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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First interaction with a psychiatric patient.  — June 4, 2016

First interaction with a psychiatric patient. 

 
My journey into mental health started many years ago, it must have been when I was about 22 years of age. I knew nothing of mental health and what it was all about. The one thing I wanted to do was to find out and from that day I have never looked back until now. Don’t get me wrong I love my job and have never wanted to be a qualified nurse. I quickly worked out it is the health care assistants that are the eyes and ears of the ward. 
I had previously worked in a general hospital and had not had much interaction with people that had mental health issues either in the community or in hospital. All I grew up with from friends is people with mental health issues are to be given a wide birth. At this point I didn’t know why. But on one particular day it was about to change my whole outlook on mental health and give me an understanding and insight on the vast subject. 
At this point in my life I worked in a general hospital in the midlands area as an A&E porter alongside security work. This was an exciting job and did open your eyes to many sights and situations within the hospital. All porters/ security workers carried bleeps and radios for emergencies within the hospital. The radios were for general jobs and the bleeps were for emergencies around the hospital; when the bleep went off, if you weren’t with a patient you ran and ran fast. It could have been medical emergency and we had to run with a defibrillator, alarms in maturity went off or people need security for other problems. 
As I was saying, this one particular day I was asked to go to A&E and babysit a patient that had become verbally threatening to the nursing staff. When I got there the Charge nurse had told me that the ambulance had brought this man in for assessment and possible admission to the psychiatric ward. All I was to do was keeping an eye on him and persuade him to wait for the doctor to speak to him. I thought to myself that this is going to bed boring plus all I grew up with was give people a wide birth who are ‘mental’. While I was in the side room the man looked in his early twenties, dirty face but clean tidy hands, a yellow plain t-shirt with stains down it. To me it looked like he had just had something to eat and spilt it down himself. His hair looked messy but had clumps missing so he had a number of bold patches all over his head. He wore black jeans that were also a little stained around the knees and lower legs. He did wear any shoes or trainers just a pair of socks that looked like they hadn’t been changed in a long time. So if you were to go off looks you maybe would think he was homeless. 
As I entered I did smiled at him and introduced myself and reached out my hand to greet him in a friendly handshake keeping my smile. The man looked at my stretched out hand then as I watched his eyes they followed my arm up my shoulder to my smiley face. As our eyes met I said to him it’s ok and all I want to do is shake your hand, nothing else. So the man’s uneasily reached out his hand and shook mine in return. To be fair he shook my hand with a very tight grip and I could see his facial expression change a little; like a naughty little boy being naughty. Then he looked back at me and as he saw me looking he changed his expression back to someone who looked frightened and worried. Unusual I thought to myself but thought nothing else of it. I sat on the hospital trolley in the room and put my feet up on a chair that was placed in front of him. It must have been used by the nurse that was in here before. While doing this it kind of blocked his exit to leave the room but he didn’t seem to care much. I introduced myself and asked him his name. He told me his name was Darren and then clammed up again. I told him 

‘Nice to meet you Darren’.

But Darren just looked up and nodded in acknowledgment. I had a suspicion that he didn’t want to be there. I mention to Darren that I was only here to keep an eye on him, nothing else; we just had to wait for Dr Jay who was going to talk to Darren. He looked up at me looking a little worried and asked 
‘why is he coming to talk to me’. 
‘I don’t know, sorry’ I replied to him. 
I explained that Dr Jay was a great doctor and he was the sort of doctor that everyone liked. Dr Jay always made time for people and patients no matter what the issue was. He also didn’t dress like a consultant; he dressed mostly in jeans and t-shirts but rarely wore a suit. His excuse was it made him more approachable to people. Which it did to be fair! 
As I sat there I occasionally looked over at Darren and I could just barely see his lips moving, just like he was talking to someone; just like he was talking but didn’t want anyone to notice. Every now and again he would make a little grunt noise like he was being pushed or knocked by someone. At this point I didn’t know what to think or say as I have never had much interaction with people with mental health problems. I did eventually open my mouth and asked Darren if he was ok. He turned and looked at me with a scornful look of disgust as if I had just disturbed an important meeting. When Darren had looked at me he turned his head back facing away from me and continued talking to whoever was there with him. 
It had been at least 30 minutes and the door opened and a middle aged face appears and smiles while saying to me 
‘Can I talk to you please’?
‘Of cores’ I replied. 
‘Darren I’m just going to speak to this gentleman, I’ll just be outside the door’
Darren continued to talk to his imaginary friend and I stepped out the room. Outside the room was Dr Jay, who was the one who popped his head round the door and a nurse who was a female about in her mid-thirties. She was about 5ft 6, short brown hair a little bit spikes. She was dressed in black trousers, blue shirt with a t-shirt underneath the shit with black flat shoes. Looks smart, more like an office worker. She introduced herself as clinical nurse lead Ford. Dr Jay asked me what he has been like while I had been sitting with him. I told him about his appearance as in how he was dressed and unwashed. I told Dr Jay that Darren appeared frightened and worried when he was spoken too. Dr Jay said that could of been paranoia but he couldn’t be sure until he spoke to him. I also mentioned that he was sitting in a chair facing the wall slightly and I could see him talking but trying to be discreet about it. Also that his facial expressions were always changing, like he was responding to something with the odd verbal noise now and again. 
Dr Jay says ok let’s go and see him. But he asked if I minded coming in as I was the first person Darren had met and spoken too. I walked in and said to Darren
‘Darren, Dr Jay is here to talk to you’ 
Darren looked round at me and looked frightened, then Dr Jay walked in and suddenly Darren jumped up like a frightened animal caught in a corner. Staring at Dr Jay Darren in a frightened little boys voice said 
‘keep him away from me,
I reply ‘ Darren it’s ok he’s a friend, he just wants to talk to you that’s all’.
I do this with my hands out in front of me and my palms facing Darren waving them side to side. While doing this I slowly walk towards Darren letting him know that no one is going to hurt him. I tell Darren to keep his eyes on my still walking slowly towards him reassuring him that he was safe. Darren looks at me and as I reach him he slowly sits back in the chair muttering to his self. Couldn’t make out what he was saying as he was speaking very quietly. Now Darren is seated I let him know that everything is going to be ok and Dr Jay is a good man and he is here to help him, that’s all, make him feel better. Dr Jay thanks me and asks if I could wait outside the room but not to go anywhere just in case. 
After about one hour of me standing outside the side room like a palace guard; Dr Jay pops out and says to me that I did great work earlier keeping Darren here and calming him down. I thought to myself that I don’t know how to take that. Don’t hear many compliments. Dr Jay says to me that Darren is a troubled man and he has agreed to come to the ward so we can assess him more. But there is one condition; I have to walk Darren there as he feels safe with me. 
‘Ok not a problem’ I tell Dr Jay. 
The Doctor goes back into the room and brings Darren out with the nurse. As I look at Darren he looks at me with a smile of embarrassment, tilting his head to the side. To be fair it looks like he had been crying in that room. Maybe reality had hit him after speaking to the doctor or he was upset he was being admitted to the ward. Myself and Darren start to walk off to the ward with the other two walking closely behind with Darren looking back occasionally at them. Was this because he felt safer knowing that they were there or was it because he was feeling paranoid with them behind him?. I ask him if he is ok as he keeps looking back and Darren just bites his bottom lip and nods while looking at the floor. As we get to the ward Darren stops and hesitates and hearing his breathing getting rapid I reassure Darren that everything from here on will only get better. Turning and facing me he asked me if I would come and see him later as I was the only person he knew. I let him know that if he went in with the nurse and Dr Jay I’d try and pop back to see how he was doing. But I couldn’t promise anything. I step back and let the other two walk onto the ward with Darren and watch as the doors close behind them. I notice Darren look back and smile as I start to walk off back to work. 
This was the first dealing with a person that had mental health problems and I had never known how interesting it would be. Darren was the first person that would start my journey off in working as a health care assistant. About a week later I asked for a transfer from porter/ security to working in a psychiatric ward. Best job I have ever had.

Another Day working as a Health Care Assistant — May 28, 2016

Another Day working as a Health Care Assistant

This little article will try and make people see what it is like working as a health care assistant within a mental health hospital. There are many different names a healthcare worker will be known as, such names as Nursing assistant, Health care assistant, Nursing Assistant or Nursing Auxiliary just to name a few. To work as a health care worker there is at the minute but it is looking like the health authority may change that in the future. One of the main things you need is a good understanding of people, a caring side no matter what happens and to be none judgemental attitude towards people no matter why they are there.

People (patients) will   be in hospital for all sorts of reasons; I have come across people that have been admitted due to developing mental health problems due to the stress of being in prison. Patients come in for reasons of being abused by people known to them, Witnessing traumatic events such as war crimes to them or others. Eating disorders, Schizophrenia, self harm due to abuse or trauma. Depression and bipolar are just to name a few. Yes they are or can be big issues for newly diagnosed patients but with the right medication treatment and therapy to deal with problems they can be managed well on the ward and in the community.

Just because some one has this diagnosis it does not mean that you have to cross the street when you see them or that they are dangerous. The best and most supportive thing you can do for someone with a mental health problem is say HELLO or just ask HOW ARE YOU? Then be there for them, listen to them and treat them like a friend or an individual. Don’t judge  them because of an illness. Be an ear for them, a person to talk to or just sit with them and spend time with them. Don’t get me wrong it can be difficult at times and you will hear stories of a horrific nature whether its something they have done or they have had done to them. All you need to do is listen and not show expressions of shock or horror in your face. Listen, give guidance if they need it and be supportive no matter what. Some patients may have urges to hurt themselves at times and all you need to do is be supportive and try and guide them away from wanting to hurt themselves. This can be difficult and mentally stressful on you. So no matter how mentally strong you think you are you will need to unload on your mentor or a colleague just so the stress of the information does not well and build up and stress you out.

With what I have written the job role is extremely rewarding and mentally fulfilling and when you have had input with a patient and you see them doing well and then they move on to a better placement or even back home. You must think that you have had a massive input on that persons life and made it better. Doing this job is definitely not for the money but the emotional rewards is massive. I work in a very stressful job as a health care assistant and have been doing for over 19 years. The place I work is very demanding and can be physically demanding at times due to the nature of the patients and their problems but no matter what happens I can’t see myself working anywhere else. If you decide to become a health care assistant you will come across people (staff) that are good at de-escalation, dealing with confrontation, and one or two staff will be good all round no matter what is going on on the ward.

Myself, without trying to sound big headed, I can deal with most situations such as aggression, confrontation, self harm or just a shoulder to cry on. I always pass over to the nurse in charge what has been disgust and enter everything in the  patients notes whether it be hand written or electronic patient notes. At the end of every week or day depending how stressful it has been I sit in a room with someone I feel I can talk to and unload onto them. What you need to remember is when you speak to the colleague is not to be afraid to show your emotions when chatting, this helps you release the stress.

What is Self-Harm? — May 24, 2016

What is Self-Harm?

In this article I will try to explain what is self-harm and the reasons for this; from the views of a health care assistant with at least 20 years’ experience in mental health.  There are people in hospital who self-harm and also people in the community that self-harm but to different extents. Everybody has their own personal reasons why they do this and if you meet someone that does this please do not judge them. They are in turmoil, mental pain or they used to be and now they have learnt to control it to an acceptable level. What needs to happen is the health service and the private companies need to make awareness and knowledge more acceptable to the community to understand. I hope that what I have written here will help even if it is just a small amount. Any information that helps is better than nothing at all.

There was a horrible story in the papers a few months back about a young lady who had scares on her arms from self-harm and she went into a big super market chain, I will not name them as I don’t want to get in trouble, she went to the cashier with a bottle of alcohol and the cashier told her that they cannot serve her the alcohol because she had scares on her armWhat  The young lady was told it was company policy not to serve alcohol with anyone that self-harms. To me this is disgusting as alcohol is not the reasons why people self-harm and if she was out in the community she has a big control over these urges to hurt herself. You cannot judge a person just because they have scares. I have a few scares on my person but that does not mean I self-harm, I’m just clumsy.

