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!
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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.
