Worse Than Expected

Sorry, I've got kind of a downer of a post today.

Today was my first day back after my run-in with a patient on Saturday, as I wisely called in sick on Sunday and had Monday off anyway. I would be lying if I said that I was not at all apprehensive about stepping back onto the unit. It's weird to feel nervous about going to work, wondering how my still very visible battle wounds are going to affect my patients' temperaments and if my mere presence is going to cause conflicts.

I slept in a lot later than I thought I would, and when I woke up, I noticed it was snowing quite heavily. This made me happy. I love snow. I love winter. 20 minutes later I came to the realization that my car now had its first winter driving test, and it failed miserably.

(Digression: Who in the world actually likes long cars? They suck way too much gas, are difficult to park, and much, much more difficult to control on a slick road when turning. Is there an advantage to them outside of legroom that I'm failing to see? I drive a 1995 Dodge Intrepid because it was all I could afford to buy at the time, and I routinely rue the fact that it's so honking big that it's awkward to park it most anywhere. Anyway, my car slides a lot during turns. A lot. I'm not used to this in the slightest, and joined the 360 club after getting off of the interstate on my way home. Then a giganto truck had the nerve to tailgate me on an icy road for the entirety of my trip. How close was he following me? Close enough that his headlights actually outshone mine. Who does that? But back to the story.)

There was apparently some form of accident on 70, as I got stuck on the highway long enough that I was 15 minutes late to work despite the fact that I left 10 minutes earlier than usual, and I usually get to work about 6 minutes ahead of time. My coworkers were relieved to see me, as they thought I was simply calling in again or worse, just not showing. However, I was stressed from my drive, which was also complicated by snowflakes turning to ice as soon as they hit my windshield, making it impossible to see out of and impossible to clear once the ice attached itself to the wipers in addition to the sliding, icy conditions and the stopped traffic, and was thus unable to deal with that beloved patient standby, the bum rush.

"H-h-h-h-hey Andy. How's it g-g-goin?"
"Hey, Andy, can you tell Ruth I have privileges now and let me out?"
"HI DAVID ANDY! Is that Jerry Jarvis? Am I being good? Come 'ere and tell me what's for lunch today!"
"Can I have some gum, Andy?"
"Hey whatsyername, can I get my snack? I didn't get my snack!"

On a normal day, this would've been easily manageable simply by saying, "Guys, I've got to get the shift report. I can talk to you after we get out," and they'll dissipate. Today I had no such luxury, since shift report was over, and couldn't get away. Plus, very few were receptive to my evasive techniques, and I absolutely had to find out what was going on with the patient that attacked us on Saturday and if any of the other patients were reacting to him. As a result, I had a very difficult time getting the patients to leave me alone for long enough to get this information, and the tone of my day was set with me trying to get away and being unable to.

As it turned out, the violent patient was not at all better and still causing serious problems. Multiple codes had been called to get him under control the previous day, and he had been threatening to attack a few of the evening shift staff all weekend, myself included. As a result, he was on one-to-one precaution for protection of others, and I would be sitting with him on my own for an hour.

It was bad. Really bad. He was looking for a fight, but he's not dumb enough to go after staff. For that matter, he's not dumb enough to go after his peers. When he wants to fight, he wants to be sure that he doesn't throw the first punch so he can claim he's defending himself. What he did do was threaten and intimidate and insult any patient around that he thought would respond violently to him, and when I went to stop him, he turned around and threatened violence against me. This is not particularly scary, as it's just a method to get attention, and as I said, he's not dumb enough to actually attack staff. He wanted me to come after him, and when I didn't, he ratcheted up his obnoxiousness by knocking over the laundry cart, taking all of the magazines from the common room, and demanding that everyone watch what he wants, in hopes that staff would call a code or try to take him down. And every hour, he had a different staff to irritate, always trying to goad staff into crossing a line.

Not only was this exhausting, but it also made all of the other patients, especially the more excitable ones, angry and edgy. From after dinner to bedtime, there was no downtime on the unit, just constant movement from one patient to another to de-escalate them. It was a losing battle, but we managed to stop all of the major conflicts.

After work, our evening shift staff all worked together to dig out our cars, and then left as a group. I am fortunate enough to work with an excellent staff, but everyone on my shift has an application in to work elsewhere. In a couple months, I may be the only one left on the unit with a bunch of rookies, and I only have four months in myself. This, also, is a bummer.

And now I'm home. My apartment is a messy wreck, even worse than usual, but I don't have the energy to do anything but sit in front of a screen and veg out, either surfing the internets or playing a game.

And from the looks of it, tomorrow will be much the same.