August 18th, 2004


Upon entering the block I was assigned to, I could hear the distinct sound of Sally's (not her name) voice incoherently echoing off the walls.

Sally's 17 and mentally retarded. Some people with MR are so mild that you can't tell until they begin...

January 20, 2005

There's a large piece of paper with each patient's name on it. Next to their name is a box for each shift. In this small box you are the write with careful consideration and try to explain everything that patient did that day - Did they shower? Did they get up on time? Did they go to sleep on time? Did they flip out in the recreation area and start throwing ping pong paddles at peers and staff alike?

You get the idea. There was about 15 people that were on the 3pm to 11pm shift. We'd just arrived at work and were all sitting, as is required of us, in the minikitchen listening to the cross-shift report. It's a time to listen to a recount on each patient and understand what to expect when you get on the unit.

It's actually my favorite part of the day. It's a time for the staffing to come together and feel a common bond on each patient's treatment. Sometimes it's just eyes rolling and scoffs from everyone. Sometimes we're all rolling on the floor laughing because of something a patient did that day.

Today was not one of those days.

The teenage girls unit is full, so the hospital split them in half and put some in the overflow unit. The overflow unit usually houses the patients that need more acute care - the ones that you don't feel comfortable having your back to, the ones that are on precautions who have to eat their food with a spoon because they can't have a plastic fork at dinner or shoe laces on their feet. The overflow unit is also used to seperate certain patients from each other who have been constantly escalating and getting in each other's faces.

This is presently not the case because so many different girls have been going at each other. It's been hard seperating them and it's nearly impossible.

So with all that in mind.... Smile There was about 15 people that were on the 3pm to 11pm shift. We were all sitting, as is required of us, in the minikitchen listening to the cross-shift report. They were reading report on Sharon when the alarm went off. Everyone's head turned up to the black box on the wall. There's a list of the units on it and there was a little red light next to the teenage girl's name. There was murmurs of "oh shit" and the scooting of chairs as about half the staff in the room rushed out and through the doors. lol I just..sat there. I was like "That's about 8 people....they got it. I'll chill here."

As the wide heavy metal door to the girl's unit was unlocked and swung wide for the large number of staff to enter, I could hear what sounded like the entire unit blowing up in screams.

The staff who had decided to stay behind heard this and jumped to their feet. Entering the dayroom, I saw one girl on the floor, four staff were laying on her. She was screaming with every breath she took. Exhalation of noise and distress, quick fast inhalations, repeat. She sounded like she was quickly on her way to hyperventalation. Another girl was pushed by staff into the nurse's station. She was standing in the window I recognized her as Sharon. Sharon's twelve years old and almost six feet tall.

"You fucking bitch! I'm gonna fucking kick your ass if you ever fucking touch me again!" Sharon was screaming the usual slew of insults and threats, wildly points her finger at the girl in restraints on the floor who couldn't even hear her over her own screams.

Other girls on the unit were being ushered into their rooms for their safety by the rest of the staff. Some of them were refusing to go, wanting to watch what was going on with their fellow patients. They also wanted a piece of Sharon. Some staff were dealing with Tiffany, who was also screaming insults back at Sharon through the window.

A girl that appeared very sedated who was on 1:1 was being held fast by the wrist by her staff, being pulled down the hall away from the rest of the girls. Sometimes...when one girl attacks, they all jump in and join in. Like hiyenas. She was also screaming wildly at Sharon through the glass.

There was a wall of staff, surrounding Sharon in the nurse's station. The door was opened and we herded her into the hallway and down it. Half of this method was to just get her down the hall - the other half was to make a wall of staff around her for her protection. She was still screaming "I'm not just gonna let these fucking bitches beat me up every day like this! I can't take this shit anymore! What the fuck do you expect me to do about this shit?!" When she escalates, she gets a wild look in her eyes. You can tell that something happens in her brain when she gets angry. She wont come down from her anger high somtimes for hours later. She was ushered out the unit door and down the hall to the music room.

This all happened in about 30 seconds.

I returned to the minikitchen and sat down to hear the rest of report. As I did so, I could hear screaming from the children's unit and saw a nurse rushing through the room with a tell tale blue box - the one they always carry the shots in.


All of this within the first 30 minutes of arriving at work. I knew I should have called in sick.

February 12, 2005

There's been some staff changes at the hospital; trivial information that would only be interesting to the desperate ear. The point of the fact is that we've been very short staffed and all very overworked. This would also account for my recent honeymoon from posting my logs. When I get home I've simply not the strength to recount the day's events.

I had been placed on the teenage girl's unit today. The girls watched movies, played with each other's hair and played pool in the rec area. We were understaffed and tired from running each girls' errands, but it was a pretty chill day.

It was after lights out, at 10pm, when I was told to go to the teenage boys unit because they needed staff. I entered the dimly lit hallway and could hear screams and the shuffled of feet. I could also hear people banging on doors and windows - loudly, constantly. Light was shining from each open Quiet Room door, but I could see no staff assessing the patients inside. I first walked to the right one, and could see a small boy in a stretcher restraint laying on the floor. His clothes were ripped and he had a large open wound on his head, bright read. He was screaming to be released from restraint. A boy across from the Quiet Room immediately asked me if I could let him into the restroom. I ignored him, naturally. There was more important things happening.

Many of the patients were standing in their doorways, trying to see a piece of the action. As I walked to the second Quiet Room, I told them all to stay in their rooms and close the doors. The second Quiet Room contained a larger male laying facedown on the four-point bed. He was thrashing wildly and grunting as he pulled on the cuffs around his arms and feet. On his right arm was a sheet tangled about his wrist, bloody. A nurse was at the foot of the bed, holding the boy's right calf down with his knee as he tried to buckle the strap around his ankle. I approached the front of the bed to see that his struggled was finally paying off and his sheeted hand was nearly free. I grasped it firmly and he stopped his squirming and looked up at me in surprise. "Hi." I said as I brought his wrist back into the cuff, "I'm Heather." The nurse had finally locked his ankles in and looked up at me saying "He tried to slit his wrist. I think the bleeding's stopped."

Seeing that the patient was securely in restraint, I exited the Quiet Room to assess the rest of the unit. There was one boy standing in his doorway whispering at me "Miss...please..I have to use the restroom." I informed him that he should have used the restroom before lights out and he explained that he needed to change his Depends. At this point, I remembered who this boy was. I'd never seen him before, or knew his name, but I'd heard of a boy who had been raped repeatedly, for years and years, by his father. The actions of this brought about an inability for the adolescent to have control over his bowels and he was forced to where a diaper, and probably would for the rest of his life. I allowed him to get a diaper and some wipes from the nurse's station and let him into the restroom.

Another boy was standing in his doorway saying that he also needed to use the restroom. The other staff told me that he was not allowed to go because he had just gone five minutes before. Apparenly he has a bladder infection and feels like he constantly needs to unleash his bowels. They explained to him that the feeling would be constant whether he truly had to go or not, but since he had just relieved himself it was impossible that he had to use the toilet again. After this was explained, a slew of insults - cunt, bitch, fucking bullshit, mother fuckers, stupid fucking shit, i hate this fucking place....yano..the usual - came sprewing from his lips. After awhile, I walked over to his door and simply closed it. He began screaing wildly and banged his fists against the window in the door in a fury. The boy in restraints in the stretcher restraint began screaming wildly "make it stop! make it stop! make it stop!" over and over.

Another boy who was on 1:1 precautions for 24 hrs a day, even asleep, was laying on his mattress in the day area. He had just been admitted that morning at 3am for trying to hang himself from his ceiling fan at home. He peaked his head out from under his covers, smiling. "Miss? Miss......Can I pop him?"

"Excuse me?"

He motioned to the boy banging his fists against the window. "C'mon, Miss. Can I just pop him one in the jaw? He's really annoying me."

