Today I'm home with the two little guys. It's always fun to watch them play together.
Wil had preschool this morning (still doing fine!) and Zac and I played and played and played. Then we ran to the grocery store before picking up Wil. We were there to get milk to make homemade yogurt; I used to do that all the time but haven't for awhile and want to get back into it because the heathens would eat yogurt for all 3 meals if they could! Anyway--we were in the diary department and there is this big cow head that moos. When Ana was little she would scream her head off whenever she saw that thing. Zac? Well, he starting mooing and last I checked (as I was putting him down for his nap) he was still mooing.
On the way home I looked in the rearview mirror at Wil and he reminded me of Hans. That has happened before, and it has something to do with his cheeks being full right now. So I said, "Wil, you look like Hans." and Wil said "No, I don't. I'm still just Wil!"
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A couple days ago I was about to google something and the following term showed up in my search box (meaning it was the last search done):
birthday pardy supplice
Do you think Elijah has been on the computer?
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A couple quick stories from work. First, we currently have a patient, a younger man (early 40s) who appears normal in every way except one. He is quite convinced the US Marshalls have taken his testicles. He cannot be told otherwise. So, he is with us until he finds them again.
Sunday evening I had my first "assault". Most people working in psych will eventually experience some type of violence by a patient. I have known that and it didn't faze me at all--still doesn't--because there are so many safegaurds in place that rarely does an injury occur. It's just never made me nervous (still doesn't). So anyway I was going on to the unit through the double doors and as I walked in I was attacked from the side by a 91 year old guy. Yeah, 91! But--he is an old farmer and do you know how strong they are? Anyway he tried to strangle me and he used some old military maneuver. He had his huge hands around my neck and I was imagining the headlines: "Nurse Killed By 91 Year old WWII vet". Fortunately his balance, unlike his strength, befit his age, and we were shortly vertical on the floor with a phalanx of staff heading our way.
I was fine, if a bit shaken; he got 1/2 ml of ativan and slept the rest of the night. When he woke up he had no memory whatsoever of what had happened. I had to spend a good deal of the rest of the shift doing paperwork and meeting with police and the doc on call. Yesterday when I got to work my boss called me in and she asked what I thought could be done to improve the blind spot that he was hiding in. So, the VA takes our safety very seriously, and I'm none the worse for wear--plus I have the dubious honor of almost being offed by a nonagenarian.
To close, I want to include a quote from one of my teachers in response to a posting in class (it was, of course, a story from the psych ward. Come to think of it, I'll post that below too). Warning, it's obnoxious, but it's my blog, right? :)
Tracy: What a great story. You need to think about writing as a career. I was on the edge of my seat reading your words waiting to find out what had happened. YOu aslo mentioned purposeful, goal directed and evidence based thinking which is clearly indicative of CT. Thanks so much for sharing with us.
And here is the story:
In psych nursing it seems that the times when we use our critical thinking skills the most are not during medical emergencies but during behavioral ones. Because of this, it is harder to find examples (examples worth noting, anyway) where I have used the principles of science in making critical decisions. However, psych does offer ample opportunity to use thinking skills that are purposeful, goal directed, and evidence based. My unit is acute care so we frequently see out of control behaviors in the emergent setting. The challenge at that time is to take whatever information we have about the patient and use that information to calm the patient and prevent injury to patient and staff alike.One incident I recall with pride as a day when I realized that I could love this speciality. The patient had come in the day before extremely psychotic, believing demons were after him, summoning him, and sodomizing him. He was violently out of control and stated clear homicidal ideation (he thought we were demons also, and he needed to kill us), and for the sake of safety he did have to be restrained. He was the epitome of the stereotypical psych patient--literally stark raving mad. His eyes rolled back into his head and his mouth was foaming as he screamed about the demons on him. I should note that it is rare to see someone quite so psychotically sick. His diagnosis was schizoaffective disorder and he had been off his medications for a long time. He had been found running on a highway naked.The majority of his "ranting" was religious in nature. Those of you in psych know how common this fixation is. It occured to me that a clergy person might help calm him. We called a priest up (the patient was recorded as being Catholic) and the priest laid his hand on the man's forehead and started talking in a very soothing voice about there not being any demons. Now, here I must clarify that this is not intended to be any sort of religious anecdote.Anyway as the priest went through the Catholic rituals (Hail Marys, Our Fathers) the patient fell asleep for the first time since admission. When he awoke he was significantly improved.However, he was still psychotic and unpredictable enough to the point where restraints were still required for his safety and ours as well as the other patients on the unit. He was quick to lunge and strike out when his hands were freed. He was also refusing to take his medications, without which he would never stabilize, and an emergency order was obtained for IM injections. Giving these injections was very challenging because of his strength and violence. The hospital security had to come up each time and help to hold him still so we could give the shot. Needless to say it was very sad to see and experience this, even though he was always treated with the utmost care and respect.During one of these injection administration circuses, I was near his head trying to talk him through it, and it occured to me that the priest had been able to calm him so well. I started saying the Lord's prayer and telling him "Come on, XXX, say it with me. Come on, remember what Father said? Say it with me" and eventually he did begin to follow along. As he focused on the words he was saying he calmed enough so that he was virtually still when he recieved the shot. That was the beginning of his return to health, because after that we knew how to relax him enough to take his medication, which was very effective for him and in turn relaxed him further.By the end of his hospital stay he was a completely different person. He was clean shaven, soft spoken, completely behaviorally appropriate, fully medication compliant, and generally just a really neat guy. I will most definately never forget him!
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I see Wil in the living room looking through his cookbook for something for us to make. I better get going.
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