Thursday, 18 July 2013

The mood of the night

The mood of the night.

We heard the newcomer before we saw her. In fact I was convinced that every hospital in the country could hear the newcomer as her crying and swearing erupted outside the unit. I had got a team of four ready to welcome her as I was not sure what I was to be expecting, according to the very brief report by the psychiatrist that had been sent over by e-mail she had been experiencing extreme mood swings that changed by the hour. One minute she could be an intellectual normal well believed teenager and then next minute she could be swearing at nurses, crying in the corner or trying to slit her wrists making her an extra hard patient to care for. The admission to the ward could have gone a thousand ways depending on how her mood had flipped but as with the night so far she had seemed to be delivering in the worse possible state. Part of me wanted to crawl under the table and refuse to come out and deal with what was expected of me but that wasn’t what I did. I was going to be strong team leader Esmee if it killed me that was the bit about me that I liked to feel. I didn’t like the little girl I could change into at the drop of a hat that had emotional outburst. I had to be who I was fighting for because I had lost her far too much lately. I had to prove just for one night that I could be superman again. I had to be the nurse the others had begun to expect. It was just what I did and it should have looked easy. My stitches pulled against the bandage on my arm as I used it to roll off of my seat in the office, mocking my confidence.

“Right I need people to remember that she is scared and that is the reason for her being so angry with everyone,” I announced to A very sleepy looking Ava that had rolled out of bed to fill in as an emergency, a NA called Olivia that Ingrid had so elegantly pouched from the Oaks and a far to alert Edward who had also abandoned his night of sleep to come to the unit in the place of Jacob who Ingrid had pretty much called continually for the hour to show our displeasure. “For that reason I would like a “to the floor” restraint to be used as a last possible resort. I would also like to remind people that she has a BMI of 13 so she will be fragile with brittle bones, any touch might be very physically painful for her as well so light hands as much as possible.”

“I told you that I don’t want to go the loony bin! I am not insane and I am not anorexic I don’t fucking belong here! I don’t want to go. Let me fucking well go!” The girl between two police officers yelled as I opened the front door of the unit and took a step out into the coldness of the night. I grimaced as I saw her two tiny wrists trapped in biting metal handcuffs and the way their arms where locked so tightly around hers at the same time as the other spare arm pressed down on her back so she had to hunch over slightly. I could easily feel the physical pain that she much have been in pull at my joints. The handcuffs where what offended me the most though and it wasn’t just the fact that having them on such thin wrists where going to leave her with horrible injuries. It was about what they represented to the west of the world as well. They were so indisputably linked with crime that even three year olds drew them in their pictures to depict the bad guy.  She wasn’t bad no matter how much she shouted or swore, that was due to fear and pain which was not being helped by the way she was being physically manipulated.

“Hello Pollyanna. I’m Esmee; I am one of the staff nurses here OK. Let’s get you inside and then we can take off those hand cuffs.”

“We are more than willing to take her all the way to seclusion if you want lovely,” the smarmy sounding thirty something police officer said lightly as he pulled harder on Pollyanna’s arm like he was trying to use his brute power to impress me somehow.

“We don’t have seclusion,” I snapped far from being impressed.”  We aren’t a prison; there are no criminals inside these walls. I also have no plans to put her in intensive care either,” I stated firmly as I pulled my body up to its full height and puffed out my chest before I realised I looked more like a cockerel than a taller version of myself.

I could see Pollyanna’s eyes looking up at me from under her hair that had fallen over her face and for a moment she was still her screaming quietened until she was forced over the freehold and her mood changed instantly like someone had flipped a switch. Something about the inside of the hall way weather it was the generic sofas of the board of notices on how to get an advocate or how to make a complaint made her howl in a pain. I could only just remember that feeling somewhere in the back of my head. I swallowed a lump inside my throat.

“Pollyanna, do you want to come over and sit on the sofas with me. Maybe I could get you something to drink.”

“I’m sorry, I’m sorry for everything. Please please don’t make me stay. I don’t want to stay here, I’m sorry, please just let go of me,” She begged, twisting her hands hard so more blood socked into the bandages that where covering both her lower arms. I winched wondering how much more the stitches would stand being beaten up before she poped one open and we were faced with an arterial bleed.