Next I will try to explain some of the possible reasons why they self-harm and the ways people self-harm. It is mostly a female thing but it is on the rise of male’s self-harm and coming to light.

Visual and Auditory Hallucinations

Some patients within a hospital setting who suffer from hearing and seeing things like past abusers, demons or a coping friend due to stress or past events known as hallucinations usually not a friendly voice or vision. With a patient that has this condition, the voices are usually a kind of friend in a difficult time and is there only way of coping while it is a stressful time. The voices are usually a coping skill for the person but when someone who cares comes into their life the voices get louder as well as the visual problems get worse. At times of stress the hallucinations tell the person that they are worthless and they need to end their life because no one loves them or cares. This is why some patients find it hard to cope with when they find a staff member that actually cares. The voices get louder when the patient finds someone who actually shows a caring side. The patient will end up listening to the hallucinations as they will be as convincing to the patient as they are the only friend they have during the whole time. The patient may end up ripping their clothes tying a ligature around their necks or another limb. Maybe finding something sharp like a razor, metal, hard plastic and cut themselves to make themselves bleed. Some patients may also use the plastic from pens, metal from clothing, braking glass items. Some start to head bang and what I mean by this is that the patient usually sitting or crouching will bang their head off a wall or a door. This is all due to the voices or hallucinations they experience.

Abuse

What you may come across is mainly females but some males that have been abused from either family members or friends that know the family or it could be a random stranger which is rare. The abuse can come in all shapes when it comes to the subject of abuse, patients could start cutting, have sight dysmorphia, where they see something bigger or horrible when they look in the mirror. People could come across physical abuse, where the person will witness people being beaten, tortured or mentally abused just to name a few. It will come to a point where their coping strategy is to hurt them self to cope with the mental pain. They could start to withhold their food and fluid intake, start in to insert things whether it be through an open hole, mouth, rectum, virginal, or open wound. I know it is not nice to read but this is the facts I’m afraid. But this could also link in with hallucinations as well due to the past abuse.

Learnt Behaviour

It is an unfortunate thing but people that do go into care due to past problems will also pick up things while in care. There are some patients will see other patients do things like self-harm and find out that it can lead to maybe positive outcomes. Some patients will learn that from other patients that self-harming will bring in staff and also give the attention they need. But what you need to realise is that some patients don’t know how to ask for help in times of stress and this is the only way they know how to ask. So some patients that don’t know how to ask for help may self-harm just to get the staff member in close.

 

Eating

There are some patients that will either restrict or over eat on their food. This is a difficult situation to deal with as it could be life threatening in some cases. Some people will reduce food and fluid intake due to the stupid fashion industry. It is portrayed that the model should be skinny and beautiful, so the young mainly females will stop eating and try to up their cardio to lose the weight. The fashion industry needs to change their ways on this. Some patients in their previous lives may have been bullied at school, work or college and called fat, chunky just to name a few.

It is not just restricting food it can also be over eating for a number of days, then eating nothing. It could also be a problem where they will over eat and then self-induce vomiting as they usually think it will help them reduce weight.

 

These are just to name a few items problems to do with self-harm. If you want to look deeper there will be a number of triggers to influence self-harm.

I hope you have found this small amount of information useful helpful even if it was just a little.

Please feel free to leave a comment but remember this is just an opinion and not total fact .

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. 

Working in Mental health —

Working in Mental health

There are a few jobs that are hard on your own mental state, physical being and sanity but yet still rewarding at the same time. That is working as a health care assistant in mental health in a hospital setting. I have done it for about 20 years and still doing it today (for now). 

The job can be very stressful on you and you can end up thinking why the hell do I do this job? Surely there are better jobs out there? Answer because you are made for this job and there is no better job out there. It takes a certain type of person to work in mental health. I mean some one that is not judgemental, not self opinionated, a great listener and actually gives a shit about people no matter what. 

In my job I have been told things by patients that would horrify the everyday public; we have to keep level headed and not judge. 

People think it has lots of perks;NO it doesn’t. Don’t get me wrong helping others, bringing people out of a bad place in their own mind or world gives you a kind of wellbeing and achievements. Hearing those two words, Thank you, just makes it all worth it. It’s an amazing feeling when you see a patient change from when they were admitted to being discharged to either home or a new placement. Yet sometimes there are low times when the treatment doesn’t seem to have any affect on them. 

For the health care assistance out there it is a great rewarding job. Stressful, painful, yet rewarding career to be in but it also could be a dead end job in the wrong place. There will be chances for lots of training to deal with patients, aggression, emergencies and many more situations. If you want to learn about different kinds of people, life, bad upbringings, the kind of nasty people that are out there, how to read potential risk situations then go into health care in mental health. 

I have learnt so much in my job as a health care worker with in a hospital and have so much information and teaching to pass on. I think something like blogging is the only way I could do it now. Don’t let anyone in your job talk down to you. People don’t realise that the health care assistance are the front line troops  in a ward setting. The patient will usually trust and form therapeutic relationships with health care assistance before anyone else. The patients will open up to you first and disclose things to you before qualified nurses or doctors. You are the eyes and ears of the ward and if people want to know something about the patients, you can guarantee the information would of come from a health care assistant first. Health Care Assistants are the backbone of the hospitals and wards; it needs to be recognised throughout the services whether it be NHS or private charity hospitals. 

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.

 

 

 

 

 

 

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.

 

 

 

Ordinary day for Jack — June 1, 2015

Ordinary day for Jack

Toaday is an usual day for Jack, this is because he has no work on today and he has not had any messages to come into work. So at this moment intime all Jack is doing is Just laying awake in bed looking at the clock on the wall ticking by second after second, minute after minute. After a while the clock hits eight oclock so Jack decides to get up and gets dressed in his gym gear. Obviously he doesn’t have a shower as he will be twice as smelly and sweaty when he gets back from the gym. So after getting dressed Jack goes down stairs and tries notr to wake his wife who is sleeping in bed. Jack prepares his protient shake (2 scoops) with raspberry flavouring and a 800 ml of squash with a little pinch of salt added to replace the lost salt from his workout. This squash to be fair is just like buying one of those workout drinks but only home made. Jack checks he has got his lock and key for his locker, music while he works out so he can drown out everything around him and concentrate during workout, gloves to reduce the chance of gripping blisters and finaly his sweat towel to mop his brow during workout.

Once hitting the gym Jack starts of with a cardio workout of twenty five minutes at a steady run, during his run Jack ups the pace a little more then after a few minutes reduces the pace, so his heart rate goes up and then goes down to make his body work harder. This will hopefully help Jack build up his endurance and help Jack burn some of his body fat as well at the same time. In Jacks line of work it does help for him to stay and keep fit as sometimes being inrestraint can have a toll on your body aand fitness will reduce the toll on this. After Jack finishes his run he decides to go to the seated row to work out on his back, some machines will be different in weight but Jack decides to set it at 70kg and does about 13 reps and repeats this at least four times. This works out those little wings on the side of you body lol. After this Jack strolls over to the free weights area and sees that are a lot of big lads around this area and most of them appear to be zoned out and concentrating on just them selfs. This is why Jack likes this gym he goes to as most people don’t stand in front of the mirror admiring themselves, People just get on with their own stuff. Once in the free weight area Jack decides to work on his biceps and does it standing with a barbell. On the barbell Jack sets the weight at about 25kg and does 15 reps and repeats this at least four times and after this Jack can feel his arms about to burst as he does his reps at a quick pace just to push his body that little bit harder. Once this is done Jack gets a dumbbell at the weight of 27.5kg and decides to do a one arm row, which means Jack kneels on a bench with one knee and braces himself with one arm and pulls the hanging weight upp to his chest at least 13 times and repeats this four times each arm. This will work out his back muscles at the top of his back/shoulders. Jack walks over to the lateral Pull down and sets the weight at about 65 kg and works out his back again with his biceps secondly. This for Jack after working parts of his back out is starting to be a little bit harder now. He does this though just to push himself that little bit harder and does 65kgs 13 reps at four sets and after Jack is now feeling it. Jack thhinks to himself why do I put myself threw this every other day. Walking over to the free weights again Jack picks up two dumbbells of 10 kgs and starts lateral arm raises to work his shoulders and the back of his neck, working the with reps of 15 and repeats these reps four times dropping the weights on the floor in pain but a good pain of accomplishment. Finally Jack decides to finish off with some more cardio and decides to set the running machine on a setting 5 which is hill running working up to 6% incline then after five minutes it straightens out again then repeats the angle of 6% again. Jack tries this for at least 15 minutes and does quite well at this. Jack knows if her had done this first he might of been able to do this a little better and faster, the only thing is now Jack is starting to feel the burn from working out. If any of the readers work out you will understand what Jack is feeling.

When Jack arrives home he strips off his gym clothes that are full of sweat and jumps in the shower, the reason Jack waits to get home and shower is because at the gym the showers are usually full and this will safe time and Jack can relax in the shower. After washing in the shower Jack dries himself off and hangs up his gym clothes to dry by an open window. Jacks wife is still alseep so Jack starts to walk down stairs and and goes to the kitchen. In the kitchen Jack makes himself a coffee and collapses on the sofa and puts on a film but turns down the volume so not to wake his wife up. Jack looks across at the time and it is already 12:00 midday but Jack decides to finish watching his film before making himself something to eat as he doesn’t feel hungry yet. Just because it is midday why should he eat if he is not hungry?.

Once the film has finished Jack wonders into the kitchen and makes himself a little snak to eat, he decides on some wheat bread crackers and mackerel in a sweet chilli sauce. Jack scoffs this down like there is no tomorrow and follows this with a green tea and mango drink. After washing his stuff up Jack wonders up to his room and jumps into bed where is wife is still sleeping. Did I not say, sorry but Jacks wife is still alseep as she worked a night shift and got home at five am that morning and she will work tonight as well. Whilst Jack is laying in bed he hears his phone ringing down stairs and jumps out of bed and rushes to his phone, answering it just in time. It is the agency asking if Jack can work a night shift in a hospital which is about 15 miles away from where he lives, this place is for the worst of the worst violent offenders with mental health problems. The agency say that because this place is such a high risk of situations the money will be about £35-45 an hour for a ten hour shift. Jack thinks that this is not to bad and agrees to take the work. This place Jack is going to is called Daniels Ward in a high secure unit where patients could be locked in the rooms for up to 2 hours off and on depending on their behaviour whilst mixing with other patients. If there is any risk or signs of a patient becoming unsettled they are escorted to their rooms and lock in there for a minimum of two hours. If a situation has started  due to a patient becoming unsettled then they will be secluded in a padded room for anything up to five hours depending on their behaviour during seclusion. On Daniels ward it is rare for a patient to be secluded long but it does happen.

Coming across as paranoid. — May 31, 2015

Coming across as paranoid.

Jack has just had a phone call  for an emergency shift cover, it is at a hospital for adults with mental health issues and the ward he is working on today is Belvoir Unit. This unit is a ward for  males from 18-65 years of age and the diagnosis ranges from Paranoid schizophrenic to self harmers and alcoholics. This ward is a ten bedded unit with mainly male staff but it also has female staff, as you will find out if you work on a male unit it always helps to have female staff in certain situations. Sometimes when a male patient has a situation that could turn violent a female presence doing the talking , de-escalation has a calming effect of the patient,  Don’t get me wrong it does not always work it could sometimes have the opposite effect. It’s all about knowing your patient and constantly assessing the situation and willing to take the lead in changing it in the last seconds. You will have to realise that even though all patients are there for treatment on one ward/unit they are or should be treated as indaviduals with careplans that are for the patients benafit not to make it easy for staff but easier stay for the patient.

