#still doesnt allow me any sudden movements but no longer needs me to go away before he comes up to eat

[meyhew]

say hello to my dears rn 

[low-budget-mulan]

Hi! How often do you run into psychiatric patients during work as an EMT? I'm doing psych right now and we had a 12 yo girl whose mom had her in porn at 6mo-9mo and I just want to scream at 1. these people who are pro-porn and 2. the mom is clearly mentally ill, but still what the effffff. So how do you deal with these patients?

I'm going to start this off by saying that those parents should be reported to CPS. That is absolutely disgusting and I would not let those monsters anywhere near a child. If you have not contacted the proper authorities yet then please do so now because their child (children?) Are being abused and absolutely nobody deserves that. Especially an innocent child. If you have actual evidence of the abuse and the evil things that the parent did then those kids should be taken away and locked up never to see the light of day again. Pieces of shit.

We run into psych patients on the regular. Whether it is a person who is having a psychotic episode, a person who is suicidal, a person who cant take care of him/herself, or a person who just has some sort of addiction where they are self medicating to forget about their problems (either drugs or alcohol. Sometimes both). It is all part of the job. Each patient is different. I've had psych patients who wanted complete silence. I've had psych patients threaten to harm/murder/rape me. Hell, just a couple days ago one tried to attack me in the back of the ambulance on the way to the hospital. I've had psych patients who just wanted someone to talk to. And I've had psych patients that I didnt even realize were potential psych patients until after the call was over. You have to be able to assess the situation and from there you can move forward in patient care. I'll give you a couple examples of times situations were handled well and times they were not and how I decided to act/treat my patient.

1.)

We had a 911 call for a behavioral overdose. Sheriffs were already on scene (good). We get there to find a high school aged girl. She was alert and oriented (AO). Her whole family was around plus the sheriffs, plus the fire engine, plus the fire medics, plus me and my partner. There were too many people. We are trying to talk to our patient and figure out the whole story but she isnt really talking. I turn to the fire medic (they technically are in charge of medical calls, so what they say goes even if it's wrong and stupid) and say let's get her loaded up and he agrees. We walk her to the gurney and load her into the ambulance. Typically we allow one family member/friend to ride along with a patient especially if the patient is a minor. Unless the patient is a psych patient. And heres why. Once the girl was in the back of the ambulance and away from the hoards of people she started answering our questions. She told us everything that happened leading up to this point and why she did it and how she was feeling. I gained her trust by talking to her and separating her from what was causing her anxiety and other feelings that werent good. During the transport I realized she just needed to be distracted. I was monitoring her closely with the medic and got all the medical information I needed. So we just talked about school and plans for college. We talked about her favorite tv shows and how I spelled my name wrong for 13 years. That's all she needed. But not everyone needs that. This is an example of a good call.

2.)

I will start this off by saying I can be sarcastic. Which is not always a good thing. Okay so. This was a transfer call for a man on a legal hold. We were taking him from an emergency room to an actual psych facility where the remainder of his hold would be carried out. This guy was extremely tall like over 6 feet and used to be in the military and still worked out a ton so he was pretty muscular. I just so happened to be driving this day. While my partner was getting his report I went to go get a set of vitals to make sure he was stable and nothing was wrong. Before I can even get them this dude is making all sorts of racist remarks and how he doesnt want to go to whatever psych hospital we are taking him to because "its associated with a certain kind of people if you know what I mean." Then goes on to say hes not going (which tbh if you're on a hold it doesnt matter if you want to go or not. You have to go until you are psychologically cleared). I explained that because he was on a hold he had to go and I wasnt the one who set up the transfer. I literally am just the driver and I go where my dispatch sends me. He then responds with "well what if I fight you" I realize I wasnt going to get my vitals and that this guy was going to be a problem. I walk over to my partner and tell him what's going on and that we need to use restraints (which I rarely use because who wants to be restrained?). At this point we now have sheriffs there to help us get the guy on our gurney and to protect us if this guy freaks out. We get him on our gurney and I put the restraints on. After putting on restraints you have to check for a pulse in the extremity and make sure they can still wiggle their fingers/toes. So I ask him to wiggle his fingers and he flips me off. Me being the sarcastic person I am and without thinking I responded with "oh thanks. I havent had that in a while. Could I get another?" The dude then threatens to rape me and becomes very agitated. I messed up. We de-escalated the situation thank goodness. But I could have handled that situation better. I knew he was already agitated and a dumb comment like that could have easily been the breaking point for him. Dont do something stupid like that.

3.)

