A Nutsy Day

Today was another one of those situations at work where the psychiatric illusionaryishly (new word...) connects with me and although it is sweet and convenient for me, it makes hell for everyone else and is quite a problem.

It all started yesterday. I got report of the following on her "She has been awful all day. Thank god there is a psychiatric attendent in there because she is impossible to deal with."  So, awesome. So I conveniently dodged the first couple call bells from her room, but it was alas time for me to go in there. I had to relieve the attendent so she could go on break. So its all me in there with this lady (we don't even know what psych disorder they have) its all up to us to just....guess? Wing it? Go with the flow?

So the first thing she says to me  is this, "Oh! So nice! Finally! A Jewish Girl! They finally sent me a Jewish girl! Oh, you are so nice."  She went on to tell me that this hospital is full of Nazi's and all these blond people are German and they are making her nervous.

First of all, I'm not Jewish. I don't even think I look Jewish. But I certainly was not going to take away that misconception if that meant causing irritation. So I sat with her a couple minutes with her and got my initial assessment in. I realized she knew darn well what she was talking about. All her information later checked out to be correct. She also was no fool and she was diligently watching everything. And I mean everything. She also had this errie sixth sense where she knew things about people that I really don't know how she knew.  *Sidenote: She diagnosed me with a thyroid problem, I'm low in Vitamin D, I'm anemic (She said I look like a vampire and my hands are too cold), and that I should get my kidneys checked out. * Lol. I'll look into that.

ANother SIde Note:  The elder psychiatric patients, most commonly schizophrenics, but I have seen others, are always reallllly smart. They all studied at major universities in exquisite majors. Like my patient today, they tell brilliant stories of their younger years of travelling the world and studying. This really makes me to never want to be brilliant and smart, ever.

From that conversation on, I went in the room periodically to do my job (blood sugars, vitals, etc.) Each time she was delighted to see me. She would be talking very nicely to me, in normal conversation tones, and then someone would come stop in to say hi that she knew and she would scream at the top of her lungs to "get lost you crazy Mother F*****", and then continue on talking nicely to me.  For Shits and giggles, after he left, I asked, "Is he German?" and got an "Obviously."  in response.

Today was a little bit of a different story. She was missing an attendant all morning due to a lack of communication and travelling mishap. However, she was perfectly content, well-behaved, and preferred being by herself. However, due to a fixing of the lack of communication, her psychiatric aide showed up. Well, this caused all hell to break loose. Long story short, this patient is about to be a Code Grey (Security) because she is literally throwing things at people (she threw a bedpan at the aide) and storming around the room. On the plus side, she called security for us, meant to be against us,  not realizing that they would surely come up against her.  I happened to be busy in another patient room at the time and could hear the screaming through both doors shut.  I asked, "She's been fine without an aide all morning. Do we really need one?"   And I got back, "Yeah, so we can teach her that if she acts up and starts screaming, she gets what she wants and doesn't have to have an attendant?" ....."Good Point."

Well, the aide eventually left and one of our aides had to sit with her instead, while I went on break. I got back, and heard that she was refusing all treatment (meds, blood sugars, everything).  

I waited for her to calm down a little, and then went in- asked if I could grab her blood sugar, She says "Absolutely, my dear."  So I got that.  So the current aide asked if we could switch since the patient liked me. So I decided to sit with her on the 1:1. Thats when I began to realize that I was the only one she was listening to. Then it hit me: Borderline Personality Disorder.

I specifically remember from psych lectures that the key trait of BPD is manipulation to a certain staff member. They will praise you, pick you out, only listen to you, cause hell for everyone else, ask for you, and then...start asking for you to do things. Then, she starts expecting you to have all magical powers and answers for her. When you can't do something or you are not there, all hell breaks loose.

So, this is why I don't work on a psych ward. Never ever ever, thank you. I can manage perfectly fine on my own when need be, but I will never prefer it or willingly ask to be on a psych ward.

Interesting day.

~WNB