Psychiatric Nurses Often Work In “War Zones” But It’s Worth The Risks

Here is a recent email that I received and want to share with you. The author asked that her name and where she works be withheld for privacy reasons.

Dear Pete,

 

I am a psychiatric APRN (advanced practice nurse) at [a well known hospital] and have worked in emergency departments as a staff nurse. Your descriptions in your book, CRAZY, about the jail block in Miami Dade County where psychotic prisoners were incarcerated rang disturbingly familiar as to how a hospital emergency department operates with its psychiatric patients. The inpatient unit is actually less restrictive than the emergency department. In both places though the staff is burnt out, and many have been victims of or witness to their co-workers being victims of physical assaults by psychiatric patients.

     In some ways I could commiserate with the correctional officers profiled in your book. We never abused the psych patients as the COs did or would need to order people to leave to cover something up. But working with this population in a barely controlled environment is crazy if nothing else- and leaves scars on a person both physically and emotionally.  

    I know that’s not what you want to hear– because I could feel your contempt for the CO’s in your narrative. I also appreciate that the nurse in your book on the ninth floor was the only seemingly humane person in one scene.

     I just want to point out that working in a prison and in a emergency department is much like working in a war zone and until you do it and live it and breathe it, don’t judge to harshly. Again I would never condone physically abusing a prisoner or a patient but I do condone the way the CO’s felt and the frustrations they faced and limitations they encountered in dealing with a sick and potentially dangerous population. 

      I can tell you the hardest thing I ever did in the emergency department was walking back into work the day after seeing two of my nurses and six security guards walk away bloodied and beaten by a patient who assaulted them. The nurse went in to ask if the patient wanted water and the patient attacked. 

     It was awful, and it took everything we all had to walk back in the next day and still take care of that patient. The police wouldn’t press charges because she was a minor and “not in her right mind”. We all felt betrayed. 

     I didn’t walk away though. 

   Our driving forces are different, but many people in mental health want the same thing you do- better than ‘adequate’ care for the mentally ill. I, for one, also hope for a day when emergency department nurses do not come to work afraid.

    I loved your book and will certainly recommend it to people I work with — staff and families. I just want to say that there are other sides to every story and in this case multiple layers to every side.  Working with the mentally ill population can be dangerous, heart-wrenching, and at times completely rewarding. I am proud to be among the special people, my esteemed colleagues, who have the compassion and the courage to walk back into work each and every day.   

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