We’ve been getting a bunch of new patients at work the last couple of weeks and we’re getting close to capacity again, which means we’re both short on staff and the margin for error has been narrowing.
Monday, we got three new guys. Two of them were placed in an apartment that was otherwise empty and myself and another RA were assigned to that room as our new rotation.
When new patients arrive, you get a pre-admit form which goes over basic medical and psycho-social information, as prepared by one of our company’s roving evaluators. These things have the bare bones information about a patient. What’s missing is the color.
In other words, you really don’t know what to expect when these new patients are dropped off.
The two new guys under my care are absolute stunners. One doesn’t seem quite so bad. He’s a mellow, friendly sort who just has problems with occasional memory and lapses in judgment. Usually, after cooling down after an incident, he realizes what he did was wrong and expresses confusion as to why he acted that way in the first place.
In other words, we’ll be able to rehabilitate him in short order. The right mix of meds, rehab, and counseling should get him on the right track.
The other guy is going to be a bit of work.
You see, in two nights, I’ve been kicked, pinched, spat at, had my shirt stretched out, and punched repeatedly by this guy. He wants to exit his apartment, or anywhere he is at any given time, because he’s confused and thinks he needs to be at his job, car, hotel room, hospital room, etc. And he can’t properly verbalize these needs or understand what exactly he needs at any given time.
He’s going to be a massive project. His family sent him to us in an effort to try and bring him back to the person he was before, or at least an approximation of who he was before. They obviously love him very much. They’re very involved with his rehabilitation and were actually trying to do it from home before they sent him to us.
Thus far, it’s been a case of trying to figure out exactly how to start helping a person who constantly wants to leave, hitting everyone he can on the way out. When it takes three people to bathe someone, you know you’re going to have difficulties.
Last night, the other RA and I were experimenting with control and freedom. We would actually give him time periods where we’d leave him alone and let him make full decisions on his own. I would guard the door (he can’t move me and he hasn’t really injured me yet, so…) and the other RA would roam around in case he got too aggressive.
Generally, the patient would try to leave the apartment by pushing me or hitting me or pinching me or attempting to bite me. But sometimes, he’d go off to the bathroom, or sit on the couch and stare at the TV for awhile. Then, a few minutes later, he’d return to trying to kick my ass.
That freedom, at one point, actually led to a fall by the patient, so both myself and the other RA got drug tested (which is company policy when it comes to patient accidents). The patient barely noticed the small wound on the back of his head and continued to try and bite everyone in sight, including the nurse.
But there’s no giving up. The other RA and I have taken it upon ourselves to help this guy get better, no matter what the cost. We’ve seen occasional flashes of what he can be. The calm version of this man puts his hand on your knee and gently pets it. The calm version of this man smiles at you. We want to make those flashes the norm.
And we’ll take a punch or fifty every evening to make it happen.