Jack has turned up at 13:00 on a Thursday afternoon for his shift , he has been here a few times and has found it a little bit difficult as one of the patients pays a lot of attention to Jack. This is because the patient has told him he reminds him of a man the abused him as a child, thats why the patient pays a lot of attention to him. Jack has come across this attachment disorder before and it does not bother Jack, as he knows that he is not to alone at any time. So Jack goes in to the office and asks for a handover which took him about ten minutes to start as the nurse in charge is dealing with an incident on the ward. As the nurse in charge finishes and walks in the office she smiles and says to Jack

‘Sorry about the wait, we had an issue with Jon’.
Jon is the patient that has the attachment disorder with Jack. Jon over heard staff talking about Jack and another person coming in to work, which excited Jon and he started getting elaited in behaviour and could not bring himself down again. With Jon’s behaviour getting worse he had to either have oral madication to help him calm down but her refused this and had to be assisted by staff to have an Intramuscular injection to help calm him down. So this meant staff had to physicaly hold Jon by the arms, luckily Jon was willing to accept this I.M injection in the right arm just below his shoulder.
Jack listened to the hand over about the patients and the goings on in the ward and it appeared that it has been a settled day with just Jon playing up a little. After the hand over Jack walks onto the ward and greats the rest of the staff and says hello to the other patients on the ward. While talking to one of the staff after greeting everyone Jack talks to a member of staff called Carl. Carl is a senior health care assistant, who has worked on the ward for about seven years and to be fair he knows his stuff and knows most things about the patients. On the ward Carl is what is commonly known as a fire fighter on the ward, this means he is the first port of call for any incidents that occur on the ward. Carl starts to hand over a few things to Jack while they sit at the dinning tables which are just across from the day area where all the patients are sitting watching a film. Carl tells Jack that Dean who is a patient that has been there for just a week is having a rough time as he is suffering from Paranoia and p[eople should be careful when Dean is about. Dean is having such a bad time even if people look at him to long he starts to get paranoid.
As time goes on by on the ward Jack is sitting in the day area just keeping an eye of everyone, doing the hourly observations. This basicly means for the next few hours Jack has to be able to see all patients every fifteen minutes for the next few hours. Jack went off down the corridor with Carl to check on the patients in their bedrooms, and when they come across Jon’s room he is there standing at his door looking threw his observation window which is in the door. Jack looks in the observation window and gets a fright as he sees Jon just stairing straight back at him with a look of fear on his face. Jack turns to Carl and says
‘ Dam that scared the crap out of me’
and they bothered laughed at this and walked off, not thinking about the affect it will have on Jon who as we know is paranoid. As Carl and Jack walk off down the corridor back to the day area Jon comes out of his room shouting at Jack, as he knows better not to start on Carl. Jon starts to march in an agrressive manor towards Jack and Carl raising his voice but directing it at Jack saying
‘ what did you say about me?, what the hell are you planning?, your going to try and kill me arent you?’

Carl suddenly stands infront of Jack and tells Jon to stop shouting at Jack and he will let Jon know what they was talking about. Jon carried on marching towards Jack and Carl pulled is alarm and takes hold of Jon and Jack jumps in and takes hold of the other arm containing Jon just in case he gets aggressive. Carl raises his voivce a little bit just so Jon can hear him over his own voice, Carl tells Jon that Jack and his self was just saying that Jack got frighterned when he looked threw the observation window aand saw Jon just stairing and watching evrything going on. Jon shouts at Carl and says

‘liar you planning to kill me in my sleep, your working with them liar’.
Carl and Jack start to walk Jon down to the day area and went to sit on the sofa whilst still holding him. As we walk in the lounge the patients all get up and walk out of the lounge as Jon is shouting his mouth off. Jon is sat down on the sofa with Carl and Jack and Carl is left doing the talking as Jon has a little bit of hatred towards Jack as he thinks that Jack is out to kill him. Jon contiues with his raised voice saying that Jack is working for the company and they are sending Jack messages through the TV and he is recieving them by a transmitter in her head.According to Jon, Jack is recieving messages from ‘The Company’ and hearing orders on how to kill off Jon without anyone knowing what has actually happened.
At this point Carl activates his alarm and more staff respond into the lounge where the three of them are sitting. The reason why Carl has activated his alarm is because he knows when Jon starts talking about ‘The Company’ it usualy ends up with Jon getting so paranoid that he could get so aggressive that he may hurt someone. Carl looks at Jack and nods down to the floor as if to relocate Jon to the floor to control his outburst. As Jon was talken to the floor and the other staff came in and took hold of JOn, There was staff holding his left and right arm, legs and head. The qualified walks in and asks Carl what has happened and Carl explains to the qualified what did happen and at this point Jon shouts out
‘ You liar, you are planning to kill me tonight, I saw you whispering while you and Jack was watching me’.

Carl continues to explain what happened and Jon continues to shout.
‘There trying to kill me’

Nurse in charge says to Carl ‘i’ll get an I.M for Jon’

Jon hears this and starts to struggle more during the restraint by staff and shouts out
‘ No don’t inject me, someone help me she is going to kill me with an injection, please help me,

The other patients don’t bother with Jon as this is nothing new to see or hear. Carl starts to talk to Jon explaining what has gone on and what will happen like the injection as the situation has gone to far now. After five minutes the nurse in charge brings the injection and injects Jon in the left butt cheack and during this Jon starts to cry and says
‘I hope you are happy? You have just done what The Company have tried to do. You have just let her kill me’.

After the nurse in charge leaves it takes about ten minutes for the injection to work and now staff can relocate Jon to the seclusion room to calm down for a short amount of time. Staff come off Jon’s legs and ask Jon to bring his knees to his chest and the member of staff holding his head raise it up to hip level while kneeling. Once Jon is in kneeling position the staff guide Jon to standing with the staff but with Jon’s head ramining at hip level to the staff memeber holding his head. The staff and Jon walk to the seclusion room where Jon will spend a little bit of time to chill out. Once in the room they get in position to relocate Jon to the floor and once on the floor Jon starts off shouting
‘Don’t lock me in here the company will gas the room and kill me’
Once again Jon starts to become resisitive as in trying to get out of the room, but luckily the staff have put him on the floor face down and have full control of the situation. Fist thiing to happen is Carl and Jack bring the patients arms to his back to the point of resistance and the nurse controling the heand stands and takes hold of the arms and Jack and Carl leave the seclusion room. As Carl shouts that the door is clear the nurse on the head lets go of the arms and exits backwards from the seclusion room, shutting the door and locking it behind them. Jon gets up suddenly and starts to pound on the door shouting
‘Let me out, they are going to kill me’.
The nurse in charge goes to the observation camera and observes Jon for a while as he continues to pound on the door.

Inn the next few hours Jack has escorted patients to sessions and out round the grounds with no problems but the one thing the rest of the patients ask Jack is if he is ok after what happened. Jack just smiles and nods at the patients asking him this. Jack knows that he really should not be discussing the situations with other patients. Apart from this situation Jack has had a very peaceful day doing things he enjoys and also the patients sat in the day area watching a film. I thhink it was a comandy, rom com.

The thing you have to realise about people that suffer from paranioa is that if you whisper or constantly look at them you could trigger off their confrontational side. They may thing that you are plotting against them in some way. The government are sending messages through the TV or radio for people to attack certain individuals, plotting to start a revolution. When they are suffering in a bad way no matter what you say to them it may not register what you are saying and you are part of the plan to get them.
Hope you guys like what I have writtien? If you have please follow or leave a comment. I still have plenty more to write.

Just another day in Mental Health. — May 17, 2015

Just another day in Mental Health.

As you will find out if you are just starting in mental health or thinking of starting in this line of work, no two days are the same, they may appear the same but if you sit back and think about it you will see that nothing is the same way. In some small detail there are always differences no matter how big or small, plus you will find out that this line of work can be as exciting as you want or as stressful or boring as you would like it to be. So no matter how the job is it is what you make it and no matter what happens it is not always your fault ok, you need to remember this.

The patients wehter they are men, women, children or adolescents and in a setting of learning disabilities, mental health, rest bite, sectioned or day centre, they are there for a reason and what ever happens so be it. You have to look at the bigger picture with a patient, what I mean is if they swing for another person, you have to look at why they have. Are they hearing voices?, Do they see something evil or scary in the other person? or are they paranoid?. There could be a number of reasons for the outburst and you as a career should not think of locking them out the way (seclusion), yes you may have to use physical intervention to what level is down to the level of aggression at the time of the event. Once you control the situation then try and find out what is going on. You may only need to sit with the patient and de-esculate them (TALK), and you could find that after ten to twenty minutes of chatting that the situation may not of been under their control. So you need to show understanding and a lot of empathy in times of situations no matter what has arisen. Don’t get me wrong it can be hard not to feel anger when you get someone in your face either verbalising you with all sorts of threats and offending matter or aggression. You will come across a few idiots that do work in this line of work and enjoy a good restraint, if you can and you find yourself in a restraint with someone like this, try and get them taken over by another person. A person like this is likely to hurt you or hurt the patient and it will happen, I have come across people like this, not good.
You may at times find that a patient may fixate on you through no fault of your own, they just obsess about you, get excited or silly when you turn up for work. They may start to start a situation just so it drags you in to them and they will somehow get that contact with you. It could be starting a fight, self harming, destroying property or tying a ligature and when you do intervene they enjoy the contact. This contact could be anything from you just standing there observing a situation, restraining them, talking to them or telling them the error of their ways. If you find this happening then you need to try and not get involved with this patient on your own or stay out of any potential situation no matter how it turns out or if they request you, let OTHERS deal with it. Every nurse whether they be a qualified or a health care assistant you will come across a patient that will develop attachment problems with you no mater if you are male or female, in a relationship or single.
One of my biggest bug bears is that new staff wether they be young or older come into this line of work and after a few weeks they seem to think that they are there to be the patients best friend, NO, NO,No this is not to happen on any level. You are a Nurse and they are a Patient end of, they are there for their own issues and no matter what you are there to look after them and you DO NOT cross that line. Unfortunately it happens and this makes me sick. Wether they are adults man or woman they are classed a vulnerable adult and need protecting. So please no matter what the patient says to you or promises you remember you are staff, you are not their best friend. Along side this is staff thinking it is ok to tell the patient all their own personal details. This is a big NO as in later days it could present as a huge problem.
I remember an incident when a member of staff got on well with a patient and this member of staff told the patient the area they lived in and described things in the area and once the patient was discharged from hospital the patient went to the area the staff member lived and over a number of days looked about until they saw this staff member and followed them home. One night the patient knocked on this staffs door and lucky for the staff member they checked who was at their door through a window. The staff member called the police and police found that the ex patient was carrying a knife, who knows what would of happened? The patient was later sent back under section but to another hospital as this patient was proven to be a danger to the public. It was later found out that the patient had also been taken drugs which had an adverse affect on their mental state. So let this be a lesson to you that no matter how they appear at first their intentions may not be of sound mind. Not to scare you but things like this are rare and people learn quick from this.
One thing that always fills me with joy is when you first get a patient in and appears to be Psychotic and delusional then after building up a relationship with staff end up either going back home or to a lower secure setting. Even though you may not get a thank you from the patient you know at the back of your mind you have had a huge impact on this patients life. You have helped them get to were they are no matter how big or small the input. What a lot of people tend to forget is that we are all a team and no matter if you are the ward clerk, kitchen staff, cleaners, Health care assistant or qualified nurse we are all equal. Well we are supposed to be equal, but you will come across certain staff that will see HCA’s as a lower form of staff. Don’t let this put you off, if the wards did not have health care assistants the place would not run at all, no potential dangerous situations would never get found out and if there was no HCA’s was on the ward who would be the first people to deal with situations on the ward. The HCA’s well some not all are the firer fighters of the mental health world and I think this is needed to be more recognised in this industry.
There are a few HCA’s in mental health hospitals that will be the first into a situation to protect the patient or others with no regard for their own safety just so that the vulnerable one is safe. In mental health the HCA’s and other staff will come across situations that will involve weapons which could be made from all sorts of things. Things like toothbrush, pens, ligatures, pieces of broken wood or plastic. The problem is that the staff do not have the opportunity of protective clothing or training to deal with situations like this. Usually you will find that it is the policy to call the police. You will find that in the hospital settings that there will be more than enough staff willing to do training to deal with these dangerous patients and situations. I’m not the only one that thinks that the police should not be the first port of call for these situations, there should be a group in most hospitals that deal with dangerous situations just like in the prison or detention centres.

