Psychiatric Nurses' Most Memorable Experiences, In Their Own Words
My most memorable experience as a psychiatric nurse is...
When I retired 2 years ago, a patient came up to me and said that I had always shown her kindness and understanding and that she would miss me. I was touched that she would reach out to me through all her own distress.
Rosa Landinez, RN, MSN, PNP
It actually was before I became a psychiatric nurse. I was an ED nurse for many years and had patients in the ED often who were suffering from mental health issues. One evening a 16 year old male was brought in who had attempted suicide by cutting (deeply) both anticubitals. His wounds were deep and life threatening. He was discharged home after sutures were placed with his distraught mother because he could not be admitted to the psychiatric hospital. The next day I went to my director and told her that if we in the ED were to treat the mental health patients I wanted to know how to do it appropriately. I went back to school, earned a BS in psychology and then an MSN and CNS in Psychiatric Mental Health, then an NP in Psych-Mental Health. That patient sent me on a path I might not otherwise have followed. It has been a rewarding path and I have learned a great many things along the way.
Establishing a therapeutic relationship with a 9 year old who developed PTSD following 9/11. He had been drawing planes that were on fire and crashing, unable to sleep alone, unable to separate from his family, and unable to leave his home. After many months, he was able to fly on vacation with his family.
In the early 1990’s I was on a geriatric psychiatric pharmaceutical research team at the University of Alabama at Birmingham. During this time I interviewed patients and/or their caregivers for several double blinded research protocols that were for Alzheimer's medications. One of the items in the study for investigative drug known as E-2020 required the subject to draw intersecting pentagons. This was a test of visual perception, a key deficit in patients with Alzheimer’s disease. We had dozens of patients and I wasn't allowed to know their names, their diagnoses or any other pertinent information about them. As part of the double blinded process, I did not know if the patients were on the study drug or a placebo. Well, even though I couldn't know any personal information, I could remember the people and their respective abilities even though I wasn't allowed to keep any notes or share any information with the others on the research team. About two months into the study, the patient only known to me as "MJA" drew the intersecting pentagons perfectly. I knew then that she was on the active drug and what promise E-2020 might hold for future patients with Alzheimer’s disease. Prior to this session she couldn't even come close to drawing one pentagon correctly, much less two that intersected. The placebo drug would have never produced that profound result. I knew then that the patient was on the active drug and it was agonizing to keep this a secret from the others on my team (that was a long ten months for me). The reason that moment was so special..."E-2020," once it was approved by the FDA, is now known as "Aricept." "Aricept" is still the gold standard by which all other Alzheimer's medications are compared. I became tearful and my voice quivered a little bit when "MJA" drew those pentagons correctly and still remember it like it was yesterday.
I unexpectedly met one of my older VA group therapy patients at the physical therapy dept. at the VA. He had recently had a stroke and was very frightened. He was so comforted to see me. It made me impressed about how we, as psych nurses, have such an impact on someone. We have an intimate connection with our patients.
There are so many memorable experiences; it is difficult to come up with just one. However, there are patients that touch your heart in different ways than others. I remember that during my first year or so of psych nursing practice we had a patient admitted to the unit who was quite unkempt, appeared very grumpy, was very quiet and kept to herself. Some staff dismissed this behavior as hostile and resistant to treatment. I saw something different. I saw a woman who was struggling with her marriage, struggling with parenting, struggling with finances and most of all struggling with depression and horrible self-esteem. I made it a point to sit by her during meals and introduce conversation with her. She was very guarded because she had been hurt so many times in the past. Gradually she opened up to me and she started to blossom. I learned all about her kids and how smart she was. She had awesome goals for herself, but never felt confident enough to pursue them. We had a family meeting with her kids, which was incredible. It was one of the first times the family talked about their feelings with one another and there was no fighting. She learned how much her kids loved her and they learned that their Mom was going to be ok. They were very worried when she came into the hospital. The day she was dismissed, she left a letter for me. I read it after she left. She wrote about how our talks made a difference in her life. She wrote that she had decided to kill herself and as a result of our conversations and my interactions with her, she did not feel that way any longer. She had hope for the first time. I still have that letter. When I have a tough day, I pull it out and read it. I reflect back to this woman who never once admitted to being suicidal except in the letter she wrote. She walked out of the hospital with makeup on, smiling and feeling completely different than when she was admitted. I have never been more touched by a patient. Her words were heartwarming and continue to be to this day. That was almost 25 years ago!
