Thursday, February 10, 2011

Makes One Wonder

Although a believer, when working with psychiatric patients,I never discussed the paranormal.A few of the staff knew of my interest.
One nurse asked me to consult with the staff to develop a treatment plan with a psychotic patient on the locked ward.They were at a loss she said as to what to do with him.

Currently, he was in restraints in a seclusion room.(patients in restraints are placed in locked rooms for their protection from the others on the unit.)We talked for a while.He recounted his belief of being abducted by aliens.He felt the Aliens had implanted a worm in his brain which talked to him and called him "bad" names like "coward" and "loser."They told him he was not suitable for them until he became more assertive"

We talked more about being assertive and a little about what he was doing and thinking before the"abduction"as well as whether the voices ever told him to hurt or kill himself or another.("No.")

He said the aliens did not like him to be here and sis not want him"tied up"However they did want him to take his meds.He said they told him to tell me he needed to be in a room that was not green,"It is not good for my studies" yellow or green would be better, he said.

He had assulted two Police officers and the admitting staff so had been only in this room and in and out of restraints (with injections of meds which were refused by mouth.)He did not know the regular rooms were yellow.
He seemed calmer and mostly lucid during our session. He agreed to take his meds orally from now on and not to hit,but to tell staff if he was getting"upset"He also seemed to understand we needed to trust him with these things so he would have to stay in the room.

That afternoon I met with the sraff.They recalled that the night before and several times that morning he saud the aliens had visited and they did not want him tied up...I discussed not talking about the content of his delusions but try to identify the underlying feeling and speak to that in a way that did not require a response.We agreed to take him out on the ward a few times at least twice a shift,offer his meds by mouth in a matter of fact way.and if all went well move him out of seclusion to a yellow room the next day after the morning team conference. We were all satisfied.

The next morning I filled the Docs and Social Workers in on the plan.(In case they did not read the notes.) The nurses reported he took his meds and went foe walks without incident.He had told the staff the aliens had visited and told him he was being moved yo a yellow room and he would be untied in the morning.

After the meeting the team makes rounds.When we got to his room,he was out of the locked restraints, dressed in his street clothes,and excited to move to his yellow room...When asked how he got his clothes and out of restraints, he said "The Aliens did it....

No one from the staff ever acknowledged that they unlocked his restraints or clothing...

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