Jack at the Bungalow — August 24, 2014

Jack at the Bungalow

08:30
Jack hangs up his phone and looks at the clock and it says 08:30 but it feels like it is the early hours of the morning. Jacks phone call was from the agency and they have asked him to go and work in a small town called Brinklow. In the town is a purpose built bungalow that houses two gentlemen in their fifties’ and they both have learning disabilities. One of the men is known as Charlie and the other man is known as Chris. Charlie was born with learning disabilities and has a tendency to be aggressive at times if he is asked or told to stop doing something. The good thing with Charlie’s aggression is it usually stops when staff have to physically intervene, don’t get me wrong Charlie is not that bad. He is a loving and affectionate man, to affectionate at times, plus you can have a great time playing around Charlie. Now Chris is a cute man, he is cheeky, likes to try and play tricks on people and loves to wind Charlie up. He was born a healthy baby but when he was about five he developed a tumour on his brain. The doctors decided to operate on the tumour but this left him with brain damage but it was either operate or his parents would have to watch him die slowly. Chris is a gentle bloke but he has the odd occasion where he has aggressive outbursts. The two guys mostly have fun and settled days going out to parks, town, pubs for meals, college and in the next town over there is a disco held in the evening for service users. The nursing team always has to assist the guys with getting dressed, toileting, baths and cooking for the two guys. This building is built just for the guys and it has a big garden with high walls and Charlie loves to go outside and kick a ball about which seems to make him laugh. Whereas Chris just likes to sit in the garden on his own chair.

09:30
Jack arrives at the Bungalow in his car which happens to be a ford focus sport, with black and silver paint work. He has to drive about to find a parking space as some people who can only be described as bloody idiots have parked at angles and double parked. Jack finally pulls up into a space and jumps out of his car and turns and walks off to the Bungalow. As Jack nears the building he can hear screaming and shouting coming from the building opposite. That building is a house for adults with learning disabilities but it is for rest bight. So it is a short term basis to give their carers a break from a few days to up to a month at a time. Then all of a sudden Jack can see at least four to five men and women running from different buildings over to the house from which he heard screaming. So he continues to walk up to the Bungalow and rings the bell. He waits a few minutes and there is no answer so he tries again but just as he presses it he can see someone come from around the corner.
It is a woman in her thirties long dark hair and slim, as she walks up to the door she opens it with a stern look on her face and when she opens her mouth what she says comes out in a harsh stern way just like she is talking to a naughty child,

“What, erm can I help you” she says.

“I’m Jack from the agency and I have come to help you for a few hours” but thinks to himself with a smile on his face “bloody rude cow”.

“Come in, sorry for the way I spoke it’s that we have just had Charlie kick off a little bit and we had food thrown everywhere”.

“Ok not a problem” replies Jack.

“I’m Alison and I’ll be working with you this afternoon, come and take a seat and I will give you a hand over of this morning”.

The hand over takes about twenty minutes which to be fair is a long time just for two patients that have simple easy needs. So after Alison has finished she stands up and asks Jack to follow her in to the lounge where Chris and Charlie are sitting watching TV and playing with toys. Alison walks into the lounge with Jack following behind and turns to the other staff member Lisa and Chris and Charlie and says

“Everyone this is Jack he come to work with you this afternoon” saying in a loud voice.

Lisa turns and smiles at Jack and says “nice to meet you I’m Lisa”

“Nice to meet you too” shaking her hand and responding with a smile.

Charlie puts his toy down and just stairs at Jack then as he starts to get up he walks over to Jack and stands very close to him and gives Jack a huge toothless smile and hugs him. Jacks heart has just jumped about twenty feet from his body as he was not expecting that. As Charlie is hugging him all Jack can hear is

“mmmmmmmmmm” coming from Charlie

“OK that’s enough now let me go” is Jacks response to this show of affection.

After a couple of seconds after saying this Charlie lets go and goes back to his toys mumbling under his breath but to quietly for anyone to hear. Alison just looks at Jack and shakes her head as if to say don’t worry about that. Then Alison walks over to Chris and says to him

“This is Jack you going to shake his hand “

Chris laughs and giggles at Alison and then holds his hand out as if to shake his hand, so Jack holds his hand out in response to Chris and shakes his hand. While he does this Chris taps his cheek with his other hand and then Alison and Lisa laugh at what Chris did

“What does that mean” Jack asks them while they still laugh

“He wants you to kiss his cheek, he like you” replies Lisa

While Jack still has a hols of Chris’s hand he can feel a little pull from Chris, so Jack bends forward and presses his check against Chris’s cheek. Up on doing this Chris starts to giggle like a little kid and pushes Jack’s hand away, as if to say you can go now. Jack stands up and smiles at Chris and says

“I can see you are a cheeky one”

What seems like a grunt from Chris comes out of his mouth at the same time he nods his head as if he was saying yes.
Alison then turns to Lisa and says to her
“You can go home now if you want; I’ll still sign you here until twelve mid-day”.

Lisa smiles and thanks Alison and walks out of the lounge and picks up her bag from the office which appears to be somewhere he has not been shown yet. Alison asks Jack to follow her and then she continues with the tour. As she walks out of the lounge she turns right then right again and she is in the nurse’s office. Alison then quickly shows Jack this and then shows him where the bathroom and the toilets are for the two guys and staff. After his little tour Alison and Jack head off to the kitchen and sit at the dinning table. Alison asks Jack

“do you fancy a cupa”?

“strong, milk no sugar thanks” replies Jack.

So Alison stands up and walks off to the kettle and starts making the drinks.

“Chris, Charlie, come and get a drink”.

A second or two later you can hear a little giggle come from Chris and then what sounds like Chris singing Dupy do a few times over. Then both Chris and Charlie come wondering in to the kitchen but as they both enter Charlie pushes Chris out of the way. With Chris being a little instead on his feet, over he goes. Jack jumps up and goes to Chris’s aid, as Jack goes to help Chris he attempts to hit Charlie but misses as Charlie was to quick. Jack helps Chris up on to his feet but Chris has started to get upset with the whole situation. Alison turns to Charlie and raises her voice to a tone of mother and points to were his room would be, saying to him

“Go to your room and think about what you have done”.

Charlie just sits at the table and looks at Alison as if he has no idea what she is on about. Again Alison raises her voice and demands that Charlie leaves the kitchen. Still Charlie sits looking at Alison and then she walks over to were he is sitting and pulls Charlies seat from under the table and takes hold of his wrist. At this point Charlie stands and walks with Alison, while I am still with Chris. As Charlie gets near to Chris he sticks his tongue out and starts to attempt to hit Chris. When Charlie sticks his tongue out its a tell that he is about to be aggressive. Jack being a hero stands in front of Chris so he does not get hit. At the same time Jack grabs both of Charlies wrists and Alison pulls Charlie away from Chris. All of a sudden Chris screams out at Charlie and all you can then hear is

” bastard”

Jacks says to Alison ” Wasn’t expecting that” and laughs.

Charlie is taken into his bedroom and both Jack and Alison sit him on the bed. Carefully they let go of Charlie and back away towards the door. Jack goes off to the kitchen and sits with Chris asking him if he is ok. Chris responds with a little grunt as he nods his head and then looks at Jack with a cute smile. Alison continues with making the tea but instead of just three cups she makes four cups. She places the four cups on the table and then calls out

“Charlie, teas ready”

Jack hears a door slowly open and then shut, it takes another minute or so for Charlie to make an appearance. Alison says to Jack quietly

“Just look at him”

Jack doing as he is told just looks at Charlie who slowly appears from round the door and enters the kitchen. Just picture a naughty told off teenager who is looking rather sheepish, this is Charlie’s manner at the minute.

“Come and have your tea Charlie and be good” says Alison.

What can only be described as eeeeeeeee came from Charlie as he came and sat down at the table. Alison stood back up and walked over to the cupboard and pulled out a tin. Jack looks at Chris just to make sure he is ok and notices that he has a huge smile on his face. Just as if he knew what Alison has reached for.

“Anyone want some biscuits” asks Alison.

She turns round and sees Chris and Charlie smiling like a pair of Cheshire cats. Now this is a great sight seeing the simple thing please these two guys. Alison hands the tin over to Charlie and when she does this Charlie hands the tin to Chris as if in his own little way in saying sorry. Chris giggles at this and then Charlie starts to pick a huge handful of biscuits for himself.

“Charlie” is snapped from Alison

With this Charlie drops the biscuits back in the tin and this time takes out just two biscuits. Charlie then hands the tin to Jack and so he takes a biscuit out and says

“Thank you Charlie” with a smile on his face.

For the next ten minutes there is silence while drinking the tea but then Alison asks Jack

” so what do you think of this place and the guys so far”?

” love it, this is the first time I have worked somewhere were it feels like a home not a hospital” replies Jack.

“so would you come back then”? Asks Alison

” without a doubt I would” responds Jack.

After everyone has finished their drinks Jack stands and offers to do the washing up. With this the two guys leave the kitchen rather quickly giggling to themself. Alison says to Jack that the guys are supposed to do the washing up, but as you offered they ran off. Jack can hear the humour in her voice as she talks to Jack.

11:00

The washing up has been done and is drying on the draining board and Alison has just made an entry in both the guys notes about Charlie pushing Chris over.

“Can you cook” asks Alison

” I’m good at spag bol” replie Jack

” ok great the guys love that, do you mind making it and ill help but keep an eye on the guys” responds Alison.

“Sure not a problem” responds Jack.

Alison walks out the kitchen and Jack hunts through the cupboards and the fridge for the ingredients for his version of spag bol. In from of him he has two large onion(salad onions), peppers, mushrooms, pot of gravy, chopped tomatoes and spag bol sauce. To start with Jack peels the onions then washes them under cold water. This is supposed to help reduce the crying affect when cutting onion’s into pieces. Does this work? The hell it does after cutting the onions Jack eyes are watering like a water fall and sting like nettles.

” What’s wrong, why you crying? Its ok” says Alison with some humour in her voice.

Jack finds Alison’s humour funny and laughs at what she said. With the onions cut Jack washes his hands then rinses his eyes just so he can see again. Then he makes a start on the peppers and mushrooms. Alison explains that the peppers and mushrooms need to be cut into small pieces so the guys can swallow them with no problems. Once these have been cut Jack fills the kettle up with water so he can boil it for a small amount of gravy and so he can have some stock to pour in with the mince beef. Once Jack has prepared this he looks for the deep frying pot and calls for Alison

“Where is the frying pot? I can’t find it”.

“In the cupboard next to the sink on the left” replies Alison.

Jack bends down to peer in the cupboard and finds the pan buried at the back, as Jack tries to pull the pan out and he is able to knock everything over.

“You ok in there”? Calls out Alison, with what sounds like laughter in her voice.

“Yes I’m fine I just knocked all the pans over”.

Jack leaves the pans for now and continues with the cooking, as he turns on the hob on the cooker and puts the pot on top but without any oil. He puts the mince beef in the pan and starts to cook the beef for about five minutes. As the mince starts to cook he adds the mushrooms, onions and peepers into the mince beef and continues to cook this for about another ten to fifteen minutes. Turning down the heat Jack pours in the spag bol sauce mixing this in he also pours in the stock and mixes it well. Leaving it to simmer for a while Jack asks if anyone wants a cup of tea, in walks in Chris and Charlie with big grins on their faces and Chris is repeatedly saying
“Tea, Tea, lovely tea”.

While they both take a seat at the table Alison comes in the room and tells Jack that she is going to do the washing up and makes a start with this. Jack moves all the equipment he has used and places it next to the sinks draining board.

