 |
| Copyright © Mark Kelly 2025 |
On the floor by 0700hrs after the hand-over, and was informed I'd be covering two areas. Nothing unusual there, but this day the department was short-staffed. I flitted about making sure things were in order, stock levels and the such, before things began getting busy as patients who had been there overnight would start waking and the buzzers start buzzing.
It was just after my return from break I encountered an elderly lady looking lost. My initial impression was she could be a relative seeking the way out. Not unusual, and happens frequently. People get easily disorientated.
I asked if I could help in any way. She smiled, and told me she was looking for her dog. Okay, I replied, and gently steered her towards the main desk, to find out 'where her dog was'.
Nurse-in-Charge took one look and pointed to a cubicle with a smile, "She's from over there."
So, we casually walked back to the cubicle and I offered her a chair. Turns out she was a new admission to our section, suffering from dementia. I then get the word, "You're going to be one-to-one with her."
Inwardly I sigh. I know how these things sometimes go. I do a time check: two hours before end of my shift. "Ok," I think, "it's not too long, we should be good."
Our conversation went smoothly. I offered her tea or water, which she politely refused. We talked about her family, their dogs, her previous work. The usual things that help them to engage. Little did I know at the time that this lady had been here through the night, but in a different section, as no-one had given us a hand-over.
And then it switched. Something in this lady decided it was time to go. She insisted that she was needed at home, which to her mind, was only "down the hill, not far away." She was miles from home in reality. As best I could I explained where she was, and why we were looking after her. initially this placated the lady. Not for long, though.
The escalation and her detachment from reality was rapid, and she insisted on leaving, making her way out of the cubicle and into the main thoroughfare of the A&E department. I managed to coax her back tot he doorway of the cubicle, but now she was angry, accusing me of keeping her there unlawfully, and stating the Police would be involved and I would be arrested.
That's when she made a determined effort to leave. I placed myself between her and the other cubicles, as other patients were now being disturbed and upset. This is when she grabbed my arm and sank her nails into the flesh of my forearm, her face contorted and red with anger. It never fails to amaze me how strong frail-looking old people with dementia are. Where does this strength come from?
The squeeze was hard, slightly painful and full of intent. I now have a Staff Nurse and Sister with us.
The final trigger, it would seem. This once cheerful and pleasant elderly lady grimaced, her face contorted in anger and her fist flew into my chest.
I'll be honest here, my first thought was, "That was a good punch." Truth of the matter, it was. Her fist caught me square and flush, and if I didn't know any better I'd swear she'd had trained in some combat sport. It reminded me of my karate sparring days and competition fighting. I looked down at her. She was spent. The stinging on my arm irritated me from the dragging of her nails through my skin, but that was a minor thing. My two colleagues ushered the now sobbing lady back to her cubicle, talking to her quietly, leaving me to stand there feeling like a big bully. Sometimes, more often than not of late, I hate that job.
A hand on my back announced the arrival of the afternoon staff. I smiled weakly at the NA there to replace me. So I gave her as detailed a hand-over as possible, cautioning her not to let her guard down with our little lady in the cubicle, who we were later informed was a regular attendee and had a history of aggression - all found out too late.
My second incident of being punched by a dementia patient. The first was a punch to the face just under my right eye as we helped move the gentleman up his bed. That time I did suffer a bruise, a rattling of my brain (yup, confirmed I possess one), and an onset of headache. Two paracetamol took care of that.
Closer to home, my own mother died as a result of vascular dementia three years ago. Thankfully she didn't suffer the cruelness that dementia can inflict. She was more often than not very happy, reliving her childhood memories, and when she passed I was fortunate to hold her one last time and tell her how much I loved her - for the first and last time.
None of us truly know what fate has in store, so live in the moment, appreciate all that you have, live life, don't just let it roll by, and talk to those whom you love and hold dear, for once they are stolen, the clock can never be turned back.
I'll leave you with the haunting, "Abandon Window" by Jon Hopkins.
No comments:
Post a Comment