Underestimating Psych Patients

Angry white man with tattoos on arm sitting on black leather padded chair

The Unpredictability Of Psychiatric Patients

There are some patients who are very unpredictable, despite knowing them very well and believing that everything will be all right on future encounters. These patients are unpredictable because they are either suffering from psychosis, borderline personality disorder, antisocial personality disorder or under the influence of drugs. A common mistake that many psychiatrists and other healthcare workers make is letting their guard down when around psychiatric patients with whom they previously have interacted with.

Whether you are a friend, family member or healthcare worker, you can never let your guard down around mental health patients. This does not mean that you should be rigid and not flexible or relaxed around them; just don’t lose your guard. This is because mental illness, personality disorders or traits are very unpredictable; they can often cause a person to change at the snap of a finger.

I personally had this happen to me recently with a chronic psychiatric patient suffering from schizophrenia. The nurse had called to inform me that the patient was pacing in the hallway, which is an early sign of agitation for him. As I made my way upstairs to the respective unit, the nurse called again and warned me to be careful as the patient was near the hallway next to the unit door; at first he warned me to stay out of the unit.

About thirty seconds later, he told me that I could come onto the unit. As I slowly unlocked the unit door, the coast was clear for a few seconds, until the patient appeared in the hallway looking straight at me. He started walking towards me in an agitated manner and not making any sense in what he was saying. My immediate inclination was to turn back towards the door and leave the unit as I had no way of making my way to the nurse’s station for more clarification of the situation.

The mistake I made is that I decided to bravely stand in the hallway and attempt to understand the patient as I figured, “What the hell, I’ve talked to him before when he was agitated and he never did anything!” But this time was different. As soon as he arrived next to me, he lunged for the keys that I was still holding in my hands without realizing. I was then struggling to hold onto my keys as he was diving deeper into my palms to snatch them.

At this point I knew that I couldn’t wrestle or fight with the patient because as healthcare workers, we are trained to defend ourselves but not actually engage in fights with patients. It is then that the unit staff came rushing onto the patient and retrieved the keys after a brief manual hold. The keys were returned to me. The point of the story is that I made the mistake of believing that this psychotically agitated patient who I had multiple previous encounters with, likely would not do anything on this encounter as well.

But I was wrong! This is evidence of the unpredictability of psychiatric patients and why you should never underestimate their potential for harm towards others. Always trust your intuition for it is there to guide you when your logical mind gets in the way. Even though logical, your mind does not always place you in the best positions in life and that is where your intuition steps in to protect and guide you. I was lucky that I came out of this situation unharmed!

Have you had any experiences that have gone wrong with psychiatric patients?

Are you Ready? (This is Defeating Stigma Mindfully)

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