to her knees and lands in the blood oozing out of her dad and starts to cry.

Whilst Tabi is kneeling in his blood she hears a voice all around her saying “it’s OK now you’re safe”. Looking around to see who said that she says to her dad who is looking unconscious and says “What”?

In a questioning tone, Tabi’s mum says to Tabi “Who are you talking to”?

“Him “replies Tabi.

“But Tabi, he didn’t say anything, ” says the mum.

Then Tabi blankly looks down to the floor and starts to rub her hands through the pool of blood that has gathered on the floor where she is kneeling, with a vacant look on her face, grinning from ear to ear but at the same time starts to cry.

This is where all the violent thoughts and voices she starts to hear and the killing of little animals. The thing is if you grow up with evil and violence all around you that is the life you will start to live violence to protect yourself. Due to what happened to he, she was admitted to an emergency care order to a low secure child’s unit but due to the ongoing aggression, she has displayed in her unit due to finding herself getting close to staff. The aggression is to stop her getting hurt by people that care as it has happened so much in the past. Now she was transferred to a medium secure unit, The Firns. Tabi was transferred on a section 3, which means Tabi is detained under the mental health act for treatment. Her last placement could not manage the amount of aggression she was displaying so they transferred her to the Firns.

Jack walks onto the ward and walks over to Tabi and introduces himself to her. With a smile on his face and greets her

“Hi I’m Jack and I’ll be your nurse for the next few hours”, doesn’t cost to be nice to anyone.

Tabi looks Jack up and down with a look of disgust and mistrust. With this Tabi says in an angry tone to Jack,

“You look like my dad, he was a fucking Twat”.

“Sorry for the way I look, but you can blame my parents for that”. Responds Jack.

Tabi responds to this with a little smirk and says “Your OK, you’re funny”.

“At the end of my time with you, you will probably still think I’m a Twat” and smiles back at Tabi.

Then Jack sits down next to her at the dining table and watches Tabi play cards, Solitaire. Tabi sits there playing cards and every now and again looking at Jack, to which he has noticed but says nothing. In an intimidating tone, Tabi asks Jack,

“Did you get a full hand over about me”? As if it was a scary thing to hear, but this did not bother Jack, nothing new to hear. To play down the question Jack says to Tabi,

“Yes I have had a full handover and I know what you can and can’t do or have” and leaves it there.

Much to the disappointment of Tabi but acknowledging his response with a smile and carries on with her card game. After about twenty minutes Tabi turns to Jack and asks him for a book to read but in a more submissive tone,

“Can I have a book to read”? Smiling at Jack.

Jack turns around and calls a member of staff, Tabi looks at Jack as in why are you calling him over? Jack had noticed the look and automatically tells Tabi,

“I called her so she can get it while you are playing cards, that’s all”. Tabi gives a nod as in acceptance. Tabi asks for a book called Silence of the Lambs, and the staff member goes off to get it. To Jack he thinks is this a suitable book for a young lady that has violent outbursts but who is he to question the regulars? Five minutes later the staff member returns with Tabi’s book and gently throws it onto the table. Jack thanks the nurse for the book. Clearing up the cards Tabi heads off to the lounge area. Once entering the lounge Tabi and Jack sit in the lounge on one of the sofas. Due to the care plan, Jack has to sit next to Tabi within arm’s length. Arm’s length is because for the protection of others as in staff and patients. Tabi opens the book a third of the way through and starts concentrating on the book. Jack in a secretive way manages to read the back of the book and wonders if this book is good for a person of her mental issues. Whilst Tabi sits there reading her book, Jack watches TV but keeps an eye on Tabi. One of the patient’s starts to put a DVD on and now Jack find himself half watching 50 first dates. To be honest the film is a good and funny. Every now and again Jack does look over at Tabi and notices that she has an unnerving grin on her face while reading her book.

