On the Edge of Insanity

docpsychrn42, ASN, RN

"She just cut her neck with a broken light bulb!" said the aide. I told the nurse to call a code blue but the pager system was down. So another aide ran down the hallway yelling for help from another unit. A few aides came running over.

The other patients on the ward were taken down the hallway and put into their rooms while I frantically assessed this patient as she lies almost unconscious.

"Are you okay? Open your eyes!" the crash cart finally arrived and a few more people.

"Thank god!".

My first crisis since starting in the psych ward and it had to be an attempted suicide. Nurses were running around making calls to 911 and helping me stop the bleeding as well as trying to take vital signs. All I could keep thinking was, I have to get her stabilized and stop the bleeding.

There were patients yelling or should I say wailing and sobbing and trying to see what was going on on the floor. I screamed for a #18 iv needle. I searched everywhere for a possible vein but this patient had over 300 scars from all the years of cutting.

I tried to start the iv in her left ac. No good. I was sweating by now, praying the ambulance crew would show up to help me. I yelled for another #18 needle. The iv bag was primed and ready to go but I just couldn't get an iv started! I kept telling her, "stick with me m...Hang on.."

After I tried one more time and couldn't find a vein the patient held her head up and in a whimper stated to me "the best vein is over here" and smiled. She smiled! She wasn't dying!

She wasn't unconscious!

She wasn't even dizzy.

It was at this point, at this very time that I learned my greatest lesson of all.

This borderline had milked this to the very end and my reacting in a pure panic just added to the drama. The cuts were superficial, only requiring a few stitches and she was back from the hospital before my shift ended.

Once back on the ward security asked where I wanted her and I told them to put her in the seclusion room so we could watch her. This upset her to no end and she proceeded to run off the ward trying to pull her stitches out as she ran. Several of us ran after her and fell on top of each other when a chair was thrown in our way!

That was truly comical after this eventful night!

After a slight struggle, we got the patient restrained and secure as she cussed us the entire time. All I know is I didn't want to have to try and start another iv on this woman and have to call 911...Again!

I worked with this patient for another 5 years and she had repeated acts of cutting, inserting and aggression. She would put pens in her arm, insert sticks into her forearm, find pieces of glass and then use them to slice her arms, face, and legs, bite herself and hurt others. But I had learned my lesson from her.

I never reacted to her acts of self-harm or aggression, in the same manner, I did that first night. I truly learned the art of working with borderlines from working with her. She too learned a lesson from me after this incident. She knew that every time she harmed herself, I was not going to react quite the way she wanted me to. At least on my shift, the incidents of self-harm were decreased because I learned not to feed into them. A true lesson learned the hard way!

On the Edge of Insanity

About docpsychrn42, ASN, RN

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