Monday, November 10, 2008

Not so routine shift start

Start shift. Night nurses not in a good mood all talking at once. Something more than the usual must have happened. I move around the conference room gathering supplies to start my day listening with half an ear to the night nurse give report to the days team leader. My full attention is caught when I hear the other nurses question where they are to get new red bags from cause the “cutter” nicked his artery. In the jail we have two kinds of bags, a blue one and a red one. The blue one we grab when we receive any medical call in the jail. They have basic supplies like items to take vital signs, kerlex wraps, band aids, diabetic supplies, burn cream..things for basic first aid. When someone calls for the red bag, we know things went south real quick. The red bag has IV supplies, oral airways, O2 masks.. items needed when a band aid just isn’t enough. This particular cutter bleed all over two red bags, the stretcher, the wall, the floor anywhere you could get blood, this boy did. Medical is waiting at the big metal door watching helplessly as an officer is holding pressure on this kids arm. Finally it is clear and control can open the door. Medical comes rushing in and the officer lets go to make room for the team. As he lets go, the kid starts to move. He doesn’t want help, he wants to die and here come the people who are going to stop his plan. Officers jump on him and hold him down while medical gets into place. Very quickly they don’t have to hold him down, he bleeding out. He becomes less responsive. As a nurse you almost breathe a sigh of relief because now you can get to work. The officer holding him has blood up his arm and on his clothing. Approximately 80% of the jail population has hepatitis C. Still he risked it for someone who will more than likely despise him later. Large gauge IVs in both arms, officers squeezing bags of fluids into this boy trying to give his heart something more to pump. Packaged and transported out to a waiting ambulance.
The next day the boy is brought back to jail, sutures and staples are holding his antecubital together. He is no longer allowed in general population (GP) his new home is in the acute psych unit where he is placed on Full Suicide Precautions (FSP) status. He is naked with nothing but a suicide blanket which is a thick, heavy blanket sewn is such a way that it cannot be used for anything but cover. All his meals come in a paper sack, he gets no utensils and he a styrofoam cup. His nurse will monitor him frequently and an officer will do a visual inspection every fifteen minutes. The boy is not happy to be where he is. His eyes are dull and he refuses to acknowledge anyone. He stares blankly at the ceiling or sleeps. He still could care less about anything but at least he is not messing with his wound. Social workers come and speak with him; the psychiatrist comes to see if meds will help. All I can offer is a kind word spoken softly, letting him know that someone actually sees him as a person, not a case number or a prisoner. Slowly his eyes turn to me, he takes a deep breath as if to say something, changes his mind and looks away. How could he think that coming to jail was the end of the road? How would it be to have no hope, to live in such darkness…Maybe tomorrow he will talk to me.