The power of youth

I have finally gotten over the fear of feeling trapped awhile on my inpatient psych rotation; always having to key my way through 2 doors before I can even get to the unit where I need to be.   Then I get my new assignment to the child psych ward.  For those of you who know me I sometimes get a little bit nervous when I am around 5 or more children, especially if they are all running around shouting and all hyped up.  I really get panicked that I can’t control them all at once so I was not really looking forward to the child psych ward where there are many uncontrollable children.  However, I convinced myself that I could for sure handle it after spending 4 weeks on the inpatient adult service, adults are a lot more scary than children right….wrong!!  I was slightly creeped out when I met face to face with one pre-adolescent child as I wheeled the chart rack back to the nurses’ station, no big deal simply said good morning and walked around the kid.  However, I had that sinking feeling in the bottom of my gut. I got over it and went on with my day, lecture, lunch, seeing pts, and then all hell broke loose.  The boy I met earlier in the morning that was up in my face got upset, then angry.  I am still not sure what it was about but the kids started to knock over the entire chair, tip the table, cuss, spit, yell and finally wedged his body into a corner.   The staff did what they were trained to do, try talking him down, figure out what is upsetting him and help him deal with it.  Well that wasn’t working so they called in the reinforcements.  When the boy started to get violent again, kicking the staff they had had enough, talking wasn’t working they moved to the next step of physically restraining him.  This next step includes one staff member to each limb and even one to the abdomen if he is bucking about.  They held him there for 5 minutes trying to get him to calm down but he was not having it.  He began to spit, yell, be inappropriate, and that landed him with the spit mask and the staff tying him down to a backboard type transportation bed that was soft.  This allowed the staff to carry him in a safe manner to the seclusion room where he was put in four point restraints on the bed (that means both hands tied down and both legs tied down).  He would stay that way until he could calm down and quite being a threat to himself and others.  This is where I left the disturbance and went to write my notes.  When I can back to the floor later on in the afternoon the same boy way playing as if nothing had happened. 


There are several tragic points to this story, one that the child could get completely out of control that it came to this point and two that one of the other newly admitted patient’s mother saw this episode go down.  What parent in their right mind would want to leave their child in a place where there was an uncontrollable male child with their sick young daughter?  That set off a whole new string of problems.  To me witnessing this for the first time was disturbing, here you have a 10 year old kid being held down by five adults and still fighting, part of me wanted to cry another part of me wanted to go free the kid.  I can’t really explain it, it was simply barbaric from the outside looking in but the reality of the situation it was necessary to protect the child, the other children on the unit, and the staff.  Everything was done in the safest most controlled manner possible.  I left thinking what a way to start off your first day.  Hopefully it will go better tomorrow, Meg