November 31, 2004

I had Tina as my 1:1. She's 11, has frowed out hair, but she's completely pale skinned, absolutely fixated with hair and makeup. Oneday, we saw that her breasts looked a little....;x bigger. Then we noticed that one was lumpier than the other.

Sometime last week, during Art Therapy, the therapist passed out a large blank sheet of paper to each patient. She told them to draw a T-shirt that they would wear, something that expressed them. Well of course..the T-shirt is supposed to be them, but the kids don't get that right off. After the kids finish, they do a little show and tell bit. The first one to be finished with their's is Maria. Maria's ten, 5'6" and pushing 300 lbs. She's a little girl inside and doesn't know the boundaries of her own body, so she's clumsy, loud, pushes people on accident, she's very hard to control when she gets angry. She's very mexican, very into her family, very insecure, very depressed. I'd never seen her smile since she'd been in the hospital. She's first to stand up and holds her paper up for a second and then flops her arm down swiftly and makes it whip through the air as she makes a face and says "Mine's ugly. I hate it." Everyone's quiet for a few seconds. The therapist asks her "This is supposed to be a shirt that you would wear, Maria, why would you wear an ugly shirt?"

"Because I am ugly." She says. She holds up the picture again for a second, looking at it, and then lets her arm flop back down. "I'm fat and ugly. That's what my shirt is too." Everyone thanks her for sharing her picture and she sits down. The second person to get up is Tina. Not only has Tina done her T-shirt, she's flipped the page over on it's back and drawn a tiny little Tshirt on a body that she's made with help from the easily traceable lines of the orignal Tshirt on the front side. She points to each accessory, each piercing, purse, and shoes and explains what brand they are; even down to her "Ambercromby" shirt. She smiles and laughs as she's telling the group, talking fast and looking over at the therapist often to make sure she's getting all the attention she needs. After she goes through her entire wardrobe she says "aaaaaaaaaaaand I'm a hoochie." My eyes immediately widen and I look over at my coworker across the room who has clasped both her hands over her mouth, eyes staring back at me full of laughter.

Tina's also reportedly claimed to a nurse that she and another male patient were in the bathroom together, naked, and they kissed. She told another female patient that she was going to have sex with him before she leaves. That was allsometime last week.

Tina was my 1:1 today. She on precautions for sexual activity and assault. She likes to punch people when she gets angry. I don't have many conservative clothes. I wear a lot of things that any 21 year old would wear. I go out with my friends alot, I got out to clubs. I barely even have any long sleaved shirts because I live in fucking Texas. I also wear kinda..low riding pants, so sometimes when I come to work, my middrift is showing a bit in the front, even if I wear layered clothes. As soon as I walked in, Tina saw that my stomach was showing. "ummmmmmmmm! Ms Heather! I can see your bellybutton."

I frowned and pointed to my fucking belly button (at least 3 inches above the bottom of my shirt) and informed her that she could in fact NOT see my fucking belly button, but yes, I had some skin showing.

"Are you a hoochie?" she asks. My coworker just busts out laughing and walks off. I sat down with Tina and asked her if she knew what a hoochie was and she replied "Yeah..somebody that wears raggedy clothes, right?" I pointed to my fucking shirt and said "Does this look raggedy to you, honey?" I got the great pleasure of describing everything to her about what it was to be a hoochie, down to ads in magazines, strippers, sluts, whores, and self respect. She listened like she understood it all, and then apologized to me for calling me a hoochie.

Later, while we were flipping through a magazine, we flew past a page with Bill Gates' face on it (it was nothing BUT the page). She goes "Ewwww..he has acne." I laughed and told her that some freckles are red and that he was the richest man in the world. She scoffed with "Richest man in the world? He looks like a nerd."

Then she told me that she thought she had a "urine infection." lol....."You mean a UTI?" I asked her why she thought that. "Well..sometimes..when I get up really fast, I pee a little bit." lllllllllllllllawl. I was absolutely speechless. What, oh what, do you say to that? I thought about telling her about kegles, but thought better of it in the end.

So even after all that...drama the day was looking pretty chill; 5 kids, 3 staff, 2 1:1's and 1 precaution for assualt and sexual activity. Bed time rolled around and only a couple kids freaked out for about 30 minutes and everything was quiet. The tv came on and we watched Futurama.

During Family Guy, the nurse called me into the station and told me about a new admit. A girl called Samantha was coming from another hospital and they were sending her to us because she hit a staff and was apparently out of control. I ran around getting her shit ready, throwing the paperwork around. I decided what room to put her in and made her bed. As I was trying to put the pillow in the case, I heard security open the side door. The new admit glanced over at me as she walked past, eyes wide, men in security uniforms, blue, walking behind her.

