Tales from the Nuthouse: Lest You Think I have a Really Cool Job

[SteveDallas]

Originally Posted by wolf

Five or so hours later he was still crazy, but less so, and at least was relatively quiet and cooperative, with no memory of what had happened in our parking lot.

I think I'll remember it for a while, though.

What's your intake rate for former and/or current staff?

[Griff]

It all sounds so glamorous, how can I get in the nut harvesting business?

[Clodfobble]

Originally Posted by wolf

Late 1980s Sentras didn't have fancy fold down rear seats. He pulled the upholstery off to get into the trunk.

Man, that would totally ruin your manicure, right there.

[wolf]

Originally Posted by SteveDallas

What's your intake rate for former and/or current staff?

Counting the psychiatrist who went catatonic in the chart room?

Lower than you might think. I know that several people have gotten quietly sent off to rehab a couple of times, and we had this really bad run of "Peer Specialists." A "Peer Specialist" is a recovered nut/druggie who works with patients. They are supposed to have a special kind of street cred with other nuts/druggies.

Unfortunately, not all of them are recovered enough to do this. We lost one or two of them shortly before they began working, and the other had been doing really well, but the stress got to him and he started using drugs again (after five or so years or so sobriety). The supervisors in our department (who spent the most time with him) were the last to figure it out, even after money started disappearing from the safe and dude would be really jumpy right before lunch and really calm afterwards. There was a tense couple of weeks with the "new clock radio" in our copier/safe room ... the cool part about the hidden camera was that it actually told time and had a decent radio tuner on it.

And then there was the fellow who replaced the druggie, who wasn't a peer specialist but might as well have been. He was the one who got caught by Perverted Justice (yes, the people from the Dateline episodes). He was using computers in our office to chat with someone he thought was a 13 year old girl.

And years ago there was a young lady who had worked as an intern in our medical records department that became psychotic. She has some good periods of stability, but lately she's been in and out.

Guess there were more than I thought. But given the number of employees we have, it's still a pretty low number.

Last night ended with our getting a crazy nurse from another facility. She was a treat. Think of the crankiest nurse you know, and then imagine her hearing voices.

Made Nurse Ratched seem like a real sweetheart.

[xoxoxoBruce]

Originally Posted by wolf

A "Peer Specialist" is a recovered nut/druggie who works with patients. They are supposed to have a special kind of street cred with other nuts/druggies.

And a great way to get source leads.

[TheMercenary]

My wife was the admin manager for a Psych Department in a major Army medical center for 2 years. They were all crazier than their patients.

[miketrees]

What a great thread and a good read.
I cant say I have had those sort of experiences in my job.
I do have contact with people suffering from delusions of parasitism tho.
I work with insects, I do identification and we have a free service for biosecurity reasons.
Every now and then we get some one (usually coming off drugs) that believes they are being eaten by insects.
Its a very difficult job to handle because there are quite a few cases where there are real insects involved (itch mites ,bed bugs etc)
The bloody doctors often know these people are delusional, yet they find it easier to sent them to me.
I have gotten pretty good at handling them, telling them early on that I can only do something for them if I find insects, planting the idea there could be some other cause.
If I find no insects I have to check to see what medications they are on (refer them back to a Dr to check for drug reactions)
I remember one old lady that was really in a bad way, no one had helped her and she was right off her tree.
I persuaded her that its common to get skin reactions from some drugs (heart drugs are bad) so she went to a Dr that re-checked her medication and found there was a problem.
It was great when she rang me back after about two months to thank me for taking the time to explain . She was as good as gold.
I still get skin samples , bedding samples, dust samples thankfully only one poo sample sent to me to check for imaginary insects.
Drugs are bad MKAY

[ZenGum]

Hi miketrees!
I finally met a person who I should see if I am being eaten by giant spiders. Cool.
You should start a few scary spider story threads. Like the one about the woman with the bee-hive hairdo with the red-back spiders, only real.

[miketrees]

I did have people that returned from Africa with live screw fly lavae in sores on their arms

[TheMercenary]

And of course there is always this!

http://en.wikipedia.org/wiki/Morgellons

http://abcnews.go.com/GMA/Health/Sto...2246987&page=1

http://www.canlyme.com/morgellons.html

[miketrees]

Originally Posted by TheMercenary

My wife was the admin manager for a Psych Department in a major Army medical center for 2 years. They were all crazier than their patients.

Mercenary. my wife is a nurse and they all say that Psych carers are just as nutty as the patients.

[wolf]

So the other night we get this guy who looks just like the GEICO Caveman. This would probably be a funnier story if he looked like the GEICO gecko, but even the nuthouse isn't that weird.

So, he needs to be restrained and I happened to be down near the feet. There were six people from nursing helping out with the restraint. Based on what happened, it was lucky that the dude was relatively cooperative.

I take off his shoes and get a look at his feet and ankles. I immediately looked up at him and said, "Hey buddy, are you itching a whole lot, like all the time?"

"Yep," he says.

"So, has anyone told you that you have scabies?"

"Yep."

Suddenly, the man was kryptonite. The other crisis worker and I ended up finishing the restraint ourselves after all the nursing staff jumped back like they had gotten electric shocks off the dude.

Scabies is really only mildly scary stuff. If you're wearing gloves, you're pretty much good. It requires skin-to-skin contact to transfer, and fairly extensive skin-to-skin contact at that. Rarely transfers off of surfaces.

Oh well, I guess it was their first scabies exposure.

