Written by Fox.
Keri couldn't settle at all last night, even after all her medication. The staff eventually found her asleep by about 7am fully clothed lying on top of her duvet with her headphones in. Even though she didn't get to sleep until that ridiculous time she was awake before 10am! Her anxiety about being transferred to Lime Unit was getting to her but she managed to pack her stuff up just after getting up. We were all asking for our stuff! Most of the stuff in Keri's room isn't even hers or she doesn't like it!
Her anxiety levels were pretty good up until the point she had to walk out of the door of Alder Unit. She started panicking. Matt and Fi took Keri over to Lime with Nigel, a nurse who'd brought a new patient over from Lime. She was the one who's bed Keri was going to be having so they were essentially swapping except Keri still has her room waiting for her back on Alder. They managed to walk Keri over without Sally coming out and kicking off but Keri felt suddenly really upset as soon as the main entrance to Lime had been closed behind her. She hadn't even had her medication that morning as Sally had played the "take your meds and I'll come out" card so Keri's anxiety levels were worse than they would've been if she'd taken her tablets. Fi stayed with Keri for a while in her room and drew a couple of nice sticky notes for Keri to put on her wall. Motivational things to keep Keri going and remember it was only temporary.
Dr. Wilke wanted to see Keri and had a discussion with her in the ward round room. He's granted two half an hour escorted leaves a day. He asked whether Keri thought she should be on ten minute obs or hourly obs. Keri said hourly, so they put her on ten minutes, saying that they could put her on hourly depending on whether any risks showed up over several hours. He also decided that weaning Keri off of her Diazepam was a bad idea as it was needed as the mainstay for her anxiety symptoms. Instead he wants to wean her off of the Quetiapine to see if it provokes a psychotic episode (to try and find out whether her previous psychotic episode was triggered by extreme stress or whether she has a diagnosable psychotic disorder and needs the antipsychotics to keep the episodes from happening, or happen less frequently, or be less intense). The problem is Keri was put on so many medications and had the doses changed quite quickly in a short space of time so no one knows what medication is doing what or causing any side effects. As Keri's going to be an inpatient for a while they're able to mess around with her medication more freely than if she wasn't in hospital.
Keri went out into the garden and was pacing round in circles smoking and trying to get hold of her mum. Sally had started coming out so Keri was still mainly in control but had serious anger problems and was lashing out at inanimate objects. Fiona turned up for their psychotherapy appointment while Keri was just trying to phone her mum on her mobile. It was obvious that Keri was sharing her body with Sally as she shouted down the phone "Pick up the phone!". For the whole therapy session Keri was either kicking things or crying or Sally would eye up the fences.
In the end Keri lost it, despite Fiona's caring efforts to try and say something comforting or helpful. She said she couldn't take it on the unit anymore (baring in mind it had been less than two hours). She walked quickly inside and up to the desk.
"I want to go back to Alder," Keri said to Sim who was behind the desk.
"I'm afraid you can't do that, Keri," Sim said.
"What do you mean I can't go? My room is over there. I haven't even unpacked. Just let me out please!"
"You were sent here to keep you safe. We can't just transfer you back. That's not how it works."
"Yes it fucking is! All you have to do is sign a little piece of fucking paper and I can go!"
"It's all down to the doctors."
"Then go and get the doctors! I've just seen Dr. Wilke for fuck sake so just tell him to say I can go!"
"That's not going to happen. Hey, let's go in one of the rooms and have a chat."
"No! Will you just fucking listen? Just phone the manager on Alder! I can't stand this fucking place! Let me go the hell back!"
By this point Keri was shouting, she was on the verge of crying and Sally was getting a lot more obvious. Keri started becoming unresponsive to staff and Fiona quickly cottoned on to the fact Sally was coming out and tried to get through to Keri but by that point it was too late. Keri had clocked that a patient was about to leave the unit and the staff were going to open the door.
As soon as Nigel went round and opened the door, Sally immediately made a dash for the door from the reception desk and got to the door just a little too late. He managed to get the door shut. This really got Sally annoyed. She punched the door and refused to move away from it. Nigel set off the alarm and several staff turned up to try and help. At first they tried verbal negotiation to get Sally away from the door. That didn't work. They then tried light restraint. As soon as that happened Sally lost her temper. She doesn't like to be touched or told what to do. She was getting even more boiled over because of the fact the staff were calling her Keri.
The plan was that the staff were going to calmly walk Keri to her room and sort everything out in there but once Sally kicked off and started hitting out at the staff they had no choice but to force her down onto the floor and hold her there. Keri came back out while being restrained on the floor, knowing straight away what had happened. She just burst into tears. Even though she was mainly herself, she was still very distressed and instinctively was lashing out at the staff herself while on the floor. They kept her on the floor for ten minutes before she started to calm down enough to get her off the floor (other staff members helping to keep other patients away).
They got her on her knees and then had to keep her restrained as they got to her room and on her bed. She was hyperventilating, crying uncontrollably with nothing anyone could do, refusing any medication and getting outbursts of rage which would then result on the restraint being tightened again. As she was refusing medication, they had to go and speak to Dr. Wilke to get an emergency IM Lorazepam injection written up which took a fair while. After nearly two hours (roughly, time wasn't an issue right then!), Keri finally agreed to take the Lorazepam orally, knowing that if she didn't then she'd have to be held down and injected anyway. She was kept restrained until it took some effect so instead of five staff in her room it went down to three staff, then finally down to one member of staff.
As she was no longer being restrained she thought it was time to chain smoke so she grabbed a packet of cigarettes and paced around the garden again. She was being kept on ten minute observation (which she's still on tonight and hasn't gone down to hourly due to Keri's distress). She ended up on the phone to her mum and when she asked when Keri wanted a visit Keri, without any hesitation, went "Today!" So her mum and John got into the car and drove up to see Keri this evening. They were planning on going to Bath anyway so it wasn't too bad. They spent a couple of hours together talking, smoking, drinking coffee... They got her some DVDs and her teddy bear from Alder on the way. Keri found it really good to have a visit but I think she's clinging really strongly onto her mum at the moment, maybe it's because she feels vulnerable and just wants her mum; but it could verge on being unhealthy. I'm not sure how that's going to pan out at the moment.
Keri's evening has been calmer as she's taken her medication. She's cleared her conscience by apologising to the five members of staff involved in having to restrain her and sort her out. Each one of them told her there was nothing for her to apologise about but Keri feels compelled to do that as she feels she is a burden on people. An example she used to the staff was the fact she's currently taking up two beds, one on Alder Unit and one on Lime Unit. Who cares? No one! As long as Keri starts getting better then the bed issue isn't even an issue! Speaking of beds, she should be dead by now. She didn't even have three hours sleep last night and she's still awake at nearly 2am. You can't blame me either! I came out to do the post as it's obvious how much Keri's head is racing and it's going to be at least a couple more hours before she even lies down. Where does this stamina come from?!
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