“Thanks Jack, I’d love a cup of tea as well” with a smile.

“No worries, I’ll sort that out”.

Jack places the cups of tea on the table and hands Chris and Charlie’s cups on a table mat in from of them and ask them to take it easy and don’t drink it too fast. Chris being Chris doesn’t listen and takes a big gulp and all you can hear is a moan as if it hurt to swallow the tea. Javk checks the dinner and sees it is ready and asks Alison

“Where are the plates”.

“They are in the top cupboard next to the fridge”.

Jack opens the cupboard and pulls out four large plates and places them next to the hob. Jack turns and takes some crusty uncut white bread out of the bread bin and cuts about six thick slices and cuts them in half. Putting them on an extra plate and puts it in the middle of the table, looking at the guys Jack says to them

“Leave these for now until you have your food” with a smile on his face.

The two guys start to smile as Jack dishes up the food but give’s Charlie and Chris about two large serving spoons and gives himself the same to Alison. Alison hands the guys a serviette and they tuck it into their T-shirts so if they spill anything it hopefully go on the serviette. As the guys start to eat they tuck in really well but Alison says to the guys

“Take it slowly guy”

With the eating going on there is not a lot of noise or talking going on. There is a lot of eating and dunking the slices of bread in the sauce of the spag bol, to me this probably the best way to eat this meal. The meal takes about fifteen minutes to eat as the guys are not fast eaters and If anyone got up from the table Chris and Charlie would also leave the table and it would be a little difficult to get them back. When they both finish eating Alison takes their plates and puts them in the sink and Jack stands up and places his plate in the sink as well.
Looking at the guys Alison takes off their serviettes from the top of their T-shirts and this time Charlie has not spilt anything over his clothes which is good for him. Looking at Chris he has spilt a lump of mince down his top but Chris sees the mince and picks it up and pops it into his mouth saying

“mmmmm”

Alison and Jack laugh along with Chris, Alison then asks Chris to get up and go to his bedroom so he can change his T-shirt. Up stands Chris and heads off to his room followed by Jack just to assist him if Chris needs it. As they both pass the lounge Charlie is sitting on the floor playing with his toys and Jack thinks that Charlie looks so happy, which is nice to see. Entering Chris’s bedroom there is a big wardrobe at the end of his room against the wall and a big bed on the right side just behind the door and on the other side of the bed is a high chair for Chris to sit on. In the left corner of the room set up high is what looks like a thirty two in TV on a swivel wall bracket and the remote for this is on the bedside cupboard next to the bed. While Chris goes steadily over to his wardrobe he opens the door and pulls out a blue T-shirt with a pocket on the breast.

Jack asks Chris “do you need help changing”?

Chris replies with a nod and a grunt and Jack assists Chris with taking his T-shirt off and helps him put on his blue T-shirt. Chris smiles and thanks Jack then heads out of the bedroom and starts to head off to the lounge but Jack call him back and tells him that he has some dried sauce around his mouth.

“Come on Chris come to the bathroom lets wipe your mouth clean” Requests Jack.

As Chris stops walking in his tracks he starts groaning but turns round and starts walking to the bathroom. Jack opens the door to the bathroom and wets a flannel and gently wipes Chris’s mouth and makes him look presentable. As Jack finishes this Chris looks a Jack and then suddenly burps in Jacks face. Doing this makes Chris laugh and Jack also sees the funny side of this and to be fair it was a loud burp. Alison calls out from the kitchen

“Was that you Jack? Pig” said with humour.

“No that wasn’t me, it was Chris” replies Jack.

Chris wonders off into the lounge and sits in his high recliner chair in front of the TV. Jack goes into the kitchen where he finds Alison doing the washing up. Jack Takes a T-towel and starts to dry what Alison has washed up.

“Next I will have to give the guys their medication, do you want to help me”?

“Yes sure that be great” replies Jack.

Next to where they were standing is a big white metal cupboard which has a big lock on the door, in this cupboard with all sorts of medication in side. Alison dries her hands from washing up and pulls out a pen from her hip pocket and takes keys off her belt and opens the metal cupboard and takes out two blister packs of medication. On the blister pack is written days of the week with a starting date and morning and afternoon written on the packs. This is to make it easy for staff to dispense the medication amount and times of days. First to take their medication is Charlie and Alison says that Charlie might not come but we will see.

“Charlie come and get your medication please” shouts out Alison.

Slowly and shyly Charlie walks into the kitchen with a little smile on his face. Charlie walks over to Alison as she bursts the blister pack for this time into a pot. She tips it into Charlie’s mouth as he has a history of throwing his medication around. Charlie takes his medication with assistance from Alison and sips down some water to wash it down. Charlie walks off back to the lounge and continues to play with his toys. Alison calls out to Chris

“Come and get you tablets Chris”

Hearing a few grunts and groans Chris walks into the lounge and sits at the table waiting for his medication. Chris has to sit down when taking his medication as he would topple backwards if he took his medication. Alison hands Chris’s medication to him in a small pot and Chris swigs it back like a shot. Taking his medication Jack hands Chris a small drink of water, swigging that back jack slams the cup on the table and stands up and wonders off to the lounge and sits in his chair. Once Alison has done this she puts everything back in the metal white cupboard and locks it back up placing the keys on her belt.

“Come on let’s go and sit in the lounge with the guys” says Alison.

“Ok, so what is next then to do”” asks Jack.

“For now there is nothing to do until about three o’clock when we will go shopping” responds Alison.

So Jack follows Alison into the lounge and sees Chris sitting in his chair but he has reclined it back a little and he appears to be falling asleep. Over in the corner is Charlie sitting behind a chair playing with Lego just putting them together but not really making anything.

15:00

Alison says to Chris and Charlie “come on lets go shopping, Chris take yourself off to the toilet before we go”

Chris presses the button on his chair to sit himself up and heads off to the toilet. Once Charlie is done in the toilet he calls out and Alison says to Jack

“Could you just help Charlie get his trousers up please?”

“Yes sure not a problem replies Jack.

Jack helps Chris with his trousers and head off to the main entrance of the bungalow and waits for Alison and Charlie. Once they are all together Chris opens the door and takes Jacks hand and heads off to the car park towards their own vehicle. They have a big black family wagon with tinted windows and a pull out step for Chris to help him get in the vehicle. Jack helps Charlie and Chris into the vehicle and puts their seat belts on and then climbs into the front seat next to Alison who is driving to the supermarket. They pull out of the car park and head up the road and the journey takes about thirty minutes to get to the supermarket. During the journey Charlie has had his face pressed up to the window with the window slightly open and he must be able to feel the breeze blowing through the crack of the window. Entering the supermarket Alison gives Charlie the trolley because if he did not push the trolley he would wonder off and pick and break things. Once he has hold of the trolley Charlie’s concentration is all on pushing the trolley so he will not wonder off and cause a problem. Chris is able to be left to walk by himself, but Jack and Alison have to walk slowly so Chris can keep up. While wondering around Jack keeps an eye on Charlie just to make sure he doesn’t crash the trolley into anything or anyone. Once Jack and the team have filled up the trolley with food for the next two weeks they get to the till Alison gets Charlie to help take things from the trolley and place them on the conveyor belt. Chris stands with Jack at the end of the till and they both start to pack the shopping. The lady at the till speaks to Alison and they appear to know each other and what is great, the lady at the till is also speaking to Chris and Charlie as well and they seem to be enjoying the attention from the lady. Jack seems to be doing the packing by himself now and Alison is unpacking by herself as the guys love attention from others. Once packed up the shopping costs about £180 which isn’t too bad for two men and two staff for two weeks. Once Alison has paid the lady at the till she gets Charlie to help her push the trolley back to the vehicle. At the vehicle Jack gets Chris and Charlie into the vehicle and puts their seat belts on and then helps Alison pack the shopping into the back of the vehicle.
Once they get back to the bungalow Jack jumps out and opens his side passenger door and gets Charlie out and then undo’s Chris’s belt and he shuffles his way over towards Jack and gets out of Jacks side.

“Why didn’t you get out your side”? Asks Jack to Chris.

Chris just smiles and walks off towards the bungalow and follows Charlie to the door. Charlie tries to open the door but Alison calls out to Charlie

“Hold on Charlie I’ll open it in a second”

Alison takes some of the bags out of the boot of the vehicle and heads towards the door of the bungalow, she places one bag on the floor und unlocks the door and Charlie picks up the bag from the floor and carries it in. Whilst he carries the bag in Charlie knocks it against the door frame and against the walls as he carries it into the kitchen. Jack takes the last three bags of shopping and enters the bungalow and takes the bags into the kitchen. Chris walks off into the lounge and heads straight for his chair and plonks himself in the chair and reclines it back. Charlie hands things to Alison from the shopping the bags. Alison thanks Charlie for helping her and tells Charlie that he can go and play now but Charlie just sits at the table watching Jack and Alison. Now Alison starts to make a drink and asks if Jack would like another drink and fills the kettle up and gets four cups out on the counter. Once the kettle has boiled Alison makes four cups of tea and calls for Chris to come and get his drink but no reply. Jack gets up and wonders into the lounge and sees Chris in his chair laying back and it appears that Chris has fallen asleep. The long walk round the super market must have worn him out. So Jack decides not to wake him and just lets him sleep, to be fair he does look peaceful while lying back in his chair. So Jack goes back into the kitchen and tells Alison that Chris is asleep and he didn’t have the heart to wake him up.

“Not a problem, I’ll make him one later when he wakes up”. Alison says to Jack.

Jack sits at the table next to Charlie and sips his tea; Jack thinks to himself that Alison makes a great cup of tea. While Jack sips his tea Charlie passes over a tin filled with biscuits and Jack takes out two biscuits and enjoys dunking them in his tea. Unfortunately Jack left his biscuit dunked to long in the tea and as he takes it out of the tea it falls back in the cup splashing out. Alison starts to laugh as well as Jack as to be fair we have all done this at some point in our life.
Charlie finishes his tea and walks off to the bathroom. Alison follows Charlie and calls out to Jack to give her a hand with taking Charlie to the toilet as Charlie could be a handful and her being a female. Jack follows them into the bathroom and assists in toileting Charlie. Once this was done Charlie walks off to the lounge and stands staring at Chris as he is asleep and takes a few steps towards Chris. Jack gently takes hold of Charlie’s arm and says

“Charlie leave him alone please” smiling at him.

Charlie listens to Jack and goes and sits on the sofa and looks at Jack while pointing at the TV, so Jack turns the TV on and Alison who just walked in hands one of Charlie’s DVDS and asks Jack to put it on. Charlie is trying to see what DVD Alison handed Jack but he cannot see which one it is. Once it starts playing Charlie starts to bounce up and down clapping his hands together while sitting on the chair. Alison tells Jack

“This is Charlie’s favourite film”

Charlie loves to watch The Frog Princes but also likes other Walt Disney films as well. It goes on for about a hour and half and during that time all Jack can hear is laughter coming from Charlie. Hearing this makes his shift and job so worthwhile.

19:00
As Jack takes the DVD out of the TV he puts on another one for Charlie. Chris had already woken and gone off into the kitchen with Alison as she went to make him a cup of tea, the one he missed when he was asleep. Also Alison stated making the evening snack which consists of sandwiches and a few cakes.
The door bell rings and Jack goes and walks to the door and sees a tall man standing there with a rucksack on his right shoulder. Jack slowly opens the door and says

“Yes can I help you”?

“I’m Tom I’m the night nurse tonight” replies the man.

“Come in Tom, I just made a drink you want one” calls out Alison from the Kitchen.

Jack opens the door and smiles at Tom to which Tom smiles back at Jack and walks to the office which is opposite the door. Tom places his bag in the office and shuts the door behind him and heads to the kitchen. Sitting at the table is Alison and Chris and seeing the excitement in Chris’s face must mean that this bloke Tom is a decent guy and Chris likes him. Jack sits at the table with the others and drinks his tea and Jack turns to Alison and asks if she could sign his time sheet for him.