I ignored him and walked back to the Quiet Room with the four point bed. A med nurse had arrived with a shot and some gauze. I watched as they removed the boy's wrist from restraint and dabbed the deep open cut with cotton. The slash was messy, jagged, and slanted. It was also running perpendicular to the vein. I fought off the urge to say the first thing that sprang to mind: "You did it wrong." When slitting one's wrist, you always cut with the vein for optimum bleedage.

Other staff were tending to the boy who had been banging his fists on his door window. I could hear banging from another room - the door was closed and the light was off. I entered the room to find two giggling boys on their beds. They had been tossing a large plastic clothes hamper back and forth as a game. I removed it from the room without a word and came back into the day area. Another boy was standing in his door whispering at me "Miss....Miss....I need to use the restroom too."

I recognized this lad as Samuel. He has narcolepsy and falls asleep just about anywhere if he's sitting down for long enough. There are very effective medications for this particular sickness, but Sammy doesn't take them. There's a large scar that surrounds the top of his forehead, running from ear to ear around his scalp line. He walks very slow with out-turned toes, speaks in a deep whisper, has a creamy white clear complexion - the kind that many mentally retarded children have - and his eyes are crossed. It freaks me out, really, because I never know if he's truly looking at me. I had asked my coworkers about the scar when he was first admitted and they'd told me that he'd had a piece of his brain removed because of cancer. Once while passing the med room, I saw a long blue wand shaped object and asked what it was. The med nurse had informed me that Sammy had been in an accident and had to have a part of his brain removed, including his pituitary gland. He had to take shots daily in order to stay alive because of this. His normal temperature is in the 94.0-95.0 range. Any higher is considered a fever.

Sammy whispered me over to his door saying that he needed to use the restroom and wanted a glass of water. He also said that the staff were measuring in take and out take of his fluids and that I'd have to do so if I were to grant his request. Meanwhile, the boy who'd been banging on his window was receiving a shot and not taking it too well.

The boy in the stretcher restraint was released and he was let into the restroom to assess his head wound. The boy in the fourpoint bed was released after his medication kicked in and he was too incorherent to speak, let alone hurt himself anymore. I allowed Sammy to use the restroom when another boy came out of his room, long black hair and a Cradle of Filth shirt. He was on precautions but wanted to close his door - which is against the rules. Now I'm a cunt and a bitch because I wont allow him to close his door.

All this happened within the last hour of work, and I'd never felt more numb to the entire situation.

February 13, 2005

I was placed on a 1:1 with a very peculiar girl. She's 1:1 for "her own safety" which means she's in her own world and needs staff protection from some of her more aagressive peers. We'll call her Media, because I've always liked that name. She doesn't talk much and when you speak to her, ask her anything, she normally doesn't respond. Sometimes we think it's because she's simply not all there, other times you can tell she's flat out ignoring you. Media's very tall, about six feet, fat, 17, and black. She walks very slow, responds to staff very slow, and talks very slow when she speaks, which is usually a whisper. Her hair is usually messed up (frowed out) even though she's constantly messing with it. She claims to be pregnant, but upon admission, each female patient is given a pregnancy test and her's came back negative. We believe that one of her immediate family members, sister, mother, cousin, is actually carrying a child presently and that's why she's preoccupied with the ides. She also claims that the baby she is carrying was fathered by her girlfriend. Cucko. Cucko.

When I arrived on the unit, she was asleep on one of the dayroom couches. I was thankful for this, because she's not 1:1 when she's asleep, so I was free to actually get some work done. When snack time rolled around, I awakened her and gave her some cheese crackers. She accepted them without a word. She didn't ask to use the restroom, but simply walked into the hallway and tried to open the locked bathroom door. This rather urked me, because she's 1:1 eyesight and she knows it, but is simply disrespectful. I allow her into the restroom and she walks up to the sink, pulls a brush from her pocket, wets it in the sink and brushes it through her hair. THIS is a big black person hair no no. This was the first thing that made me think "This bitch really must be crazy." I watch the little mirror in the corner as she uses the toilet and then promptly begins to walk out. I'm holding the door open for her as I say "Not gonna wash your hands hu?" She doesn't respond, just keeps walking away.

She was able to go to recreational therapy, but didn't particpate much. She doesn't interact with any of her peers, and nobody really talks to her. She's in her own world. She asks to use the restroom again and then walks out. "So uuuu...Media...not gonna wash your hands this time either, hu?" At this point, I was tired of not getting a response and decided to be a sarcastic bitch to her for the rest of the day.

After dinner, it was such a lovely day out that it was decided to take the group outside to the sports court area. There's a basketball court and a large grassy/tree area surrounded by a high, hard-to-climb-over, fence. This is when I noticed that Media wasn't wearing shoes, just those weird socks with the rubber treading on the bottom. I told her that she would have to return to the unit with me to retrieve her shoes. She became angry at this saying "I've been outside all day without shoes on." A quick look at her 1:1 sheet showed that she hadn't been outside at all that day. I persuaded her to walk with me to the unit and as we made our way down the hallway past the visiting area, she simply stopped and removed her socks. *sigh* This is a big don't in the hospital, because germs are easily spread through walking barefoot through a psychiatric hospital - just try to imagine all the bodily fluids on the floor; vomit, urine, feces, mentrual blood, you get the idea.

There's a special room on the unit that houses many of the girls' possesions that they aren't allowed to have - special shampoos, hairbrushes with metal teeth, bracelets, shoelaces, etc. Media's particular precaution requires that she sleep in the dayroom, so she doesn't have a room and has to keep ALL her belongings in this room. I open the door for her and see that a large upright brown paperbag (this thing's huge, I could hop in it and win a potato sack race) has her name on it. She slowly walks over to it and begins pulling clothes out and tossing them on the floor. She removes two shoes and begins stuffing the clothes back in the bag. I put out my hand and suggest that I hold the shoes while she does this. She hands them over and then I realize that I have to take her shoelaces. I explain this to her, and she gets really pissed off.

Suddenly she isn't so quiet anymore and her vocabulary is perfect. The lethargic movememnts I'd witnessed prior to this time period vanished and the glazed over look in her eyes was replaced with alert clarity. She snatched at the shoes, trying to wrench them from my hands. "Stupidass. Give me my god damn shoes."

She starts arguing with me about the whole situation and then expresses that she doesn't want me to throw her shoelaces out. I make her watch as a I get a plastic disposable waste bag, write her name on it, and place her shoelaces safely inside and with the rest of the possessions that the girls aren't allowed to have. She puts on her laceless shoes and I walk her out to the sports court.

Once outside, I sat on top of a low brick wall near the doorway next to my coworker and explained what had happened to her, just to vent, yano? Media sits at a picnic table for a few minutes. Then she gets up and comes to sit by us. A few minutes later she returns to the picnic table. Then she gets up and comes to sit by us. She repeated this action 4-5 times without reason and presumably without the knowledge that she was even doing it.

The girls lined up to go inside and Media cuts in line. I'm telling her to get in her place in line, as is all the girls, but she simply doesn't respond. It's uncertain whether she truly can't comprehend sometimes or whether she simply doesn't give a shit about anyone else.

Once on the unit, she wanted to take a shower. We're supposed to actually watch them take a shower if they're on 1:1, but a degree of privacy must be granted, so I simply cracked the shower door ajar and pulled up a chair next to the door. I could see her undressing out of my peripheral vision, but seriously had no desire to see this girl in the buff. She showered for 30 silent minutes. I would poke my head in from time to time and speak to the shower curtain to see if she was alright. Mostly, she wouldn't respond unless I truly pressed her, and when she did respond, she sounded very irritated at me.

After she exited the shower, she tried to hand me her towel and asked me to put it up. I retorted with "I'm your staff, not your maid." I followed close behind as she placed her towel in the dirty clothes hamper and then into the hygiene room, prusumably to put up her hygiene box. She set her box down on the counter and poured shampoo into her hand and began rubbing it into her hair.

"Media, what are you doing?"

No response.

"Did you already shampoo your hair in the shower?"

No response.

"Why are you shampooing your hair again? If you want to do that, why don't you get back in the shower?"

