He came to the nurse’s desk and demanded to know, “How many people have put their fingers on my clothes since I came to the hospital?! Cops, doctors, nurses…I demand an answer!”
Disheveled and unkempt, hair cut in an unusual fashion and sporting a strong body odor, Bradley Coffey did his delusional best to get the attention of the nurses on Sunday morning.
“Brad, we’re washing your clothes for you. They were soaked and growing mold. We’ll give back whatever you can have after they’re dry,” I informed him.
“They’re my special uniform!” he bellowed. He now had the attention of a combination of about eight other patients and staff members. “The Legion demands that no one touch the uniform!! They’re special to me! I paid for them with money I actually earned!”
From the report we heard about him from his admission on the previous night shift, and the condition of his belongings, it was obvious that he’d been off of his meds and living on the streets for some time. The clothes were all he could relate to that he knew were absolutely his, and gave him some small measure of control. They helped to feed into his delusion of his own importance as a ranking official in some imaginary military. He’d already approached us several times in the previous hour with requests regarding his clothes. His behavior had escalated enough that the secretary knew to immediately call security and we locked the outside doors to the nurse’s station. He wasn’t my patient, but his nurse wasn’t around when this started, so we did what we do up there when that happens; we take over in their absence.
I asked, “Brad, do you want some medicine to help you settle down?” He was less than enthusiastic about my offer. I then offered him a choice between taking pills or getting a shot. His resounding F*BOMB!! echoed off of the walls and gave me, and the floors both above below us, the answer I needed. I went into the med room to draw up the injections. I opted to use two of them together, as I know deep psychosis when I see it, and this guy was a powder keg. The more meds, the merrier.
Security arrived and tried to deescalate Brad, verbally. I knew it wasn’t going to work, because he was so sick and focused on his tiny bit of control that they were going to set him off even worse by trying to reason with him. Since I was his current target, due to the fact that I was holding two syringes, I kept telling the guards that his argument was over. Take him to his room. Go to 264. Now. They kept trying to talk him down and he started edging ever-closer to me around the nurse’s station. I kept backing a few more feet away, every twenty seconds or so. I got firm with Security and directed them to do it now. I’m a veteran up there. I knew this situation wasn’t going to get any prettier, but it had the potential to get even worse.
As they started moving him to his room, Brad pivoted around, saluted, clicked his heels, and in front of the entire nurse’s station and several patients, declared, “I am Major Benjamin Forthnicker and my serial number is 8736595! You can only inject me if you outrank me!” At this point, our secretary blurted out, “She’s a general.” Bradley then spewed many epithets at me and my “generalness” as he turned and went to his room, followed by security, three other nurses and myself, armed with syringes and alcohol swabs.
He got the injections, but not without much spewing of venom, a bit of wrestling and more than a few threats on myself. I gave him a time-out, (Yes, we actually use time-outs on adults up there.) but he remained challenging with security, long after I left the room. They hung around until the meds started kicking in, then left. He slept for the rest of the shift. That always makes me happy, because I know that the meds are working and he’s getting some relief. (Not to mention that I know I won’t get my ass kicked.)
The situation was deescalated before his nurse got back from dealing with her other patient. I was given the name of “General” for a minute, until I informed them that I needed to be sure no one ever out-ranked me again on the unit, for safety’s sake.
I’m now known as the General Admiral CEO Diva of the psych unit. The delusions of the mentally unstable ain’t got nothin’ on me!