All of a sudden Tabi stands up and dropping her book to the side of her and hitting the floor. Tabi turns her head and gives Jack a vacant and blank look. The sort of look that is vacant, but if you touch me I’ll kill you, sleep walking. With this look, chills run down Jacks’ spine as it feels spooky and spine-chilling. Like a robot under the control of someone else Tabi turns her head and faces forward, then she gives an almighty scream and runs at the wall head first but aiming for the wall at the other end of the corridor.  Tabi gives out an almighty cry, scream and runs at the wall head first, like a charging bull. With this Jack jumps up and runs after Tabi along with another staff member. They both reach her and restrain her just as she is about to make contact with the wall and end up on a head on the floor. With the force of the two staff she stops dead in her tracks. With this Tabi loses her footing, with her body weight she loses footing and drops her weight pulling the staff and her to the floor. By this time other staff have come out of the office and see the two staff crumpled on the floor holding Tabi. The responding staff assist Jack and help take hold of Tabi in restraint and assist her in sitting up as she no longer is fighting with staff. Jack picks himself up and gets himself together, then he sits back next to Tabi as she is on the floor in holds with staff.

With this, Tabi has tears rolling down in her face and turns her head and apologises for her actions but she did not mean any harm towards anyone. With Jack sitting next to her on the floor he consoles Tabi and tells her that it is OK and there is no need for apologies. With this Jack looks at Tabi and says,

“You OK, do you want to talk about what’s going on”.

Tabi nods “Yes please” with tears running down her face.

Jack looks over at the two staff holding Tabi, giving them a nod as in nonverbal to let go of their holds. The two staff holding her let go of their holds but moving away so they are safe. The two staff move away a little, this is just so if anything unto wards happens the staff can step in for assistance. Tabi gets comfortable on the floor and sits next to Jack who is sitting next to her on the floor, leaning against the wall. Jack asks Tabi,

“So what happened”?

Tabi explains that she was reading her book, The Silence of the Lambs, and it got her having violent, gory, bloody thoughts and also got her aroused. Tabi had actually found herself getting excited with the violent action in the book that she was reading. When she started getting excited she blanked out then come to again and found that she had thoughts of killing animals or people. With these thoughts, she realised she had possibly killed animals in the past as her thoughts were so graphic. But these thoughts did excite her as well as upset her. In the past when she felt like this the voices would start to come back to her and they sounded like her dad, saying,

“Your worthless, you’re a naughty child. Look what you have done” with this she realises that she is not right in the head. Tabi explains that she is realising that watching and reading about violence excites her.  With this, her emotions and feelings plus her thoughts all over the place it gives Tabi violent ideas that are strong and because it excites her she wants to act upon her feelings, emotions or urges. Tabi explains to Jack that they are only urges and feelings, even though they excite her she is fighting not to act on them, plus she knows it is wrong too as well.

While Jack continues to sit and talk to Tabi, she turns to face Jack and says to him

“can I explain something to you please”?

“Of course, you can” replies Jack.

“I don’t want you to get frightened,” says Tabi.

Jack looks at Tabi wondering what she is going to say. Is this the point Jack should be worried and be prepared for something? Tabi looks at Jack then she looks down at the floor and then starts to tell Jack about her thoughts and urges. Tabi explains that because Jack looks like Tabi’s violent father, she wants to hurt Jack but this is due to the voices in her head.

“Ok,” Jack replies trying to look unnerved by this.

“I’m not going anywhere; you can tell me what you need too,” says Jack.

Jack explains to Tabi that he will sit there and listen to her and no matter what she says the nursing team will not judge her. In fact, it is a good thing that she can open up to someone and talk about what is going on with her and she will be praised. Along with talking about her thoughts

“This why you are here, the need to control your urges and talk about then”, explains Jack.

Tabi replies to Jack “I don’t trust staff, really”.

Jack sits there and they both get comfortable and get a cup of tea each while they sit there on the floor. Tabi stands up and Jack decides to follow. While Jack starts to stand up he feels his knees and hips start to crack and pop. Tabi starts to laugh at the sound of Jack’s joints cracking. Tabi turns to another member of staff and says,

“Steve, could you make me a coffee and Jack a tea please”?

Steve goes off to the kitchen and makes the drinks while Tabi and Jack walk off to the dining room and they both sit at the table. Tabi sits down and Jack sits opposite her across from the table. Jack sits opposite her as he hasn’t forgotten what Tabi has started to tell him.  It would be safe for him if there was a barrier between them. Jack tries his hardest not to look a little worried as Tabi may open up to him and this would not do if she notices him looking worried. Steve walks into the dining room and hands over one cup of tea and a coffee and says,

“Tea up, you two”.