I could hear that she'd stopped in the dayroom and was talking to my coworker. The first words out of her mouth were "Are you a staff here?"

Ricky replied "Yes I am. I'm Ricky, nice to meet you."

"Do you have any makeup?"

"No. I don't have any makeup."

"That's fucking weird." I thought and put down the pillow and walked out into the dayroom. She heard me come and turned to meet me. Her eyes and hair were absolutely wild looking. She was shaking from head to foot; tremors from withdrawals. The girl was almost as tall as me, about 160 olbs. The first thing I thought was "They've made a fucking mistake..this kid's supposed to be 11."

"Do you have any makeup?" she asks me. I told her that we didn't have makeup and that since she was on a children's unit she wasn't allowed to wear it. She turned to the female nurse just exiting the nurse's station with the skin assessment sheet in her hand. "Do you have any makeup?" she asked her. The nurse ignored her and came over and whispered into my ear that the Samantha was coming down from withdrawals from "street drugs" and the tremors she was having her a product of that and the side effect of the psychotropic drugs she's on.

Samantha asks repeatedly to take a shower. We tell her that it's lights out and there's no way in hell she's taking a shower. The nurse and I go into the bathroom to do the skin test. We cheack every inch of her body and draw up the scars and cuts, bruises, she has on her body. Samantha repeats herself over and over, asking to take a shower, asking for clothes, asking for makeup. I wanted to fucking strangle her.

I got her to sit on bed and I brought her a magazine to read. She refused to lay down, she refused to have her light turned off. When the night shift came in, I caught them at the door and told them not to give her anything. As I left, I heard her arguing with night shift, asking for clothes, asking for makeup.

November 1, 2004
I was hungover and got all fucking crazy drunk the night before, so I missed a day of work.

November 2, 2004

I came in a little early and brought some a'sketti and some bread with me. I warmed them up in the microwave and sat in the minikitchen all by my lonesome. I was reading a bit and eating my noodles when a coworker walked in and asked "Well what the fuck happened to you last night?" I tossed her some bullshit excuse and we talked for a short bit about life and nothing in general. The minikitchen has two complete walls made of glass, hallways run along either side that are normal and sometimes unavoidable frequent passages for patients. My coworker was gabbing away when we heard an easily recognizable knock. It's funny, because at this job, I've come to recognize each sound that can happen in the place and know just where it's coming from. We both turn to look over at the children's unit window to see Samantha's head obstructing the entire window, frown on her face, white stuff at the corners of her mouth.

"Oh, shit. It's that crazy bitch." Says my coworker and just turns around and picks at her own food. "We had quite a day with her yesterday when you were gone."

"Yeah, I was here when she came in, I replied." We both sat in silence until cross-shift started, picking at our food and ignoring the increasinly louder knocks coming from the unit window.

For some reason I've yet to understand, on Thursdays the child unit meetings are held on the unit. After all the regular staff arrived, the four of us retired to the unit nurses's station. We had to push past Samantha with no's and not right nows. Once in the station, her case worker was there. She's become so out of control that she's been put on 1:1 for 24 hours. That means somebody not only has to watch her wipe her ass and eat, but they also have to watch her sleep. The case worker tells us that she has a long line of sexual and physical abuse from family members. That she's been in and out of psychiatric hospitals for her short 11 years. She's only been diagnosed with bi-polar mixed. A normal bi-polar will be depressed for a time and then manic for a time. Bi-polar mixed is a new diagnosis that's beens howing up more frequently. It's when the person can be both manic AND depressed at the same thing.

One thing that's particularly tricky with bi-polar's is that when they become depressed, many of them want to commit suicide, but they're SO depressed that they just wont even care to go through with it. Many of them that are depressed that start anti-deppression medication will have a sudden burst of energy from the meds and finally get the nerve to do it. That's why many of the suicidal patients just starting prozac or celexa must be watched carefully.

Bi-polar mixed patients though have the depression and the energy to go through with murder and suicide naturally without the enhancement of anti-depressants. It's really freaky shit. The girl's absolutely nuts.

All through the cross-shift meeting in the nurse's station, as the case worker is talking to us, she's beating on the door and the windows, screaming to talk to her fucking doctor, screaming to open the door, accusing us of abuse. My coworkers all agree that since I was absent the previous day that I should be the one to take her.

