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

Photo credit: Glenda Otero
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…

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