Psycho patients

The title says it all. Specifically, the title says that I'll probably be getting an e-mail from the people at NAMI pointing out that such language is demeaning to people with mental illness.

They're right, but I don't care. Why? Because this last week at work was truly characterized by my psycho patients.

Midway through last week, I had a patient who was actively suicidal. And I've had many suicidal patients over the years, and the routine is the same no matter what hospital I've been working for--get the patient a sitter (just like a baby sitter, but for adults!), get a psychiatry consult ordered, and encourage the patient to tell you if the suicidal thoughts/feelings get worse. Above all, keep the patient from harming themselves or other people. But this gentleman was different. Specifically, he tried to jump off the fire escape. (Have I mentioned that I work on the 8th floor?)

I'd gotten a free moment to chart at the charting desk, and was taking advantage of it. Then I had to go to the main nursing station for something. When I got there, three or four security guards were escorting my patient back to his room. Apparently he'd managed to out-run the sitter and dashed out the emergency fire exit. He was holding on to the railing when the sitter and one of the other nurses managed to drag him back into the building. I hope he does better on the [locked] inpatient psych unit....

So when I had a different suicidal patient later on in the week, I was prepared. I politely but firmly told her that the sitter was for her own protection and would be staying with her at all times. The first day I had her as a patient, she wasn't happy, but she tolerated the sitter. The next day, she started telling me how not only did she not need the sitter (she didn't deny the suicidal part, just the need for a sitter) but that she didn't want the sitter to be privy to "confidential information."

"Ms. ----, I know you're a very private person. And that's why Mary Lou will be wearing earplugs." I handed the sitter a box of earplugs. "But she's still going to be in the room with you."

Shortly thereafter, Ms. ---- "fired" me as her nurse and demanded a new nurse for the rest of the shift. I wonder if she was disappointed when she discovered that having a different nurse didn't change the fact that she had a sitter?