We had a transfer for a woman who was on a hold. This was out of one of the worst hospitals I know. Literally the hospital that killed my grandpa. I already hated being there, but how the staff treats patients both medically and professionally (if you can even call it that) was absolute shit. I hated this hospital even before my grandpa was a patient there because of how incompetent and rude the staff was. Sorry I got distracted and ranted, but the backstory is relevant. I go to try and get a report from the nurse who knows absolutely nothing about this patient. Cant give me any history. Doesnt know what meds (if any) were even given. And gets annoyed when I ask for an actual report. Not just the "oh yes that lady is on a hold. She can talk but is being selectively mute. And you're taking her to this place. K bye." At this point I realize I'm going to get nothing from this 'nurse' and I just look through the packet. I go over to the patient who is just sitting there on the bed staring off into thin air. I realized that any loud noise or sudden movement scares her. So I slowly inch my way to her and introduce myself. I tell her I'm there to take her to a different hospital where the staff will be able to take care of her better and where she can get the help she needs. In that whole interaction I got her to say maybe a couple words. And they were basically what's going on. I realized the staff at this shit hospital did not tell her what was happening. Nobody told her she was being transferred. They literally just left her to sit in her own feces because they couldnt be bothered to do their job. Before I even touched her I told her everything that would happen. I walked her through the entire transfer process and let her know what was going on. Then once we were ready to actually start getting her onto our gurney before I made any movement I told her exactly what I was doing. She was completely fine with me. Once we get her to the psych place we finish up our transport and are about to leave she grabs my partners hand says "are they going to be nice and take care of me here?" My heart broke. I told her that yes she would be taken care of and that she wouldnt be ignored here as I know this hospital has great staff. She smiled and let us go.

By assessing the situations and the patients you are able to figure out how to handle your patient. Ive learned from my mistakes and I've learned from my coworkers who have been around longer than me. But always be cautious as a patients mood can change at any time. Even if you dont do anything to trigger it. A patient will go from happy and smiling to trying to punch you in the face. Know your surroundings. Be ready to react because things can change in an instant.

Addition: any sort of illegal activity I will report to the proper authorities. I have reported hospitals, families, and nursing home for neglect and other forms of abuse. If you are sure then ask someone who knows more. I usually ask the supervisor I trust or my coworker who's been doing this for 20 years.

[battystumutchildren-blog]

MAVRIK: -It's very late into the evening, most shops and stores on the station are already shut down or in the end process of closing, and the only transportalizers left running are the few 24 hour ones.-

MAVRIK: -There is hardly anyone left walking about, and as the slow trickle of employees from the Silvah dollar exits the building there is a deep quiet. But before the owner has had the time to leave or lock the doors, a figure is melting out of the shadows and slipping into the restaurant.- 

MAVRIK: -The hood of his sweatshirt is drawn but there is no disguising his horns or the cracks running along one of them. Mavrik might look rather sinister with his eye patch and his hands stuffed into his pockets if it wasn't for his twitchy appearance and the way it seemed like it was impossible for him to focus in one area of space. This whole place reeked of troll and disgusting cooked food. But focus, he had to focus. He's here to see silvah.-

SILVAH: -Silvah's not hard to find on such a small station, especially since Mavrik ought to be aware of the troll's fairly predictable routine of being the last one out the door, closing up shop and making the lazy walk to either the transportalizer pad back to Skaia or the shuttle depending on his mood and the convenience of either option. It's the end of a pretty busy day, so he's sweaty and dirt tired. All the lights have been turned off but just as he's going to lock up, he rounds the corner and is momentarily startled by Mavrik's sudden appearance. After days and days of hearing nothing but rumor of the ugly fight, and after all the tension his conversations with Ryan and Jack have been building up in his mind....it's almost surreal. But he relaxes slightly and at least puts on a welcoming face.-

SILVAH: Didn't expect t' be seein ya back here

SILVAH: -He scratches the back of his neck thoughtfully.- Thought ya'd be planet-hoppin by now. MAVRIK: -His eye is locked on Silvah, intense and cold. Not like the usual grumpy look he wore before, Mavrik looks like his mind is distant.-

MAVRIK: Mhm.

MAVRIK: I came by to get my last paycheck.

SILVAH: -Lets out a big sigh....- Alright. Yer entitled t' it.

SILVAH: I'm....mighty fuckin sorry things turned out this way. I wouldn't a let him hurt ya if I'd been there.

SILVAH: An' he's not allowed around here no more, y'know. MAVRIK: -Grunts and shrugs rather sharply, his whole body is stiff and tense.- Shit happens. 

MAVRIK: This was always going to end up a limited gig. All my jobs always do. 