“I want the hand cuffs off of her,” I ordered to one of the police officers emotion making more appearance in my voice then I would have liked.

“I can’t do that, not until she is in a secure room, she might become violent with us.” I could feel the anger build inside my chest. This guy wasn’t a police officer he was a bully on a power trip, thank god this wasn’t a normal trend, most members of the force where lenient and professional. I saw Ava write down five numbers on her hand in biro that matched the one’s on the police man’s uniform and I gave her a smile of thanks. I obviously wasn’t the only back he had got up.
“Now she is inside this hospital officer…”

“Cain”

“… her duty of care is with me. Now you may have feared that this underweight five foot four child was a threat to your safety but I don’t think she is to mine and I am sure the rest of my nursing team agrees. I would also like to point out the injuries to her wrists. I am assuming that she wasn’t bleeding like that when she left the general ward.”

“It’s your funeral love,” He grumbled as he opened the cuffs from her hands and they backed off out of the door  pulling it closed just in time for Pollyanna to smear herself against in it In a last attempt to get back into the real world. She sobbed harder when she realised it wasn’t going to budge. There was no violence in her just pain and fear. It appeared even I had grossly overestimated the amount of man power I was going to need and with a nod I sent them off to do other things.

“Do you understand why you where sectioned under the mental health act honey? Did the psychiatrist give you his reasons as to why he thought this is was needed and are you aware of what section you’re on and what it means.”

She did not respond to me and instead slid down the wall like a budgie that had flown into a glass door before commencing to bash her head against the door with all the force that she could manage as she rocked back and forth sobbing, her skeletal blood stained arms blocking her face from view.
The first reaction was to try and talk her down, to calm the frenzy that was inside her head but to her at the moment I wasn’t someone that she could trust to protect her when she felt so out of control so my words would have made her worse. My silence would be better until the body took over from the emotion and made her calm, but at the same time I had to keep her safe so gently I reached out my hand and placed it over the back of her head to stop her from damaging it. It was in theory a stupid thing to do and an action that was frowned against, but I had learnt on the job where as some people would bash your hand against the wall as well as their head most people would stop because they refused to hurt another person and as expected Pollyanna was one of these people. She tried to wiggle away from my hand to find the concrete walls but I was as fast as her and managed to maintain a defence for her even if it made her shriek.

“Are you managing?” Ava asked as Pollyanna gave up on her head and turned to trying to rip the bandages off of her arms so she could get to the stitches that hid underneath. I felt my own stitches pull as I grabbed her hands and a ball of nausea exploded inside my tummy. Twenty four hours ago Pollyanna and I wouldn’t have looked all that different. I had lost control like this and yet I somehow had keys to the door she was so desperate to get out of when she wasn’t allowed them. I felt breathless and my guard dropped allowing Pollyanna to attack the wall with her skull again making the walls shake so much Olivia bounded out of the office door.

“Ava, come and grab her hands for me, and Olivia can you go down the clinic room and grab some of the click activated ice packs and some vomit dishes please.” Crying like Pollyanna was felt terrible to a physical body as well as it did emotionally. The ice packs would help with the head ach that was guaranteed to be pulsating so forcefully insider her it would feel like someone was trying to rip her face off and they would keep her cool. The vomit bowls where for what was the inevitable in my eyes. Her sobbing would turn to coughing when her lugs had enough and the coughing would turn to heaving when her gag reflex protested at the coughing.

“I can’t stop,” Pollyanna sobbed as Ava took her hands and I went back to protecting her head. “I want to die; I didn’t want to be saved.”  I broke my own rule as her words echoed around the hallway and i looped my arm around her shoulder loosely allowing her room to pull away if it hurt her or she didn’t want the comfort from a total stranger but surprising she acted in the exact opposite way and fell into me, her head resting on my chest. It was an act of defeat, an act of breaking down but she had no other choice.

“I’m scared,” Pollyanna whimpered, her mood turning from an all-consuming depression to terror of something unknown in the space of seconds. “I’m so scared; I don’t want to be hurt anymore. I can’t stand being hurt.”

“Your safe now,” I somewhat foolishly promised in my hast to try and make her feel better, “you are safe here.” 

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