Saturday

It's rare that a patient frightens me, but there was one last night, an angry, aggressive, manic patient who I could have sworn was going to attack someone and end up in a restraint. I think with a little more moxie on the patient's part, it would have happened, but it didn't happen even though it was touch and go there for a few hours. (Turns out people with mania don't seem to experience time the same way most of the rest of us do. Go figure.) So that was fun.

And I didn't realize that the time change was last night, so a twelve and a half hour shift (that I walked into already exhausted from not sleeping well the day before) turned into a thirteen and a half hour shift (that I ended dead on my feet). I had more caffeine than I've had in awhile, just trying to stay on top of things. There was an admission at five in the morning and it took ninety minutes, which was an awful kind of blessing, the amount of exhausted time it ate up.

Before the admission (and supposedly because of the time change) the computer applications that we use to access the patients' electronic medical records went down for hours, so there was almost nothing I could do patient-wise, as in chart on patient care or familiarize myself with patient histories. So instead I opened up one of the programs that allows us to "nominate" (i.e. give) co-workers for something called "iCare" points (which they can trade in for various little things like pens and hats and mugs). I sat there and gave out points to every single employee whose name I could think of, even if I had only been introduced to them once when I was first orienting to the hospital. When I ran out of names, I looked at the hospital directory which lists important numbers, like the pharmacists and housekeepers, and gave points to everyone on it. Then I just started searching for common names ("Christopher," say, or "Robert") and then giving points to everyone with that name in my department with a note saying, "You're great at your job!" or simply "Thank you!"

I crawled across the finish line, clocking out at my usual time, only an hour more exhausted.

I came home, ate two pieces of cold fried chicken that my brother had sent. I washed them down with a warm calcium-magnesium drink, good for relaxation. Then I lay in bed and slept.

I've been dreaming about work a lot.

I don't talk a lot about the environment I work in, but like many hospital settings it is a very specialized environment. Our hospital is designed to prevent children from harming or killing themselves or harming or killing someone else (two criteria, one of which must be met for the child to be admitted to the hospital). If you were to eliminate everything in your house that can be used to hurt or kill yourself, of course you'd start with guns (in America) and knives and scissors.  Would you think to get rid of your nail clippers? Pencil sharpeners? Hardback books? Pencils or pens or staples that you could use to scratch or stab yourself with? You'd empty the cabinets of all medication, of course. But would you think to get rid of all hygiene products, things like lotion or toothpaste, that you might ingest to make yourself sick?  How about batteries? Would you think to get rid of them because you knew that swallowing one could kill you? (Kids sometimes swallow them accidentally and sometimes they swallow them on purpose.) Would you remove all the drawstrings from your clothes, all the laces from your shoes, all the scarves or belts from your wardrobe, or change your doorknobs or shower heads to make it impossible to hang yourself? Would you think to get rid of all your plastic bags to prevent yourself from wrapping them around your head or neck to suffocate yourself? Would you bolt your bed to the ground to keep from being able to lift it and drop it on yourself to cause a crushing injury? Would you get rid of all your ceramic bowls and mugs so that you couldn't shatter them and use a shard to stab yourself? Would you think to get rid of any device that you could use to google ways to injure or kill yourself?

Eliminate all those things and this is the environment that I go to work in.