James was one of our security guards, who’d worked here probably since before any of us had been born. You’d only need to look at him to know that he’d been here longer than you had. He was about 6ft 2, in his 60’s and walked with a hunch and a notable limp. He could probably touch his toes without bending down. He was still a unit of a bloke. That said, he was still one of the nicest guys you could talk to. He’d always say hello and ask how you were doing: ”awright, ‘ow ya doin’?” as he lumbered past you down the corridor, responding to someone up to no good. He spoke a bit like Phil Mitchell from Eastenders (in his earlier days, when he wasn’t an alcoholic)– he was almost identical actually. He’d seen enough in the department that he knew just how to handle certain people. He knew when enough was enough and that the person being aggressive and violent to staff needed a firm attitude to just pack it in. Conversely, he knew when someone was in a vulnerable position having a mental health crisis and would spend hours with them calming them down and reassuring them that they were in the best place to get help. He was truly an asset to the team, not just a heavy pair of hands.

I fondly remember many an encounter with him. Whether that’s him hanging onto the feet of an acutely aggressive and violent patient (either by drugs or brain injury, we weren’t sure at that time) while we prepared to sedate them, and he’d still crack a smile at me with his “nice weather today innit H??” as he clung onto what seemed like a Tasmanian Devil.

One such encounter with James involved a woman who had taken some horrendous unknown concoction of drugs, and was on the back of the ambulance going absolutely berserk- assaulting the paramedics, trashing the ambulance and shouting and roaring incoherently. You could see the ambulance rocking sideways as you stood outside of it. We scrambled to prepare our special room for her- a closed off cubicle with 1 way opening doors, roll down shutters (so medical equipment attached to the wall couldn’t be damaged) and padded walls. Whilst this was going on, police were desperately being called in order to assist with what was going to be fairly advanced/complex restraint as we brought her inside. All of the security guards were very reluctant and spent a lot of time just planning how to get her out. James had come on shift and hobbled over to the cacophony.

“Awright. Oi, what’s goin’ on ‘ere?’ He said, gesturing to the swaying ambulance.

The young and somewhat impressionable security guards hastily tried to explain what was going on.

“Oh forkin’ ‘ell.” He mumbled to himself, disappointed that the others hadn’t dealt with it. He went to the ambulance doors and flung them open, to which the crazed woman directed her cacophony of roaring and shouting at him instead of the paramedics. He lumbered up the step, grabbed her by the scruff of her hoodie as she clawed at him, and hauled her back out of the ambulance with her at arms length, and shuffled down the corridor with her like a feral cat in his hands scratching at his arms and yelling incoherently.

“which room?” he grumbled to me, unfazed. I figured that he’s had years of this that by now he’d probably formed a natural thick callus of skin on his arms, as the woman’s scratches and pulls did nothing.

“Room 10 mate, all good to go. Need a hand….?” I replied emptily, knowing he wouldn’t.

“Cheers H” he said, and booted the doors open with a free leg.

“Gerroff’ me arm...forkin’…gerrof’, there y’are, gerrin, get…in’” he grumped, shaking his arms trying to release the woman as though he was trying to shake a bit of sticky tape off. She soon released and James shut the doors, turned around and slowly lowered himself laboriously onto the chair that had been left outside the room. I half pictured him picking up a TV remote to turn on the football, he’d sat down that casually.

I mean, not the most conventional or recommended methods of getting someone like that in, but it worked and he wasn’t bothered what she spat or scratched at him. Before he’d arrived, we were clearly at a stalemate. Waiting for police, waiting for security, waiting for a room, waiting for her to calm down, waiting for it to be safe. No decisions being made. She was trashing the ambulance (which would have taken it off the road for repair), assaulting the ambulance crew and anyone that came near, and police were too busy to be able to respond within any reasonable timeframe- she was a danger not only to herself but also members of the public and staff. He saw what needed doing, and just did it. Thank god for James.

Another time, I remember seeing a patient (we’ll call him Michael) who was coming down off a cocaine high, he too had been violent and aggressive, consistently rude and racist to staff, always swearing and gobbing off, but had since calmed down and was more just being a general twat, rude, racist and swaggering about with a smug and entitled face (Ok I’ll say it, it …was one of those very punchable faces). Not that punching it would have made any difference- he only had 3 teeth left. If he hadn’t have taken a shit ton of cocaine, he’d have long since been booted out. If we were to discharge him, against his wishes, with adverse observations as he did and then he went and collapsed and had a heart attack in the street that would very much go against us.

