I spent today counting people. Actually, I spend most of my days like this. I am told by the managers of each of the nine psych units that I work on that Observation Rounds are the single most important safety precaution that we can provide our patients. Therefore, I take it pretty seriously. So, every 15 minutes I go around and find every person on the floor and mark where they are. "PR" for patient room, "DR" for day room, "B" for bathroom, "E" for ECT treatment and so on, and so on. I also make sure they are breathing if they are napping, assess their level of agitation, and a quick safety check of the environment.
All I did today was count people. I talked with them, discussed their reasons for coming into the hospital, assessed their mental status, and helped them form ways of coping with stress.
And I counted people.
I stood at the nurses' station and counted people.
I was reminded of another job I used to have. For two summers I was a life guard. Glorious summers of getting a great tan, enjoying the sun, and watching laughing children...and counting people. That was the main way to make sure everyone one in the pool was breathing.
Standing at the nurse's station I was reminded of some of the similarities between the two jobs.
In both, I have a removed position.
My main purpose is to save people's lives.
The only way to save lives is to get to where the people are.
As a life-guard I could do nothing to help the little splashing camper flailing in the deep-end of the pool unless I got off my chair and risked getting messy. If the little swimmer was close to the edge and simply struggling in the attempt to make it to the other side, I really didn't have to get too wet, I could just hold out my rescue tube and guide them to the ladder. It was the really struggling kids that required me to really get over myself and just jump in and go get them.
For the really struggling patients, I have to just get over myself. It's not about getting wet this time. It's about confrontation, I have to get over my desire to be liked. The patients that are just struggling to get where they want to go, I can just stand at the edge and offer guidance. The ones that are slipping under the surface need me to jump in too, enter their world and go get them.
That happend earlier this week when a patient was suicidal to the point that she slammed her head against the window in an effort to break the glass and "hopefully slit my throat." Jumping in meant calling a code and holding her down until she regained control. But I couldn't have done that from the nurse's station.
So whether from a desk or a beach chair, I have spent a good deal of my life set on hypervigalence, looking out for others. So for now I count people every day at work. And get ready to get in the middle of people's messes. But somedays it's just easier to count people.
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