MAVRIK: I just need the money and I'll be out-- -Suddenly looks to his left and jolts at nothing visible. There are a lot of smells in here, a lot of lingering essences of people who have been through the building today. Its like a constant assault on his nose and eyes. Too much really. He has slept in a few days, hasn't eaten in longer. Hes becoming delirious.- SILVAH: -Gives him a long, searching look. While he's looking, he investigates Mavrik's emotions and feels the odd intensity and desperation and hunger coming off him in waves. It doesn't bode well. He turns to walk away towards his office where he keeps the payroll....but hesitates.- Y' aren't lookin' too good, man.

SILVAH: Do ya need help? Money?  I mean besides yer paycheck, that is. Place t' stay?

SILVAH: -The things Jack said about Mavrik, what he's capable of keep cycling through his mind. He can't help but think there has to be something he can say or do stop it.-

MAVRIK: -He watches Silvah move across the room, as if he's anticipating some sort of sudden movement from him.-

MAVRIK: No, I just want what I haven't been paid yet. I don't need your money just mine. 

MAVRIK: I'm fine. Perfectly fine. SILVAH: Look, ....I know a fucked up situation when I see it. I ain't blind. Just got one functionin' peeper. Like yerself currently.

SILVAH: I can tell yer scared and ya ain't firin' all cylinders. Apt to do somethin' regrettable.

SILVAH: But it don't have t' be that way.

MAVRIK: -He is listening to silvah talk, and seemingly still neutral up until he mentions mavrik doing something "regrettable"  then all bets are off, and Mavrik goes entirely rigid. Hardly even breathing for a short time.- ...........

MAVRIK: "Regrettable." -Repeats it with a rumbling growl in the back of his throat.   And odd choice of words. Jack had attacked him for something he hadn't done, would he have told silvah? What if silvah also believed him capable of those things was he being paranoid? How much did Silvah know about him?? Jack knew plenty what if he told.-

MAVRIK: What am I doing that's regrettable? What doesn't have to be what way?? Hm?? HM??! 

MAVRIK: I'm doing fuck all, I'm not scared of anything I'm FINE!! -Steps suddenly towards Silvah, hissing loudly, before he comes back to his senses again and backs down.- ..... SILVAH: -Uh oh. Silvah doesn't need complex math equations to know he made a bad call by trying to appeal to Mavrik. For a moment all he can do is blink in surprise at Mavriks sudden spike in paranoia and  hostility, and for the first time he feels the madness too- which comes in a cocktail of potent emotions that make his head spin. The situation  obviously isn't as manageable as he first thought. He has to be careful. Very careful. He makes his voice sound worried, but still relaxed and soothing.- Now I don't know nothin about any a that. I was just sorta speakin in general terms . Relax would ya? I'm gonna go get your pay check an then if ya still wanna talk about this yer welcome t it. -He just casually as can be starts walking to his office.- MAVRIK: -Relax.... he could do that, he could relax... maybe.-

MAVRIK: -He takes a few deep breaths, picking up on that forced calm Silvah has and trying to do the same for himself.- Okay... y-yeah okay. 

MAVRIK: -His eyes follow silvah as he shuffles over to the counter to wait. This just felt dangerous to him, going to a less populated area, no where to hide, and silvah might very well know what he is.-

SILVAH: -He does go and grab Mavrk's paycheck as he said, his mind racing the whole time while his body leisurely strolls....but while in the sanctity of his office, he makes sure to equip his armkind . One twist of the wrist and he'll have his weapon at the ready- literally at hand. Just a little insurance policy. In case Mavrik actually is as crazy as Silvah thinks he is. Text from his conversation with Jack is scrolling over and over again in his head, especially the end bit.  He's too far gone. Silvah still doesn't know if that's true....Not for sure. But he has a bad feeling about all this now. The sooner he has Mavrik out of his resturaunt, the sooner he can actually do something about it. He approaches the counter and slides the paycheck over to him wordlessly, along with a few extra hundred dollar bills. Maybe all he really needs is money.  It's possible right? That's what most people need.-

SILVAH: ...Well I was closin up when ya came. Think I'm gonna head out now.

SILVAH: Take care a yourself. MAVRIK: -When Silvah comes back out Mavrik snaps back to attention, having previously been hunched over the counter top staring at nothing. He looks up at Silvah, then down at the check and money before snatching it up checking to be sure it was signed and then tucking it away for safety. Suddenly he felt some relief wash over him, just these few hundred dollars extra meant maybe he could keep further in reality, further from daily feeling like he was dying. Mavrik lets out a sigh.- .............. Thank you. 

MAVRIK: And. 

MAVRIK: I............ I never wanted it to go that way. With Ryan's friend. That guy. 