Receiving a thank you note from a patient I'd cared for earlier that week. The handwriting was almost illegible and the content largely tangential, but a very sick man was doing his best to thank me for listening and offering encouragement. I will never forget him.
When my patient told me that what keeps him alive and not committing suicide is his relationship with me, his therapist, and his two Vietnam veteran buddies. When he started to tell about his war memories and nightmares and other PTSD experiences, I felt very privileged to hear these painful things he has suppressed all of these years. He trusted me that much to finally disclose his tormenting thoughts. He chose a nurse, not his medical doctor or psychiatrist to share this with. Quite a touching moment.
Having a patient that was having treatment resistant schizophrenia with continued prominent hallucinations and delusions with no friends or family, that I had worked with for many years, scream out in court that I was an imposter and then he found me to warn me to check my bank accounts and be cautious as there was a woman impersonating me who had civilly committed him. He wanted me to protect my family from this "really good imposter". I realized at that moment that I had become his friend and advocate. Even though I was not caring for him at the present time, I could not conduct court exams. Once a patient advocate even to the most severely disabled...always one.
When a young man who started on Clozaril began to exhibit symptoms that were out of the ordinary, the doctors kept insisting it was not the Clozaril. The doctors did multiple tests, multiple antibiotics and he continued to worsen. I stood my ground insisting it was the only thing new. The doctors finally transferred him to a medical unit where specialists determined he was having a rare reaction to Clozaril and was in early stages of CHF. They discontinued the medication, did a symptomatic approach to treatment and the patient recovered well. I pride myself in my staying with the med reaction focus as it saved this young man's life.
When as a new grad, in my first job, I observed an experienced psychiatric nurse interacting with a person with schizophrenia. She listened actively, nodding, agreeing, and commenting back to him, while I was puzzled and didn't understand a word he said. Later I asked her how she did that. She told me that over time I would come to understand what they were saying. She was right of course. But I will always remember her role modeling for me how to communicate effectively!
While teaching psychiatric nursing in a BSN program one of my students worked with a very psychotic patient. At the end of the rotation I had to force the student to say goodbye to the patient as he (the student) did not feel comfortable with termination and his own countertransference. The patient who had never been coherent said "you've stolen a piece of my heart". Two rotations later that patient approached me and said "I'm ready for another nursing student". I truly felt that psychiatric nurses made a difference in that patient's quality of life. He was able to feel cared for and wanted to have another therapeutic relationship.
When one of my former patients told me that our quick five minute talk in the parking lot a week earlier enabled him to see his situation as a blessing rather than a failure and decided to enjoy life instead of ending it when he got home that day.
I have been a nurse for 35+ years, the majority of which have been in psychiatric nursing, and there are numerous memorable experiences. One of the more recent experiences happened when I was a nursing instructor and brought nursing students for their psychiatric clinical experience at a Forensics Unit. The patient that one student was assigned had a history of gang involvement, murder, and numerous other crimes. His personal history involved abuse, neglect, abandonment, and identification with gang members. Due to a learning impairment, he had made minimal progress over many years of incarceration in learning to manage his anger and repeatedly would lose his privileges due to physical acting out. After being assigned two different students (one male and one female), the patient learned to step away from a fight, talk to the staff, and gained an increase in privileges. The rapport established between student and patient opened the door to learning new behaviors. The male student provided a much needed role model for behaviors as well as reinforcement of positive responses through much repetition. On the last day of class for the student, the patient stood at the full glass window with his nose pressed to the glass with both hands on each side of his face and tears in his eyes. Needless to say, the entire group of students and I also had tears in our eyes for the phenomenal growth and life changing experience that we had the privilege to participate in. As I have shared with many others over the years, there is NOTHING that can change a person's life like helping them to change their interpersonal behaviors.
