I recently started my new job as a Nurse Extern at Mission Hospital. Today was my first day working at Copestone, which is the psychiatric unit on St. Joseph’s Campus. Copestone is the only inpatient psychiatric unit in Buncombe County, so we treat people from all walks of life. I had never been in the unit before and honestly when I walked in this morning, I was terrified. I had no idea what to expect. I had heard horror stories about this unit, NA’s and nurses who had been attacked, patients attacking other patients (just the day before); and as bad as it sounds, we’ve all seen movies about mental hospitals and those are the images that were in my mind as I stepped off the elevator. I had a psych rotation in clinical my last semester of nursing school but the hospital we went to was very small and the majority of the patients there were admitted for drug rehab and were non-aggressive. You can imagine my emotions (and heart rate) as I walked into this very intimidating and unfamiliar territory.
As the time went by and I started to learn more about each patient my feelings changed completely. I went from being afraid every time I had to approach and interact with a patient to being absolutely enthralled by them. I hate to admit that I believed societies stereotype for the mentally ill, but I think that until anyone actually experiences time with someone or time in a facility like this, it is very hard to really understand that these people are just like the rest of us in so many ways.
Of course, I’m not going to share any names, personal information or even room numbers (HIPPA!) but I do want to share two stories that really touched my heart today. Both of these stories are about patients who I was particularly afraid of going in, either because of what I had heard in report from the previous NA or because of their appearance (I know, it’s terrible, but it is the first thing you know about a person and it’s human instinct to make that judgement and put your guard up if necessary - and just let me say, looks can be deceiving) or because of my imagination or a combination of the three.
The first patient, I had been told, had the possibility of being aggressive if agitated (lets be honest y’all, who doesn’t have that possibility, right?), he was supposed to have a male (not female) sitter (someone who performs 1:1 observation and care), and he had been known to behave “inappropriately.”
The patient stayed in his room for most of the morning and when he came out into the hallway he paced a bit but was very calm. As time went by, he began interacting more with the staff and came across as friendly. At one point during the shift, he came up to myself and the other NA’s and said that he wanted to tell us a poem which he proceeded to recite as he came up with it off the top of his head. Later, he remembered every single word and wrote them down for us. Throughout the rest of my time in the unit, he remained calm and agreeable and continued to communicate appropriately with the staff. There were instances that he became excited but he was de-escalated quickly.
Now, I know I must sound very naive.. So I want to say I do know that everyone has good and bad days and that in situations like this, even though the patient seems to be doing just fine, that their status could change at any moment. I just want to share this experience with new nurses, NA’s, and everyone really because it really made me realize that we have to remember especially when we know that someone has a mental illness or any kind of problem going on, they are still a person. That we still have to respect them and look at them and appreciate them. I feel like a lot of times, people in these facilities never have a chance to grow and heal because their healthcare providers label them as what their problem is and they feel like they are never able to get away from that. How could we ever expect anyone to overcome anything if we look at them as if that one problem is all they are?!
My second story is about a man whose story applies to so so many others. This story breaks my heart. I thought about it my whole drive home and I still can’t get it out of my mind or off of my heart. This older man came in off of the streets a few days ago, he is homeless. The man exhibits signs of chronic alcoholism.. (And don’t get me wrong, I know drinking alcohol is a choice that someone makes but I can’t help but to look for the best in people. I always try to look at someone in their current state, no matter how they got there, and empathize with them.) He has lost most of his ability to communicate effectively, he shuffles his feet when he walks, and his cognitive functioning is in and out. This to say - it is very unlikely that he will be able to find or keep a job to support himself on. But anyway, what little communication I did have and understand with him made me think that he could have been someone just like us before something happened to cause him to have a break. He told me about a job that he used to have, and about how he used to be able to make friends where ever he went. And then it was everyones designated snack time. All of the patients lined up to get their snacks from the nurse behind the nurses station. This man got cereal and coffee. He went back to his table and sat down. After all of the other patients had sat down, he went back up to the nurses station and knocked on the window several times saying he needed some milk to go with his cereal. The nurse must have been caught up in something because she didn’t answer him. He continued to knock but she didn’t respond to him. And then as he turned away to go back to his table I heard him say quietly, “It’s ok, I’ll go without. It won’t be the first time.” At that moment my heart just absolutely crumbled. I could feel tears burning in my eyes and I felt helpless because, as a staffing pool employee, I don’t have access to the nurses station (it is locked on the psych unit). That sentence is burned in my memory. The nurse eventually brought him a small carton of milk (the little ones we got in elementary school) but he was already done with his cereal. Knowing he was going to be discharged later, he put the milk in the pocket of his pants. This patient was discharged later during my shift. He had no home to go to, as far as I’m aware of. I asked him before he left where he was going to go and after telling me several places he had to go to first, he finally said he was going to California. No one should ever have to go without and it truly breaks my heart that we would discharge someone and just let them go back out onto the street. It’s a vicious cycle of loneliness, not being able to take care of themselves, feeling worthless, desperation, and hospitalization. Needless to say, I can’t stop wondering where that man is right now or if he’s ok.
When I shared this story with another extern who was in the unit training with me, she gave me these words of comfort that are already proving to be true: “Be encouraged that the time we get with them is a chance to show compassion and love that no one else has the chance to show.”