I don’t do loud. It is disruptive and interrupts other patients and can escalate others. It isn’t okay to escalate other patients because you can’t control yourself.
I had an involuntary throw a strap back at me once, gave me a small bruise. She threw it out of rage and protest, but didn't mean to hit me with it. I was collateral. She then apologized to me. She was AOX4 GCS15, she apparently threatened suicide by pills or alluded to such things. Her daughter convinced her to go to ED. She apparently is a counselor or psychologist and was freaking that she was going to a facility that she sent a lot of her patients to. She made the very logical (imo) comparison of a cop in prison. My partner had no sympathy, saying she placed people in bad facilities (He didn't like the ones she frequently sent people to. I don't think she's being malicious in this or how she decides who goes where. Could be insurance or anything else, yeah?). She made a decent amount of fair points about how she was stupid to go to the ER for this and now how she's involuntary and such. I really was not sure if she was right to be sent to a facility and have that on her record. I don't think the hospital made the right call. I think it was just a dumb thing she said in the heat of the moment. She was screaming and yelling and making a scene. The Dr was like 6'6 and stood in the door so she didn't escape like she announced she was gonna just leave. They ended up giving her versed (She agreed to it. But if she didn't, they can't legally give it to her, right?)
But at the same time, if they didn't admit her and EPOW her and then she did legit try or actually kill herself, are they liable for refusing treatment? I dunno. Maybe it is purely CYA or profits they were looking at? Or maybe they really did think she was a nutter butter.
They originally told her she'd be going to a different psych facility she didn't really mind going to (in comparison), confirmed they had a bed for her and all. Then some muckup happened and they no longer did. So she was mad about being lied to (Understandable), talked about suing the hospital and whatnot. I bet she got a lawyer.
With the psychs I've had so far, most EDs aren't equipped to handle it past trying to make sure they don't hurt themselves or others in an acute sense. Which makes sense, they aren't rehabs or whatever. I don't know why people go to the ED for "feeling sad" (With no other complaints or threats, just didn't feel right). Is it wrong to think this? I just think there are more effective options that won't result in the same hassle or treatment.
So many patients stay longer in the hospital because poor or no insurance and the only facilities that will take them are full and there are no beds, so they wait.
The mental health system is so wack.
Had a fella the other day, he was pretty chill. I think he also was attempted suicide or SI. But he was one of the most chill dudes ever. Voluntary. He wanted help, I truly think he did. He just looked pretty depressed and really wanted to smoke a cigarette. He wanted to walk to the ambo but we can't let them. Liability and all. He just had this look about him like he was just kinda done living. Like a burned out fire that went cold, but you knew it was supposed to be lit. He chatted a little, not much. He was quiet and polite, one of the most polite patients I had.
We checked with the facility and they let him smoke outside. Wished him the best. He wasn't that old either. It's kinda sad when you see people so much of an empty shell, a shadow. Light is barely on, someone's kinda home.
It hurts me to see people so hurt. And maybe I guess for me I should limit that. Not that I go home depressed, but it's a heck of a (not so great) thing to see people of all kinds. Some went through the wringer and are as chipper as all get-out. Some are so scared they don't know what's going to happen to them, they feel so distanced and alone, some are apathetic to whatever, and in one case, one was in tears begging us to kill her and throw her in the garbage/ditch. I have seen things (Not to pretend suddenly I have a ton of experience) that I really didn't expect. It's nice when you have a discharge and the person went from not great to better or getting there, that they're on their way and much better than they were.
We had an MVC patient that was in the hospital for like 9 months, she was going to an LTAC because she was finally stable enough. She had been bounced from IMU to ICU for most of that time. She'd been eviscerated, basically gutted and nearly torn in half in the wreck. Still had a lot of lines and tubes, meds, pain. She was very anxious and scared to leave the hospital and just wanted to go home. We encouraged her the best we could. She got pictures with all the staff and her drs, she didn't want to leave the hospital. She had a trach and could barely speak. They closed off a certain line or tube in her abdomen, and upon arrival, it was leaking dark green kinda mushy stuff. Was it a PEG or JP drain or something? I cannot remember the line. Made a note of it to the nurse, but he didn't seem that concerned. I dunno if it was low priority or they just were not attentive staff.
She was just... it was kinda bittersweet. She was getting better but still had a long way to go.
I just wish I could fix people. And maybe I'm getting too attached. I don't always think of these people, but when I sit back and see all the ups and downs, victories and pain, it's just kinda... a window to humanity that sometimes I wish I didn't see. But that sounds like some ignorance is bliss bullcrap, because even if I didn't have a view, it still happens. I just wish I could do more. At the very least, I do all I can for the patients I do have. Try to be sympathetic and reasonable, listen to them, but not patronizing. Be a person to them because a lot of times, people aren't to them.
We had a patient that was a doctor. I assume she helped a lot of people. But at this point she was basically nonverbal, managing weird grunting noises and something that sounded like "Oh my god". She was contracted and had a DNR. Her vitals weren't great, but were stable. She'd had a CVA or something and had dementia. I bet she used to be really smart, but now she couldn't even care for herself. Pressure ulcers and not being able to communicate very well, it was just another "This used to be a very different person". She's still very much a person and should be treated with respect. Her time would be soon, I assume. She was going to a hospice care facility. She would scream like a siren at everything. Being startled, being moved,being touched, getting a BP, and seemingly for no reason.
I wonder what it would be like to meet these people when they were younger, more healthy, etc. What would they be like on their best days?
I feel like people very quickly don't see them as people anymore. Just a burden or an annoyance that society deems we keep.
I kinda went on a tangent, but that's kinda my current thoughts on this.