MAVRIK: I wasnt what he said I was. SILVAH: -It's impossible for Silvah not to keep feeling sympathy for Mavrik, despite all the evidence piling up against him. Silvah in that moment genuinley hopes the poor guy will take the money and run. Find somewhere to be happy- or at least less miserable. Not hurt anyone or be hurt by anyone. Silvah just nods and strides slowly towards the door.- not trusting himself to say much more without upsetting him again- ...I  know. -He wants to believe it. But he's not sure.-

MAVRIK: Mhm. 

MAVRIK: But I'm running out of options. And chances. If he said anything to you, if Ryan said anything to you...

MAVRIK: Silvah I've always hated every single troll with a burning rage you cannot even fathom... -Turns his head and stares at Silvah as he starts moving towards the door.- But you cut me some slack when I needed it so I'll give you a heads up. 

MAVRIK: Stay off of Lauctis. And if I ever see your face again there wont be a second time. -He needs to protect himself, and if that means pulling intimidation tactics so be it.

SILVAH: -Silvah's been doing a pretty good job of keeping his cool this whole time....but the blatant threat startles him and gives him pause,. His skin prickles like the temperature in the room dropped several degrees. It's kind of ridiculous in a way- the giant military trained troll that he is, being intimidated by a tiny thing like Mavrik. But it's not really Mavrik himself that gives him this creepy feeling but the malice in his voice. Once Silvah hears that, feels the intensity of that hatred...towards all trolls, .all the doubts in his mind are swept away. He has to get out of here  and find a way to help. Even trying to postpone the music festival would be a start. Instead of turning around and talking to him again...he just keeps walking. But faster than before.- MAVRIK: -Ah. There it is. That spike of fear clear as day and absorbing Silvah in a whole new shade. He knew it. Mavrik fucking knew it. Any other person would be confused, maybe a little nervous from the death threat but look at him Silvah was a tank? Why would he be this nervous of a guy half his size. Silvah knows something is up.- 

MAVRIK: -When Silvah doesnt even so much as respond and starts walking, Mavrik shoves off from the counter top and swiftly follows at his heels.- I thought you were interested in talking before. What suddenly happened to change that. SILVAH: -FUCKIN HELL, he's on to me. Silvah wonders whether it would be be better to stop and try to stall him or just make a break for it. Silvah's not the fastest person in the world, that's for damn sure....But maybe intimidation can go both ways? Just relying on instinct, he whirls around, clicking his arm into place as he turns and suddenly there's a sort of strange looking gun  where his arm would be, pointing at Mavrik point blank.- Death threats don't tend t' make me too conversational, my friend.

SILVAH: Go on. Take the money 'n go on t' Lauctis and we needn't trouble eachother no more. MAVRIK: -GUN ARM!!-

MAVRIK: ................. -He stares down the barrel of where Silvah's hand used to be and internally sweats. His outward expression straining to not look fearful while a good two thirds of his own instincts tell him to flee the scene. But what use is running for self preservation if Silvah can go and tell some sort of lawful official that could start a manhunt for his ass?- 

MAVRIK: -His hands twitch at his sides.-  You... You dont have the nerve to fire that weapon. -steps closer just to test it.- SILVAH: -Growls when he steps closer. It's a VERY LOUD growl, like a motor revving.- Wrong. I don't wanna fire this weapon. But I will if I have to so mind your p's and q's. -He starts backing off towards the door, just interested in getting more space between he and Mavrik.- MAVRIK: -He jumps at the growl backing up again several paces, but rather then the growl completely scaring him off it just makes Mavrik raise his metaphorical hackles.- 

MAVRIK: -He hisses back at him.- NO YOU WONT!!! -His gaze suddenly darts to the table next to him, Mavrik may not have super strength, but he does have enough muscle to lift and flip it towards Silvah. Get wrecked.- SILVAH: -The table never makes contact, but it does surprise Silvah into firing the gun- which turns out to actually be some kind of plasma-based blaster that basically melts the table away into pieces and dust, grinding out a stream of filthy curses under breath as he stumbles a bit, while also trying making a dive to dart out the door.- MAVRIK: -J E S U S- 

MAVRIK: -He is very glad that table wasn't him, but in the time it took Silvah to demolish the table, Mavrik has skittered off and jumped onto one of the booth tables. What he might not have in size or muscle he makes up for in agility, which he demonstrates by jumping off the surface to launch himself onto Silvah's back before he can get out the door.-  