I stood and watched (pissed off, really) for a few minutes as she lathered up her head and then washed the soap out in the sink in the hygiene room, all the while asking her WHY she was doing this. Once she felt her hair was sufficiently clean, she dired it with a fresh towel and then meticulously dried off the sink with another one. She then opened her conditioner and smoothed it through her thick hair. "WHAT are you doing, Media?!"

She turns and looks at me, her face completely blank, and walks straight past me. She walks to the room with all her possessions in it and tried to turn the knob. All the doors are always locked on the unit. I go to open the door for her and become totally DISGUSTED when I realized that she's slathered the door handle in conditioner from her hands. After unlocking and opening the door for her, she steps inside and places her dirty clothes in the clothes hamper. She then exits the room and I quickly lock it and follow her back to the hygiene room, where she's now turned the sink back on and is rinsing the conditioner from her hair.

And I'm wondering...why didn't she wait until she was finished shampooing AND conditioning to put her dirty clothes away.

At this point, I didn't even bother talking to her anymore. I figured I'd pay her the same silent luxury. I watch as she wets her hair and dries it, then meticulously wipes the sink of water droplets. She then goes into the dayroom and sits to watch tv and eat second snack.

It was close to lights out, so we set up her bed in the dayroom; sheets, blankets, and pillows, oh my. Media then lay in her freshly made bed and closed her eyes. A few moments later she approached me and asked to use the restroom.

The bathrooms are set up rather weird, but strategically. When you open the door, you're looking down a long narrow hallway with a small half-round mirror in the top corner. Depending on the restroom, the narrow hallway will either open to the left or right to a larger room which actually houses the toilet. So you can't see see the person using the restroom, just the small bubbled reflection smiling down at you.

I walked her to the back hallway and unlocked and opened the door for her. I stood with my foot in the jam for a crack and watched the mirror and she unzipped and sat on the toilet. She then got up and squatted on the floor.

"Media, what are you doing?!"

No response.

"WHAT ARE YOU DOING IN THERE?"

At this point, I opened the door wide and began asking more loudly. I refrained from completely walking into the restroom, because then the door would shut. Me + a patient in the restroom together - cameras = possibly lawsuit, possible allegation of sexual assault = me getting fired. All I could do was stand in the doorway and hold the door wide, stupidly asking her what was obviously happening.

"What are you doing in there?"

She stood for a moment and began to unroll the toilet paper and wad it up. She began to wipe (or did she simply pick something up?) the floor and I heard a "plop" as she dropped it into the toilet. It's unclear whether the toilet paper was simply soaked or she was dropping shit into the comode. After she did this, she squatted on the floor again. I wasn't having this shit anymore. I screamed for my coworker to come to the back hallway. I could hear her approaching down the hall, keys jingling, as I saw Media in the mirror standing up, trying to pull up her pants. Suddenly, she slipped on the floor with one foot and fucking BUSTS HER ASS. She begins laughing hysterically. As she buttons up her pants and walks toward the corner, I see her big 70s bush poking up through the top of her pants. My coworker's arrived at this point and holds the door open for me as I walk in to assess the damage. The entire floor from wall to wall is soaked in moisture.

I walk out of the restroom to stand by my coworker as Media begins walking out "NOT GONNA WASH YOUR HANDS?!?!?!" I ask her. She's still laughing. I ask that she stays in the restroom as my coworker fetches a towel for her to clean up her mess. I hand the towel to her and she wets it in the sink first. Not only is this bitch crazy, she's stupid too. Throughout this time, I'm asking her why she would do something like this and she doesn't respond. After she cleans it up, she tries to hand me the towel and asks me to put it up for her. I respond with my same earlier response. "I'm your staff. I'm not your maid."

She puts the towel up and comes into the dayroom. I sit at the staff table with my back to Media's bed. I don't give a shit anymore at this point. I'm just looking at my coworker, and she's looking at me. We're both in disbelief that this just happened. I turn around to look at Media and she's getting under her covers. She's wearing NOTHING but her underwear.

"MEDIA. WHAT ARE YOU DOING?! You can't be in the dayroom with no clothes on. It doesn't matter if you're under your covers. You CANNOT be in the dayroom with no clothes on."

Her siple response to me as way of explanation is "They're wet."

I get up and open the room for her so she can get some fresh clothes. She lays down and goes to sleep afterward with a smile on her face.

February 15, 2005

I had Valentine's Day off, and so was in a rather good mood coming into work. Little did I know I'd be going home with six new bruises today. When I walked on the unit, I began checking all the doors when I saw Greg had gotten loose of the quiet room and was running my direction. I was holding a water bottle and my purse, and had to drop them in order to catch hold of him. He immediately buckeled his knees and fell to the floor, screaming. I'd no idea how this situation had come to be, but I helped the dayshift staff by getting one arm, as he got the other, and walk Greg back to the quiet room as he screamed to "fucking let me go!"

Ignoring Greg's screams, I looked at all the paperwork on the staff table. I decided to take little Toddy as my 1:1. I don't know much about Toddy's history, but I do know that he's 9, screams constantly, and if he doesn't get his way, he'll start biting and scratching people. "SHUT UP!" is his favorite phrase. I'd heard in the cross-shift meeting that he'd gone to get his EEG done. EEG stands for Electroencephalogram, which is performed to detect abnormalities in the electrical activity of the brain. This test is done for everyone in the hospital before they are discharged as a matter of principle. It requires that the patient sit very still, which is nearly impossible for a child of Toddy's high ADHD calibre to accomplish. They had to hold him down during the entire process. The test and trip to the clinic usually takes about 45 minutes. For Toddy, it took TWO HOURS.

Toddy whines constantly. He doesn't talk to other children much and when he does he screams at them to get away or shut up. I've never seen him smile. Ever. And like Media, when you speak to Toddy he rarely RARELY responds. He never makes eye contact either. Ever.

When I got on the unit, Toddy was asleep in bed. The nurse on duty told me that he was given a "Mickey" to help with the EEG and he was probably going to be pretty out of it all shift. We woke him up to take him to Recreational Therapy in the rec area.

As Toddy's standing in line to go to therapy, I approached him and squatted down to his height and said "Hi, Toddy. I'm your 1:1 today." He looked past me and walked away and down the hall to the restroom door and tried to turn it, whining as it wouldn't budge. I opened the door for him and watched in the mirror as he used the toilet. He flushed and immediately tried to walk out. "Please wash your hands, Toddy." He began WAILING. No coherent words, but high pitched squeels. "I'm not letting you out of this restroom until you clean you hands, and screaming isn't going to get it done any faster. Please use soap. It'll take 5 seconds." He rinsed his hands with water and came out to get in line. All the while in the line, I'm telling him to stay in his place, stop cutting people off, etc. Just annoying shit.

Once in the rec area, the recreational therapist had the children sit on couches in a semi-circle around her with a table with two clay balls, one pink, one yellow. She explained that today's activity was like charades, only with clay. She would show the chosen child a notecard with a word on it and they would have to make this object using the clay color of their choice while the other children guessed what they were forming with their hands.

The first child went up and started the activity. As he began to mold and shape the clay, Toddy screamed "Hurry up, already! We're hungry!" All the children laughed at him and the first thing I thought was that Toddy wouldn't be able to perform this activity. Many of the children made TERRIBLE clay sculptures, but I underestimated them all because each item that was made was guessed, though I couldn't possibly see a teddybear, a car, a pencil, any of the guessed random objects in the glob of playdo the children produced. All through the game, Toddy did not guess once and sat quietly, but the other children were screaming and laughing loudly, enjoying the game.

