Paranoia

Tonight is my sixth night duty in 8 days
And it’s a night when a paranoid new admission who can physically do some harm if left untreated Was admitted
Patients can be paranoid for a variety of reasons, ranging from hypoxia( lack of oxygen), chemical imbalances, trauma and mental illness
I was hoping for a quiet night
Fat chance
Thankfully dealing with unpredictable patients is what I do well
And after four hours and a very shaky start, things seem to be under control.

The rule of thumb when managing paranoia is that you control the situation before it escalates

I learned this rule many years ago when I worked on a mother and baby psychiatric unit on nights.
The unit was split into two with an enrolled nurse caring for 4 babies in a nursery on one side of an office area whilst the four mothers and 12 general psychiatric patients were nursed in single rooms and small dormitories of two and four beds on the other .The adult patients were my responsibility aided by another staff nurse of similar rank.
Two nurses to oversee 16 acutely ill souls

That night we had a new mother admitted suffering from a suspected post partum psychosis
The patient’s paranoia had been masked somewhat by the Patient’s self medication of alcohol prior to admission but in the middle of the night it started to surface and the patient asked to see her baby in the nursery .
Luckily I refused. Something told me not to give her total access,  so instead I brought the patient in her nightdress to the ward office where she could see her baby sleeping in its cot through an observation window.
Initially the patient seemed satisfied with this but her mood turned on a penny when some bizarre thought took hold and she launched herself at the window in an attempt to break it.
She wanted to kill her baby
As the enrolled nurse desperately  pulled the baby away from the window I grabbed the patient who let rip her paranoid strength on me and immediately I felt as though I was in a fight for my life.
Mental illness has no filters when it comes to such situations and as my fellow staff nurse ran for the emergency bell To gain help...
I was on my own.
In the  two minutes it took for her to return and for runners to appear from each one of our 6 sister wards ( and for a another patient to run down from his room to help me) I was scratched and punched black and blue and was actually bitten twice, both times bizarrely on my shoulder
I had lost at least one clump of hair , had my glasses broken and had been urinated upon during the fight which even more frighteningly had taken place in almost total silence on the floor of an office that looked as though a tornado had hit it.
The patient was expressionless as she attacked me, even when blood from a slash on my ear covered her hands
She was eventually controlled very quickly by the runner nurses and given emergency medication by injection on the floor of the office
I was taken to the staff room to wash up then to A&E for a tetanus
I was just 24 years old
and it was my first fight at work.
After the tetanus I asked the ward sister if I could use the bathroom and she directed me to the nicer staff loo in A&E

Where I locked myself into a cubicle
And cried like a baby