MAVRIK: -Hes snarling and wide eyed, practically feral and giving into his natural urge to defend himself combined with his dangerous above average aggression. Silvah can try to throw him off but unfortunately before he can get the chance something even worse takes place. The smell of Silvah's skin so close to him... Mavrik can practically taste the sweet metallic taste of blood from memory alone and never before has it been so overwhelming that Mavrik felt as though he was practically blacking out from the scent alone.- 

MAVRIK: -He doesnt even remember thinking about it first, doesn't remember doing it, but quite suddenly Mavrik opens up his mouth and sinks razor sharp fangs through Silvah's clothes and into the back of the trolls Shoulder.- SILVAH: -He doesn't yell, or scream, but let's out a furious roar of pain once he feels that swift, vicious bite that seems to cut so easily into his naturally tough seadweller hide- like the sharpest knife ever.  Even if he knew that Mavrik had already gotten what he wanted, at this point he wouldn't care- his blood is up now. Since he can't reach Mavrik to shoot him, instead he rolls,  slinging the creature pretending to be a troll to the floor and tying to slam his entire massive weight down on top of him.- MAVRIK: -Its like spooking a horse or any large animal, they try to crush you. Mavrik is too caught up in the rewarding buzzing through his skull from having started chewing on Silvah back, he wouldn't say each blood caste had their own unique flavor but it does taste just a little bit sweeter knowing how high up on the spectrum Silvah is.-

MAVRIK: -Not that he gets much time to savor it, Mavrik is brought back to his frazzled senses when quite suddenly his body hits the floor and there is a tremendous weight on him thats threatening to crush his already still damaged ribs to dust, he is certain one of them just completely broke given the sudden pain in his right side. Mavrik shrieks and tries thrashing and clawing to get his way out, he cant breathe with Silvah on top of him and the pain from his ribcage is growing.- SILVAH:   Filthy. Cuntin'. Traitor! -He spits at the impact- the shrieks from Mavrik only intensifies his rage. His eyes are blood-shot and rimmed with purple. Here comes the gun, directly following it, the steel barrel aimed right at Mavrik's mouth which is currently stained purple with his blood. Silvah doesn't dare fire it since the plasma splash would hit him too at this range, but it makes a decent blundgeoning weapon in a pinch.- MAVRIK: -For a brief and terrifying moment Mavrik actually thinks Silvah might just shoot him in the head, but getting slugged in the mouth with the gun hand hardly feels better in the moment. He takes the shot right to his jaw and feels the crack resulting from it.-

MAVRIK: -He chokes on a yelp and wrestles to get his hands up to try and grab hold of the blunt weapon being waved in his face, all while turning to spit out a combination of Silvah's blood, his own, and bits of crushed molar.- SILVAH: -Given that it's his arm, Silvah has a much better grip on it and easily yanks it out of Mavrik's flailing hands, breathing heavily as blood spills from his shoulder in a hot gush. But instead of hitting him again, he twists at the base of his wrists again, and suddenly in place of the blaster is a blade- some kind of cutlass.- MAVRIK: -This was quickly becoming a bad fight for Mavrik, as the hands change he cant decide which attachment is worse. Gun or sword.- 

MAVRIK: -It doesnt matter though because he wont willingly stick around to find out. Mavrik brings up his knees and attempts to drive his heels into Silvah's stomach as hard as he can.- GET!!! OFF!!! SILVAH: -The kick makes impact and while it doesn't manage to push Silvah completely off, it does stun him for a moment, causing him to rear back. If Mavrik is quick he might be able to squirm away before Silvah savagely brings the cutlass slashing down for a killing blow.-

MAVRIK: -He is seizing the moment and scrambling as fast as he can out from under Silvah. He almost falls flat on his face again in the process of standing up but once hes on his feet Mavrik makes a mad dash for the door. His heart beat is pounding in his ears, blood rushing, pulse rapid. All factors that make him run as fast as his quick legs can carry him.- SILVAH: Ss...son of a bitch.....-His breaths are coming in heavy puffs as he tries to drag himself to his feet again. The blood-rage is certainly strong enough that he would've gone chasing after Mavrik to finish the job despite the small chance of being able to catch up to him...but as his head clears and  his heartbeat slows he realizes that they've been rolling around in a pool of his thick, purple blood and it's everywhere- on everything- soaking into his clothes, shining black in the moonlight. Mavrik's teeth were longer and sharper than Silvah ever gave them credit for- they must've hit a vein or an artery. Or something.  Medicine isn't his forte. He can't even see the wound since it's at the back of his shoulder but he knows it's deep. He's begining to feel lightheaded. With a low groan, he grips a nearby table leg and drags himself to his feet, unaware that within the next couple minutes the first signs of the infection will begin to show themselves, unware that his mind is already not his own.-