When it was Toddy's turn, he came to the front by the table and began to shape the clay. He was doing this for about 2 minutes when one of the children blurted out "It's an airplane!" Sure enough, I could see that Toddy was indeed making a very sadly, un-sky-worthy airplane. I was quite astonished. Toddy returned the clay to the therapist and refound his place on the couch. The boy directly next to him was chosen to come up. When this boy got up to be the star of clay charades, Toddy lay down on the couch. I didn't say anything to him, because I knew he had been medicated and many sedating medications make you feel ill if you aren't laying down. I allowed him to stay put until his neighbor's turn was over. When the boy returned he asked Toddy "Please move out of my spot." Toddy did not respond. I asked him to move and he screams at me "NOOOOOOOOOO"

I got up and grabbed each arm firmly and sat him up and then returned to my seat as Toddy was still wailing. I said "THANKYOU!" to Toddy as if he'd done the act on his own The boy sat down next to him saying "Thankyou." to Toddy. Toddy screamed "SHUT UP STUPID HEAD." I said something to him about respect and name calling and Toddy screamed at me "SHUT UP!" He got up from the couch and kicked my shin and sat back down. A coworker and I each took one hand and started walking him back to unit explaining that if he could not control his behavior, we would control it for him. As we walked, he pulled his arm down to his face and bit my coworker's hand. He also tried to do the same with mine. At the unit door, we paused to unlock it and he pulled my hand to his face and tried to bite me again. This time he scraped his teeth on my hand leaving a large red mark but not braking the skin.

We took him to the quiet room and he turned and kicked me in the shin again. Once we'd closed it, he banged on the door and screamed and screamed. He finally sat on the floor. A nurse arrived with a pill and asked him to take it to help control his behavior. He refused to take it and would not speak to any of us. He ultimately lay on the floor and closed his eyes. I asked him at this point if he wanted to lay in his bed, but he didn't respond. I came into the room and placed one hand under his knees and tried to place the other under his neck to lift him and carry him gently to bed. He wailed "noooooooooooooo" I removed my hands and sat looking at him quietly. A few moments later, I tried again and got the same response. The third time, he didn't protest and let me carry him to his room. I removed his shoes and sat in a chair in his doorway until I believed him to be asleep.

After recretional therapy, I knew that the children were going to be taken outside, and I was rather depressed about having to stay inside and watch Toddy sleep because it was such a beautiful day.

I heard the unit door close and could hear the voices of one of the nurses and Greg walking onto the unit. The nurse was asking Greg why he had become angry. This particular nurse is known for his unprofessional laid back attitude. He ever follows protocol and gives children candy sometimes when they're acting out in an effort to calm them down. The only reason why Greg was returning to the unit from outside was that he had done something terribly wrong, and the correct protocol is to take him to the quiet room. Instead the nurse allowed Greg to stay in the dayroom.

Greg picked up a teddybear that was on one of the couches and began strangling it. "Tim's bear. TIM'S BEAR. TIM'S BEAR!!!!" he was screaming as he ripped one of the ears off. I then watched in horror as Greg walked to the drinking fountainand push the button, placing the bear's head under the stream of water.

The nurse wrenched the bear from his hands and escorted Greg to his room to calm down. I was quite worried about this situation now, because this STILL wasn't protocol. I got up and walked toward Greg's room as I heard a racket coming from behind the closed door. I opened it to find that Greg was beating part of the ceiling light fixture on the wall. The nurse and I took Greg to the quiet room where he immediately got down on his knees right next to the wall and began SLAMMING his head against the wall, screaming louder each time he did so. The nurse turned to me and said "fourpoint." and we each took an arm and escorted him into the restraint room. As we buckled his arms and legs in, he screamed and screamed to be released. "I just wanted a fucking scooter! I just wanted a mother fucking scooter!" I saw that the restraints were securely fastened and exited the restraint room.

Just then Toddy came out of his room and asked me "Can we go to dinner now?" I informed him that dinner was in an hour and his face contorted into pain and he threw his head back and screamed "AWWWW COME ON NOW!" His voice is seriously like nails on a chalkboard.

"Screaming isn't gonna change what time it is, Toddy. The food isn't even here yet."

I herded him back into his room and he sat on the floor, then finally lay down. About five minutes after he'd calmed, I asked him if he'd like to go outside for a short while. He didn't respond, but sat up five more minutes later and asked to go outside.

Once outside, he didn't talk to anyone, but silently sat on the ground in the large sandbox surrounding the playscape and ran the sand though his hands.

Toddy was very happy when it was dinnertime, but he only ate about 25% of his meal. Toddy brought his tray to the counter and I asked him to throw away his paper and plastic stuff (spoon, milk, napkin). He responded with "Paper is insanity! Paper is insanity!" He was one of the first to finish eating, and started to become board and agitated. I asked him if he'd like to go outside before the rest of the group and he agreed.

Once outside, I sat at a picnic table in the shade and watched as he would go to the large sandbox, pick up a handful of sand, and then slowly walk around the play area letting it slowly sift through his fingers. Repeat. At one point, he was doing this and kinda..mosied on over to where I was.

"Who wants to push me on the swing? Raise your hand!"

I looked around....surprised. "Toddy...there's only you and me out here....."

He made no eye contact with me, and made not even a response showing that he understood my words. He simply turned and began walking toward the tireswings.

I kinda shrugged to myself and got up. Tireswings are a funny thing, and are usually a circular activity. You just kinda swing around in a circle, sometimes spiralling at the same time. I started pushing him and he seemed scared at first, giving me one word commands. "Stop" when he started to get too high, "Push" when he felt he was getting too low. After five minutes of pushing, and my back and arms getting really tired, he began singing to himself some incoherent song and I could tell he was enjoying himself. I could see that he was smiling. I tried to make conversation with him during this time, but mostly he didn't respond. He seemed to better understand the short questions.

"Don't push too hard," he said "or my dreams will become my worst nightmares."

"What do you dream about, Toddy?"

"I dreamt I was on a ship."

"A ship hu? A boat-ship or a spaceship?"

"I was on a ship. It was a dark and stormy night."

"That sounds rather scary. Were the waves really high?"

"Uhu...and I was holding onto my thing and I was going 'wooooooooooooooooooooooooooo woooooooooooo'" he started making siren noises as I spun him in circles.

"Were you scared?"

He didn't respond to my question but replied "My dream was like a movie I saw."

"What movie was that?"

"Spiderman."

"I've never see Spiderman on a boat before."

"It's a videogame."

"oh...."

We had a few more exchanged sentences, most of them not making sense. Toddy also said "Coming to you live from the English house of weiners!" at random about 10 times....whatever the fuck that means. I asked him if it were from a song or tv show and he didn't respond.

The other children came outside shortly afterward and I was surprised to see that Toddy began playing with another boy that was his age (who also happened to be from the same small white trash Texas town). They seemed to be getting along very well and Toddy had no problems for the remainder of the time he was outside. One of the nurses even commented on his good behavior and I was glad that I'd taken him outside early.

Once on the unit, he wanted to take a shower. He became VERY angry that he had to leave the door ajar. I know for a fact that he's been at the hospital for over a week and he's been on 1:1 the entire time. Having the door ajar should be no issue to him at this point. He screamed and screamed at me as I pulled down the shower curtain, placed his fresh clothes on the chair in the shower, hung his towel up on the small hook, and put his soap and shampoo on the ledge for him. I sat outside the door for a short silent 3 mintues when he began wailing again "IT'S NOT GETTING COLD!"

Sometimes, when there's four showers going at once..it just doesn't get cold. His voice was really really starting to get to me. "You screaming at me isn't going to make the water warm, Toddy. In fact, it's not going to do anything."

"SHUT UP."

I began spewing out lines about respect and favors and blah blah, and he started telling me "Shut your idiotic mouth."

He repeated it over and over, screaming it. It seemed like a rather strange line for a nine year old to say so I leaned in close to the door and poked my head through, speaking to the shower curtain "That doesn't sound like something you'd say, Toddy. Is that something that your parents tell you sometimes?"

He got really quiet.

A few more heavenly silent minutes passed and then he began wailing again "IT'S COLD. THIS WATER'S FUCKING COLD!"

"Tell ya what, Toddy. Put some shampoo in your hair and then just rinse it out and your shower will be done."

