As a young nurse stepping into mental health 21 years ago, I had no idea what to expect. I was more than a little shocked and some nights very uneasy to work on a unit of 15 patients alone. I always asked my supervisor if someone was going to be assigned with me. On an average night the answer was no. The supervisor at the time seemed to love to see your shocked facial expressions. I made sure to never let her see it on mine. She was mean and I was stubborn.
Finally one night I received a new assignment with extra staff. I was assigned to my regular unit plus the six units across the top of the building for medication if anyone needed anything during the night. Most of the time, I would just have to give someone a Tylenol. There was a 6 AM medication pass with at least one patient on each floor would get something. If nothing out of the normal happened I could get it done in an hour.
I had to start early just in case something else came up that would need to be handled, and there was always something going on. With an average of 15 patients on each floor anything could occur.
My first experience walking onto an all male mentally retarded unit was a night I will never forget.
I had to call from the all female unit next door to let the staff know I was on the way. One of the male staff would be waiting at the door to walk with me to the office. When I walked on the unit for the very first time I stopped and just stared down the hall. The first thing that came to mind was animals in a cage. Over half of the men on the hall were naked. The male staff laughed at me as I stood, watching the patients wandering around the hall.
One man sat rolled up in a ball in one of the few chairs that was still on the unit. He had club feet that were so twisted his toes folded under his foot and calluses had formed on what should be the top of his feet, where he walked on them. Another male patient sat in a squatted position on the floor with his back against the wall, his head lying on folded arms and appeared to be asleep until I noticed he was urinating in the floor.
Most of these men had been in the hospital since they were as young as 18. The average age now was 30 and above.
Most of the furniture had been broken or soiled with human waste until it was removed from the unit. There was a mound of wet soiled linen piled in the middle of the hallway where the beds had been stripped for the morning and new sheets were being put on the beds.The mattress were being sprayed with disinfectant. The smell that burned my nose is not one that I will forget any time soon. The blankness in their eyes was a faraway look, not even sadness, but a shell of a person. There was one that did not seem to even really be thinking, but merely just breathing.
I did not talk to the staff much; I was the new kid on the block and they led me from patient to patient to point out the correct person to give the pills to, a cup full of pills to keep them calm and medicated.
I was about finished on that unit when I started walking toward the door. I heard someone holler out and a tall, lanky man started running toward me naked and bare footed. His private parts were exposed and hanging in plain view. His eyes were wide and I could tell he wanted something, but his communication skills were that of a four year old, maybe a six year old. He stood 7 feet tall and wanted me to get him a "bana". I ask again, “What do you want? I don't understand." Without warning he reached out and wrapped his huge 10 inch wide hand with the longest fingers I have ever seen around my two inch wrist and began dragging me down the hallway. The shoes I had on were slick on the bottom and I had zero grips to push against the floor. He had a grip on my wrist that had no intention of letting go. I was going where he wanted me to go; he was going to show me what a "bana" was. I began screaming for the male staff that had gone into the shower room to begin the morning bathing.
By the time they had reached me, the patient had stopped pulling me. We stopped in front of the treatment room door. He was pointing at the door and saying, "BANA!!!" I looked at the staff and they did not understand and told him to go sit down and wait for his shower.
That made the patient mad and he ran over to the only door leading to an exit with a window in the door. He smashed the window with his hand. As glass flew everywhere, cutting his hand, the patient was pointing to his fresh bleeding cut and again saying, "BANA". I looked at him and said, "Band aides?" He started jumping up and down shaking his head smiling. I walked into the treatment room to get supplies to clean his hand and saw the Band aides with his name on the box; they were Scooby Doo.
After I cleaned his cut and added the band aide to his hand he was so proud he wanted to show me over and over how "petty" it was. I ask him to be good for me while I cleaned the mess he had made of the window. This 7 foot man with a four year old mind began telling me he was sorry. His ears flapped on the side of his head as they were extra large; his facial features were abnormally bulky. His heart was that of a child wanting approval, wanting to be loved and did not know his own strength.
Walking down the hall to leave that morning I spoke to a few of the men that were there. Rarely would they look or speak to me. It was as if I was walking among zombies. I will never forget that unit or those men. Most of them have passed on by now. They marked a place in my life I will never be able to forget, a memory of a place that no one can even believe really exists, had they not been there themselves. A unit on the other side of a steel door remained far away from real life.
Working as a nurse in this type of environment has a weird sense of reward to it, not one that you can measure with praise from your supervisor or fellow co-workers, but from the inside of the nurse. Knowing you cannot change their life or really help them to be any better than who they are, but by being touched by someone so different that they change you, the nurse, becomes the biggest reward possible.
Angela Brooks has worked in a state-funded psychiatric hospital in Kentucky for 21 years as a nurse, assisting sometimes-dangerous patients who come in shackled and cuffed. At AngelaBrook.com, she offers stories of life on the inside of a psychiatric ward, and the site, as well as her company, offers support for nurses in the mental health field and helps them bring passion into their role at work.
On her BlogTalkRadio show, Mental Happiness with Angela Brooks, she shares some of her experiences “learning to love those others have forsaken” and gives tips on how to bring peace to your own life.
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* Please note: I am not here to CURE, DIAGNOSE, Treat or suggest replacements for what a doctor prescribes – I am sharing my nursing adventures with you.
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