“Would you fancy working again tomorrow morning Jack” asks Alison.

“Yes for sure, I have loved it today it has been nice and peaceful shift “replies Jack.

Jack stands up and takes his time sheet out of his back pocket and hands it to Alison and she takes a pen from her pocket and signs his sheet. When she hands it back to Jack she says to him

“I’LL book you in now for the morning, the shift is from seven am until one pm is that ok”.

Jack responds with “that’s great, thank you very much for a great shift and I’ll see you in the morning”.

“Thanks very much Jack, see you in the morning” replies Alison.

“Nice to meet you Jack, see you in the morning” says Tom.

Jack says goodbye to Chris and Charlie and then heads off to the car park. Jack thinks to himself that the shift was great looking after the two guys, watching DVDs, cooking and going shopping. Jack is happy to be going back to the Bungalow tomorrow and wonders what sort of shift he would have.

Jack’s Day in Physio — August 19, 2014

Jack’s Day in Physio

Jack has a day off today and with one of his only days off he has to get up early but Jack is not feeling to bad about this, as he has an appointment at his physiotherapist and he has been waiting about two months for this appointment. Jack has an ongoing problem in his shoulder leading to his neck, so he has been told by his doctor that it torn tendons in his shoulder. Because of this problem Jack has minimal strength in his right should and arm. What he has in his arm is a constant stabbing pain around his shoulder joint and what only is described as a muscular pain in his tricep, like he has over worked it in the gym. Occasionally Jack also gets a down his left arm as pins and needles in his first two fingers and up his forearm and this has been going on for a while now and he has had enough of this now. In this time he has had this pain and discomfort Jack has had to miss out on going to the gym and using the free weights and it even hurts him when he runs. As well as this Jack has had to miss out on kick boxing (self defence) and missing this is not making Jack happy at all.
08:30
Jack sets off from home giving his wife a kiss goodbye as she is leaving for work at the same time as Jack leaves. Jack decides to walk because his wife is going in the opposite direction even though his wife has offered to give him a lift to the hospital, Jack decides to walk and waist time. As Jack watches his wife drive off to work he turns and starts to walk up the street and as he walks off Jack can feel in his left arm pins and needles set in with a pain in his shoulder. While he walks it feels like Jack is carrying a heavy weight in his hand but this discomfort is not to bad but the pain in his shoulder is annoying him as it does at times wakes him up from sleeping at times so he is hoping that the physiotherapist can help sort it out. It takes Jack about twenty minutes to get into town which is not far from the hospital where the physiotherapist is based. As he gets into town Jack walks through the town and off to a local popular coffee shop to get a medium latte. As he walks into the coffee shop Jack stands in the cue and starts to look around and watches what people are doing while sitting drinking their coffee and some eating pieces of cake. In the shop there are people dressed like business men and women and chatting like they are discussing business stuff, people using their computers, typing madly and some of them looking at their computer intensely and Jack just smirks to himself. The coffee shop worker says to Jack
“How can I help you”?
“Can I have a medium latte to take away please” replies Jack.
Jack hands over his point’s card and pays for the coffee with his points and then Jack stands off to the side and waits while the server makes his Latte which takes about five minutes in total. Jack thanks the coffee server and starts to walk out of the shop sipping his coffee and suddenly gulps as the Latte is too hot when it hits his mouth. I’m sure we have all done that at some point with a take away coffee. While Jack starts his journey off to the hospital he walks past a few offices asking for assistant P.A’s, receptionists, warehouse workers and packers, Jack stands there and reads what is written but nothing takes his fancy this time so Jack goes on with his journey. As Jack arrives at the hospital he tries to find on the hospital map where the physiotherapist dept is and only then Jack realises he has entered the wrong end of the hospital. Jack stands there a few minutes and studies the hospital map and goes on his way. Jack arrives in the right department and sees the reception is closed so he has to register on a computer touch screen. Jack goes and takes a seat and whips his phone out and starts to play in his phone and checks his face book and twitter and sees there is nothing new from earlier. Due to the injury Jack also sits and contemplates his future and thinks about what else he could do, maybe security, work for Mi5. After about fifteen minutes a man comes through the door and calls Jack’s name, so Jack puts his phone away and stands up and walks up to the man that called his name. The physiotherapist is a young man who cannot be more than twenty five/six and greats him with a smile. Jack follows the man into a room and he looks around and notices a table that looks like a massage table, three black chairs with a swivel chair and a table with two computers on them. The man sits opposite Jack and says
Hi I’m Toby; this session is about assessments and working from what you say”.
Cool, I don’t care what you have to do I just want the discomfort and pain to stop, the doctor in A&E and my G.P just seem to dismiss me” replies Jack.
“I won’t dismiss you or but in when you are talking” replies Toby.
Jack sits there and explains what happened in the past and what others have told him and what he has experienced in the last few months. While Jack is explaining what has happened he notices that Toby is writing everything down and drawing on a body map of the problem areas. While Jack observes this it does make it seem ‘at last someone is listening’ which makes it all worthwhile now. This whole process takes about fifteen to twenty minutes and then Toby shows everything he has written on Jack which pleases him.
“Can you sit on the edge of the bed and take off your top please and we will try a few exercises to sort this out” Toby says to Jack.
Jack stands up and takes off his top and walks over to the massage table sitting on the edge. Toby walks behind him and tries a few movement exercises and a few tension exercises and then Toby explains to Jack that it is not his shoulder that’s the problem.
“I’m going to press on your neck and while I do can you lift your head up and down” says Toby.
Jack sits there while Toby is pressing his neck and Jack lifts his neck up and down Toby explains
“I’m pressing on your vertebra C6 to be exact “
Jack carries lifting his head up and down while Toby presses on his neck and Jack suddenly realises ‘there’s no pain or discomfort’. Jack start to feel like a huge weight has just disappeared off his shoulders. Toby repeats this exercise with Jack at least ten times. When Toby has done with the exercises he mentions that he needs to repeat these exercises as much as he can lift his head up and down and this should reduce the pain and discomfort. Toby places physio tape over Jacks shoulder and down the left side of his neck. When this has been placed on Jack he feels that the pain is going to nonexistent. When finishing the session with Toby Jack feels so much happier and feels like that a weight has been lifted.
12:30pm
After the time in being treated by Toby Jack decides to go and try a work out in his gym, so he gets his gym stuff ready. Once Jack arrives at the gym he walks in and head to the changing rooms and on entering it is a little noisy with men laughing and chatting loudly about their workouts they have done. With Jacks shoulder just starting to be on the mend he decides to take it easy. Once changed into his gym kit he walks out of the changing room and fills his water bottle up. The first thing Jack goes on is the treadmill and does some interval running, this help burn body fat for the next twenty four hours so he was told. Jack walks for two minutes and runs at a reasonably fast pace for two minutes and repeats this for at least ten times and Jack adds the odd sprint in a few times. After completing this Jack goes to the free weights section and attempts bench press at 25kg- 13 repsx3, decline bench press at 17.5kg-13 repsx3 and then incline press at 25kg-13×3. Jack rests and starts to move his shoulders as he can feel some discomfort after this. After about a minutes rest Jack tries seated fly at 45kg-11×3 and then walks over to where he can do hanging leg raises. Jack attempts to try fifteen leg raises while hanging from a bar, but he can only manage about five in each set which he repeats five times. After doing these exercises Jack goes on the exercise bike and cycles for about twenty five minutes but this finishes Jack off. After doing this Jack realises that he may just have done a little too much but it was not painful for him. Jack goes off to the changing room and has a shower and freshens himself up and changes his clothes and realises that his tape on his shoulder is still attached. Once Jack is ready he head off out of the gym and walks home.
14:00pm
Jack arrives home and chucks his gym kick in the washing machine but also throws in some dark clothes from the laundry basket. Once the washing machine is set and running Jack sits on the sofa and crashes out and falls asleep like an elderly person having an afternoon nap.

Jack with the Adolescents — August 17, 2014

Jack with the Adolescents

Jack is working on an adolescent ward this afternoon and it happens to be a ward that he has worked on before. He is on Castle unit this afternoon and it is a ward for teenage girls that suffer from mental health issues such as self harm, eating disorders, past abuse and visual and auditory hallucinations. These patients have had a poor to horrific upbringing from family members to so called family friends. Jack thinks to himself how on earth can people do such nasty things like this to innocent children. It doesn’t matter who you are working in this line of work you do tend to feel for some of the patients that have to stay in hospital like this.
13:00pm
Jack enters Castle ward and walks into the nursing office which is just off to the left when you come onto Castle ward, he greets the nurse that is sitting at a computer with her back to him.
Jack greets the nurse;
“Hi I’m Jack from the nursing agency; I’m on an afternoon with you guys”.
The nurse stops what she is doing and swings round on the office swivel chair just a little too hard and nearly topples over as she tries to catch herself on the side of the desk she starts to laugh at herself. Jack wonders if she is laughing through embarrassment or does she genuinely finds what she did funny? As she lifts herself up Jack notices that she has turned a nice shade of pinky red and says to himself ” embarrassment” but only says this in thinking. To save her dying from embarrassment Jack says to this;
“At least I’m not the only one that falls off chairs”
Then gives her a little smile and takes a seat next to her. The nurse introduces herself as Karen and she happens to be the duty nurse manager of Castle ward. Karen asks if Jack has worked on here before to which he nods and says;
“About six months ago was my last shift, I spent most of my shift on a constant with a patient called Sarah”
Karen replies to Jack “Sarah has been transferred to adult services back in her home town”
Jack just smiles as that shift was a bit of a nightmare from what he can remember. Karen hands over about the patients to which there are eight girls in total, mostly suffering from abuse and have a history of violence to staff and self harm. In Jacks history he has found that he does work well with patients that have aggressive behaviours and self harm. Karen mentions a patient called Terri;
“She has a history or aggression and serious self harm which possibly stems from early abuse and has a six inch open wound on her left arm which will not heal as she keeps reopening and now the skin will not grow back over it and it is all dried up. Terri does try to stick objects in her arm and will try to make her arm bleed”.
First thing Jack asks is “is she on a constant and do you want me to be on her constant”.
Karen looks at Jack and smiles and says;
“Yes I’m afraid so, is that ok”?
Jack simply nods and responds to her by saying;
“that’s fine with me I do my best work with difficult patients like Terri”