He responded by screaming like a girl at me, repeatedly. A few moments later ths hower went off. I could see him dressing out of my peripheral vision and then he emerged from the shower. His hair was covered in suds of shampoo. I told him that he hadn't washed it out and he called me a liar. I walked him down the the hygiene room (dragged is really the term I meant to use) and turned on the bathtub. With much coaxing, I told him to close his eyes really tight and put his head under the faucet so I could rinse his hair. It took only two minutes to rinse his hair clean and dry him off. The nurse brought him his night time meds early, because Toddy's a handful and everyone in the hospital knows it...He then sat in the day area, mesmerized by the grand babysitter Spongebob Squarepants on the tv.

When snack time rolled around about 45 minutes later, he was still sitting on the couch, staring at the tv, when I whispered in his ear "Wanna go to the diningroom and get snack with me."

Without a word he got up and walked with me to the diningroom. I asked him to open the refridgerater and get the bag of yogurts and graham crackers on the second shelf. The kids LOVE doing labor when it comes to food. We walked back to the unit and passed out snack together, which he seemed very happy to particpate in, though he neither smiled nor talked during this time.

After snack, he approached me and asked me a resounding question. "Can I have my candy?" All the children had received Valentine's Day candy the day before and many of them had eaten it, but Toddy hadn't and had been asking me ALL DAMN DAY for his fucking candy. I'd given him the same response each time "At snack time, sir, you may have your candy." and now was the time.

I walked into the nurse's station and picked up the heart shaped plastic container on the desk with small pink, red, and white, heart of compressed sugar inside while Toddy waited patiently at the door for me. I came to the doorframe and asked him to open both his hands for me so that I could pour some candy out. He began screaming and screaming, holding his hands out to try to grasp the candy from my hands. It was apparent that he wanted the entire container. There was no way in hell I was about to give him ALL that sugar right before bedtime, so I explained to him that I didn't have to give him any of it, and he should be thankful that I was offering him even one piece of it. He wasn't listening, and continued to grab at me, trying to scratch me now. He slapped my hands a few times as well. I put down the candy and closed the nurse's station door. "And that's it." I said.

He began screaming wildly, arms swinging in circles like windmills, as his legs assaulted the nurse's station door. I placed him in a basket hold and took him to the quiet room.......yeah....again.

I put him in the door and closed the door, expecting him to calm down just like before. He was cursing at me a lot this time. "FUCKING BITCH! STUPID FUCKING IDIOT! Fucking BITCHFACE! SHUT UP! SHUT UP!" I stood outside and listened as the cursing dwindled and he became quiet. I opened the door and found him laying on the floor. I began speaking with him about the situation, about how I didn't have to give him any candy at all and that I was doing him a favor and he was screaming at me and calling me names for no reason.

He began with the "bitchface" and the "shut up stupidhead" things again, so I just closed the door again until he quieted down.

After awhile I re-opened the door. He was quiet still, but this time I saw that he had been picking at a large scab on his arm and it was now bleeding. Toddy used to be on precautions for self injurious behavior. He had twin scabs on each fore arm where he picks his skin until it bleeds. He does this when he's bored. I asked him to stop and he told me to shut up. I grabbed both his arms and placed him in an "I love myself" personal restraint. He bit at my hands during this time, scratching at the wrists with his nails and trying to pull my hair (I wore it down today). The nurse arrived and tried to speak with him, but Toddy wouldn't respond. The nurse asked him repeatedly "If we let you go, will you continued to pick at your scabs?" He made no sign that he understood anything we were saying.

It took three of us to strap Toddy into the fourpoint bed, the same that Greg had been placed in just hours before.


*sigh* I'm too tired to write anymore.

When I got home, I counted six new bruises on my legs, one on my arm.

I wasn't scheduled to work on Sunday, but my supervisor asked me to anyway. The weekends are always the worst and we're always understaffed, so I was dreading it. I was especially depressed about the situation as I drove to work in perfect sunshine and weather just to have my journey end at a locked down "inside" facility.

As they read report in cross-shift, we all discovered that out of the three units, we had four 1:1's and two 2:1's. This means that we're legally required to have 6 staff to cover the 1:1's and then an extra staff for each unit (legally we should have 9), but we only had 7 staff for the day.

I had a rather numb feeling in my stomach as the nurse's from dayshift read report on each patient. The children's unit was having a great day, no emergency meds, no restraints. The teenage boy's unit was doing alright, but a few of the boys had been overheard talking about "jumping" one of the boys who had a particularly dirty mouth, sharp tongue, and was in a wheel chair.

On the teenage girl's unit, everyone had a good day but Kasandra. She's suicidal and diabetic. She had eaten breakfast and received her first insulin shot of the day, but when lunch rolled around she refused to eat, saying that she wasn't hungry. She lay in her bed sleeping the entire day and by 2:45pm she had gone into diabetic shock. She lay in bed silent and limp as the nurse passed a flashlight in front of her eyes, checking to see if her pupils were still responsive. Normal blood sugar levels range from 70 to 110. Kasandra's glucose level was 18. She couldn't speak, so when they pried open her mouth to poor juice down her throat, she made no sound of protest. They explained to her that if she didn't eat something with sugar in it, she was going to die, but she still weakly tried to bite down on their fingers to fight the forced orange juice.

After report was read, the ground's nurse - she had tape in the middle of her glasses holding them together - looked solemnly at everyone and said "If the alarm goes off, and you have a 1:1 and feel that they'll be ok, just leave them. Just leave them. We don't want a repeat of yesterday and just because we're understaffed doesn't mean that we can allow these children to beat us up."

I was sent to the music room to be part of the 2:1. This is when I met Kera. Her reputation had definitely preceeded her. I had heard about her when she'd first arrived a week before. A coworker had told me the story of a 14 year old girl that truly wanted to die, that truly kept trying to die. She's done so much self injurous behavior that she has a high pain tolerance, which in the end does her no good because she that tolerance needs it in order to cut through the deep scare tissue on both her fore arms, her stomach, her calfs and thighs. She had been at home when she had cut another deep gash in her arm. She was sent to the hospital when they had deemed the gash too deep for stitches. They had instead put long deep staples in her arm to hold the skin together to stop the bleeding.

She had lost a lot of blood when she arrived at the emergency room, so she hadn't been in a fit. Once she regained consciousness, once her strength returned, she ripped the bandages off her arm and pulled the staples out and began to claw her way back into the healing bruised flesh to bleed afresh.

Normally the patients are brought to us, but this is when the hospital called our facility and told us to come pick her up. In the week that she's been with us, she's snuck into the nurse's station and drank cleaning solution, trying to still commit suicide. She's stolen pencils and staples off the floor and tried to carve into her legs and arms.

Now she was on two to one close proximity. This means two people have to be within five feet of her all day, in the shower, in the restroom, in her sleep; This girl wants to die. They moved her to the music room and away fromt he unit because they feel that her behavior is so self injurous that she'll depress anyone she's around, especially other patients.

When I walked into the room, she was asleep and looked harmless. She had on comfortable looking clothes, sweat pants and a sweater. Kera's 14, 5'7" and 270 lbs. This is a huge girl. Since we had no staff, the grounds nurse was sitting with me to help watch her. She was bitching and moaning about her glasses that a boy had broken the day before during a restraint. She was playing with the broken spectacles and some superglue, constantly on the phone and calling all the units and nurse's to make sure everyone was ok.

I had stopped off at the children's unit and picked up some crayons and coloring books so I'd have something to do while Kera slept. I was humming and coloring when Kera awoke, making small moans and opening her eyes. I introduced myself to her, but she didn't respond. She lay in bed for about an hour, just looking at nothing and not reponding to us.

After about an hour, I asked her what she liked to do. "Nothing." was her reply.

I asked her where she lived, and she replied that she lived in Galveston. "Oh? Do you like it there?"

"No."

"What do you do for fun?"

"Nothing."

I asked her a few more questions, but she didn't respond. She just lay in bed staring off into space.