When as a young psych nurse we had a young man in his thirties placed in our care on the psych floor admitted. Stoic, nonverbal, and an odd affect. One day when he was suddenly incontinent of a large amount of urine while standing among us, we realized something else was probably very wrong. Later that day he had an extensive battery of tests and it was found that he had a large brain tumor. Several days later, he spoke a few words and told the staff that he was diagnosed with a terminal tumor while living and teaching in another state. He resigned, told no one, moved to an isolated area in the country and was living, wanting no one to feel sorry for him as the tumor grew. He had been a professor at a large university. I learned to always do a very thorough medical assessment before any psych issues were inadvertently surmised!!
Working with a long-term client diagnosed with schizoaffective disorder, who had chronic PTSD due to multiple forms of abuse as a child. I have seen her transform from truly thinking she was from an alien planet into a human person, then into a woman, recognizing her value as a wife, mother, and grandmother, and now even affirming herself as a friend and unique individual who is a survivor, is grieving and healing from her losses, is standing up for herself, and has deep caring and insight to share with others. I am so blessed to be a part of this miraculous journey she is on.
I worked in a community hospital, which had an inpatient psychiatric unit (locked). For six months we went without seclusion or restraints. I worked every weekend and was part of the transitional part of the staffing which helped to move one week into the next. We provided programming, but we also respected the necessity for patients to sleep, nap, and recover (naturally) from their acute episodes. I came to realize that rest is necessary and can be blended as part of truly "therapeutic community." Holding fast to MAKING patients come to groups, even though they were exhausted seemed excessive and seemed only to satisfy the "rules" of the unit - not the individual's needs at the time. After the six months there was a "crack down" and ALL patients were to COMPLY with the group rules. We went back to having seclusion and restraint. The question that I pose is: "isn't rest and recovery as important as peer interaction?"
Seeing the kind of drastic difference psychiatric interventions can produce when there is a team effort between patient and staff. One example is a young man who had OCD which manifested as severe fear of germs and dirt. He came in with sores all over his skin from washing with iodine and wiping off with cleaning cloths, often taking showers for as long as 14 hrs. It took several hospitalizations over years, but through CBT and ERP therapy he eventually was able to leave with his skin intact, taking normal length showers, and using normal hygiene measures. A while after discharge, he sent a DVD showing him in his school bathroom where he touched a candy bar to various surfaces and then ate it on camera, laughing at how fearful he used to be. He thanked the staff for helping him get his life back. It was a shared victory that makes it worth all the effort.
When this one lady shared her simple joy of hearing the birds. I had been seeing a 38 year old lady with schizophrenia, who was hearing voices. I had been working hard to find something to eliminate this very distressing symptom. Finally, she walked into my office for an appointment, sat in the chair across from me and smiled. She stated simply “They are gone. For the first time since I turned 13, I awoke to hear the birds. Can you imagine – I heard the birds.” I was in tears as I realized that I awaken every day and can hear the birds. Times like these are the real pay check. How could I do anything else? Where else could I make a bigger difference in someone’s life than here?
While working as a case manager at Okmulgee Youth Services in Okmulgee, Oklahoma, I had the opportunity to work with a family whose lives had been turned upside down. The mother had been diagnosed with bipolar illness and was experiencing rapid cycling. The father struggled with addictions. They were at high risk of losing their children. I worked with them for months. The mother's illness was stabilized on medications and she was ultimately able to return to work as an LPN. The father gained control over his addictions and they were successful in demonstrating appropriate parenting to keep their children with them. Whenever I have a rough day, thinking of them makes it all worthwhile!
I was a young BSN working in an acute care setting and a person with chronic mental illness wanted to sign AMA. Most of the staff was happy to let her go because she was a "difficult" patient. I sat with her and spent time listening and the empathy I provided offered her something she had not felt before. This was key for me as a novice nurse in understanding the value of genuine compassion as a powerful tool for positive change.
Taking care of a young gentleman who had "an anger problem". He was violent at times and was hospitalized after he stopped his truck and caused major damage to the truck by beating it up with his bare fists. He broke his arm. He was depressed because his wife had threatened to leave him. The wife was fearful of her husband's unpredictable and violent behavior. There was also the matter of possibly endangering their child if he went into one of his violent rages. Thankfully, the psychiatrist was double-boarded as a neurologist and the gentleman got a thorough work-up including EEG. He was having seizures. The seizures were treated, the couple worked through their marital issues, and he was discharged. His arm healed and his depression lifted with accurate diagnosing, proper medications, and a little tincture of time. A year or so later, they returned to see the staff where the husband was treated. They had a new baby and were the happiest couple and loveliest family. It was exciting to see such a miraculous success. This was truly a memorable moment.
