Sister Anne

 I have just shared a story with a colleague at work.
There was a reason I did, but that’s not for here and now.
It was a moment of ironic level headedness that was as inspired as it was funny
And it showed absolute leadership and confidence.

I once had a ward manager in psychiatry called Anne. 
She was a massive lady, clinically incredibly obese and terribly unwell who was a stone’s throw away from a cardiac arrest, yet she ran her ward with all the intelligence and energy of a much younger woman in her prime.

One of our patients was a young woman called Gill. I cannot remember much about her except for the fact she ran circles around the more inexperienced nurses on the ward. She was histrionic and personal and would not only insult the nursing staff but would belittle them and shock them in equal measures. Sometimes using physical violence and intimidation .
She would also regularly self Harm by slicing her arms and legs with razor blades. 

When I was a new staff nurse, incredibly wet behind the ears, I was asked to come off the ward to attend a staff meeting. It was a teaching session too and a debrief that was designed to help staff cope with Gill and some of her behaviours and it was facilitated by Anne, who provided a tray of tea and a plate of biscuits for her staff. 
Just as we were getting started Gill opened the door to the office and ran in. Her mouth was held wide open, showing all the staff a mouthful of unswallowed paracemol tablets and she moved like a zombie to one staff member to another moaning loudly.
Not one person moved.
Everyone waited for Anne to react
And slowly and with dignity she did just that.
Without even looking at Gill she picked up the nearest cup of tea from the tray and handed it to the patient . Who in surprise took it.
And for the longest time no one moved a hair, until still holding her cup, Gill walked slowly out of the office , her mouth still gaping wide with tablets.
Anne kicked the door shut with her foot as Gill crossed the threshold 
And Anne quietly said 
“ As I was saying…..” with the tiniest of smiles on her face

41 comments:

  1. I would have liked Anne very much.

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  2. Can't a person OD on paracemol?

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    1. Of course and it shows perhaps the big differences with “ running by the seat of your pants nursing “ that was tge 1980s

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  3. Barbara Anne4:19 am

    I would have liked to work with Anne.

    A Tylenol OD will kill your liver. True, if enough is taken.

    Hugs!

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  4. She sounds like Hattie Jacques

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    1. Never worse a blue uniform , we were all in mufti

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  5. I'm assuming Gill didn't swallow the paracetamol? xx

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    1. No, it was one of many such acting out moments that were witnessed, hundreds I would have thought, the reaction perhaps isn’t one that would be utilised now.
      It was just one I remember from a time very different to today’s treatments and reactions

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  6. I would never be able to cope in that scenario. For you, as an inexperienced nurse, it must have been very frightening sometimes.

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  7. Good story, but I thought professionals took those things seriously, no matter how many false alarms in the past.

    I once went to a doctor--an internist not a psychologist-- for a check-up and was asked how I was doing. I replied, "Well, I'm not suicidal," and THAT was taken seriously! Within minutes I was surrounded by three people in white trying to talk me out of doing something I just said I wasn't going to do! It was all I could do to talk them out of keeping me overnight for observation!

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    1. Yes, another good example of a different type of medicine practice.
      Anne was a veteran years ago, back in the 1980s, things now are very different

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  8. I suppose Anne would probably have known the patient was not intending to take those pills and thought it safe to call her bluff. Still, a risky strategy. My heart would have been racing a little.

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    1. She did indeed, but that approach would be frowned on today

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  9. I could never, in a million years, have done the work that you and your colleagues have. Hats off!

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    1. Psychiatric nursing was a challenge
      I learned many things very quickly

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  10. That comes from experience, a gift, and a sense of humor.

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  11. weaver10:39 am

    This made me smile John. For a time I worked in what used to be called SSN (severely sub-normal) schools - a disgraceful term - thankfully no long used. The head - a tiny woman, almost retiring age. A chap called Tony - perhaps in his thirties - was prone to rages which usually ended with him throwing his chair at the window (and sometimes breaking the glass). But Mrs Gill only had to stand in the doorway of the room - she didn't have to speak- and Tony's rage would disappear in an instant and he would sit down quietly. Nobody else on the staff could work her magic.

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    1. We used the term Elderly mentally infirm for some patients too

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  12. Reacting would have encouraged the behaviour, now on with the reason we called this meeting.

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    1. Exactly …incidentally I had a framed embroidery from Gill and it’s hanging by my fire

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  13. Anonymous11:01 am

    Anne was a very astute nurse. Gigi

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    1. She was in many ways well before her time

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  14. I wonder if they could still react like that now, with such aplomb. Seems like legally they might HAVE to take action to get those pills out of her mouth.

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    1. Of course not Steve , she would have been reported

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  15. Without looking it up i don't know what paracemol tablets are....

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    1. Simple but destructive painkillers

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    2. If you're in the states you'd know it as Tylenol.

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  16. Fascinating story. Anne knew what she was doing. I was once told when someone is screaming, to speak very softly so the screaming individual has to stop in order to hear what I was saying. (It works.)

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    1. Barbara Anne5:25 pm

      This works with noisy children even if they are not angry, just too loud!

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    2. I suppose with certain behavioural problems stealing the punchline will often work

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  17. Anonymous5:39 pm

    Interesting story John. Please post a photo of the framed embroidery sometime. It must be a lovely gift. I was asked recently about my home decor "style" and, looking around my home, it appears to be memory style. ;-) Jackie

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  18. Anonymous5:49 pm

    I don't know what you COULD do in such a situation? Do you make the person sick or try and get the tablets out of their mouth? I couldn't be a psychiatric nurse! No offence but I would not know what to do!

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    1. You have to balance why Gill was showing the tablets , it wasn’t a suicide attempt it was a histrionic behaviour which wasn’t reinforced by panic and treatment

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  19. Anonymous7:04 pm

    Oh john , this one is ripe for criticism .
    It’s rather amusing though.

    Keith
    Xx

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    1. Yes I thought it was “ of it’s time keith”
      Thank you for your gift btw

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  20. Most worrisome might be, how did an inpatient acquire so many pills?

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