Thursday, August 9, 2018

"Don't Worry, I Was an ARMY Ranger"

My obsession with surgical instruments and fondness of  esoteric operating room tales are not appreciated by everyone, so it's time for something completely different - a true story from that long term VA  psychiatric hospital, Downey.

It was nearing time for my annual proficiency review and I was beginning to feel nervous with an impending sense of doom. One of the key metrics in the evaluation other than restraint hours was avoiding patient elopements. The restraint hours could be managed with some clever slight of hand when filing reports and records. Maybe that's why all the nurses winked and called records of locked restraint hours the "funny papers." The favorite maneuver was to apply locked restraints and leave one of the locks open.  They were just as effective but technically not full locked leathers.

Mr. Dunkfeather who had been recently upgraded from head attendant to nursing assistant looked grim as he approached the nursing station. He had just completed the 2200 hour  patient count and came up one man short. "Fool, Hughes is not on the ward for patient count," he related. My first reaction was denial,  reasoning that it was impossible to elope from a locked ward. There were 3 sets of locked doors between patients and the outside world. Things like this never happened.

I quickly did a search of all the hiding places; shower curtains, under beds, and even inside lockers. Hughes had simply vanished. Next on the agenda was a review of the records. least he was a voluntary patient. If a committed patient was lost, the notification process was quite onerous and time consuming and involved official notification to administration and law enforcement personnel. All that was required of a voluntary elopement was the completion of a 10-2633 form which was reviewed the next day at a treatment team meeting.

When I unlocked the heavily grated main entrance door to leave at the end of my shift a surprise greeted me. It was Hughes bounding up the front steps with an ear to ear grin. I must have looked like I had seen a ghost. "How in the world did you get out of there?" I stammered in disbelief.

"Don't worry, I was an ARMY Ranger and was trained how to jump. There is a gap in the bars covering the back bathroom window so I squeezed out and jumped. I was just repeating an old Ranger training exercise. Now that I know my skills are intact everything is going to be OK."

Hughes was obviously uninjured but the window he jumped from was on the second floor  of Building 66 which was the equivalent to a 3rd floor level because the basement was elevated on that side of the building. He showed me the gap between the iron bars  and further explained some of the techniques used when landing from a jump. He seemed amused by my interest and added that he would be happy to teach me some of his jumping skills. Not tonight I muttered before stopping at the nurse's station and discarding my elopement reports. No harm..No foul.


  1. At least he turned up again. With his skills (and body parts) intact!

  2. He was indeed virtually unscathed. That man knew how to land from a fall. It helped that the turf was soft and soggy after a heavy rain but standing at the window he jumped from and looking down terrified me.

  3. I have a sad story from my days at the psych ward where I worked. We were not at that time a locked ward but obviously patient comings and goings had to be carefully monitored. However one man exited without our knowledge, climbed to the roof of an adjoining hospital building and jumped, killing himself.

    The registrar, a lovely young man, was wrongly blamed by the consultant and we were all very upset about it. This registrar, whom I shall call X, and his wife had recently had their first baby, a little girl. One Friday afternoon I walked with him to the carpark, he was looking forward to driving to Canberra (our capital city in Australia) on the weekend with his wife to show their new little daughter to friends there.

    Driving to work on the Monday morning after this I listened as the car radio reported a terrible car accident on the highway between Sydney and Canberra, where a car had run across the highway and hit a parked vehicle killing two adults and severely injuring a child.

    It wasn't until I got to work at the unit that the staff there ( all deeply shocked) told me the accident was our registrar X and his wife and their baby girl. They had pulled over on the way back to Sydney so the wife could feed the baby and X had got out of the car to stretch his legs when the car on the opposite side of the highway ran out of control and straight into them. X and his wife dead, the little girl alive but with terrible head injuries.

    It just shows what shock does as I said to the others, "X can't be dead I was just talking to him on Friday afternoon". How ridiculous.

    It took a whole busload to take us all to the funeral. The little girl was taken in by X's family, I don't know what happened to her. X had been terribly upset by the suicide of his patient and had been looking forward to the weekend away to recover.

    I guess you don't need sad tales but I've never forgotten how stunned and shocked the whole ward was that day.

  4. There is so much tragedy in nursing. It's so refreshing when an incident that could have been catastrophic turns out benign. Whenever I think of Hughes bailing out that bathroom window I feel a sense of amazement and relief. Too bad your sad tale didn't have a silver cloud or happy ending.

  5. I think the sad endings we so often see make the happy endings so much more wonderful OFRN. Nurses see so much that is tragic. I remember feeling so impotent at the dreadful fate of a young man with motor neurone disease once that I went off duty and kicked a car tyre over and over with frustration, I was so angry at that awful illness! Your story was one with very luckily a happy ending! I'm still fascinated to know how you manage to fall like that and be OK! I know as a girl learning to horse ride we were taught how to fall off our horse - and were expected to practice it. But off a building - eeek!

  6. I do have one amusing tale which showed the results of poor communication - we had a large man suffering manic-depressive psychosis and his mania span out of control one night (when I thankfully wasn't on duty) & he became violent... a new male nurse (we were the only ward at the time that employed trained male RNs) who was British and used some different terms to us, phoned the emergency number and requested "urgent aid".

    The story of what happened was relayed to me the next morning when I came on with much hilarity - what turned up at the ward door in the middle of the night was a young, petite little Nurses Aide in her pretty mauve-and-white striped dress and neat white cap - the Emergency call staff had thought the ward had requested an Aide!

    That poor RN never lived it down - we kept telling him, next time for goodness sake say "We need some big hefty SECURITY GUARDS down here fast!"

    I always wished I'd seen that poor little Nurse's Aide's face when she saw what she was expected to help with! Oh dear. Sue.