The Healing Power of Empathy: I admitted a woman into my acute mental health unit who was paranoid, believing that she and I were going to be killed. She was barricading herself in her room and so fearful. After a while, she allowed me to gain entrance into her room and she grabbed my arm and began yelling at me "They are going to kill us! I suppose you are going to tell me that you don't believe me, aren't you!" I felt so bad, I did not know if she would even hear me or remember what I would say. I was at a loss and I was hoping that I could comfort her or relieve her fears in some way. At that moment, I felt so inadequate. I felt helpless, and hoped it would not show. I told her "I know this is real for you and if I were you, I would be so scared. Can you tell me what you need and how can I help you right now to feel safe?" This woman suddenly stopped yelling. All of a sudden, she was so calm. She just stared at me for the longest time and then just walked away. My staff and I took care of her for another couple weeks and finally the day of discharge arrived. She would be able to get back home and back to work. For me, it was great to see the hope again. During the discharge meeting, our team asked routine questions that included "How was your stay? What went well?, and What could have been done differently to support you in your recovery?" This was her response: "I don't really remember much of the past 2 week here. I don't remember who was here when I was brought in or even what exactly was said. I was so confused. All I remember are a few very compassionate words: ‘How can I help you feel safe?’ There was no judgment, just compassion. In the more then 20 years of dealing with my illness, I have never felt compassion and cared for like I did that night, and if I could remember who that was, I would want to thank them." I was sitting right next to her, speechless, and to this day, tears of joy come to mind, each time I am reminded of the healing power of empathy.
When I was working on a med-tele floor and was asked to assist with a psychotic patient who could not be managed. According to staff they had tried everything including all available medications, had restrained the patient and nothing had worked. I approached the patient and he was screaming, terrified of the man in the corner of his room who was there to kill him. I asked him if he wanted me to ask the man to leave and he said yes. I told the man firmly to leave (no one was there) and asked him not to come back. I asked the patient if he wanted me to stay and hold his hand to make sure he was safe and he agreed. I did and the patient fell asleep. The staff was thankful and amazed. They had learned a valuable lesson that talking with the patient and meeting his needs, even if unclear to us, may be a simple answer to solving an acute issue.
Terri Gisher APRN
Communicating and soothing a cognitively impaired client by use of a doll. She was essentially mute; but did sing a lullaby with me as we rocked the doll.
My earliest memories of psychiatric nursing were the stories that my mother told me of being a psychiatric nurse at Waterbury State Hospital in Vermont in the depression. Treatment was talking with patients, reading to them and taking long walks. Some got better but she did not know how it was accomplished. My next contact with psychiatric nursing was as an undergraduate student. Treatment was wet sheets, deep tubs, insulin shock therapy, and ECT. Some patients got better but no one knew how it was accomplished. The most memorable experience for me as a psychiatric nurse was the day, armed with the information generated during the Decade of the Brain, that I could teach nursing students how their words, their empathy, their interventions and medications could bring about change in their patients at the level of gene expression. I could tell them how change was accomplished.
I was caring for 12 vets in a detox ward, one who was a WW II vet and in a prolonged alcohol withdrawal delirium and completely incontinent and unable to feed himself. As I was running around like a chicken without a head trying to attend to all the detox patients, two Vietnam era vets who were doing well said they would take care of the WWII vet. They brought him to the bathroom cleaned him up and fed him while I took care of their buddies who were coming off of crack and heroin. It was wonderful to see the vets taking care of each other!! This was my greatest and most memorable day in nursing. Semper Fi.
A celebration my coworkers held in my honor in 1991 when I was 24 years old. I was going into my last and sixth chemo treatment for stage III ovarian cancer. They all made a square for a quilt. (Including the psychiatrists.) My coworkers were my greatest support system during the most difficult time of my life.
