Behavioral Health Teen and the ER Setting | Love Your Nursing Life | RN Bobbi McCarthy

Photo credit: Glenda Otero

I stood in the doorway and watched my 15 y.o. behavioral psych. patient. She sat cross legged on the stretcher, hands tightly clenched in her lap, head down and eyes closed…rocking back and forth. A loud,continuous hum escaped through her throat…not a song kind of hum…but a static sound of humming.

She came to us after being kicked out of her foster home for aggressive behavior and suicidal language and she now is boarding with us until a new home or psych hospital bed opens up for her. Because of her suicidal language all of her belongings were removed from her and she was in our blue hospital scrubs, on a watch with security and in the behavioral health section. The areas is small, has a TV, a bathroom and small area to walk around—no windows.

Hour 90 was upon us and she was melting down. As I watched her, my heart broke. This child was alone—her life story is of abuse and neglect—and now once again she is alone…Life isn’t fair for this child!

Earlier that day I silently prayed for her and I sat and talked with her. She liked to write and to draw, listen to music and take long walks. Her two siblings were with another foster family and she hadn’t seen them in over 6 months…and there were no relatives to help them out. She was afraid of where she would end up and wanted to run away. Her suicidal thoughts continued and she wanted to cut herself. After speaking with the other nurses who were on that day we decided that we wanted to buy her some journals, drawing materials and get her some shampoo and conditioner (she has long thick hair and we do not provide shampoo in the ER).

The issue with this choice was that it was in direct opposition to what the ER docs had decided. They were of the feeling that we shouldn’t pamper her in any way because she would like it too much and just continue to say she was suicidal and stay with us. I totally disagreed. This particular patient had a distinct problem and she was a child in need of some compassion, empathy and understanding. The nurses and I talked with the ER doc who was on that day and he agreed with us that we could provide her with some materials to help her pass the time. The nurses pitched in and on my lunch break I went to Wal-Mart and bought her some journals, colored pencils and drawing paper, shampoo/conditioner and a fancy pen.

When I presented these things to her she sat there staring at me with her mouth open…
“You and the nurses bought these for me?”
“Yes” I answered.
“I can keep them?” she asked, in a confused tone.
“Yes you can.”
“Why did you do this for me?” she asked.
“We wanted you to have an outlet for your pain…we wanted you to know that we care about your situation.”
She cried. The security guard teared up and had to turn away.

This patient was with us for a total of 146 hours!! 6 full days!!! Before going off to a psych hospital and then back to her foster home… During her time with us she drew every security guard a picture and she wrote non-stop in her journals…I was rewarded with a poem about myself that hangs in my locker at work.

I do not know if our nursing intervention helped her in anyway but I believe that it did. We showed this child empathy, compassion and caring! I can only hope that it meant something to her and that she will in her heart know that there are kind adults in the world…

• Anonymous

  Bobbi, I know that your actions did help her. I have been in a similar circumstance as a patient and a decade later, I still remember particular people and things they said or did. One man in particular—a simple phrase he said to me replays in my head in the most challenging times, and was the impetus for a sea change in the way I see the world.

  • Bobbi McCarthy

    Dear Anonymous~  Thank you so much for sharing that with me…sometimes I wonder if my actions are lost on people or if they really do matter. 

• http://www.facebook.com/jewel.albaugh Jewel Albaugh

  I believe that was the right thing to do also. I have performed similar gestures, even for people that were of the crimnal nature.As an adult mental health nurse I went to Mickey D’s on a dinner break one night after having taken up a list of wants from the rest of the staff. I brought a meal back for a young man that supposedly had just finished a tour in Operation Enduring Freedom. All the patients on the floor had retired to their rooms at the time of my run return, so I left the meal in ”young mans “ room.Upon my exiting his room, he opened his eyes and was in disbelief I had done that for him. To me it was the natural thing to do since he had heard me talking earlier about making a run to Mickey D’s, and he mentioned how he would love to have a burger. During following multiple admissions with this young man alot was revealed about his personality. He was a serious sociopath whom lied about everything including having been in the military. He sayed his wife had died in a car wreck,and his small children were living with their grandparents. He appeared as a lost, sad and empty man, very intelligient  also. It was discovered the wife was alive and well, living with their children in a few towns over. He used alias names, etc.. I was able to establish a repoire with this fellow that proved advantageous over the course of admissions, as he began to exhibit loose behavior at times.On one certain occassion I had another young man lunge at me through the medication window when I was dispensing medications. At that time I felt the first young man ”had my back” in this and some other intense millieu events.
  I believe we are on this earth to love and care for Gods creatures as well as humanly possible considering circumstances. I feel if I were to see him on the street he would remember my face, the meal, and the many talks we had over his course of admissions. I feel I may have made a small impact on his sad life in some tiny way during those days, I hope.
   I believe God expects us to be compassionate as he is compassionate with us. As long as I could lay my head down at night and not have a bad feeling in my gut, that I had in any way mistreated this man of many characters, I felt I had done the right thing.
  I believe in showing empathy and compassion every chance that arises,whether there is a thank you or not. The heart of the compassionate drive some of us own is a natural drive.To me it is a joy and a blessing to be cut from that cloth. Being a nurse, I believe one that nurses is of a higher calling to help people in extraordinary ways and means others are not privvy to. I believe God expects it as well.
  Thank you for creating and maintaining this blog for nurses, much needed, well done. I will be searching for your book as well.    : )

  • Bobbi McCarthy

    Jewel~  nice name     I totally agree with you.  We are daughters of the Most High God and with that comes responsibility…to treat others as Christ would.  I take my nursing cap off to you for working in the mental health field…this is a challenge dialy I am sure, but knowing that you have your eyes focused on Christ first allows me to see why and how you could get through each day with compassion and a full heart.  Buying that gentleman a burger was a wonderful gesture and NOT everyone would have done it.  Many nurses go through their day with blinders on…I think its a coping mechanism and time seems to erode their compassion.  I wont lie~ Im not perfect and I wish that I had a full heart of compassion for every human being that crosses my path…it is at times a challenge.  My prayer is that God would allow me to see each patient as he would and then I would be able to have compassion…it works most of the time!  I pray you continue to be  a light in the darkness in your job and life.  Blessings
    As far as my book…its being edited as we speak…I hope to have it in publication in a few months!!  Its a crime mystery…a creative outlet I guess…
    Thank you for communicating your story with me!