Motivational things

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.

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.

Working in Mental health — May 23, 2016

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.