When I first started working at the hospital the patients were allowed to smoke. We'd take all of their cigarettes out of the locked cabinet, hand them out, and take them out to the porch. What had been a real porch at one point had been transformed into an inescapable outdoor cancer pit. There were screens but bars behind them and the screens were so dirty you could barely see outside, let alone get a breath of fresh air. The floor was covered in ashes and butts but it didn't keep them from sitting in the floor. I was amazed that the smoking area was nearly always peaceful, though. No fights, no disagreements, no thievery. There was nothing more terrifying to my patients than having their cigarettes taken away from them and a sure way to have that happen would be for a big fight to break out on the smoking porch. Those porches were the most peaceful place in the entire hospital.
But then Ohio made a rule that there would be no smoking what-so-ever in any of their buildings or on their property. Suddenly our smokers were forced to quit smoking. Forced. They had no choice.
Quick lesson here. Studies have shown that around 80% of schizophrenics smoke cigarettes. There are many theories as to why this number is so high but I'm not going to talk about that today. Something I do want you to know, though, is that studies also show that smoking cigarettes and atypical antipsychotics kinda work with each other. If you take the cigarettes away then their antipsychotics don't work like they used to and you have to start all over again trying to find a dose that works for your patients. I believe we had about 500 patients at the hospital on any given day back then. I don't know what percentage were schizophrenic but a VAST majority of my patients took antipsychotics. I'll leave the results of making them all quit at one time up to you.
So. Anyway, one day, probably in the spring of 2003 or 2004 all of my patients were forced to quit smoking. My unit was nothing but chaos. There'd been no plans for what would replace the time the patients used to smoke and going out on the porch for a break was nothing but a big trigger. My unit had 23 men who had nothing better to do than plan on killing each other, killing us, or finding ways to continue smoking without us knowing. Continuing smoking without us knowing became the top on their list.
They'd pop sockets to light homemade cigarettes they'd made out of bible papers, dust, and pieces of grass that'd been dragged in off of people's shoes. They'd smoke HAIR cigarettes. And, of course, we had patients sneak cigarettes onto the unit somehow. I was told by a patient that a cigarette cost the $5 in there. That's $100 a pack!
And there were always stories that staff was sneaking the cigarettes in to the patients. I honestly didn't care how they were getting them. I didn't go in search of them and I didn't do any sleuthing into finding the culprit. I thought the entire thing of forcing them all to quit was ridiculous and kept the policing of it out of my job duties as much as possible.
So, one day I'm in my med room and the police come in. They have a handwritten note scrawled on the back of an envelope and want me to see it. I read it. A patient that had been admitted the day before had given the police a note saying that I was bringing cigarettes in for my patients. For a second I was REALLY pissed but then forced myself to remember just what kind of person was accusing me. He was brand new. Had the worst black eye I'd ever seen. It was swollen shut and in various shades of purple. So swollen that it looked like it was going to pop. He was a really short man and was a child molester. Those boys in jail had gotten ahold of him. He was used to pissing people off.
The police laughed after they watched me read it. They knew it was bullshit. They told me they just wanted me to know what had been said and told me to watch my back with him. I was grateful they knew not to take everything that those patients said as fact.
Relieved, I went on about my work.
An hour or two later two of my patients approached me. In hushed voices they told me that the new guy had written a note to the police, they saw him give it to them, and he'd told them that it was about me. They were worried.
"That little asshole is going to end up getting you in trouble and we've decided we aren't going to let that happen."
These boys, one named George and one named John, they'd become good buddies in there. George had had a shootout with the Cincinnati police in a fit of paranoia. It was Illuminati driven. He thought the Illuminati were after him.
And John, he'd impersonated a police officer. He was gay so I never quite understood why (or really HOW) he had the police department dispatch helicopters to what he'd described as a riot at a gay bar. Several of the gay patrons pointed John out in a line-up as a man who'd routinely bullied them for being gay.
Both of them having some problem with the police.
I told them both, "The police have already talked to me about that letter and everything is fine. I'm in no trouble. You guys need to work on your own program and let others work on theirs."
I made them promise me they'd be good.
Later that evening I'd busied myself playing cards with a few of the patients. I'd kept an eye on George and John, making sure they were following through with their promise, making sure they were silently plotting in a corner or anything. Everything seemed ok.
