Saturday, September 27, 2008

What's wrong with this picture?

There's a young man on my unit, let's call him Jim, who's a paranoid schizophrenic. He's in his early twenties and has a past history of violence, badly beating several patients, but nothing recently. Jim believes that people are trying to kill him, have already killed his father, and that he should be in the witness protection program. He is afraid of leaving the hospital because there will be an attempt on his life. He has constant and persistent hallucinations and delusions, despite the medication he is on. He's also one of the most thoughtful, soft-spoken, and caring gentlemen that I have ever met.

Today Jim came to the staff and told them that there was a wire in his leg and he had to go to the hospital. They explained to him that he is in the hospital already, he responded by turning around and punching the wall. Based on his history, staff called a "Camelot," meaning security came running and Jim was medicated and then isolated for the rest of the day. Had Jim punched a staff member instead, it says in his treatment plan that he would immediately be taken back to prison.

Compare Jim's story with another young man on my unit, let's call him Tom. Tom is also a schizophrenic and hears voices frequently, probably command hallucinations. He has attacked three people in the past four weeks, twice stating that he was trying to kill them. First he tried to choke another patient with headphone cables, then he tried to break someone's neck, finally he punched a lawyer in the face. Tom also has a history of imprisonment, and has been moved off of every regular unit at my hospital because he was a danger to the other patients. My unit was the last option, and so he's stuck there. After each incident, he was medicated and isolated, arrested briefly, and then returned to the unit because his actions did not qualify as severe enough to actually imprison him. Note that there is a forensic unit at this hospital specifically for criminals that have been found guilty by reason of insanity.

So, to sum up: Tom has a history of attempted murders. Jim gets frustrated and punches a wall. They both get the same treatment, except now if Tom punches somebody nothing different will happen. If Jim punches a person, he'll get taken to jail, setting back all the progress that has been made.

Anyone else have a problem with this?

1 comment:

Unknown said...

I have a problem with this.