Since we were so understaffed, the grounds nurse, med nurse, and myself took turns being in the room. The med nurse had to keep leaving to distrubute meds, the grounds nurse had to keep leaving to assess different problems throughout the hospital. I only left a couple times to go to the rest room and refill my water bottle. After awhile the day didn't seem so bad and it was time for dinner. Lucky for us, they were having a bar-b-que.

Kera asked for a hamburger and some chili cheese fries. The med nurse got two hot dogs. The grounds nurse got two hamburger patties (no buns). "I'm trying to watch my weight." she said. I got a hamburger and a hot dog, chili on all of it. :X lol.

After we had all eaten, we each decided that we wanted more food, so they sent me to the diningroom to get more. When I entered, the teenage boys were eating. I saw Trey sitting at the table closest to the door. He's twelve and had been on the children's unit before he was deemed to large and aggressive to be with the other children - they had moved him to the teenage unit.

The one day that Trey had spent on the children's unit, he had tried to talk to me non-stop. After he was moved, another patient, named Cameron, approached me saying that Trey had written something about me way up underneath his bed. There was no way in hell I was going to climb up under a bed to read what a twelve year old mental patient had written about me, so I had asked Cameron to just tell me what it said. Cameron had blushed saying "I can't say that, Ms. Heather. It's just wrong to say that word." I had asked him to write it down if he couldn't say it, but he refused to do that as well.

What the hell had this kid written about me? In all honesty, I had been turning it over in my head, but I had a pretty good idea of what it was about.

When I entered the diningroom, the teenage boys were eating. I saw Trey sitting at the table closest to the door.

"HI, MISS HEATHER!"

"Hi, Trey."

"How're you?!"

"I'm ok." I tried not to make eye contact as I walked past him and to the counter where all the food was waiting. Trey continued to talk to me, asking me questions. I pretended like I didn't hear him as I loaded up my arms. I turned to walk out, but saw that my arms were too full to open the door. I stopped at a table and readjusted the way I was holding everything. Trey took this as his opportunity.

"Ms Heather! Ms Heather! SIT OVER HERE!" He was waving his arms wildly.

"I'm sorry, Trey, I'm taking this stuff back to the music room." I stood up with the readjusted food and my key out and ready for the door. As I unlocked and opened it he asked "When are you gonna work on the boys' unit?"

I smiled and replied "I'm sorry, I never work over there Trey." I could see in his face that he was crushed.

I returned to the music room and we all finished out dinners. Kera had barely spoken at all. I had asked her if she wanted to listen to the radio. "Wanna draw? We have markers and crayons....Want to play a board game? There's some puzzles here...want to do one?" She had told me that she was board, but she refused to do anything but stare off into space. Now she approached me and asked for markers and paper. I happily gave them over and watched as she sat down and began writing.

She wrote for about an hour and the neatly folded them and set them aside. She then sat on the floor and started a puzzle, seperating the edge pieces from the rest. "I love puzzles!" I said. "Need any help?"

"no."

Feeling rather discouraged at being so quickly turned down, I asked the med nurse and grounds nurse to sit tight for a moment so I could go get my favorite puzzle at the hospital, which just happened to be on the overflow unit.

I said earlier that there are two 2:1's right now. Kera is one of them, the other is a boy on a unit all by himself; the overflow unit. It was once called that because if we received too many patients on one ward, we'd move some to the overflow, but it's since been closed down and is only used for terribly aggressive patients. John is one of these. He's been sent to us for sexual assault and aggression. He's very sociopathic and very psychotic. He's 17, and a lot bigger, taller, than I am. He's very intimidating. Any female he sees, he'll make some sexual comment to them or try to touch them. He's notorious for eating his feces and spreading it on the walls.

I walked onto the unit and he immediately saw me as I rounded the corner.

"Oh my god. Hello, hello. Who are you?" John looked very excited and surprised all of a sudden.

I didn't answer his question, or even look at him. I walked straight to the cabinet in the dayroom and opened the door. "I'm here to steal one of your puzzles, sir." I rumaged through the mess of the cabinet.

"Which one are you looking for?" He began to approach me to "help" me look. I silently started to panic inside, but my eyes landed on the puzzle I wanted.

"Here it is." I pulled it out with one arm, my other was hanging limply at my side and I felt something hard and hurtful brush against my skin. I looked up, but not at John's face, to see that he had a hairbrush in one hand and had scratched it across me.

"Did that hurt?" He asked. I took a step back as he swiftly did it again. The staff that were supposed to be watching him were simply sitting in their chairs by the nurse's station, watching tv and not even paying attention. I backed up, puzzle in hand, until a couch was between me and John. I used this as a wall as I quickly turned and practically ran off the unit as he screamed at me to "Come back! Come back!"

I returned to the music room with my puzzle and sat on the floor next to Kera, smiling and humming as I took the pieces out. Kera and I both sat in silence as we worked hard on our puzzles. Around us, I could hear screaming and swift feet every now and then. I could tell that the units had started showers, because everyone was screaming which number shower they wanted. Both the nurse's with me had to go to different units to give out emergency meds to some unruly patients, so they called a male coworker to come sit with me and Kera.

This coworker and I happen to be good friends, and it was good to see at least one smiling face among the staff. He sat down next to Kera and I and helped me work on my puzzle. He tried to speak to Kera, but she didn't reply. this is when he asked me if I'd read the note that Cameron had written about me.

"Cameron wrote a note about me?"

"Yeah..it says some pretty sick shit."

"Ohhh...I know what you're talking about. Cameron told me that Trey had written something about me under one of the beds. I asked Cameron to write it down for me to read so I wouldn't have to climb up under there. That must have been what you read."

My coworker's eyebrows went up "Yeah, I heard about that. He mentions it in this letter. It says that Cameron's the one that actually wrote that stuff, but he tried to blame it on Trey."

"What...? What else did it say?"

"It says that he wants you, but in many more dirty words than that."

Ew.

This is when my coworker was called away to another unit, and one of the nurse's returned to sit with us. 8pm rolled around and I was done with my puzzle. Kera had long given up on her's saying "There's no point anyway."

The nurse and I escorted her to the teenage girl's unit so she could take her evening shower. She had been wearing comfortable clothes all shift, the sweat pants and sweater, which was long sleaved. The nurse and I stood in the doorway within our respected five feet of her as she undressed. She had a very lovely complexion and gave the appearance that she was half white, half black. Her skin was the color of mocha coffee with a little cream. She was absolutely free of facial blemishes.

She removed her pants first, and this is when I saw the extent of the damage that she had caused her body over the years. Her legs were covered in scars. Each one looked razor inflicted, about 5 centimeters apart, deep and long. They started at her ankles and went all the way up to her crotch. It looked like she had stripes; perfect stripes of scarification. Her beautiful complexion paid no justice to her scars, which were dark dark brown, some looked black in places.

She removed her shirt and my eyes fell on the shiny purple mess that was her left arm. Before I had entered the music room, the grounds nurse had told me simply "This girl is very suicidal. She had gashes all over her body. Gashes." This was the arm that she had cut deep into so many times, ripped the staples out of at the hospital, and clawed her way through to get to her artery.

It looked so horrible.

They couldn't put anything on it, because she'd rip it off, so they'd used a relatively new method of bandage. After they had washed the blood away they'd placed a clear plastic adhesive over the length of her entire forearm. This gave her body a short cut, because the adhesive acted like artifical skin to protect from infection and bacteria.

The adhesive was also clear and shiny. It looked like meat you'd see at the supermarket, only purple, yellow, black and bruised. It looked like an open wound.

Her right arm had not escaped the damaged either, but looked nothing like her left. Scars ran up and down her fore arm, shoulder, the crook of her elbow. Her stomach was also covered in deep dark gashes; no cuts, just round dark brown spots that looked to once be holes she had cut in her flesh.

She hopped in the shower and the nurse and I took turns standing by the curtain, pulling it back ever so slightly to make sure that her hands were in sight, to make sure she didn't try to peel back the clear adhesive from her skin. She complained the entire time that we just wanted to see her naked, but at the end of the shower she was still alive.