So, we were transferring this guy to a ward. I had to take him, so that I could hand him over to the relevant people. James came on escort, as is usual with these cases. Of course, Michael was loving this. He got to look like he was well ‘ard, that he needed to be held back by security- his yellow 3 toothed smile brimming as he strode through the corridors of A&E with me and James. All of a sudden, something triggered him and he flew off the handle at me immediately in the middle of the corridor.

“You sayin’ I’ve got shitty teeth?! What you saying?! You saying I’ve got shitty teeth! You fucking want a fight do you mate I’ll do you one right here mate fucking come on I’ll do you one mate I’ll do you!!!” He yelled, flailing his arms about and launching himself towards me unsuccessfully as James just stood in between us both, disapprovingly- a bit like a big dog with a puppy gnawing at it’s jowls. I stood and waited for him to finish, as if I were waiting for a toddler to finish his tantrum.

A stray limp thwack landed on James’ head. Line, crossed. He had had enough. He grabbed Michael by the scruff of his collar with both hands and held him up to the wall.

“LISTEN mate if you carry on kicking off in ‘ere, I’ll make sure you’ve got NO fookin’ teeth, AWRIGHT?!” He barked calmly at him in his usual gruff voice.

Michael put his 3 teeth away and his attitude withered, as he plodded up the corridor with us, tail in between his legs, and James looking irritated that he’d had to exert himself beyond a simple walk.

Again, unconventional and not really the recommended response, but it worked. What was the alternative? Let him escalate in the middle of A&E and need more security guards to come and pin him down until he calmed down? Talk him down and reassure him that of course he didn’t have shitty teeth? (We knew already he wouldn’t be talked down, he’d been spoiling for fight the whole time he’d been here)

The other side of James, I recall fondly that I witnessed in passing. A mental health patient had been brought in, going through a psychotic episode, and was at the point where she sat on the floor in the foetal position absolutely terrified of her surroundings and instinctively hit out at anyone that came close. James, all 6ft heft of him, sat crossed legged beside her on the floor with her for at least an hour before the mental health team came to take over- reassuring her and calming her down and telling her that she was in a safe place, no one was going to hurt her, he wasn’t going to let anyone hurt her. She’d stopped screaming and was no longer lashing out, and was cradling a cup of tea (normally in these cases we’ll offer water, as the contents usually get thrown over the nearest person. Clearly James had put her needs over his own.) She still didn’t want to engage with anyone, but she at least felt safe. That was James’ doing.

He’s alright, James is. Rough round the edges, doesn’t play by the book and won’t take any shit- but rugged, dependable and always looking out for the other person first. Yes, he’s a bit knackered and about ready to retire, but he’s alright. For now though, he’s still lumbering about the corridors, gruffly greeting everyone with his trademark pearly whites still, putting society’s arseholes to rights, and protecting those that need him.

H

Kindness, Patience, Mental Health & Content Warnings on the Fediverse

CONTENT WARNING: mental health struggles, me talking about elements of my newly unearthed PTSD, reference to witnessing suicide attempts

I'm just going to get straight to the point here. I'm starting up writing again. I have a lot of thoughts that sometimes I feel like writing into the ether. What better place than primarily, the Fediverse?

You've probably seen from the content warning already, but yes- I'm going to cover some stuff here. I promise I'm not going for the shock factor and to make you feel shitty, I'm genuinely just sharing- and because I want to join in with this modern day trend of actually fucking talking about our feelings and experiences for the benefit of looking out for one another.

Some background here before I get into it for those who don't know me: I spent 8 years as a senior nurse in a busy, overcrowded and understaffed inner city Accident & Emergency Department.

Recently, I had what you could probably call a “relapse”. Or a “trigger” if you will. There's this scene in the TV series Handmaid's Tale (no spoiler, promise) where someone is hanged. As I watched it happening, I felt an intense panic building up inside me, willing it to stop. “No turn it off, stop it, turn it off” I repeated, over and over until my scrambling and trembling hand found the remote to turn off the TV completely.