As Jack stands up Karen says to Jack;
“one more thing Jack, Terri is having a visit from her boyfriend at about three o’clock and they will probably spend time in her room which is fine but just keep an eye on him as he does not help Terri”.
Jack asks ” what do you mean”?
Karen tells Jack ” he brings stuff in with him for her to self harm with but we know he hides the objects on himself and we can’t search him. If you see anything he is to leave straight away”
Jack responds “ok not a problem, he will be leaving quickly if I see anything”.
Jack walks out of the office and onto the ward and as he walks through the door he scans the ward through a window in the door just for his own safety. He doesn’t want a patient trying to run at him to get out the door, or as has before to be punched in the side of the head before as he walked into a ward in the past and it is something he doesn’t want to happen again. As Jack closes the door behind him he sees two staff towering over a patient who is sitting in a corner of the day area facing the wall. The two staff are just standing there and as Jack walks over and nods at them he wonders to himself
“why does one of them not sit down next to the patient and talk to her”?
Hey but who is he to judge right he doesn’t know the full story. As he gets over to the two staff Jack says;
” I’m here to be on Terri’s constant, where is she”?
One of the nurses respond in an unprofessional manner and say;
“thank god for that, this is Terri and she has decided to sit her and not come out of the corner and we have had enough”
Jack looks at the idiot talking to him and has a feeling of wanting to slap the arrogance out of him a few hundred times and just responds
“well maybe if you sit down next to her and try something unusual in this job, talk to her”
Jack just looks at him then plonks his butt down next to Terri. She turns round with a smile on her face and just says
“thanks, they don’t want to talk to me when they are on my constant”
Now Jack doesn’t know the full story of what’s going on here buy he is not easily fooled by patients’ as he has learnt quick. Now what you got to understand about Terri is she does manipulate or tries too, a situation to her advantage just so she can have an opportunity to self harm or get stuff to hurt herself with. Terri is a 17 year old girl from a well to do family and she is dearly loved by her parents. Het history is that she went to a general school but she was top of all her classes sand she was pushed by her parents to succeed as well. Doctors think the pressure to do well from her parents and getting bullied at school caused her mental health issues. Terri is a short girl slim with long dark hair and dresses in dark blue Nike trainers, with gold digger track bottoms and a dark blue Nike hooded top.
Jack introduces himself and says
“I’m on your constant for now, ok so lets not have a bad few hours please” the smiles at her.
Jack suggests getting up out of the corner and maybe walking up and down the day area or having a game of cards. Terri smiles and starts to get up and says
“can we just walk up and down for now”
So up Jack gets and starts to walk with her at a slow pace which suits him just fine. Terri stops and asks Hack to let her in the toilet as she needs to go desperately. Jack looks at her and says
” you are fully supervised so you need a female staff member to let you in a observe you”
Terri expression changes to somewhat of annoyance and replies to Jack in a hostile, annoyed and angry voice
” no I tucking don’t I’m not supervised”
Jack stands his ground and replies to Terri in a calm and softly spoken voice
” I have just had handover from Karen and she has told me you are on full supervision”
Terri buts in and still angry saying “well she fucking lying”
Jacks says “OK shall I just call her out and we will ask her yes” , Jack turns as if to go and call Karen but Terri grabs his arm and says
” no don’t I’ll get Susan to supervise me”
Jack doesn’t say anything her just smiles and calls out for Susan. As Susan walks over the three of them walk over to the toilets and Susan opens the observation hatch in the toilet door then unlocks it and asks Terri not to try and lock the door to which Terri responds
” I know for fucks sake” and then slams the door.
Susan lets Jack know that he handled her well then playing her bluff about calling Karen. Jack responds with just a smile as her doesn’t take compliments very well, he gets all embarrassed. After about five minutes Terri comes out of the toilet and walks away from Jack and Susan just giving and evil stair at Jack. This doesn’t bother Jack as this reaction is common in this line of work from the adolescent patients. Terri storms of and goes and plonks herself on the sofa in the day area and watched TV with some of her peers, it appears to be some sort of crappy soap that they are all watching which happens to be very cheesy in the acting parts but this does amuse Jack so he joins her and sits next to her. By the look on Terri’s face she does not seem very happy that he has joined her on the big brown leather looking sofa but to be fare she has no choice in the matter.
15:00pm (3o’clock)
They sit there for a while and then Karen comes looking for Jack and Terri and calls out to Terri that her boyfriend is here and Terri’s expression and body posture goes from annoyance and slouchy to a big beaming smile and to Terri sitting up straight just like a lady of well to do upbringing. Terri stands and walks over to her boyfriends and she raps her arms around him hugging and kissing him like a woman that has not seen her husband from before the war. Terri asks her boyfriend is known as Jon and appears to be dressing very much like Terri in Nike trainers with track bottoms and a blue hoody with what appears to be a gold necklace around his neck,
“Let’s go to my bedroom” she says to Jon and then turns to Jack and says
“Can you and Susan take us down to our bedroom please?” she asks Jack.
Jack has noticed that she is all politeness and sweat when her boyfriend is here but Jack being Jack just turns to Susan and calls for her to come down with the three of them. Susan gets off the sofa and follows the three of them down to the bedroom corridor to Terri’s room. Jack walks up to the door and opens it for the two love birds but Terri says in a demanding and bossy tone that comes across as sharp as well
“You have to wait out her”
Jack just smiles and notices that the boyfriend just stairs at Jack in a cocky, attempting to look tough manner. Jack just looks back in a manner of I really cannot be arsed with your childish way. As they walk into her bedroom Jon slams the door shut and he can hear from the bedroom Jon speaking to Terri saying
“Don’t fucking like that nurse with his cocky attitude; he’s lucky I didn’t slap him out”
Jack just looks at Susan and laughs and Susan tells Jack that he shouldn’t worry about Jon,
“He’s just a wonna be gangster but can’t stand for himself”
Jack just smiles and replies “that how it appears to me too”
Jack goes back to the door and he can see Terri and Jon sitting on the bed looking in a carrier bag that he had brought in for her. Nothing looks too bad at the minute just Jon’s dress sense and so with that Jack sits back down with Susan. They sit there and every ten minutes one of them has to get up and just check on the pair in the room. About an hour passes and all of a sudden Jack and Susan hear a sound coming from Terrie’s room. It can only be described as a yelp from a woman that appears to be in pain, so with this noise Jack walks over to the door and looks through the observation window in the door and all he can see is Terri sitting on the bed with her arm out to the side and her boyfriend standing in front of her arm and doing what looks like he is shaking something over her arm. Jack swings the bedroom door open and it bangs against the wall and this makes Jon drop whatever was in his hands onto the floor. Jack looks on the floor and it appears to be a tubular container which is white with black writing on and a load of powder falls out over the floor. Jon quickly bends down and tries to pick it up but Jack rushes over and as Jack goes to pick it up he knocks into Jon and Jon goes to the floor with a thud and Jack manages to pick it up before Jon realises where he is. All of a sudden the attack alarms go off and Jack turns round and Susan has activated the alarms and she is starring at Terri’s arm. Terri’s arm which has the open wound on it appears to be raw red almost like it is burnt with specks of white powder over her wound and it is just starting to bleed. Jack looks at what he has in his hands and what is written on the container is oven cleaner, with this Jack looks over at Jon who is starting to get his arse off the floor and Jack says to Jon in a tone what only could be described as ‘I’m going to kick your ass’,
“What the fuck is this? You little shit, how could you do this’
Jon’ response which sounds like someone that’s going to get his ass kicked replies
“She asked me to bring it in”
Jack goes over to Jon thinking I really want to kick the shit out of you but at the same time thinks to himself “you aren’t with losing my job over”. Jack grabs him by the shoulder and drags Jon backwards out of the room and tells Jon to
“Get the fuck off the ward and don’t come back”
Jon has appeared to be a wonna be gangster but to Jack he is a frightened little boy who is under the spell of his girlfriend Terri. Jack watches Jon walk off down the corridor with his head bowed down and sees him walk off the ward but as he gets to the door Jon turns round and shouts at Jack
“You better what your fuck back matey I’m going to get you”
Jack stops in his tracks and turns round to face Jon and starts to run at Jon but Jon bolts it out of the door as quick as a flash and then Jack stops and heads back to the bedroom. Susan heads out of the bedroom and raises her hand and puts it on Jacks chest as if to stop him entering the bed room. Jack stops and looks at Susan and replies to the gesture
“What? What have I done?”
Susan asks him “why do you think you done anything wrong”?
Jacks reply was “well by the look on you face I would say that I have and I’m in trouble”
Susan then smiles and says to Jack “you haven’t done anything wrong, we can’t stand her cocky boyfriend and we have wanted to kick him out for a while”.
Jack smile back at Susan and tells her “well that’s what I’m here for to do the jobs that no one wants”.
At this point the response team that came to help out come out of the bedroom escorting Terri down the bedroom corridor and into the clinic. It looks like she is going to get treated for burns to her arm and well she will have to go to the hospital later if it’s serious enough. Jack goes off to the office and sits with Karen and explains everything what had happened from the moment they got to her bedroom.
18:00 (6 o’clock)
It has taken quite a while to fill out the paper work with Karen as Jack being on the agency does not have access to the patient’s notes. So all the relevant people have been contacted, like Duty consultant, Nurse Manager and the police. To be fair even though the patient has asked for this stuff to be brought in and Terri asked Jon to poor it in her open wound Jon has still committed an offence and the police need to be informed. So once all the paper work has been done and Jack has written his statement it appears to be seven o’clock. Jack looks at his watch and thinks dam that went so quick. Karen turns to Jack and asks if he would come back and work on the ward which seems to be a great idea as Jack does need to have a permanent job with regular hours. There is a knock at the door and it is Terri standing there all bandaged up looking sorry for herself and tells Jack
“I’m sorry for that” looking at Jack.
Jacks response was “there no need to say sorry to me”
Terri quickly turns and walks away to the lounge with her two constant nurses. Jack tells Karen that he has had a great shift and it has gone so quick with everything that has happened but he has enjoyed the evening.
“Thanks again” says Karen as Jack walks off and then Susan calls out to Jack “thanks for the help”.
Jack just Bowes his head and walks off the ward through the door and thinks that was different for sure.

Some of the things Jack has learnt in mental health. — August 16, 2014

Some of the things Jack has learnt in mental health.

As I have already said before Jack has worked in mental health for a number of years and he has learnt quite a lot. Today Jack is going over things he has heard and learnt about in his working years such as:

Patient= A person also will be known as a service user with in the hospital or service of mental health.
Nurses= A person that has done training at university for up to three years and has passed their training and assessments to be recognised as a qualified nurse.
HCA= Is a person who is also known as a nurse, health care assistant, care assistant or nursing auxiliary. These people are the front line on the wards and have a lot of input towards the client or patient getting treatment.
Consultant= is the term used for the doctor in charge of the patient care while they stay in hospital and are also known as a Psychiatrist.
Section= this is a legal holding power for the mental health team that enables the hospital to keep a patient for treatment.
Section 2= A patient is to be detained under the mental health act for up to 28 days for assessment but they could be taken off the section before the 28 days.
Section 3= the patient is to be detained for up to 6 months for treatment and also they could be released before the 6 months is up. If not then the section 3 will restart after the 6 months and the patient could be detained up to 12 months.
Schizophrenia= a patient could hear or see things that are real to them but we cannot hear or see and this could be upsetting to the patient. It could affect the patients thought process, perception of reality and fantasy, set on paranoia and also aggression.
Paranoia= a patient could be thinking that people are talking about them, people are out to get them and sometimes that the government are out to get them and could lead to aggressive or abnormal behaviour.
Meds= medication given to patients that is supposed to help the patient in their treatment and help settle them.
Self-harm= this is when a patient will physically hurt them self by either cutting them self, head banging, pulling out their hair or in some cases starving themselves. There are so many reasons why a patient will do some of these things such as a history of abuse, bullying overpowering people in their lives. The list can go on.
Control and restraint= is the act of controlling a patient that could have been aggressive towards another patient or staff member and the team has to stop the patient with physical intervention. Staffs are trained to a high standard when using these techniques.
Seclusion= this is when a patient has been highly aggressive towards someone and they have to be removed from the environment into a low stimulus room. Some seclusion rooms have padding on the walls, floor and doors but some don not.
Enhanced Nursing= A patient will have a nurse with then 24/7 knowing where and what they are doing.
Arms Length= The nurse is to be within arms reach at all time.
Eye sight= The nurse has to be able to see the patient at all times.
Allocated= Is to know what the patient is doing and where they are at all times but does not have to be in eyesight.
2-2-1= a patient has two nurses with them all the time.
1-2-1= a patient has one nurse with them all times.

These are just some of the things Jack has come across in his journey in being a mental health nurse and working in different places and with different patients and nursing teams. Jack has never wanted to be a qualified nurse as there is a lot of responsibility on the nurse’s shoulders while looking after the patients and a hell of a lot of paper work too. So Jack decided to stay as a health care assistant and work mainly on the shop floor with the patients and he feels that he has more of an input in the patient’s wellbeing.
Over time we will come across a lot of patients Jack will meet with all sorts of history and some sad and some horrible, which could make you think “how could anyone do this to some people”? It is easy to understand why some patients can be aggressive towards others with their past. Have trouble building up trust in the nursing team as people they have trusted and loved have hurt them and let them down so why should the nurses be any different. Jack has come across patient that has had no family input while they have been in hospital. A lot of family visits and input and have a good family life. Drug induced problems brought on by drugs or was the problem there and the drugs just help bring it out? Who knows really.