The day I attended a ceremony honoring nurses' contribution to healthcare reform in the Rose Garden at the White House. I was so proud that psychiatric nurses from APNA were so highly regarded that Grayce Sills, Ann Marie Brooks and I were chosen to represent our specialty in nursing. It was the first year of President Clinton's first term of office - a very exciting time! And I've got the picture to prove it!
When I was in graduate school working on my MSN in psychiatric-mental health nursing one of my first patients was an adult woman admitted in a severe catatonic state due to major depression. Her family had to pick her up in the chair in which she was sitting and bring her to the psychiatric institute in the back of their pickup still sitting in her chair. She was admitted and was in a tight fetal position. All of her systems were shutting down and she was dying. We had to feed her through an NG and we had to insert a Foley catheter. I was visiting her every day, spending time reading to her. After two weeks, consent was finally obtained for ECT. It was revolutionary-after her first ECT, she was sitting up in the recovery room, drinking orange juice with a hint of a smile. I introduced myself to her and she immediately said--"Oh, so you're the visiting nurse who has been coming to see me every day, I recognize your voice!” This experience is as vivid today as it was in 1980. This patient taught me that no matter how deteriorated we may think a person is, they are ALWAYS listening.
When I watched a child, who was 7-years-old, be repeatedly pushed away when he tried to hug his mother. I felt very protective of him, but words never really comforted him. The only thing that helped in any way was my taking him in my arms and hugging him. I learned that sometimes words are not what a troubled child needs; physical closeness may be the only thing sufficient to help!
When a patient approached the nurses' station and asked for a pop from the kitchen. Being safe is a priority here, we lock the kitchen and patients need to be escorted in. Despite there being about 5 nurses up there, I stated that I would be able to get it for the patient. Once we were in the kitchen, the patient then stated, "Actually I don't need a pop. I knew you'd be the one to volunteer and I just wanted to thank you for all you've done for me...." At that moment, I received a hand-drawn card from this patient and some tears from her eyes. That experience really opened my eyes to how much psychiatric nurses can help people and that I had just made a difference in someone's life.
A young, 20 year old patient had harmed herself over the weekend. As I entered the unit, the patient was standing near the nursing station on a 1:1 observation status. She looked at me and our eyes connected, I smiled and stated “Hi____." I looked at her without judgment but instead sensed the feeling that she felt she may be judged. Instead she wasn't. She said, "Hi Anna" and smiled back. It appeared that she may have felt some relief from my response instead of guilt. My intention and my approach were deliberate. My strong belief that ethically and morally I am not in practice to judge individuals but facilitate their movement towards wholeness. I believe because of this interaction the patient had a positive moment and outcome.
Two come to mind: I had several patients when I first got out of school, who came to me after seeing all the psychiatrics in town...My first response was: How am I going to help them, as a novice new graduate, if none of the experts could??? But I jumped in and took them on, with a naive innocence, but with passion and commitment. The moment I remember was when they decided they were healthy enough, or stable enough to go back to work and come off disability. What a joy to have shared that long but successful journey with them. The second thing that comes to my mind happens on a regular basis. I wrote a book about two fictitious characters (Eloise and Jake) that represent all of my patients. (If you stand in the middle you won't fall down). I wrote it because I found myself telling patients, teaching patients the same thing over and over again. Now rather than even sell the book I probably give a copy out to patients at the rate of 3-4 a week. The moment comes when they come back to their next appointment and say: WOW this is me, thank you. I now know I am not alone! And I know there is HOPE! Those two moments happen to me frequently and always brings me joy.
When I was approached by a patient after 19 years at another facility. The patient remembered my name and thanked me for being a good nurse. The patient made my day.
