18 East

             “Someone grab her legs! Me and Allen have her arms. And watch it, she’s a spitter. And--- I’m sorry------ you.” Santos had no hands free, so he nodded towards another psych tech in the room.

“Me?”

“Yeah. Do me a favor, go in the nurse’s station and check to see how long for the IM?”

“Got it.”

“I don’t get you guys here. You guys know how aggressive this patient is, she’s been here damn near three months. You guys need to be quicker with the meds, this is how people get hurt------bad.” Santos said to nurse Allen while he nodded in agreement. Santos felt that too many people did the job recklessly or worse, some were intentionally incompetent. They thought that getting hurt on purpose and potentially exposing their other colleagues would get them worker’s comp and time at home.  

The nurse with the medication finally emerged from the nurse’s station. Santos had the arm that the nurse was going to stick so he squeezed the upper, fatty part of the left arm to get it ready for the injection. Santos breathed heavy from the previous struggle with the woman, while sweat dripped from his chin onto the floor and parts of the bed sheet.

“That should have her in dreamland in about twenty minutes.” Nurse Allen said aloud to no one in particular. “You okay Santos? I know help got here a little late, I’m so sorry.”

“It wasn’t your fault, no worries. And yeah, I’m alright, might be a little sore tomorrow though.” Santos said, moving his neck side to side while simultaneously rubbing it.

Blitzvue’s psychiatric units had notorious reputations for being chaotic, but perhaps none more than 18 East, the unit Santos worked in for the last six years. The unit was always cold and poorly lit. And it smelled of a mixture of old, musty clothes, B.O., antiseptic, and disinfectant. The walls were painted a sloppy, dull off-white with spackle patches spread out all around. The written obscenities were abundant as well, some clear, others smudged----but still legible. The floors on the unit were just recently buffed and shined so, but there were bloodstains on one end of the hall from an incident earlier in the day. Finally, Santos was able to take a break, so he retreated to his unit’s employee lounge. It was 4 am and he usually napped during his break, but the recent struggle with that earlier patient left him a bit hungry so he made a honey turkey and swizz cheese sandwich from some leftover cold cuts in the break room fridge. Nurse Allen was relatively new on the job and hadn’t encountered any physical altercations with any patients at that point, so he was pretty shaken up. He walked into the breakroom behind Santos with a latex glove that he was going to fill with ice from the ice machine. He wanted to use his makeshift ice pack to see if he couldn’t bring down the swelling on his wrist. He wasn’t exactly sure when during the scuffle this may have happened, but he was pretty sure it was a bad sprain.

“Oh. You’re still here. I’d a thought you’d be in the ER or something by now.” Santos said in between bites while wiping his mouth with a paper towel.

“Yeah, right. My tour is almost done. What makes you think I wanna spend three or four hours in the emergency room? No thanks, I’ll just ice this thing for a few minutes.”

“I don’t blame you.” Santos said as a smile tried peeking through his tired face. “You are going home though, right?” Typically, when something like this occurs, the injured staff would fill out an incident report and then be given the choice of whether they’d like to go home or not-----depending on the injury of course.

“Nah., I think I’ll finish the tour actually.”

“C’mon man, why would………” THUD! The loud sound stopped the conversation cold. Shortly after, the yelling followed. Santos’ and Allen’s eyes locked, first wide with shock, then rolled because even though they didn’t exactly know what was going on on the other side of that door, they thought they had a good idea. Santos’ heart started beating faster before opening the break room door to the chaos on the other side. It was a patient who apparently just got admitted to the unit and something set this guy off because when Santos opened the door, he saw a doctor on the ground who was still conscious but was bleeding badly from her head. Another terrified nurse was attempting to barricade herself inside the unit’s patient dining room while other techs, nurses and another doctor attempted to restrain the man. “Who the fuck is this?!” yelled Santos.

“He just got here! Go help Doctor Marrone to the nurses’ station then come back!” The nurse’s tone made the hairs on Santos’ body stand as he started helping the doctor up to get her out of harm’s way. The adrenaline bullied it’s way into Santos’ frame starting from his feet then barreling through his organs and gripping his bones. When he made it back to the commotion, he noticed other patients starting to wake up. Some just stood in their doorways and watched, but others started trickling out slowly and Santos knew this could be disastrous. He needed them to get back inside their rooms before they had a chance to get riled up. One of the things these acute patients love is an audience. They feed off each other’s energies, if one makes enough noise, the potential is there for the rest to join in the disruption, ganging up on staff.

“C’mon guys. You know when we have a situation like this on the unit you need to be in your rooms okay.” Santos’ words were quick and crisp. By the time he turned back around to face the angry patient, he had gotten free and took a swing at Santos, but he missed, crashing his right hand into the glass pane on the door to the dining room.

 Eventually, when the patient was able to be restrained and medicated, the staff congregated in the nurses’ station for a debriefing. “……well, unfortunately, a doctor was injured during this crisis, but ultimately, we were able to subdue the patient. I would like to thank you for showing up and getting after it, especially my nurses.” Said the night shift supervisor.

“Goodnight Santos.” Said nurse Allen, zipping up his jacket. “At least you have tonight off huh?”

“I was supposed to, but I think I’ll come in this afternoon for some overtime.”

That was the unit. It was a risk each time you stepped foot in it, and the pay didn’t always reflect the effort or the danger, but it was decided that the alternative would probably be worse.