New guy walked up to the nurses station knowing I was sitting out there playing cards.
"HEY! NURSE! Where ARE you?!?"
I got up. "Right here. What do you need?"
He needed Tylenol. I went back and got some for him. Sat back down to play cards.
Five minutes later he was back up at the nurses station. "NURSE! Where'd she go??? I need her for something."
I stopped the game again. "What can I help you with?"
"I need some coffee."
"No coffee after dinnertime. In the future, you can ask questions like this to any other staff member on the unit. A nurse doesn't have to be the one to answer non medical questions."
Playing cards again. MAYBE 2 minutes later.
"Where in the hell did that bitch go? NURSE! NUUURRSE!"
I approached him again, "Yes?"
"I need some shampoo."
I explained that any one of the people sitting behind that nurses station could help him get some shampoo, that this wasn't something a nurse would be needed for. (Seems like it was me alone on the unit doesn't? It's because most of my co-workers HID in the nurses station during the entire shift. They didn't do SHIT!)
And, I sat down, for the fourth or fifth time to try to finish my card game with my patients.
I saw him walk back up to the nurse station. He was up on his tip toes leaning in.
"NURSE! FUCKING BITCH! NURSE!!!"
BAM. Before I could even stand up John had bashed that man right in that same black eye that looked like it was about to bust. Within seconds both John and George were on top of him. Kicking him in the ribs, kicking him in the face. He was on all fours caught between the nurses station and the nurses station door.
I ran over, flung my glasses onto the nurses station desk, and grabbed George off of him. Yelled, "STAY!" Just like George was a dog or something.
And that left John. He was still at it. Beating the shit out of the new guy. I grabbed John up by his shirt and as he stood he caught me with a right hook. My nose burned and my eyes watered immediately.
"JOHN!" I grabbed him up harder by his shirt. "JOHN! You just hit ME!"
I watched as his face realized that he'd punched me right in the face. Blood was now pouring out of my nose. John took my face with both hands, totally frantic now. He was crying.
"Oh goddddd Bianca! I didn't mean, too! I swear it!"
He'd totally forgotten about the fight as the new guy got up. I half expected his eye to be flat now, like John had popped it with that first punch but it still looked as bad as before.
The new guy stood there, straightening out his shirt, when suddenly he reared back and punched the window to the nurses station door. A perfect square of safety glass shot back into the back nurses station and I heard the lazy nurse aides back there scream in horror. Everything was fine with them back while I was out there getting drilled in the face. No need for a code to be called when it was just ME out there breaking up a 3 person fight. Not until it appeared that they might not be so safe after all.
One of the aides had been pulled from another unit, a more peaceful unit, and it was her voice I heard over the loud speaker. "Code yellow, unit G as in GOD! Code yellow, unit G as in GOD!!!" Her whiny voice over that speaker instantly pissed me off. G as in GOD, huh? We had rules there. G as in George. That's what you were supposed to say. I guess in her panic those words brought her some peace.
It was that day that I had my melt down in front of every person who'd ran to help with the code. They walked in to a calm unit. No patients were fighting anymore.
It was just me. Standing in the middle of the patient living area. Yelling.
"I am so sick of you LAZY motherfuckers! HIDING! Fucking HIDING back there while I'm out here breaking up a GOD DAMN 3 man fight!!!''
My supervisor, a SERIOUSLY mean old black lady stood in front of me.
"And you son-of-a-bitches! Can't get off of your asses to help do SHIT! Here I am, I can't see SHIT! I hope you motherfuckers were comfortable and stress-fuckin-free back there!"
My supervisor motioned for someone to find my glasses. As I put them on I started realizing that I'd lost my cool. Everyone was watching me lose my cool, even my patients. I was probably going to be in trouble. I stood silently, blood down my face and now tears were mixing in with the blood. Involuntary tears. Never let the patients see you cry.
I was whisked away to the back med room. The police pushed their way back in there, too.
But instead of the tongue lashing I expected that mean supervisor went back there and got a washcloth wet. She gingerly washed the blood from my face and dabbed my eyes. She didn't say a word. Just cleaned me up like I was her own kid. And I sat their crying like I was her kid.
Mrs. Burrell retired a few years ago. People FEARED her. I may have been the only one EVER to actually SEE that she wasn't nearly as mean as we'd all thought.