Monday, January 16, 2006

Fashionable Psychiatry

This is why I rarely go to staff parties. It's not that I'm antisocial - far from it! Say that this Elmer guy is actually "Dr. Elmer", neurosurgeon.
It would be very hard not to burst out laughing with this image in my head the next time I had to work with him. It would probably go something like this:

Dr. Elmer: "Nurse Kim, this patient needs a brain operation, STAT!"

Me: "Bwhahahahahaha!"

Not very professional.

And let's not even think of how seriously my co-workers would take me after observing the effects of just a wee bit o' ETOH. It would be the talk of the hospital. They'd post photos in the cafeteria. They'd run it as a news crawl on CNN.

And worst of all, I might have to take Pepto Bismol.



I was once a psych nurse. I was burnt to the proverbial crisp after 10 years of critical care when a position opened in a local community inpatient psychiatric unit. I was hired.

And I was excited. Not only was I going to be working in a different field but I was going to be able to wear regular clothes!

No more uniforms!

I adjusted my wardrobe accordingly and my closet was full of new, professional wear. I began my psychiatric career looking like I belonged on "LA Law". Dresses. Suits. Heels!

My unit was an "open" unit that was directly adjacent to the "locked" unit - the entire floor was designated for mental health.

My very first shift was the usual awkward time of learning the layout of the unit, shadowing the staff and learning the routine. It was around lunch time and I was alone at the nurses' station reading policies when I heard over the loud speaker:


Oh my god....that's over in the locked unit!

I may not be able to cure schizophrenia, but by god, I can work a code! So, in my new forrest green, belted dress with flared skirt and my Manolo Blahnik heels (okay, they were really Mervyns brand. On sale.) I ran through the door to the locked unit that was now open to allow staff in for the code blue.

I was the first person in the unit as the door was only about 50 feet from where I was standing.

Where the hell was everybody? Way down at the end of the hall was one staff person standing by a code cart that was out in the hall. Huh?

I ran, oh so professionally, down the hall and came to a crashing halt at the door to the patient's room. There was no way in hell I was entering that room. The only person in the room was the patient.

Spurting blood. From both wrists. And holding a knife.

The code team had been right behind me. The ER doc told the patient to drop the knife, and by this time the patient was woozy enough to comply. The code team then took over, suturing the wounds and stabilizing the patient.

The room looked like a war zone. Blood covered every surface, including the ceiling. The knife was a typical butter knife, the kind served with meals, the kind that you wouldn't think would be provided in a locked unit.

I wobbled unsteadily back to my assigned unit on my cheap Mervyn's pumps.

From then on I wore nothing but pants, polo shirts, sweaters and running shoes.

What the hell was I thinking?

Sometimes you just have to learn the hard way.


I spent almost 2 1/2 years working in psychiatric nursing. Loved it. Great patients. Great staff. Then boredom set in, ER beckoned and I've worked there pretty much since.

Maybe someday I'll tell the story of the night my patient ran out onto the roof!

And no, I wasn't wearing heels that shift.......


At 1/16/2006 04:26:00 PM, Blogger angry doc said...

Nurses not in uniforms throw me off balance... :p

At 1/16/2006 05:07:00 PM, Blogger kenju said...

Never a dull minute, huh?

At 1/16/2006 07:14:00 PM, Blogger Dr Dork said...

Ah..speaking here as a doc with ED and psych experience as well. Codes in a psych hospital are a nightmare, as so few of the staff really know what to do...naturally one gets rusty on resus after a few years...or decades...since the last one :)

An ED nurse with psych experience - what a godsend for an ED! Psychiatric emergencies are very hard to manage in an ED environment.

I've twice had to request someone 'drop the knife'...both times in ED's though. Both were happy to do so, thankfully, with not too much persuasion. Usually they're pretty good at hiding sharp, pointy things in the locked units.

I also learnt quickly not to wear a tie in psychiatry...too easy for patients to grab hold of :)

At 1/17/2006 06:56:00 AM, Blogger The Platypus said...

Dr D: That's why they make clip-on, or breakaway, ties. Harry Bennett always wore a bow tie for the same reason.

At 1/17/2006 07:29:00 AM, Anonymous Jenn said...

Stethascopes are just as dangerous as ties I learned. A little old lady that I thought was contracted permenately in a fetal postion suddenly developed the strength of ten men and the flexibility of a ninja and strangled me. Learned to keep it in my pocket real quick.

At 1/17/2006 11:41:00 PM, Blogger tscd said...

I think you are awfully brave for doing a job as a psych nurse - psych nurses always take the brunt of violence on those locked wards.

When I was a med student, I was advised to keep my hair in a bun or a plait on the psych wards - never understood why until I saw one patient pull out a handful of hair from another patient's head. *shudder*

At 3/05/2006 12:38:00 AM, Blogger Thomas said...

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