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.

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.

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.

Working in Mental Health — May 25, 2015

Working in Mental Health

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

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

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

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

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

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

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