Steve does not go far as there is another staff member needed as Jack can’t be on his own with a female patient. Tabi looks over at Steve and gives him a look as if to say, why are you standing there? With Jack noticing the look Tabi is giving Steve, he pipes up and explains that Steve is only standing there for both their protection. Tabi turns her head towards Jack and has a confused look on her face. Jack explains, it’s just so I don’t say or do anything untoward and same for you, so it’s protecting us both,

“Ok, I understand now” and smiles at Jack.

Jack starts to sip his tea while Tabi explains about the urges and thoughts she has towards Jack. Tabi explains the thoughts are violent, as in she wants to kill Jack and also she has urges to do sexual things to him once he is dead. Jack continues to sip his tea and tries to keep a deadpan face while she talks to him. Tabi continues to keep eye contact with Jack and notices the lack of expression change in his face and continues to talk to Jack with just a little smile on her face. Tabi reaches for her coffee and takes a few sips of her drink and continues to talk to Jack.

Tabi starts to explain that when Jack is not paying any attention in her direction, as in his back is facing her she will get something heavy and hit him over the head. Ding this, it will hopefully knock him out and then the blood will gush out of his head while he is collapsed on the floor. With the excitement of the blood all over the place, she will rub the blood onto her body. Once she has rubbed the blood into her clothing and over her face, she will then strip off and then rub more blood over her naked body covering her from head to toe. If she does not have enough blood she then will cut open Jacks stomach and dig her hands around in his stomach, pulling out his intestines and then rub his blood soaked organs over her naked body. Once she is covered in his blood she will strip Jack’s clothes off him so he is naked and she can see the blood rush from his wounds in his head and stomach. She will then sit on top on Jack and ride his manhood hard. Once Tabi has done this she will tape his eyelids open and with two fingers, dig them behind his eyeballs and pull them out and put them in his stomach. Tabi will do this one by one slowly so she can hear the tearing of the muscles in the eyes as they are ripped from the sockets. Once she has put both eyeballs into his stomach she will then push his intestines back into his wound and stitch it back up. Once she has done this she will go to the bathroom and have a shower and washed herself clean getting rid of the blood.

Once having a shower, she will then smash the mirror into pieces and make at least two pieces two inches by one inch and then place them into the empty eye sockets. Once the glass is put in place Jack will wake up and not knowing what has happened to him. Tabi then explains that Jack will see things more clearly physically and mentally. Every time Tabi looks at Jack she will see herself in Jacks’ eyes but Jack will also be able to see properly and not knowing what has happened. Jack will not know what has happened because she is such a great nurse and she will know how to make sure Jack never finds out.

Upon Tabi finishing talking she looks at Jack and Steve for their reactions but she doesn’t see any reaction in Steve. That’s probably because he wasn’t listening and was more interested in chatting to a female staff member. Jack is still drinking his tea but has nearly finished and puts his cup down and asks Tabi,

“How do you feel now after explaining your thoughts”?

“Excited, I think” explains Tabi with a naughty smile on her face.

“Why do you feel excited”? asks Jack.

“Things like this excite me” replies Tabi with a little of embarrassment in her face.

Finishing their drinks, Jack takes his and Tabi’s cup and hands them to Steve.

“Cheers matey, a good cup of tea there,into,” says Jack.

Turning round Jack says to Tabi “Come on let’s go watch a film in the lounge for a while”.

With this Tabi stands up and follows into the lounge and sits on the sofa. Steve calls over to Jack and summands him to the nursing office, Jack responds with sticking his thumb up. Jack turns to Tabi and says,

“Excuse me a minute will you” with a smile.

Tabi looks up at Jack and smiles and nods at the same time. Jack walks off to the nursing office and Steve explains, that because what Tabi had told him he will need to make an entry in the nursing notes. Steve also says to Jack that he would go and sit with Tabi in the lounge until he is done with the notes. Jack spends the next hour writing in her nursing notes, he does this on the computer and starts to get square eyes. One of the qualified nurses requests to read what Jack has written, not because she doesn’t trust Jack but so she knows what was said and what is going on with Tabi. After she has read Jacks notes the nurse stands up and shuts the office door. With shutting the door, she puts up a scruffy hand written sign saying DO NOT ENTER. The nurse sits back down and lets Jack know that the report is a very well written detailed report. Jack smiles and thanks the nurse.

“Tell me how this makes you feel, what she has said to you”? asks the nurse.

