I Lost My Baby And My Phone!
Psych patient with a mysterious infection and fetal demise on one to one observation and security watch. Refusing medications, cursing and demanding her phone back that was taken away from her. Getting her back from storm to calm!
The night Nursing Supervisor was giving me report. I was taking over half the hospital including ICU, CCU, ER, LR, NICU, Postpartum and a bunch of other units. The supervisor told me about a patient who was on one to one observation and security watch. During my rounds I went to her unit. I spoke to the nurses who were all having a rough time with her for the last few days. I could hear her yelling at the top of her lungs demanding her phone and her speech reminded me of the Jerry Springer show! Every second word was a curse word!
She recently had a fetal demise and had multiple psy hospitalizations in the past. I was told that a situation developed the day before and security watch was initiated along with one to one observation. The father of the baby was barred from coming in and as he stirred up the patient and set her off every time he was at the bedside or on the phone with her. Finally the situation became so hostile that he was barred from coming into the hospital.She was refusing medications and was very labile. The doctors wanted her to sign a behavioral contract before the phone was returned and she refused. The nurses went in and offered medications for agitation and she refused. I walked in quietly into the room and introduced myself and shook her hand. She looked me up and down.
I softly told her, " I am so sorry for your loss." I asked her if that made her sad and angry. She nodded her eyes never leaving my face.I asked her did it feel like a hole in her heart? She nodded again, her face crumpling. I then looked her straight in the eye and asked, " May I give you a hug?"
She nodded. I took out my ID from my white coat, laid it at the bedside table along with my report and stepped closer to her bed. I opened my arms and she fell into them sobbing. I held her murmuring reassurances and acknowledging her loss. I told her that she was a brave and strong woman and would get through each day, one day at a time. I told her that it was ok to get sad and mad after losing her baby but it was not ok to hurt herself or others in the process. I requested her not to hurt herself or others. I looked behind me at the staff and the security guard and told her, " All these people you see are here to help you not hurt you. You have to remember that every day they get up from their warm beds and come out in this cold weather to the hospital to help patients like you. They have families that want them safe home and the end of the day. So please don't hurt my staff or yourself". She nodded and smiled through her tears. I was struck at how that smile transformed her face and commented, " How pretty you look when you smile!"
One of the staff commented that she also had a beautiful voice and could sing! Now that she was calmer, I asked her if she would sing for us. After the initial bout of shyness, she started singing, "Amazing Grace how sweet the sound". She sounded like an angel! I joined her in the second stanza and so did half the staff there and the security guard in his baritone! It was a beautiful moment and there were a lot of smiles and tears! I thanked the lord in my heart that he choose to change an ugly situation into something beautiful that we could all relate to.
I went back to the nurses station and asked security to bring up her phone.We convinced her to sign a behavioral contract. Although she was upset that she could not keep the phone for long periods of time, we reassured her that it was all dependent on her behavior. The charge RN convinced the doctor to leave her phone with her for the time being as she was calm playing on the phone and reaching out to family. She also wanted to see pictures of her daughter who had died who she had named Lilly, that she had on the phone. The last I saw her, she was quietly playing on the phone. I left the unit satisfied that she was in safe caring hands.
About spotangel, BSN, MSN
Nurse for 26 years. Many hats-bedside med surgical,telemetry, ER,LTC,Pediatrics,teacher,manager,administrator,Home care and community health nurse who loves to write and to mentor! Love to study too and hope to get my doctorate one day!
Joined Mar '12; Posts: 153; Likes: 650.Dec 9, '16People just want to be heard and understood. What's unfortunate is that the nurses on her unit were probably so overloaded with meaningless documentation requirements that they don't have time to provide person centered care.Dec 9, '16This is such a beautiful story. It's great to hear that even in a long nursing career, you care just as much as in the beginning. I hope to be like you & always care so much about the patients.Dec 9, '16There was good team there but she was not easy to handle.This was ongoing for over a week and the staff was very frustrated. Documentation in this case was important and since we have an EMR it takes less time than paper. The patient was young, with psy issues,no family support,multiple hospitalizations and a weird boyfriend that made the situation worse.She was grieving, angry and felt she had no control over her situation and lashed out! When she felt that she was heard and was comforted,she calmed down. The nurses advocated for her and helped her keep her phone once we set clear boundaries and kept everyone safe!Dec 10, '16This is absolutely beautiful. I have always had a profound respect for psych nurses. What a genuine and lovely storyDec 10, '16What an amazing leader you are. Much more than seeing her heart yourself, you showed it to others.Dec 10, '16This brought me to tears. Thank you for treating her like a human being not just the-patient-in room ###.
It reminded me again that my patients are also human beings as it can be a tough thing to remember.Dec 10, '16That's the beauty of being a nurse.You can cut through the medical issues and get to the real issue which is grief, anger and an inability to cope.Many adults struggle to cope especially when they are in crisis mode. Nursing is an art of balancing physical and emotional issues,not getting sucked in the drama and leading a patient towards a positive outcome. I always go in thinking this person was not born this way and somewhere there is a kernel of goodness inside each person.My job is to find it and help it blossom in a very short amount of time!Dec 11, '16Bravo my friend!
As a psych. nurse, ED nurse and former nursing supervisor I can see a little bit from each perspective on how challenging it is to address this kind of issue. You were respectful to the patient, validated her feelings and her experience, and worked with the team to move her care forward so that she can begin to heal emotionally and physically. So many people would have struggled to see past her behavior and forget the fact that this person suffered and incredible loss and because of her underlying mental health issues, she is using the only coping skills that she knows. Nice job on giving this patient back her dignity, this is a great story.
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