Receiving a phone call into University of Maryland's Medical Center's Psychiatric Emergency Department from a young man in the community. This young man asked general questions about our admission process. I explained our evaluation process to him. I heard hesitancy in his voice and asked him what was going on. The young man went on to explain that he felt like killing himself had a gun and planned to use it. I immediately let the staff around me know and 911 was activated. I kept talking to the young man and eventually had him put his girlfriend on the phone. I instructed her to remove the gun from the house if she was able to and call 911 or take him to the nearest emergency room. She explained to me that he was not willing to go and did not want her to call 911. The police officers called us back to let us know that they could not find the residence. It turned out that the wrong address was given. I kept talking to the young man giving and instructing him to go to the nearest emergency room or call 911. The patient suddenly hung up. My heart sunk thinking of the possible outcomes for this young man. Our attending, Dr. Falayi processed the phone call with me making sure I was all right. Our entire staff was very supportive. About an hour and half later one of our mental health associates, Mika, yelled out letting me know that the young man had been registered in the emergency department and was not harmed. I was ecstatic that the young man had made the decision to come into our emergency department for help. I finally met him once he was medically cleared and was transferred to our psychiatric emergency room where he became one the patients I was helping. I was so happy to see him unharmed that I felt like giving him a big hug! The patient was treated and discharged with a favorable outcome. One can imagine my delight when I read the quick registration form that read, "I spoke with Ms Leda in psychiatric emergency room that I was having suicidal thoughts and going through something." We get many phone calls per day from folks in the community with a variety of questions. As a psychiatric nurse we have been trained to actively listen, probe and go with our intuition. This young man has confirmed to me the extreme importance of taking time to assess every phone call even when the presenting issue over the phone was of a general admission process. Psychiatric Nurses making a difference one patient at a time!
I had been working on a child/adolescent inpatient unit while working on my Master's degree. It was the Fourth of July and the unit was not too crowded (that was back when kids had day passes to visit with their family). We had a cook out and outside activities planned. We got a call from ER - we had an admit on the way. It was a young man (8 or 9) who had just left the unit less than a month ago. His last stay to our unit had been what had been typical back then- a month's stay. We learned from ER staff that he had become out of control/aggressive towards his family. The family had informed the ER staff they did not want him to come home and refused to come to the unit to complete the admission interview. He arrived on the unit and quickly settled in. Since he was a new admit he could not leave the unit for the cookout. I stayed back on the unit with him. Together we completed one of the activities left by OT staff. The object was to write down on a circle of paper what you were Thankful for. The idea stemming from the fact we live in America -"land of the Free" and should be thankful for many things. He quickly wrote down "Joe -he follows through with things". He was referring to me. He talked of his last admission when I had sent him to our quiet room but told him that I would return to check on him. I did return and together we had worked out a plan for when he was angry or upset. That made the lesson of “you are the tool and sometimes just being there with/for the patient is important" hit home for me. He wanted me to have his circle with his compliment to me. I still have it on my refrigerator door some 15 years or so later.
Having a positive impact on a very psychotic man with schizophrenia, whose problematic behavior consisted of somersaulting whenever a "bad" thought would cross his mind. He developed large ulcers on his shoulders, to the point where a skin graft was being considered. I and another nurse provided primary nursing care, and used many creative interventions to gain his trust and heal his ulcers. When he came to us from another facility he was somersaulting a hundred times a day. By the end of his hospitalization, he only did this behavior once or twice a day. He gained weight, was healthier and less psychotic. He never required the skin grafts. Some of the creative strategies consisted of: learning to communicate with his preferred method of discussing the daily comic strips, providing nourishment where he would "find" it in the hallway since he told us he was a "street person", re-dressing his wounds several times a day, and working on distractions to the somersaulting. All in all, an amazing experience!!
Giving hope to all of my patients. Assuring them that they are valuable and are able to lead productive lives.
A patient who loved to read. She never missed an appointment at the clinic, arriving early with The Readers Digest. Her story was compelling and reminded me of the book, The Color Purple. When I suggested she might like to read it, she seemed interested and said she would try to save up the money to buy it next month. "Oh, you can just go to the library and take it out." I assured her. Offended that I thought she would steal a book, she said she would never do that. Finally I got the picture that she had never been in a library (she was forced to quit school when she turned 12 and marry a much older man). I explained the concept of a lending library to her and her face was filled with awe. "You mean to tell me that I can walk into that library and BORROW any book I want and I don't have to pay anything?" I nodded "Yes". We sat quietly for a few moments as she absorbed this new and wonderful information. Her life had been changed forever. "Thank you." She said with teary eyes. Mine were teary too. I'll never forget her.