We returned to the music room and I worked on a crosswork puzzle and Kera lay in bed. The grounds nurse brought her niught meds and she soon went to sleep.

She's 2:1 24hrs a day, but the grounds nurse took this opportunity to make her rounds again, leaving me alone with her.

I could hear the grounds nurse and med nurse conversing just outside the music room. The med nurse was saying that Kasandra's blood sugar was stable, but still low. They had found vomit in a corner in her room behind her dresser. Apparently, it's been there for a few days, because the contents of the vomit are obvious. No wonder her blood sugar level was so low.

The last thing I heard of it was the grounds nurse sighing and simply saying "Oh my god. She really wants to die." Then I heard their footsteps as they walked down the hall and into the female's unit.

I was all alone with Kera now, who was asleep. I walked across the room and found the poems that she had written earlier in the shift and read each one. Each one talked about how she didn't care about life, how she wanted to die, how she wished she had a razor to do it, how she was locked in a cold white room with idiots (us staff) who didn't care about her.

As I was copying down her poetry, for my logs, the nurse entered again and I handed it to her and she took it away. :T So I've no chance to recount it here. Perhaps that's for the best.

I walked on the ward today to hear absolute silence - well..relatively silent. I could hear no children screaming, no tv on, no shuffling of feet. I entered the dayroom to find that there were no children. This is normally a bad thing because they've all been sent to their room for a full unit time out. Joy.

The staff sitting at the table to the side of the room closest to the nurse's station had a very unhappy look on her face. She gave me a quick rundown of what I'd already been told at the cross-shift meeting. Teresa's day was the juiciest bit.

Teresa's been at the hospital for what feels like forever, but it's only been a few months, maybe 2 or 3. She's 13 years old, about 200 lbs and about 5'9". She was first placed on the teenage girls' unit because she is of age to be there. About a week at the hospital proved that her low functioning skills required she be with a younger age group and it was soon thought best to move her to the children's ward.

One look at Teresa can tell you she's meantally retarded. Maybe it's her overly circular forehead or her open lips loosely hanging down around her gapped teeth. It could be her messy wild hair that she never burshes or even straightens. Maybe it's her gait, her stride, the gracelessness she moves with. The frequently wiped away, but forever present, crusty white film between her nose and lip could be another good indication that something isn't quite right with her head. Her appearance before she even speaks says more than any judgement of her.

Teresa's mother died about 2 years ago. She had a heart attack and left Teresa to the world. She knows nothing of her father, but her mother was a heavy drug user. Teresa had been placed with several foster homes. She was bounced around to whoever would take her and because she is such a hard case, she finds herself in court sometimes.

Teresa had what's called a CASA worker, a Court Appointed Special Advocate. This is a volunteer position in some areas. This person learns a little about the court system and a little about one child's case. They are to be the advocate for the child's needs in a court setting. Teresa and her CASA worker were outside a courtroom oneday and the worker began to explain to her what was about to happen in the preceeding. This is when Teresa began to strangle the woman. She then kicked her, tried to bite her and then ran away. When police finally found her and asked why she had run, she explained that she had fled the scene to find a police officer and tell them that she had choked her CASA worker.

Teresa's funny like that.

One night at bedtime, we were very busy making sure that all the children were clean teethed, in the beds, and their lights out. Teresa approached me and asked me to pray with her. I had simply told her "No. I can't pray with you." and turned my back on her to walk away to do some work. Teresa stepped up behind me and put her hands around my neck and shook me forword and back a few times. In that instant, my heart went absolutely cold, but in a natural reaction I turned to face her. She stepped right up to my face - she has no concept of body space - as I asked her to go to her room or the quiet room. She took another step to me and I took her down. As I held her arms in a baskethold and lay on her back, she screamed "You murdered my mother! You murdered my mother!" Myself and another female staff took her to the quiet room. The shock of everything was making me sweat so bad that her hands were slipping out of mine. When the male staff arrived and took over her hands for me she began to scream "He's got a gun! He's got a gun!"

Teresa's funny like that too.

The staff today told me what had happened between her and Teresa and I wasn't surprised. I was almost thankful because many time when the children act out during the day, they don't do it on my evening shift. :X lol I figured I was in the clear.

There's only 5 kids on the unit. All male except Teresa. They're all in the hospital because they have anger problems, behavioral disorders, hard times working on their school work...that kinda jive.

The dayshift left, so I turned on the tv and slowly began to call the children out of their rooms. One very bright boy, Seanus, exited his room and asked "Are you the only staff today?" I nodded that I was and he sat on the couch. Seanus is here because he physically fights with his mother. He's nine years old and going on fifteen. When he was taken from his home, he left in handcuffs. When he arrived at the hospital, they found a cellphone on him - his cell phone that his mother gave him. I wonder what his problem can possibly be?

Marcos quietly came out of his room and sat on the couch. He had left just two weeks ago but returned after seven days. He had wrapped an electrical cord around his neck and tried to hang himself. He's eleven years old.

Henry came out of his room too. Omg I can't stand this kid. He's been to the hospital twelve times. All different lengths of time for all manner of reasons. The final fact of the matter is that he's a spoiled brat that likes to push limits and buttons. He's been placed on a number of different meds but all the outcomes point to the same thing >>>> Henry doesn't have very many diagnosable mental disorders because all his actions are behavioral. Henry's not crazy. Henry just doesn't give a fuck. Did I mention that he has an oddly shaped head? A crude description is that it's entirely normal shaped in the front, but as the head forms to the back, it kinda goes...off a little bit. I heard that his mother had never noticed until Henry first came to the hospital and one of the staff rudely pointed it out. Henry likes to keep a shaved head too. It's really never something you get over.

Another patient there is Sam. Sam's a strange one. He seems like he's in his own world. I've never seen him entirely act out or throw any kind of fit. The only thing I ever have to tell him not to do is "Please don't crawl over the furniture." , "Oh, Sam, could you stop crawling around on the floor making barking noises?" , "Sam! Get out of that tree and stop making monkey noises!"

Things like that....

As they each came out of their rooms, I saw that two people were missing. Teresa was one, but I wasn't going to bother to call her out of her room. Somedays she spent good amounts of time in her room playing with her barbies or just talking to herself, which she liked to do often, so I left her to her own devices. The other patient missing, was Michael.

I wont even hesitate here when I saw that I hate Michael. To give a short list his more likable attributes: He's loud, disruptive, speaks out of turn, speaks without raising his hand EVER, intrusive, into your business and every else's, interrupts anyone when they're talking, argumentative when redirected, slow to follow prompts, straight out rude to his peers and the staff, and he shits himself at least once a week. He also likes to punch people when they don't do what he wants. He's also a big BIG movie talker. Whether you've already seen the tv show that's on or not, make no mistake that Michael will tell you every detail while it's going on. He has a not so common, but easily recognizable disorder called Grandiose Delusions. He simply believes that he's gorgeous and everyone loves him. He thinks that his opinion on everything matters and that everyone wants to know his every waking thought. Michael's twelve years old, 5'4" and about 100 lbs.

The first day he was at the hospital, he told me straight to my face that I was hot.

None of us can ever really know how he's gone this far in life without gaining ANY positive social skills, but since no one at the hospital has ever met any of Michael's relatives, we can imagine enough that his family is exactly the way he is.

Picture if you will a family of back woods rednecks in a trailer park. This is one of those parks where you're related to half the people in it and live about 50 feet from all of them. They're all loud, talkative, annoying and dumb as shit on a stick. The family money comes from the mechanic place that the Daddy of the family owns and allows all his manly moron cousins to work at. The family itself comes from the idiotic women actually having sex with these idiotic men and making idiotic babies. God bless America.

I broke the sweet silence by calling Michael out of his room and he sits on the floor, rather than the couch, and puts his shoes on in the dayroom. I go to Teresa's door and call her out. She comes out about 5 minutes later. During this time, the tv's been on and Michael is narrating the entire thing for us. Really annoying.