She's on to 1:1. yes, but we had enough staff today, so my coworker and I decided to put her on an unofficial 2:1. We had seen her behavior thus far and we weren't even getting paid for it yet. We both agreed that the first instruction she refused to follow would land her in the quiet room. We asked her to calm down and have a seat on the couch in the dayroom with the other children and she refused. We each grabbed an arm and took her screaming to the quiet room.

Once there, she refused to back away from the door and sit down on the floor to talk to us. She refused to calm down. She began repeating herself again. First she said "let me out." My coworker replied "no." She repeated it again, and so did my coworker. It sounded like she was talking to a dog. "no." "no." "no." I shit you not, they did it at least AT LEAST 3 minutes straight. After awhile, we couldn't help but make fun of her. I mean..this shit was assinign. She started getting rather angry, but shit..so were we...the girl wouldn't fucking back away from the fucking door.

She started to put her hands on staff. She plaed one hand on my shoulder and said "move." I said "no." and pushed her hand away. She repeated this SAME ACT about 50 times. Seriously. She would even put her hand in the exact same spot and position that she had done it the first 20 times. It was like the bitch was just..stuck in a loop. fucking stuck. She got tired of me after awhile, and began doing it to my coworker too. The same exact thing. "Move." *touch with hand* *hand gets pushed away* "no." The sweep of my coworker's arm was making an arc and she started laughing and said "wax on..wax off..." and we all giggled. The girl got kinda angry and started with the "Let me out" again. We repeatedly told her no. This ALL went on for about 30 minutes.

She finally just pushed me. I told her that if she did it again, we'd have to restrain her. After a few more minutes of "no" she pushed my coworker. At this point, 3 other people had heard that we may need some help on the unit and had come to assist us. It took three of us (one of them was a big guy from the male's unit) to get her onto the ground. She was very strong, kicking, screaming, trying to punch us. We realized that she need to be in the four point bed, but we didn't want to risk taking her to the other quiet room, because she was in such a fit that she could easily seriously hurt some one. As we held her, the nurse brought in the tell-tale blue box. She said "I don't know what good this is going to do. We gave her 4 shots yesterday and two pills. We'll see how this works. Just a little pin prick now, honey." She pulled down Samantha's pants a bit and swabbed a small section of one ass cheek. "Ok....1..2...3.." She stabbed the needing in, pulled back a bit and sent the clear fluid in. She set it down and picked up another full needle. "Ok....4....5....6.." And jammed the second syringe in the same spot, pulled back, pushed down on the plunger. "Is there a 7...8...9 in there? Asked the male staff, huffing and puffing, laying on top of Samantha, holding her arms in a horizontal basket hold as she screamed incoherently. The nurse giggled and left with box in hand.

The nurse brought the stretcher in and we strapped her in face down; arms, legs, knees, back, and chest. I pulled up a chair next to the quiet room and began filling out a restraint form. Eveery breath she took she would use to scream "Let me out!" breath "Let me out!" breath "Let me out!" she was becoming hoarse, but continued to scream, stuck in a loop. AS she screamed, she worked her hands around, pulling on the restraints, trying to tear away the thick velcro at her wrists. I had to get up a few times and readjust her restraints to keep them on. The stretcher was only used for the children, really....The teenagers have the restraint chairs (the blue cadillacs) but the children can't fit in them, so we have to use the four point or the stretcher. This girl though, was almost too big for it. Sure, she was strapped in good enough, but her feet were hanging off the end. She was able to put her toes on the ground and push herself around the quiet room....

lol mostly..she went in circles. All the while screaming and screaming "Let me out." calling me a bitch, telling me she needed a kleenex to wipe her nose. I told her the usual protocol for her to get out of restraint - quiet and calm for 15 minutes. After screaming for a few minutes, she'd say "Miss...miss...I'm calm now. I'm calm. Can I get out?"

"I'm sorry Samantha. You must be quiet and calm for 15 minutes."

We did this same exchange about 10 times, each time when I gave her the same answer, she would begin screaming wildly again, kicking her feet around on the floor, pushing herself around the quiet room in the stretcher. It looked really fucking hilarious, honestly. Sure, I should feel sorry for this girl, but she knows she has control over her own behavior. She knows what she needs to do to get outta this stretcher..and could end all this very easily, but she chooses not to. She finally quieted down (the thorazine kicked in) and she was able to talk with us.


I wont even get into the rest of the day. I've worked with children as young as five years old and never repeatedly myself as much as I did with her. She constantly asked for things, would repeat the same question until she got the answer she wanted. Very fucking odd. At bed time, she said she couldn't sleep. We told her that she didn't have to sleep, she just had to lay down, she said she couldn't lay down.


I prayed for an aneurism. For me OR her..whichever would be quickest, yano?