Years ago, I wrote this for an order of nuns running a nursing home in which there was a scabies infestation that I was called upon to help eradicate:
--------------------------------------------------------------------------

ECTOPARASITIC EPIPHANY

Attempts to eliminate scabies (Sarcoptes Scabiei, the itch mite) may be futile. Various religions hold that we were created in His image. It may be divine providence that we look like God all mitey.

At first, it appears that Armageddon is at hand. Then it spreads to the axilla, abdomen, and buttocks. This ain't the seven year itch! Oh well, scratch the human race.

Anyway, we've had a Kwell time together (that's because we haven't drawn any rash conclusions about each other); but, now it's time to bug out ... mite be gone by the time you read this.

Unknown Epidemiotheologian

--------------------------------------------------------------------------

[wolf]

Sometimes the nuts end up waiting in the lobby a lot longer than is really good for them.

Our goal is to get someone from the front door to the unit in two hours. Some nights it is very, very hard to meet that goal. Like nights where we start the shift with four patients in the lobby and another six or eight join them in the space of an hour.

A week or so ago I had this guy who was totally off his nut.

He was probably a pretty pleasant guy under regular circumstances, but he'd been off his medication for the last four months or so. When we got him he was pretty psychotic. Hearing voices, couldn't concentrate, hadn't slept in a while.

We got him because he had told his case manager he was willing to go to another hospital in the area.

She said fine, let's go, and was driving him there to be evaluated.

That's when things went downhill.

Shortly after leaving his house he announced to her that he wanted to chop her head off.

She kept driving.

Then he told her that he was going to cut her up into itty-bitty pieces.

For some reason this was more disturbing to her than "I'm going to chop your head off."

She stopped the car and got out.

Yes, leaving him in the car. Alone. Not sure if she left the keys in the ignition or the car running, but we've had that happen before.

Luckily, he didn't take off in her vehicle, or start tearing it to pieces. We've had that happen too.

No, he got out of the car and started chasing her around.

Somehow his brother shows up on the scene, gets him calmed down, and takes him back home.

The case manager came in, filed commitment papers, and then I end up with him.

He was extremely disorganized, but overall, not too bad to deal with. Spent some time in an exam room, then started pacing around the lobby. We have patients do that all the time, not a big deal. One of my female coworkers found him to be kind of spooky, and wanted him placed in seclusion, which is a polite way of saying "lock him in a small room because he's freaking me out."

We need more documentation than "being spooky" to be able to lock someone up.

Didn't take more than a few minutes to get it. Actually, he'd been doing well for the first hour and a half or so he was in the lobby. After that, his patience must have just totally run out.

We hear a ruckus, and run out to find him throwing magazines and fake flowers around the lobby, and several other patients and their family members cowering in a corner.

A few husky men from nursing come out and give us a hand in escorting him to an exam room with a lockable door.

Again, he does well for a good while. Doctor sees him (with an escort) and orders a shot. This is the kind of shot that puts down bull elephants. Usually takes about a half hour to really work and put even the most agitated patient to sleep.

Not him.

First he starts pacing back and forth for a while.

Then he realizes he has some stuff in his pockets ... pulls out a bandana.

Rips it to shreds.

Then another bandana.

Rips it to shreads.

Then he finds a savings passbook in his shirt pocket.

Rips it to shreds.

Notices a box of tissues on the windowsill.

Pulls each tissue out of the box and tosses them into the air.

You know that part of the magic act where the magician appears a whole batch of hankies, and they flutter to the stage like big white snowflakes? It looked just like that.

Then he takes off his flannel shirt.

Rips it to shreds.

Long sleeve teeshirt.

Rips it to shreds.

Now, this is not going on as fast as I'm describing it. There are gaps in his performance, sometimes up to a couple of minutes as he considers his next move.

Takes off his workboots. Pulls the laces out. Throws them into the air.

Takes off his pants.

Rips them to shreds.

Sits down for what we thought would be a rest, turns out he was just taking off his socks.

Rips them to shreds.

Stands up again, takes off his tidy whities.

Rips them to shreds.

At this point, a police department comes in with another patient. The officer is starting to explain why they are there and he looks up at the video monitors and just stops talking.

"Yes, officer, he is naked, and yes he is surrounded by what was his clothing before he ripped it to shreds."

The cops stare at the monitor, fascinated by the show.

And then, as such things do, it gets better.

This man is stark naked, sitting on our (luckily easy-to-clean) couch, and reaches for the last thing that he has access to.

Luckily, he didn't rip that to shreds, but he did play with it for a while, after which he picked his boots back up and tried to rip them to shreds, but work boots are surprising sturdy and failed to yield to his attempts to rend them.

So he went back to jerking off.

And never went to happy nap land, where the doctor was sure she had sent him with the load of medications that got pumped into his rather scrawny ass. I think I've mentioned before that attractive people never get naked in the nuthouse?

There is even frosting on this particular cake.

Close to two hours after they were given the admission orders, nursing finally sends two guys out to escort naked man onto the unit. They have been briefed on what has been going on in the exam room, and have come out with a pair of hospital gowns to provide him some decorum as he is walked to his room.

I turn towards the monitor as I'm explaining the situation to them and see ... that since he's run out of things to rip to shreds, he's pissing on the wall.

This happens from time to time. After he's gowned and taken out of the room, however, I had to wade into the ocean of piss because I had to recover all of the pieces of that savings passbook. And his boots.

The only opportunity I missed was to take a drug screen test kit in with me.

[ZenGum]

Wow.