Corrections and Emergency
I'm new to corrections by 6 months. Love the job, but didn't see the poop on my shoe until last week. The setting is County jail, one nurse-me. 37 YO male is booked on Friday night with BAC 0.39. No one calls me cause he's no trouble, sleeps the whole weekend until 0300am Monday. He starts withdrawals. Hallucinations... according to the officers who call me at 0520 a.m. I'm already on my way at that point. When I get there, he's diaphoretic, trembling, severe difficulty walking and talking, yet he tells me.... I know there's no blue letters in here but it's hard not to flinch when it looks like something's flying at your face. Our doctor was in England by the way. So I give him a loading dose of Librium, 50mg PO at 0630am and make him eat all his breakfast, drink all his milk and encourage water. By 0745 he's greatly improved. No tremors, no sweating, denies visual hallucinations but still weak and he goes back to sleep. By 1100 he's had a 2nd dose of Librium 25mg. He eats all his lunch and is ready for a shower. Later that afternoon he's in court and takes care of business. He has to stay in jail awhile. By 1400 he tells the officers he has a little dog in his room and it progresses from there. I keep him on the Librium detoxification schedule. Wednesday am 0630 I find out from the officers he became aggressive in the night and they had to take him down, in fact they had to Taser him twice and he's in the restraint chair. This is his 3rd day of detoxification and he had already improved and didn't become a problem until after court, so we think it's all behavioral. I get them to let him up and discover he's as nutty as ever. No withdrawal type symptoms, but really nuts. A&O x1. Tries to feed the wall his meal. So I call our Mental Health agency to come for an evaluation and get him out of there. Well she's got all kinds of excuses and basically gave me the run around. I call the local ER and they say, "Don't bother to send him here, we'll send him right back. So, I call the main hospital and the ER DOC says "Don't send him here, we can't handle that and it sounds like you have a real problem", Yada-Yada. By 1600 I was ready to throw myself on the floor and scream. So.... I told the Commander, "Take him to the 3rd ER and drop him off in the door" That's what we did. I did not call them ahead of time as I had already learned my lesson. How in the world can a nurse get help for somebody if they all say no? It was probably the worst experience I've ever had in healthcare and was ashamed of my own profession because I couldn't come through. We have since obtained a new mental health provider, so we'll see. When our doctor got back he said it sounded like the patient had a psychotic episode due to the severe withdrawal event, that it's not likely he was going through withdrawals again after such an improvement. Sorry this is so long, I have been beating myself up over this. That is the most outrageous response I have encountered.
