moral/emotional quandry
I work as a health care security professional at a hospital in Canada. Very regularly we have mental health patients, and they comprise a large section of what my job entails. This is normally no big deal for me, I can trust my team and they trust me, we make it through the night and everyone goes home okay. Now a lot of the time you can tell that the clinical staff wants little or nothing to do with these folks and in a lot of the cases I can't blame them; they do it day in and day out they have a right to be tired of repeat visits by adult twelve year-Olds looking to snag some hand sanitizer and get Crunk. But last night, we had an aboriginal patient who had been in a residential school in his youth, with some problems keeping events in order, a lot of pain and a deal of personal stress check himself in and begin the process of a psychiatric evaluation. Over the course of the night I built a decent rapport with the fellow, as the nursing staff steadily treated the fellow as if he was one of our nightly regulars. He was less than appreciative, and due to his mental health status, the clinical staff then cracked further down on him restricting his actions further. Eventually it came to a point where the patient, who had come In with depression, a history of being abused and acting suicidal, none of these facts having been conveyed to security, attempted to off himself using a putty scraper stolen from a housekeeping cart. A nurse and I were on hand when he grabbed the tool and retreated to the bathroom, attempting to retrieve the blade. This is the part I am asking for help understanding. I'm not supposed to at any time put my life and safety at risk, regardless of the circumstances I am in. I jumped into the bathroom with the patient holding the knife, and attempted to talk the patient down, my hand on his wrist. I know from the outside, the situation had exploded instantaneously. Everyone else was more concerned about me at that point than the patient, justifiably. And I was forcibly pulled from the room as the door was closed with the patient inside. The patient had only made threat to himself, and several times over the night called me brother, once again in the bathroom while I was trying to have him hand me the knife. Then the code white was called, everyone showed up and we were made to wait for the RCMP to arrive. Everyone was okay in the end, even our patient, although at the end he was restrained in his bed quite thoroughly and roughed up a deal by the cops. I just feel I could have had the better outcome if I had had just five more seconds. Two sentences could have made the difference between explaining why we'd need him restrained as he cooperated and fighting to strap a ptsd (or close enough) victim to their bed in tears crying for their family. The situation was also half a step away from him taking that knife to himself. For however long it took for RCMP to arrive the man was alone with only the knife and his desires in that bathroom, if he had gone through with it that would have been on me. This may not have been the proper forum for me to get this out, I realize. But I tried to do what I felt was right, and I feel that because I failed to accomplish it people other than myself where uneccessarily put in harms way, and uneccessary force was used on someone who came for support as much as treatment. I want to hear how I should have handled it in the opinion of my peers, as my coworkers thought it was the dumbest thing they'd ever seen me do. And just to put another spin on things, my other half was my partner on shift, and she did half of the pulling to get me out of away from the patient. In her place, how would you have acted? For any and all who read to the Bottom of this, thank you. This has left me slightly fucked up since it happened right at the end of my shift
Posted May 26, 2015, 4:14 PM UTC
I have only your words here to go on, and not a lot of knowledge of the system you work in, but I'll give you my view of it based on that alone. Take it for what it's worth.
It sounds like you did what you could.
You found a patient that was not the usual drug seeker, and just wanted help. When he became a danger to himself, you tried to stop that. You made a judgement call in the moment that you weren't in danger from this man, so you didn't even violate policy (as far as I can tell) in attempting to stop him and talk him down. That last part is a little shaky from my perspective, but mostly because I don't know the intricacies of the rules that bind you.
As for your coworkers, they also did the right thing. None of them had the knowledge of the man or his motivations that you did. None of them had the information to make the judgement call you did, and just saw you in the bathroom with an unstable man wielding a knife. So they pulled you to safety whether you liked it or not.
And whatever happened, had the man died or not, was not on you. You did what you could. It certainly sounds like some of the problems may be in the system itself, but there's only so much you can do about that.
As for the man himself, and how you dealt with him, that's always going to be hard. I have a number of people close to me with mental issues, and even with these people who I know dearly I have a hard time knowing what to say to help... I have no frame of reference for what they're feeling because I don't suffer the issues they do. With this man, you didn't even have the basics of what motivated his thoughts and worldview.
I would advise trying to content yourself with the knowledge that you acted as you could and that he ended the night alive, which means there's a chance he can get the help he needs.