Jacks day in working as a Health Care Assistant — August 7, 2014

Jacks day in working as a Health Care Assistant

07:00 am
The alarms goes off to the music of radio one and Jack wakes to a startle as he had been drinking the night before. Jack reaches over and slams his hand on the alarm clock radio to turn the noise off. Jack rubs his hand over his head rubbing it and says to himself ‘shit what was I drinking?’. then roles back over in bed just lying there, feeling a bit worse for wear from the previous night. Jack turns over after five minutes and kisses his sleeping wife and jumps out of bed and heads over to the bathroom for a shower. Jack turns the shower on but does not check the temperature of the water and as he steps in he lets out a little yelp as the water is cold but maybe that’s what he needs as he is feeling a bit hung over. Jack just stands in the shower for a few minutes then starts slowly to wash himself over. When Jack is done he starts to wake up a little more and starts to get dressed in the bathroom just so he does not wake his sleeping wife. Jack checks the time and it is about 07:23 am and he quietly comes out of the bathroom which is off the bedroom and creeps through the bedroom and out into the landing and heads down stairs to the kitchen. Whilst in the kitchen Jack makes a strong coffee with two scoops of coffee and a little milk just to make it that bit stronger. As he drinks it he turns the TV on but quietly just to have a little thing to listen too while making some toast to eat. Jack has the strong coffee with toast with a homemade meat pate and ham on top. Jack starts to wake up better now after drinking the coffee and then walks to the sink and washes up his things but leaves them on the drainer to dry. Jack checks the time on his watch and it says it is 07:40 and collects his things and puts them in his rucksack. Before Jack leaves he heads back to the bedroom and kisses his wife on the check goodbye and says ‘I Love you’, his wife mumbles ‘love you too’ and turns over in bed. Jack heads off down stairs and out the door.
It usually takes Jack about forty minutes to walk to work but Jack has plenty of time as he does not have to start until about 08:45 am. On the way to work Jack likes to watch people and think about what people have been up to and what they do for a job. On the way to work Jack watches and looks at people and on the way he sees a man with stains down his shirt and a bloody face walking all over the place, Jack chuckles to himself and thinks that maybe this man has been in a fight over a woman he tried to chat up the night before. The girl’s boyfriend maybe took offence to this and smacks this bloke in the face making him spill his beer over his shirt. Jack walks on to work and does not see any interesting people until about five minutes from work wear he sees a bloke passed out on the grassy verge. Jack being a caring person walks over to him and gives him a little shake and asks the passed out gentle man ‘are you ok’, the man mumbles to Jack ‘piss off, leave me alone’. Jack stands back and tells the passed out man that he is sleeping on a grassy verge in the street. The man stumbles to get up and starts to wonder off. Jack turns around and walks off as the man appears aggressive and even though Jack can handle himself he does not want to get in to a fight with a drunk. Jack continues on his way to work and gets there about 08:35 am and thinks that’s not bad timing.

08:45am
Jack arrives at a Mental Health Hospital for adults from the age of 16 to the age of 60. Today Jack is working on a ward called Premier and it is an admissions ward which is mixed males and females but with two bedroom corridors, one side females and the other is males. After Jack have had his hand over in the nursing office with a team of ten nurses which has two qualified and eight Health Care Assistants and has one seclusion room for aggressive patients. On Premier ward the patients are held on a section of the mental health act which is either a section 2 which means the person is held in hospital for assessment for up to twenty eight days or a section 3 which means the person is held in hospital for treatment for up to six months then if the section is going to be restarted it will go for twelve months for treatment.
Today Jack is nursing a patient who is on a constant or an enhanced nursing program due to the seriousness of the patients self-harm or suicide attempts. A constant is a nurse has to be within arm’s length of the patient at all times no matter where they are or what they are doing. This is because the patient has serious potential of trying to kill himself. The patients name is Paul and he is a thirty five year old man who has gone through a bad divorce with his wife and Paul could not handle it as he lost custody of his kids and house. Paul could not handle this and decided to try and end his life by cutting his throat. Paul was admitted a week ago and due to Paul’s injuries he was placed on a constant as he has tried to rip out his stitches from his throat. Jack goes over to Paul as he is in the day area which the communal area for the patients, ‘Hi I’m Jack I am on your constant for a while ‘ Paul looks up and stares at Jack looking him up and down with a look of disgust. Paul stands up suddenly looking annoyed facing Jack, so jack stands his ground and holds his hand out to shake hands with Paul. The only thing is Jack is thinking ‘this guy is trying to intimidate me’ but Jack just smiles holding out his hand. Paul facing Jack just gulps asks Jack does not move and decides to shake his hand. Jack continues to smile and says ‘nice to meet you Paul’. Paul just sits back down and talks to Jack about what he is hear for but tells Jack ‘I’m on a constant because I hurt people and like hurting people’. Jacks response to this was ‘ you’re on a constant because of you attempts of killing yourself’ and just looks Paul in the eyes but Pauls response was just to smile and says to Jack ‘ ok you’re not easily pushed, I like you’. Jacks smiles and says ‘thanks’ but Jack still does not let his guard down as Paul appears to be a bit of a player but not a good one in his eyes.
Paul gets up and wonders off down the corridor toward his room and Jack gets up and follows him but Paul looks back and looks annoyed that Jack is following him, this does not faze Jack he is only doing his job and this patient will try it no matter who is on his constant. Paul enters his bedroom and slams the door behind him shutting Jack in the corridor. Jack Opens the bedroom door and enters the room where he finds Paul standing at the window looking out the window. Jack keeps the door open by putting a chair against the door and Jack stands where he can see Paul fully which means he is standing against a wall which he leans against. Paul says to Jack ‘what the bloody hell you doing in my room, did I say you could come in?’ Jack smiles and responds to him ‘ you are on a constant and I have to be with arm’s length of you all times’ which seems to shit Paul up straight away as Jack does not seemed to be fazed by Pauls attitude. Paul asks Jack ‘what if I need to go to the toilet?’ and Jacks response is ‘I need to be able to see you at all times’ and leaves it there with the conversation. Paul stands there at the window and appears to be responding to outside stimulation (voices) but from Jacks hand over nothing was handed over about Paul hears voices. Paul asks Jack ‘is you afraid of blood?’ Jack stands up straights and stops leaning against the wall and moves his hand down towards his personal alarm which will tell other staff where the emergency is so they could respond. Paul turns round and looks Jack in the eyes and Paul brings his right hand up to his dressing and rips off his dressing and with the other hand rips at his stitches. At this point Jack has set off the alarms for assistance and lunges at Paul to stop him hurting himself more. Jack grabs his right wrist and tries to grab his other hand ripping at his stitches. By the time Jack manages to grab at Pauls left hand he has ripped out his stitches and his wound has opened up and you can see inside his throat. In the struggle Jack has pinned Paul against the wall and Paul has managed to get his fingers inside his throat and hooked his fingers in side. Jack has hold of Pauls hand and pins his hand against Pauls hand against his open wound. Staff enter the room in a rush and Jack shouts out ‘don’t move him he’s got his hand in his throat’. Paul sees all the staff enter and stops struggling, staff see the situation and decide one other staff will support Jack and contain the other side of Paul to minimise the danger of the situation. If staff did not do this Paul could have coursed serious injuries or worse to himself. Another staff member holds on to Jacks hand to support his hand which is holding Pauls hand. Some of the team walk out of the room and Jack can hear them chatting but he cannot hear what they are saying. After about ten minutes but seems like hours the qualified comes back in who is called Clare and explains what is going to happen. Clare tells Jack and Paul that staffs is going to tape Jacks hand to Pauls hand and neck to minimise the potential risk of injury or death and then they will inject Paul with medication to chill him out. Paul starts shouting out ‘no fucking way’ and attempts to struggle but the team hold on to Paul and Clare rushes out and returns quickly with some tape. Clare tapes up Pauls and Jacks hands around Paul’s neck and then Clare injects Pauls in the left arm and after about ten to fifteen minutes Paul starts to relax and releases the tension in his body and Jack can feel this relaxing body. Staff in the meantime has brought up a patient trolley to transport Paul down to another department in the hospital so Paul can have treatment and Jacks hand can be let go and Pauls hand can be removed safely with no problems. Jack and the staff move Paul slowly out of his bedroom and into the corridor while Jacks hand is still taped around Paul’s neck. Staffs have helped Paul on to the trolley and Jack has to try and walk on the side of the trolley but facing Paul.
The whole journey down to the other ward takes at least about fifteen minutes and they have gone down to a clinic or theatre so that Paul can be given more medication to make him sleep and both Jacks and Pauls hands can be removed. During the whole journey Clare the qualified nurse has stayed with Paul and Jack given Jack reassurance the whole time. Once in the clinic there is a team of about ten staff all in scrubs or theatre gowns waiting for us which is a happy site for Jack. Once wheeled in to the theatre a nurse starts to put an intravenous cannula into his arm to give him medication to make him sleep. This takes about three to four minutes to take effect and Paul appears to be sleeping with an oxygen mask over his mouth. The lead person in the theatre unravels the tape around Paul’s neck and Jacks hand. Jack has held his breath while this is being done and as soon as the tape comes off Jacks starts breathing again. When Jack has done this the lead nurse in the theatre giggles and says to Jack ‘you can relax now’, Jack lets go of Pauls hand and steps back and turns to Clare and smiles and says ‘thanks’. The theatre staff asks Jack and Clare to leave the room while they operate on Paul. With a feeling of happiness from Jack he walks out of theatre and has all sorts of emotions running through his head and body.
Jack leaves the theatre and wonders down to the canteen to get his head together. What Jack has been through is not what anyone should go though, as seeing someone trying to kill themself is not an event that is ever nice to see. Jack orders a coffee and takes a seat and relaxes for about thirty to forty minutes before Clare enters and sits with Jack with a drink and askes Jack ‘How you feeling?’ Jacks response is ‘shit that was fucked up but I’m fine thank you’ and just smiles ay Clare. Clare askes Jack ‘really?’ and Jack just nods. Clare finishes her drink and says to Jack ‘I think we should head back to theatre and collect Paul and take him back to the ward. Clare and Jack stand up and return their cups back to the counter and say ‘Thank you’ and walk slowly back to theatre. Once in theatre they see Paul in recovery and see him still sleeping on a patient trolley and the recovery nurse say that he is ok to return to the ward now. A porter, Jack and Clare return back to Premier ward and return back to Paul’s room and slide Paul over to his bed. Even though Jack has just been through a bad incident Jack has to remain on his constant and observe his breathing and vital signs. To Jacks delight he will have company has company while observing Paul it is Clare as a qualified nurse as policy states with in the hospital.

12:45pm
Jack is sitting there doing his job well with Clare and he looks at his watch and notices that he only has about fifteen minutes left on his shift as he is only working a half day today. Clare askes Jack ‘do you think you will come back and work here again?’ Jack just looks at Clare and smiles as he nods and says ‘yes, it’s been exciting’. Clare lets Jack know that she will write the incident report of what has happened this morning and he needs not to worry about anything that has happened. Jack was told that he has done a great job and that he has probably saved a man’s life with his actions. This brings a smile to Jacks face and made him feel worthwhile in his job as a health care post. It hits one o’clock in the afternoon and another nurse comes in and says ‘I have come to take over you on Pauls constant and you can go home now. Jack responds by saying ‘thank you for an exciting shift.

13:00 pm
Jack walks out of the building and thinks to himself ‘what the hell’ but really Jack did enjoy his shift today. Jack wonders off home and looks forward to getting home but the only thing is that his was wife will be at work and he will be alone when he gets back. So Jack wonders off in to town and decides to buy his wife a gift just because, this means there is no special occasion just to say I Love You. It reaches about 14:30 pm and Jack gets home and after having a shower and dumps his clothes in the laundry he changes into shorts and a vest and sits on the sofa with a bottle of wine and puts on a movie. Jack sits there and thinks to himself where and what will he be doing tomorrow and how long will his shift be.