So I got floated over to Behavioral Health last night. It was interesting . . .
The hospital I work at is connected with a Behavioral Health unit. Sometimes, if the floor I’m on is overstaffed, we will float an nurse over to another unit. In the year and three months I’ve been an RN, I haven’t yet been floated to the psych wing, but that changed last night.
I’ve had plenty of experience with psych patients. The floor I work on actually has a whole wing for medical/surgical patients who will be transferred to Behavioral once they are med clear. I’m down that hallway quite often. And, of course, you have to do a psych rotation in nursing school. But those experiences still don’t quite equal doing an entire 12-hour shift in psych, where you get a little deeper insight into a multitude of personalities. These were my most interesting patients:
1. A 19-year-old guy who had no history of psychosis, but was found wandering in the woods babbling about having “eaten from the tree of death.” Apparently, he smoked some K2 and just went off his rocker. He was claiming he could talk to insects, that he was able to bend light with his bare hands, and that he could use the tree of death to invent a new hallucinogen. He also pointed to various plants and sticks and said he’d created them. He said it was a very complicated process, an reached into his pocket and pulled out a roll of papers with these equations he’d written down to try to explain it to me. I only got a glimpse of the papers, but they looked something like this:
He was a pretty nice kid, although completely delusional and psychotic. He was preoccupied with how distorted his sense of time was, and kept asking me, “how long was that?” during our conversations. When it started to get late, I found him wandering around and grabbing his head, as if he was experiencing an excruciating headache. I asked him what was wrong, and he said he was “remembering what nothing was.” He was quite upset about it. He kept asking what nothing was. Then, after a few minutes, his eyes got really wide and he asked me, “What is something?” as if he’d just realized that that was an even more important question than what nothing was. After a while he finally got sleepy and went to bed, and he didn’t make a peep the rest of the night.
2. A 50-something year old woman who was bipolar and definitely in the midst of a manic state. She would be talking normal (well, as normal as she could), then turn around and walk down the hallway and yell something like, “I’ve got my own F%*@KING PROBLEMS TO DEAL WITH!” Just out of the blue. She was up almost the entire night. She turned on her shower and wouldn’t turn it back off. It ran for hours. She said she was waiting for the water to heat up.
At one point while she was talking to me, she was telling me that she liked to talk with her hands a lot. I said something to the effect of, “Oh, maybe you should learn sign language.” Her eyes lit up like I’d just given her the secret to the universe. From then on, for the rest of my shift, whenever she said anything to me, it was accompanied by these extremely exaggerated hand movements and facial expressions. I think she wanted me to think that she was so skilled at talking with her hands that she was able to spontaneously incorporate actual sign language into her communication.
3. A mid 40s guy who was kind of boisterous, but other than that seemed rather grounded in reality. At one point, he rushed out of his room, tears streaming down his cheeks, and said he had something caught in his throat. He said he’d just tried to throw up to get it out, but that he could still feel something cold lodged in his throat. We did his vitals and listened to his breathing. He was moving plenty of air and didn’t appear to have any signs of choking. He sat out there in the hallway for about an hour, hacking up phlegm and saying he was afraid to go back to sleep because he thought me might die. Personally, I think it may have been a brief case of globus pharyngis, which is a very real thing that some people I know very well suffer from. I guess he eventually felt better because he disappeared off to his room and slept after a while.
4. A mid 40s man who used to be in the military and had PTSD. Wasn’t too much going on with him except that he was due begin Electroconvulsive Therapy in a couple of days. Always makes me think of Requiem for a Dream (hence the cover image).
It was an interesting shift, and while I’m just as fascinated by mental health as I am by physical health, I don’t think psych nursing is for me. I like sticking needles in people and shoving tubes into them way too much 🙂 A lot of the shift is just trying to deescalate people and doling out psych meds. Of my experience in behavioral health units, a vast majority of people are there for suicidal ideation. The really bizarre cases are rare. I’m glad there are people with a passion for that type of nursing and are able to provide good care for those who need it. I just hope there aren’t any real life Sister Judes around.