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Originally posted by winneythepooh7
Well I started my new position yesterday! I like it a lot. The only major difference besides it being more clinical and us being the actual "treatment" team is that the clients are much more agressive. Most of them can (and do!) become violent if they go off their meds. My first day yesterday I got to ride in the back of a cop car cuz we had to call 911 on a client who was becoming agressive. But we plan ahead too before we go to the client's home (ie. calling 911 before going into the home) so we never have to put ourselves in a dangerous situation.The Director also wants us to try to go out two at a time too so we are never alone. The client we had hospitalized yesterday, it was pretty scary because the EMT who showed up knows him pretty well from having to go there a lot. She said he kicked her once in the stomach and she also saw him punch the hospital Social Worker in the face one other time. Anyone else have experience working with violent clients?
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I worked inpatient psych for 7 years and partial day treatment for 6 and worked with a lot of violent clients. In those settings, it was much easier, because there are a lot of staff around. However, one time, the staff who was supposed to be with me in an off unit activity room decided it was her break time and left me alone with 12 inpatient adolescent girls. I had a fulltime OT student with me, but she had just started and was very green (and timid by nature). Two of the girls got into a full blown fight and I had to split them up. I was thinking the OT student would call someone or go get help, but she just froze. I wedged myself between them and got one of the girls into a basket wrap and was moving her around the room as the other one was still trying to punch and kick her. I had to yell to the student to get help. Luckily, one of the RTs and a Child Care Worker from the unit were on their way back to the unit from the gym and heard the commotion and came in. A minute or two later, some other CCWs showed up, as the student had finally gone to get them. The others took over and I went to the staff locker and fell apart. A punch had landed on my jaw during the mayhem and it was hurting a lot, but I wasn't really crying from the pain, it was from the fear of what could've have happened and from being left alone to deal with that. I always handled a crisis and then fell apart later. I went into a treatment planning meeting once I got myself together and the psychiatrist looked at me and said "You need to go to ER". I said I was fine, my jaw was just a little sore and she said "NO, Go to ER now". She told me to look in a mirror. I went to a staff bathroom where the only real mirrors were in the building and saw that my jaw wasn't lined up. Turned out that punch had dislocated my jaw.
The only other time I got injured, there were other staff there. We were with the boys this time, 11 and 12 year olds and two got into a scuffle. Another staff and I each grabbed one and got them in basket wraps but they were too close to each other and the one was still trying to kick the other. I twirled the kid I was restraining around so that he didn't get kicked by the first kid, and was kicked myself. Lil sucker bruised my kidney that time.
Those were my only two injuries and they were both with adolescents who tend to blow faster. My recommendations:
Hopefully they've trained you in the mental health department approved methods of restraining patients. Also in the methods of getting out of holds, bites, etc.
The biggest key is never let them get between you and the door.
Adults tend to escalate a little more slowly than kids (in my experience). If they seem to be getting more agitated and you can't talk them down pretty quickly, get out, then call for help. The slower and calmer your voice is, the more likely they will de-escalate. Don't touch them, just talk. Emphasize that you want to help them. Stay at least arm's length away from them, and keep moving toward the door.
After the jaw dislocation incident, I decided my personal safety was more important than the patients' safety, and if I had to re-do it, I'd have gotten the other girls out of the room and gotten more staff. My instinct was "Stop the fight so they don't hurt each other".
Be Careful!
Dee