“Don’t know really, a little freaked out I suppose, but I can deal with it” replies Jack trying to appear tough. The nurse looks at Jack in a way of saying I don’t actually believe you. Jack notices her questioning look and responds with a smile and says,

“I’m fine, honestly”

“Ok then if you’re sure” responds the nurse.

With this Jack gets up from his swivel chair and walks over to the door and opens it and walking out he turns left and wonders off in to the lounge where they are watching a film. Jack stands in the door way and watches what film they are all watching. It appears that everyone is watching SMURFS. With this Jack sits down in a spare chair and watches the film as well. Jack looks at his watch and sees it has already come to 19:00 and it will be time to leave soon. The nurse comes out of the office and says to Jack,

“Sorry I forgot to ask you, could you do a few hours tomorrow for an escort please”?

“Yes sure I’m free tomorrow” replies Jack.

“Brilliant be here for 10:00 and it should only take a few hours” responds the nurse.

After that he is please for more hours but in regards to what he was told by Tabi he needs to get home and unwind to his wife on Skype. Maybe get a bottle of wine on the way home as well. With the shift tomorrow he can’t wait to see what this will bring for him. To be fair it has not been a bad afternoon shift just a little mentally draining.

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Who screams louder  — May 23, 2016

Who screams louder 


What you going to do? 

Let the voices in your head scream louder than you or are you going to   Scream back. The voices are scared that one day soon you will not need them in your life so they keep showing their scary faces/voices. 

They are not in control! You are and let them know that. 

Today’s Society — May 13, 2016

Today’s Society

Night’s out

I am going to talk about people who go for a night out into town but end up with things getting messy or things that we cannot remember after a night out. People go into town with friends and have a few drinks and have one to many or friends that don’t know when to slow down or stop. Don’t get me wrong we have all been there at some point but some more than others. Then you wake up in the morning thinking what happened, did I drunk text, wake up in pain due to fighting, or your kidneys hurting due to the alcohol intake. Then the next day or two days you are feeling like the world is ending.

I occasionally work in town on some pub doors and have seen a few funny things and a few not so good things. It does make you think about the meaning of friendship and what family means when out.

Friends in my mind means that whoever you go out with you look after them and make sure that they do not go over the limit and get to a point where they don’t know what they are doing. I saw one night a group of friends out on a night out celebrating one of the lad’s birthdays.  When they came to the pub I was working the birthday boy was getting to the point where he would be unable to talk properly and walk safely. As he stood there he was swaying like a tree in a gale and could not look at me without closing his eyes while talking. To be honest I thought he was going to fall asleep while talking to me.

I was in a pub the other day with a few friends and I went to the bar to get another drink, I had only had one drink previously. While waiting to be served I saw one bloke with one of his friends who was being served. He was talking to his friend and to be honest he was being an obnoxious prat. The bar man came back to them and he got their drinks, but previously I heard the idiot say ‘watch this’. As soon as the bar man came back the idiot started to argue with the barman saying you got the wrong drink. The barman apologised and said what did you order then, looking confused. The idiot who was getting to the point of annoying said a different drink. As the bar man went to get his other drink I piped up and said ‘excuse me barman, but you did get the right drinks, he just said he was going to pull a fast one and make you look stupid’. With a look of disgust the idiot looked round and said to me what the hell? I mentioned to him that I was standing here listening to his loud voice saying what he was going to do. He turned to me as if he was going to start something and at this point I noticed the bar man talking in his ear piece and suddenly three door supervisors turn up. Feeling confident I say to the idiot ‘Do you really want to do this’? Without him noticing the door staff, he in a drunken state said you’re going to get it if you don’t fuck off. Then the door staff step in and I back away and they escort him out of the pub. The drunk idiot looks surprised but scared and not so tuff.

People go out for a nice time and relax with drinks with friends and return home hopefully not interacting with stupid drunks. So why is it that no matter when we go out we will mostly always meet a drunken idiot whether it be male or female and they can in a few words or action ruin your night out? What happened to the times of when people could go out for a few drinks and come home with no troubles?  Personally I think that door staff should be allowed to use breathalysers on punters, people out for drinks and if they are beyond a certain limit they should not be allowed in to a pub.  I know it could run your night out to a short ending but then it may also cut down on problems with drunks.