Hangings, while of course distressing even in fictional situations, wouldn't have usually affected me so much, as in- I was somewhat sadly using to dealing with them, whether that was dealing with the after effects of them or worse in this case, having immediate flashbacks of finding a patient in a cubicle hanging, still alive and with both of their wrists slashed. In the moment of scrambling to grab the remote control, I was at the same time reliving slashing at the makeshift bandage noose with my scissors as I tried to hold the patient up over my shoulders.

Actually, it’s only in writing this post that I’m reminded of another time I had an unexpected “trigger” flashback- which my brain had again conveniently forgotten. The TV series Stranger Things, (again, no spoilers coming up don’t worry) I was having a riot binge watching this with my other half. Totally fictional, out of this world stuff that is easy to disconnect from. All of a sudden, there’s a scene where there’s a baby crib on fire, and it is alluded that the baby is in there still. The scene only lasted all of 5 seconds, but it was enough to send me into a shaking panic and repeatedly urging for the TV to be turned off. I don’t need to detail what the flashback was.

How can TV series and Movies do a better job of warning people beyond “some scenes some viewers may find distressing”? Maybe that’s one for another day.

Since the most recent one, I've been coming to the realisation that I am no longer the same person that I used to be. Quite some time has passed since I last stepped foot off an A&E department and yes, as I am often asked, I miss it. A lot. So why did I leave? Maybe that is best left to another blog post some time, or perhaps, more pressingly, my book that I’m currently working on that spans a whole host of my career. Let me know if you’re ever interested.

Well, I miss the job- just not the situation we were in. That is, increasingly understaffed, underfunded and hideously overcrowded. I lost count of the amount of times I was dealing with a cardiac arrest in the middle of a waiting room or corridor, with no physical bed space anywhere at that moment in time to take said person- we just had to work on them on the floor while some poor bugger was kicked out into a temporary corridor space so we could use their bay full of life saving equipment.

Back to the point of this post- the scene that I saw that I did not expect to affect me the way it did. As a general rule, seeing things like that in perhaps, a game, or as a photo- doesn’t seem to have the same effect. The fact is, the scene in question seemed to so closely resemble what I experience for real that it literally was as simple as a trigger. The last time I felt something close to a trigger was a few years ago when I was in a crowded shop, and felt in increasing sense of panic as I felt as though any of of the people swarming around me was going to suddenly run up and thrust a floppy and unconscious child into my arms.

I should point out, I’m working through this. I’m doing ok. I know the people that will be reading this are most likely the kind of people who’d reach out and ask if I’m ok. Honestly, I’m obviously not fine, but I’ve got it in hand and am working through it. If anything, I’m coming to learn that this experience is actually somewhat humanising- that I’m now starting to lose that numbing, desensitising protective factor that my brain perhaps filtered everything I saw with- and actually for the most part has made me forget a lot of what I’ve seen, until that totally unexpected trigger happens.

Which leads me on to Content Warnings on the Fediverse. I used to find them a bit over the top, and feeling as though it felt like treading on eggshells whenever you posted. I still to some extent think content warnings have been over used, likely as a result of people on fedi over policing other people’s posts and creating a bit of a hostile and unwelcoming environment- however: I land on the side of the idea that it costs literally fuck all to be kind, and respectful. Content Warnings are NOT censoring, as some might shout until they’re blue in the face. It’s just a way of going “ey, just a heads up there’s probably some shit behind this you might not like, you sure?”. And that’s it. What’s the harm in that?

I for one, am learning to respect this way of thinking. It never came from a place of malice, but because I became so used to seeing a certain degree of grim things day in day out, I almost forgot that the majority of people are fortunate enough to have not experienced those things and that they may find them actually quite distressing. How do I know this? Well, because still, every once in a while, I become that person. That person I was before I set foot into the underworld of emergency nursing. That vulnerable, emotional, wearing my heart on my sleeve person. The one that didn’t find a fictional depiction of something on TV too close to home that I couldn’t function properly.

I’m not sure if I’ll ever become that person again.

Perhaps, one day, it’d be nice.

Look after each other, peeps. X

H