Working in a Geriatric Psychiatric Hospital, a lot of our patients are awake at night which requires the staff to do a lot of interactions with them to help promote sleep. This particular night, my lady was awake at the beginning of my shift, loudly talking and pacing in her room; unsafely preventing her roommate from sleeping. We questioned her as to what was wrong and what could we do for her, we were unable to pinpoint what was wrong therefore a staff member was assigned to stay with her until she calmed herself or went to sleep,
Unfortunately, this did not work. She was adamant that she wanted to walk up and down the hall. We decided that maybe this may relieve some of her anxiety. Due to her unsteady gait, we applied a gait belt as it is recommended by PT or all patients that may have unsteady gaits or difficulty transferring. The belts are applied around the patients' waist while the staff js positioned close near the patient so they are able to grasp the belt if needed as a means to provide safety for the patient.
After applying the gait belt she let out a piercing scream and began to cry...... her reaction stunned us all causing an instant pause. Tearfully she pleaded for us to take the belt off and began telling us how as a child her father would beat her with a belt then use the belt to tie her to a boiler while he played cards and drank with his friends.... it made her feel just like a dog. We immediately removed the belt and walked her to her bedroom. She continued to cry repeating over and over how she could not believe this is happening again. After assisting her to bed we sat with her for a while, looking up at us but not focusing on us, she began to say how much she loved her father but could not understand why he did this to her. She recalled her mother telling her how her fathers' drinking was the reason he did these things and he did not mean to do it.
Listening to her story saddened all of us. There was not a dry eye in the room after her revelation. She looked at each of us and proceeded to tell us how she thought she had gotten over it and really she felt she should have but when we put the belt around her it brought back those painful memories she thought she had long ago tried to forget. Noticeably calmer now, as she lay in her bed just as we about to leave her side speaking in a soft voice, she wanted us to know that it was not our fault she failed to tell anyone what had happened to her.... it was just too painful but next time please listen when someone is trying to tell you something.
Even though we were not aware of the traumatic experience she had, we should have realized that something was wrong. We must not only take the time to listen but listen with empathy and compassion using all of our senses to be able to individualize patient situations as they arise. She was referred to our Psychologist who scheduled weekly counseling sessions. All staff were alerted to the non use of a gait belt for her. This was one lesson well learned and will forever have an impact on us. As for my self, I will never forget this incident and it has encouraged me to look at my patients differently. I will from now on ask more questions, pay more attention to changes in behavior and focus on body language.
There are times that small things are overlooked when you are very busy and or dealing with difficult patients. That saying "One size fits all" when it comes to Psychiatric nursing should be "One size does not fit all".