Just five minutes, a quick coffee and a ciggie then back to the ward where I was able to let myself in as I’d been given keys and a swipe card for the downstairs door. Derry had gone into Management Round which, I was informed, happens each Monday morning. Apparently, this is where the Doctors plan ward round allocation of patients, who are normally seen on a weekly basis.
The phone was ringing off the hook but there was no one else around to answer it so I gingerly picked it up, saying ‘Good morning, Lavender ….’ A female interrupted and spoke urgently “Why is my brother off the ward? He’s banging on my front door and all the bloody neighbours are out on their doorsteps. What’s going on?”
“Uumm, good morning. I’m a student nurse. Do you know who you want to speak to, which nurse?”
“Someone who knows what they’re fucking doing would be good.”
“Ok, what’s your name and your brother’s name …..”
“It’s Pauline Kennedy calling and my brother is John. He’s screaming through the letterbox now, can you hear him? Fucking arse”
“Pauline, hold on a second.”
“Not you, him, sorry.” I’m glad she clarified that cos I’ve been called some names in my time, but that was a new one. “Ok, Pauline, give me a second, would you like to hold on or shall I call you back?”
“No, I’ll hold…” she tutted. I dashed up the corridor, knocked the door to the meeting room and popped my head in to tell Derry and the Doctors. “For fuck sake.” Derry’s Irish brogue rang out and “Has she called the police?” enquired one Doctor, the elder out of two. But Derry was out the door heading for the office and I followed.
“How’d he get out?” Derry muttered to no one in particular. “Hello Pauline, it’s Derry here. Is he still there? Have you called the police? Aye, I know but okay, I’ll do that. You just keep yourself safe and I’ll call you back in a wee minute.”
“Jesus, we’re in trouble now. This guy used to live with his sister and he’s paranoid about men wanting her, that they want to have sex with her. He’s already done time for smashing the electricity man in the face with a brick after the poor man went to check the meter. John’s on a Restriction Order* so he is.”
“Here, you call the police on this number and let them know what’s going on. Pauline’s address is there,” said Derry, pointing out a page in John’s file. Alison had just come into the office and I could hear Derry filling her in while I spoke with the police. I was a bit stunned, having never been in a situation like this before, but I was able to give all the necessary details to the police.
Derry, bless him, winked and gave me the thumbs up while he was on the other line to Pauline, letting her know the police were on their way. At the same time, she’d told Derry that John was quietening down a bit. The two doctors; the Consultant Psychiatrist and an SHO** appeared at the office door. “Everything alright Derry, Nancy? Oh, hello Nancy. Sorry, I’m Doctor Shand and this is Doctor Wiles. Do we know what’s happening? Let me know when he’s back on the ward please.” he smiled and left.
“Good job there Nancy. Will you just write in his notes; what happened?” Derry asked. It wasn’t long before the ward door opened and I could see John being led in by the police and half a dozen people who, it turns out are part of the Hospital Rapid Response Team (RRT), called to assist in emergencies like this. John shuffled in head down, looking shame-faced and went to the smoking-room while a police officer spent a moment with Derry then led his team away.
The RRT was a team made up of six-seven people, mainly men it seemed, one from each of the wards, who responded when a bleep and the radio sounded telling them where to go. On this occasion, they’d been called to the hospital entrance when the police arrived with John to escort him back to the ward. The Team had now followed Derry into that tiny office and, probably being a bit nosey, I went to the smoking-room where I offered John a ciggie. I’d cottoned on that ciggies were the currency used if you wanted to engage a patient and this time was no exception.
However, sitting between John and another patient, who’d introduced himself with a cut-glass English accent as James and asked for a ciggie, I felt decidedly uncomfortable. John was muttering he wanted to kill someone and James was bouncing back and forth in his chair, fists balled tight. I was wondering how I could finish my ciggie and make my exit back to the relative safety of the kitchen without bringing too much attention to myself. Just at that, the door opened and Derry said “Come on John, you need to take your meds.”
“Nope!” John had no sooner hurled back at him when the RRT burst in and launched at him, grabbing him by the wrist, pulling him up out of the chair and on an authoritative command “Down!” to the floor. John was yelling “Fucking bastards. You fucking wait.” and struggling among the fag butts and drink slops, battling against the five staff holding on to him; one on each arm, one on each leg and one at his head. The person at his head was talking to John, calmly telling him what was happening, that it was for his own good and that he was okay. He was safe. Hell, it didn’t look okay to me. Alison then came in with a small cardboard tray holding two half-filled syringes and waited while someone pulled John’s jeans and boxers down about six inches. My heart was pounding for more than one reason and my eyes felt like they were on sticks as Alison swabbed an area of John’s right buttock then saying “A sharp pinch John.” she calmly popped one needle in and squeezed followed by another.
RRT held onto John for a minute or so and Derry said “You good John? We’ll let you up. Easy now.” One by one limbs were let go and the team dispersed. “Into the office boys and girls.” Derry continued, as if this hadn’t just happened, so I thought it best to leave too. There was a quick debrief where I learned that John had obviously managed to sneak out and no one was taking responsibility for letting him go. I felt safe in the knowledge that I’d only been given the keys prior to my ciggie break and he certainly didn’t leave with me, despite the knowing glances I was getting. The team agreed that the situation had gone well, no one got hurt and the RRT left the ward, leaving me, Derry and Alison. I observed as they documented the incident in various places and heard that someone had to complete an incident form. They chatted away, telling me that John hadn’t taken his morning medication which included ten milligrams (mg) of Diazepam, known to have a sedative effect, hence the paranoia and visit to his sister’s.
The intramuscular injections they’d given John was what the team called ‘ten and two’; ten mg of Haloperidol which has a sedative effect within ten minutes and two mg of Lorazepam which creates sedation within thirty to forty minutes. These drugs are normally used in the management of acutely disturbed patients?
Note to self: “Empathy is seeing with the eyes of another, listening with the ears of another and feeling with the heart of another.” Author unknown.