Psychosis

Last night, I walked over to another area of our ED where we hold patient's that have been admitted and are waiting for inpatient bed assignments or are waiting for transfers to other facilities, to give report on a patient that I was about to move into this unit.

There was a patient that was already there, awaiting a transfer to another facility... who literally, just as I got there, right as I walked in, had a violent, psychotic break. The patient body slammed a Security Officer, was yelling at and threatening everyone, swinging at (and hitting) and kicking at (and connecting) at a Nurse and Nursing Assistant.

I watched as the patient swung at the Nurse, the Nurse blocked and grabbed the patient's arm in an attempt to control the patient, and the patient proceeded to lunge at and bite the Nurse's wrist, breaking skin. Not withstanding the Employee Exposure that just occurred, this patient had now committed a felony with the assault & battery against a healthcare worker... but that is a different story.

This all occurred in less than 10 seconds... but it seemed to take on that weird, slow-motion, as it was happening time slows down kind of thing...

The Security Officer recovered and had regained physical control of the patient's upper extremities, but now the patient was wildly kicking at anyone in the immediate vicinity. The Nurse and Nursing Assistant had taken a step back. I set down the paperwork I had in my hand and walked over and into this situation.

I'm not the gung-ho, ninja, get into the fray, kind of Nurse... nor was this a male thing, watching my female co-workers getting hurt... this was a crisis for everyone involved; both the patient and my co-workers! This situation needed to end quickly to prevent escalation and further injury to all, the patient and my co-workers.

Too make a long story short, I side stepped towards the patient, the kick came at me, I blocked and grabbed the ankle, held the leg up, crossed the knee over the patient's other leg, looked at the Security Officer, said "floor now!" The Security Officer started to go down, I went down, and suddenly this patient was one the floor, injury free, under physical control, and was able to receive an emergent injection of an anti-psychotic medication intramuscularly. Within 5 minutes we were able to safely transfer this patient back into their bed.

These things don't happen that often. And rarely, as dramatic as this situation played out.

I won't get into the felony thing, as a patient's offense has to be truly egregious for a healthcare worker to even consider pressing charges...

Yet here again, I found myself somehow being right where I needed to be, right when I needed to be there.

The point of my ramblings? I don't know, maybe just to share and decompress? Maybe to educate that when I don't get to your request immediately, I might have been busy with something more pressing? Maybe it's just to give you a glimpse into what I do? Who knows... take from it what you will...

I took some Ibuprofen about an hour later, as I felt a little twinge in my back... about to take some more before sleep time!


Peace!