The other day at work, a co-worker told me that she didn’t believe I ever got mad…since in a year’s time she has never seen me mad or angry. I quickly disagreed with her and told her that I do get mad, and in fact she had just missed the opportunity to see me very upset…in fact I was upset enough to want to physically harm someone (this time I not only wanted to but was very tempted to just reach out and punch some common sense in the guy).
I had switched to day shift for a few days to help out with the shortage our unit is experiencing. Because of this switch I had to interact with a lot more people: family members, doctors, social workers, teachers, guards and patients. One of my patients was a prisoner and did have a guard at the bedtime. As I received report on the patient, I quickly learned that the patient’s ammonia levels were critically high. This caused the patient to go crazy and act irrational and crazy. The night before he had laid on the floor and crawled on it like a dog, got on the footboard of the bed and stood on it and tried to fly off of it…of course leading to him falling flat on his butt. The patient was quickly restrained and given some Ativan to help calm him down.
When I arrived he was sleeping due to the medication and had one hand and foot cuffed to the bed. When I entered the room to draw some labs, the guards were changing shifts. This meant that I got to listen to the conversation. The night guard told me to be careful and to keep my eyes peeled. I agreed and assured him I would. The new guard coming on decided to get a smart mouth right from the beginning and stated: “I want to use my gun today…maybe I’ll get to use my gun on him…because I guarantee I will not hesitate to shot”. This statement in itself upset me and did not start the day off right between this guard and myself.
As I was finishing up the lab draws, the new guard was asking me a million and one questions about the care of the patient. I kept telling him that I was not able to tell him anything. He insisted that he needed to know so he could tell the facility. I told him to have the facility call me and I would talk to them about the patient and only them…he then mumbled that he was not a guard at this particular facility but was only assigned to the patient because his location was closer to the hospital then the facilities guards. This did not make me any happier with the guard.
The rest of the morning the patient slept off the medications and was fine. About 1400 the patient began to awaken. He was very sweet and apologized for what had happened the night before. He was very compliant and followed all of my prompting. However as I was walking out of the room, the guard asked me, “would you knock him back out…he’s getting mouthy”. I looked at the patient who of course overheard the guard. He quickly reassured me he was not getting mouthy. I nodded at him and walked out of the room.
The guard continued to be mean to the patient for the rest of the day. The patient was beginning to get upset and edgy but remained calm and polite. The patient and I could not wait for guard shift…it could not come fast enough for us.
Seriously, the guard is there to protect if anything happens with the patient…however, I found myself more afraid of the guard, because I could totally see him pulling his gun and shooting one of the health care members in his ambition to shoot the patient. It was just setting up to be a bad situation if something did happen. Fortunately nothing occurred and the guards finally switched out…but if I ever have another patient with that particular guard…I will remember the type of man he is…a sacredy cat who is probably more dangerous with the gun then the patient would be.
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