I turn the tv off and have them all line up. Normally, we'd go outside at this time, but it's been pouring rain all day. I take them down the hall, outside, and to the gym. As soon as we got there, Michael asked me to open the very last cabinet. I told him that I didn't have a key, because I don't.

I open the first of the cabinets and begin tossing about 15 basketballs, kickballs, volleyballs out behind me as the kids scream and giggle and grab at the balls flying every which way. After I scoop all the balls out, I turn and close the cabinet. Michael's standing there staring at me. "Hey. Open this cabinet." He walks down to the last cabinet.

"I don't have a key to that cabinet. I already told you that."

I was playing basketball with Teresa and Seanus when Michael approached me again asking me to open the last cabinet. I wanted to pull my hair out and strangle the child with it. I was so angered at this point, that I decided we were going to play a controlled game, otherwise I was going to lose my mind. I instructed the children to put up all the balls but one - a kickball.

Teresa got very close to me - about one foot away and screamed and cried that she didn't want to play kickball, that basketball is what she wanted to play. She said that she didn't know how to catch a ball, and so couldn't play kickball well. I asked her for the basketball in her hands about 10 times before I finally just snatched it from her. I backed up slowly, verbally coaxed her to calm down and then said her name, to get her full attention, before I lightly tossed the basketball to her. She caught it. I said "There ya go. You can play just fine."

As we played the game, Michael began telling everyone what to do. He screamed at people when they didn't throw the ball to him when he believed he could get some one out. He rudely said to a few people that they ran slow or "kicked like a girl." He also wouldn't let anyone else on his team be pitcher...and when I made other people pitcher, he tried to take the ball from them. He started being a little shit is what happened.

I was thankful when I looked at my watch and saw it was dinner time. I asked everyone to line up and Teresa immediately began screaming that she didn't want to leave the gym. She got uncomfortably close to my face again and cried and scream that she'd done nothing wrong and didn't want to be punished. I told her that we were simply going to dinner and she lined up. While in line, the last in line, she began to flail her arms around, hitting the person in front of her, and kicking her legs at the wall behind her.

Michael was standing second in line when I heard him tell the boy in front of him to "shut up." I told him that if I heard him say anything rude for the rest of the day that he'd go to bed early. He began screaming that he'd done nothing wrong and hadn't been rude. This kid was absolutely screaming at me. This is when a nurse walked into the gym and I walked the line outside. The nurse said that he would keep Michael for awhile.

I took the kids to the diningroom and everyone sat at their respected tables. The trays arrived and I passed them out to hungry and happy faces. Everything was fine until Henry began shoving pieces of bread into his mouth, whole pieces of bread that is. Marcos was sitting at the same table as Henry as was laughing wildly as Henry continued to shove the food in his mouth for attention. I asked Henry to come stack his tray. He got up immediately and mumbled "Well, yeah I was going to eat it, but now I guess I just wont." When he brought his tray to the counter, I realized that all his food had been pulverized, as he'd been just playing with it and had no intention of eating it at all. Did I mention that I can't stand Henry?

I took all the kids back to the unit and put three of them in the shower. I then set up a table and played Uno with the rest of them while Teresa sat and watched a pokemon movie on cartoon network. I gradually got all the kids to take a shower, inluding Teresa, who always goes last because she takes forever.

Since Teresa had been watching tv for an hour and a half, she had gained her points for that time period. She's on a special program where she had a bag full of small toys in the nurse's station. Retard bribery, anyone? I call Teresa into the nurse's station and she picks a bottle of fingernail polish shaped like a bunny rabbit from her grab bag and happily walks back to her room. The activity coordinator shows up at this point with Twister and starts playing with the kids. I take this opportunity to go get snack from the diningroom. Today snack is milk and generic cheese crackers with peanut butter between them.

I get back to the unit and set them on the table. The children all get their snack, all except Teresa. She approaches me and I tell her to get her snack from the table. She says "ok" but walks past the table and into her room and get the bottle of fingernail polish that she's just gotten. She goes over to the couch and sits down. Everyone around her is eating their snack. I figured after awhile that she had eaten her's too.

At 7:15, I take all the children for night meds. For a child with ADHD, standing in a line waiting for everyone to finish doing what you've already done is an excruciating time. Amanda has some drawstring pants on - Betty Boop. I have my head turned, looking down at the med room and listening to what the children are saying the med nurse when Amanda says "Ms Heather." I turn my head to face her and see that she has pulled the drawstring as tight as it will go around her waist and created a lot of slack. She's then taken this and tied it around her neck. This is the second occasion that I've seen her do this.

I tell her immediately that she needs to remove the string from her neck and that when we return to the unit, I'm going to either remove the string from her pants or take the pants away. She walks straight up to me and stomps on my foot. I didn't even blink an eye, because I knew she wanted a reaction out of me, but it hurt like hell.

We all go back to the unit and 8pm rolls around and I turn the tv off for start storytime. This time I'm reading Treasure Island to the children. They love storytime, and so do I, because some of the children don't want to hear the story and go straight to bed. The rest of them sit quietly and learn some new adventure.

I'm sitting at the staff table, which is right up against a wall and close to the nurse's station, in case I have to run inside for protection and pull the alarm. As soon as the tv goes off, Teresa approaches me - very close - and says that she didn't get her snack. I'm not standing between Teresa, a wall and a large heavy unthrowable chair. She has me blocked in. It's 30 minutes before bedtime and I tell her that snacktime is over and that I'm not going to give her one. She begins screaming and screaming at me and cries "I'm fucking hungry! I didn't get my snack! You didn't give it to me!"

She continues this and I finally just ask her to go to her room. She doesn't budge and just screams and wails. I pick up the walky talky and call for a nurse's attention. "Heather to Robert, over." This is when Teresa pushes me into the wall. I hit the window of the nurse's station and the staff table too. I wasn't hurt, nor surprised, but she was screaming so loud that I thought heard the nurse respond on the walky, but I wasn't sure.

I quickly stepped around Teresa and she continued to scream whale calls at me, and I walk over to the quiet room asking if she'd like to give herself a time out. She follows me there and refuses to go into the quiet room. I bring the walky up to my lips again to call the nurse and she knocks it out o my hand and then tries to punch me. I ducked, so her fist missed me, but her arm smacks me in the head. I grabbed her arms and put her in a vertical personal hold. She begins to kick her legs up just as I take her down sideways to the floor.

This is when my ankle twists and I feel and actually hear a loud POP. It hurts bad, but it just feels like popping a joint that I've never popped before. Teresa continues to kick her legs and I have to release one of her arm and try to reach the walky talky that's 4 feet away from me and completely out of reach. Teresa takes this opportunity to flip over on her back. I'm still holding her wrists and she's trying to pull her own hand down to bite at mine. Her legs are kicking wildly and she knees me in the head.

I twist my body around and knock the walky closer to me with my foot and scream "ROBERT! COME TO THE CHILDREN'S UNIT!" About 20 seconds later, I hear the door slam and keys jingling as three large men come running down the hallway toward us. They fall on Teresa and drag her into the quiet room. I got up and hobbled over to the staff desk, shaking and panting. I read about 3 pages of treasure island to the group as Teresa screamed in the quiet room as they gave her an injection of geodon. This medication suppresses schizophrenic tendendies.

When the kids finally all went to sleep, Henry was at his door cursing and laughing at me because he didn't want to turn his light off. I threatened to throw his stressball away and he went straight to bed. When the time came, I hobbled all the way out to my car and absolutely dreaded driving my clutch all the way home.


And as I sit here and write this, watching my ankle swell up, I wonder why the fuck I do this shit.

The unit was absolutely blowing up, and I was thankful that I had to go to the music room to be with the 1:1 there. I could hear screams on the unit from my quiet and not so musical room as the children ran a muck.

At 4:30, I walked my 1:1 down to to get his dinner tray. The other children should have already been there, but there was so much shit going on that they were late. As we walked down the hallway to the dinginroom, I saw a man si