+[Bipolar]--

Our patient swallowed a AA battery from her toothbrush in some sort of suicide attempt and was taken to the ER. Because of a negative reaction to anesthesia, doctors decided to let it pass naturally.

Back on the unit again, she appeared more relaxed than when she had left. She laughed about the incident, stating it wasn't a very good idea. She had a bright affect and could converse easily with staff and peers.

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Back in the charting room, Psych Doc jokingly asked me if it was a lithium battery...

I said I didn't know, but would continue to check vital signs and voltage throughout the shift....

Patient Goals for Today

I went through some paperwork that patients hand in when they request a "level" to be allowed to go out and smoke. This is a direct quote and not something I've edited in any way.

Daily Goals:
make up bed
clean face
read bible
sing praises to the Lord
praise the Lord
go out and smoke
take meds
shower
cast out the devil
eat food
go to classes

Another patient wrote something I thought was surprisingly clever in it's sarcasm (considering the patient). Now, I don't know if I remember it word for word, but it was really close to:

I shower I still stink
I brush my teeth they still hurt
I take my meds nothing changes
I love this place I want to stay forever
It's Paradise

I think by "nothing changes" he was referring to the fact that even after a few requests he still wasn't getting a level to go out and smoke. This was written on a level request form. Getting a level is also dependent on cooperation and going a little while without a behavioral problem such as arguing with other patients or being sexually inappropriate.

It's great to read what patients write because it shows a different side of them. Many of them are quite guarded and paranoid when you speak to them directly.

The Psych Hospital

Sorry I haven't posted in a while. It seems the more days go by without a post, the harder it is to actually come in here and write one. I guess I get embarased that I don't have anything to say..

Work is going well. Psych is a whole diferent world, and there are sometimes not enough words in the dictionary to describe the feelings I have for some of my patients. Some just come in for 72hours of emergency crisis management (all involuntary) and some end up there for months because of placement problems. Lots of things happen during the day, but it seems to me the stories are sad rather than anything people would want to read about.

Somehow in the med/surg world (at least at the busy hospital I was at), interaction with patients gets pared down. I know I could rarely find time to spend a few extra minutes consoling someone or listening to problems or even serious medication or health education. People pull you in all directions. Stays in a medical hospital are on average - what? - three days? I don't know. You have so little time to really get to know your patients. In the psych hospital in many cases this IS the patient's home. You go to work day after day and see the same people, and even when they discharge, many come back. I've been there a bit over two months and I can already name a handful of people that have been in and stabilized, then out for a few weeks and decompensated, and were picked up in some manner and brought back.

The stories are just plain sad in many cases. There was one young woman who had a long history of psychiatric problems and her father is a scientologist - he told her she should go off her meds, and that she could cure herself (I'm not sure quite how). The woman goes off meds and decompensates and becomes psychotic and does who knows what and gets herself another stay! He still calls her and tells her she shouldn't be taking the medications. She is so messed up by this - I mean, it's bad enough to have a mental illness thats debilitating in its intensity, but then to have your own parent tell you you're supposed to somehow fix yourself. She's simply not functioning well enough to deal with this sort of stress in addition to the delusions and voices.

So thats a horrible story. How about this - A woman was brought in unable to care for herself and homeless. She had such a bad case of lice and constant scratching had scabbed up her scalp to the point that her matted hair was in some places tangled under the scabs. I practically had to get into the shower with her and try to shampoo and then comb the lice out. It was a lost cause because of the matting and scabs, and I got scizzors and cut every hair on her head (after some diplomatic patient education). I felt so sad for her because she had no idea how bad the problem was. She also had scabies. I went out and bought her a wig to cover up her bald head, and went to value village to buy a shirt and pants for her. Some staff wondered why I did that, but I said basically that she came in with nothing, we took her clothes and disposed of them (scabies) and then we took her hair. We took everything this woman had, her clothes and her hair. She looked like a little old man - she'd already lost her teeth long before she met us.

Anyway, thats how things are going. The stories are miserable.

My life is going well. I truly enjoy many parts of my work. We're starting to look for a house to buy. I'm traveling to NYC in May for a class and an extra day of sights. I bought a (used) Escalade.... I guess renting that DTS spoiled me!! :D heheheh