I have seen people so drunk that they have fallen asleep in their own vomit or acted in ways that they would not normally act in a social setting. I know that pubs are out in competition with other pubs but surely there should come a limit to where bar staff whether it be servers, door staff or managers should say no more. It is a shame that staff have to call on the police a lot of the time to try and control people that do get out of hand, as they have enough stuff to deal with.

As well as the drunks you see sitting in the parks and on the corner of streets drinking strong cans of strong bow or strong ciders. Most of them men or women would not say boo to a goose and would not harm anyone.  But unfortunately you will get one or two drunks that will course a few problems, but realise that they are mostly harmless.T

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.

 

 

 

 

 

 

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.

 

 

 

Working in Mental Health — May 25, 2015

Working in Mental Health

Don’t get me wrong working in mental health has its good day but the good days out way the bad. If you have experienced this you will understand where I am coming from. You could get a patient admitted on a really low point in their life, something on the lines of committing suicide, self harming, taking a hostage due to hallucinations. What you need to do is remain natural in every situation. it is hard at times but think about the things that are going on in the person’s head like thoughts that are not theirs.

I have come across a patient one time who suffered from violent out bursts, killed little animals and would attack anyone who appeared a threat to them and their ways of living and thought process. This patient had an up bringing of witnessing constant violence , such as men beating on their mum or dad and other family members and have witnessed this from such an early age. When they grow up all they know is to deal with being told no or your wrong is to solve it with aggression. When someone does experience this all they will understand is aggression or violence is the only way forward in solving any situation. This patient had witnessed so much violence towards family members and them self that the only thing they understood was beating someone up was good and anyone showing them care, sympathy and compassion is to push them away in any way possible.The people that should love and care have done nothing but hurt people and them.

When we had this patient come in , it was difficult at first because you could be talking to them one minute and then the next they could be trying to beat the living day lights out of you. This was due to the patient suddenly hearing or seeing things telling them that the staff member is a bad person here to hurt you or that the staff member is not to be trusted. So what they will do is attack first and not let you in. At this point the best thing you can do is not to back away but push yourself forward into their ways as in keep showing you care and do care no matter what they give back. This patient did constantly attack me by punching and kicking me every time I spoke to them, this did not push me away it actually drew me closer as any one could see this patient was hurting emotionally and mentally but it was not under their control. I have ended a shift with this patient with bites, bruises, broken skin and black eyes. This did not push me away, as at the end of the day I could speak to the nurse in charge and unload it of my chest.

After about two weeks the patient sat and spoke to me saying that they understand that some of the staff are here to help them and some of the staff do actually care and not there for the money. Trust me the money is not that great for the work we do and the violence we could face. The patient spoke about the things they had observed and witnessed and then later they had spoken about the violent thoughts they had going on in their thoughts. One day the patient had spoken about violent thoughts they had towards me and another member of staff, which was quite horrific. Like I said before after a time of working in this line of work you will start to become unfazed by these situations. This patient wanted to knock me and this staff member unconscious and tie us up, once we was tied up the patient wanted cut our eyes out and replace them with glass so the patient could see them self doing things in the place where the eyes was. This did kind of worry me a little but I thought if I showed fear the patient could play on this and make things worse, plus I was not going to allow the patient to get the upper hand on me. Don’t get me wrong it was quite worrying to hear this but I loved my job and I wasn’t going to be put off by anyone but it did make me more aware of the patient.

When the patient had been here for a while they had opened up a lot towards certain staff and it got to the point when the violence and aggression decreased and they sat with staff talking about their thoughts and hallucinations they were experiencing, which if you work in this line of work is a vast improvement. Rather than acting on their experiences the patient would talk about it with staff they trusted or write it down on paper and ask for a reply either verbal or in writing. I have spent many an hour sitting talking or writing with a patient about the thoughts they were having, but rather that than having to physically intervening on situations.Any decent HCA will tell you thy would rather sit there talking about things than get physical, any one else that says different should not be in that line of work, it’s all about talking.

The patient ended up talking about their urges thoughts and feelings on a daily basis and when this happens keep them talking record all conversations in their notes and keep staff informed of everything that is said and discussed.

If you don’t like something I have written please don’t be hostile towards this, just let me know and I will try and alter things. Im not saying everything I write id fact but it is not lies either. Please let me know what you think. Thanks for reading.