Psych and the ER

  

In nursing school I found our psych rotation fascinating.  The abstract of the human mind and it's interconnection and dependence on the more tangible brain with it's many labyrinths and mysteries and illnesses and unbalances is very very interesting.

That being said... I have never had the slightest desire to be a psych nurse. Not because it isn't a fascinating area, because it is. But it is also a very frustrating one. And so rarely (it seems) a fruitful one.  And so it has been very stretching and rather trying for me to discover that being an ER nurse means being a psych nurse 30% of the time.

I could never have imagined the extent of the psychosis in our midst.  It is so strange to have a patient speak to you from a disjointed reality all their own, that you can't convince them isn't real. And it's unnerving to have someone stare at you with their calm face but intensely pressured gaze that plainly tells you what they are willing and capable of doing to you (and maybe did to their mom, brother, cousin, uncle, innocent bystander) and might do at a moment's notice, before you can call "code grey!" I could never have imagined the large number of thrashing, screaming, wild eyed men calling for children they don't have or referencing encounters with Jesus, Mary, or Oprah that most assuredly did not take place.

Maybe my feelings for mental health nursing have been poorly influenced by encountering it in the ER.  The emergency room must be the least therapeutic place for someone with really any psychiatric problem.  Take the violently paranoid schizo who gets pinned to a gurney by a few men (and women) and strapped down with lock and key restraints.  He must surely be feeling his paranoia must be a little bit justified. And have you ever tried keeping someone with bipolar in manic phase in one room?? And thanks to poor funding and few resources, we've had to keep mentally unstable patients with us for days!  With none of their normal meds, unfamiliar surroundings, people watching them all the time, and nothing to do but become agitated, angry, demanding, or try to escape - sometimes naked.

Maybe if I felt in some way we did them some good I would be able to cope with it better. But I don't.  At best we keep them from hurting themselves and us (usually).  But other than that it's like an unpleasant version of Purgatory. And we're the angels that drew the short stick.

Maybe if I had Jesus' ability to set people in their right minds.  But I hardly have his insight. Or compassion.  And I can't seem to help my morale hitting the floor when I hear the words, "you're getting an ambulance in 10 minutes with a violent, combative patient in 4 point restraints." And I know I'm not alone.  God help us.  And God help those fragile, tangled minds.