When one of my patients was given back custody of her twin daughters who were taken away from her immediately after birth. We worked together to complete her program prescribed by the court, and to prepare her emotionally for the responsibilities that parenthood entails. She didn't let me know when the court finally delivered the children to her. On my last day at the mental health center where I worked as an NP, she brought her twin daughters with her on our final session. It was enough to make me more proud of what I do, and a testimony of the kind of work that psychiatric nurses do that can make a difference in other peoples' lives.
Caring for an inpatient that was psychotic and out of control. I bonded with her and she always came to me when she felt like she was getting out of control. I spent literally hours with her each day helping her to work through coping skills and gaining control. With medication management and my interactions with her she gradually day by day gained control and was able to deal with the voices in her head in a calm therapeutic manner. When she was ready for discharge, she wrote me a personal note. In the note, she said "I will never forget you. Thank you for giving my life back to me and helping me to live a "normal" life". I have never forgotten this patient and often wonder if she is still doing well.
Spending 2 1/2 days during the Chicago blizzard of 1967 working as a staff nurse! Although we managed to maintain professional boundaries with our patients, nothing matches that time we spent together... just us, with no one leaving and no one coming. Talk about a "therapeutic milieu"!
My patient was about to be discharged that day from a psychiatric inpatient facility. I saw him come out from the doctor's office, upset, head down. He went straight to his room, which he did at times. It was a busy day of course, but I really wanted to talk to him. Something didn't seem right to me, but I wasn't sure what. He was never much of a talker to begin with and when I approached him it did not come as a surprise to me when he said he didn't want to talk about it (whatever "it" was). So I just sat there next to him in his room, quiet for a bit. After a few minutes the patient looked at me and said "it's not fair for him (the doctor) to do that." As it turns out, the patient had a very bad session with his doctor that day and something that doctor said had provoked the patient. He eventually opened up to me (his nurse) and said that he was planning on "drinking [himself] to death" right after he was discharged that day. After a long discussion with him, his social worker and, eventually, his doctor, we agreed that the patient needed a little bit more time inpatient. A few days later, before his discharge, patient approached me and said: "You saved my life. I would have killed myself and I have a granddaughter to live for (which came up in our earlier conversation)". That statement moved my heart.
Caring for a man from the onset of his bipolar disorder through the time of his death some thirty years later. He was bigger than life throughout his all too brief time of earth which ended from complications of bipolar disorder and the many years of meds. He was a bright, complex, accomplished human being who taught me most of what I know about bipolar illness. During his stays on our acute inpatient unit, he demonstrated courage and resilience through the trials of mania. On the day of his death (knowing that it was approaching, but not realizing it would be that day); we called in all of the "old" nurses who knew him throughout the course of his life. Although bedfast and in pain, he greeted everyone with his own special brand of grandeur, kissed our hands as always, and talked about what we would do tomorrow. He died on our unit, shortly after those of us who knew him best had left the hospital. We all felt that he knew the end was near, but couldn't be bothered with that small detail...he had so much to do! I think of him often and thank him for the many lessons he taught me about psychiatric care and about how to live life. Thanks TB!
When I met up with a former patient we will call Bob, after not having seen him for over five years. I was the DON at a state psychiatric hospital and had worked with this patient five years earlier as a member of his treatment team. I came upon him outside the local post office and he was obviously having difficulty with hallucinations. He was a man with an extremely severe case of schizophrenia and had been in a state institution most of his life. When I stepped out of the car, he was pacing back and forth and talking to himself, shaking his head and fist at some person or voice only he could hear and see. As I approached, he suddenly stopped in his tracks and looked at me and said, "I know you, don't I? Your name is Ann." I replied," Yes it is Bob" He said, "How are you doing?" I replied that I was well and told him it was good to see him. I then asked how he was doing and he replied shaking his head, "I'm not doing so well right now...I am due for my shot tomorrow." I said, "Well hang in there. I wish you well." He thanked me and went back to hallucinating and talking to himself and I went on my way into the post office. When I returned to my car he had disappeared. It amazed me that after five years he remembered me and my name and all of this while actively hallucinating. I am often awed by the resilience of people with mental illness and how powerful they are at times in managing life despite their illness.
Evacuating with my patients from LSU Behavioral Health-DePaul Campus in New Orleans during Hurricane Gustav. It was a rewarding and team-building experience to see everyone, including our patients, pull together to make a challenging week succesful. The adversities we overcame were tremendous.