I was early in the nurse's station. The first group was scheduled to occur around 3:20, and I sat quietly inside with 30 minutes to kill. Being alone, I found it possible to explore a little. I scanned the different folders on one of the desks: "Lesson Plans", "Emergency Procedures", and various other standard protocol lay spilling with paper. There was a very antique-looking intercom system that was laden with dust; I wondered if it was still in use. A cabinet on the other side of the round nurse's station read "restraints" in big, bold letters.
Restraints are almost never allowed to be used in the hospital anymore. According to published reports that date several years back, many safety and health concerns were raised against the hospital by evaluators. The consistent use of restraints was one of them. Since then, the hospital has sought to adopt other, non-physical methods of controlling conflict. Paula spoke to me of a woman suffering from borderline personality disorder who climbed up a tree last week and refused to come down. "The staff spent twelve hours talking her into climbing down," said Paula. "No one was allowed to forcefully remove her." Whether this is in effect in situations other than what has been cited, I have yet to know.
As the time drew near, employees came in. With a list of the daily activities in hand, I decided to find my way to the spiritual group. I wandered in to a friendly pastor playing a keyboard and leading a small group through hymns. Nearly everyone in the room participated and sang earnestly. Next came Bible study. The topic for the day was controlling anger, and the pastor tied his point in with Dwight Eisenhower and his plight to destroy anger and replace it with patience. "Dear Lord," the pastor prayed at the conclusion of his study, "please assist everyone here to work on recovery so that they may be able to leave and return to their families." It was the first time I had heard someone mention recovery, let alone leaving the facility. Many of the individuals in the group nodded, their heads hung low in silence. "Amen!" everyone shouted in unison.
Outside, individuals in the spiritual group were finishing up the maza they had received from the pastor. I became acquainted with Joseph, an older individual who prides himself with street cred. His baggy clothes, tattoos, and chains are a representation of his life before the hospital. Joseph has an air of intimidation about him; he seems to repel a lot of the other individuals at the hospital. Some seem scared off by his look, and if there is more they are afraid of, I had yet to find out.
Joseph decided that he'd play PIG with Jorge, another star basketball player. The competition was on. I was quick to notice that Joseph spoke incoherently; however, every now and then, he would come at you with very clear messages. This was one of those times. "Jorge, my man, you got nothin' on me!" he shouted. The two battled it out until they were both left with a "P" and an "I". Jorge scored from the sidelines, and Joseph was to duplicate his shot. It was game point.
Joseph looked around and seemed to become a little nervous. He muttered something inaudibly and went for the shot. It hit the rim and bounced up, but fell to the side. He didn't make it. Joseph seemed a little shocked by his loss, and walked over to a table where he sat and silently observed the volleyball game that was unfolding. Jorge, also in slight shock, approached his win humbly and continued to shoot the ball until the patio period was over.
I was concerned with how little staff involvement was taking place in the game area on my first day, but this time, I noticed many more recreational therapists, psych techs, and social workers conducting talk sessions and playing games with the individuals. It was definitely an improvement-- one that I hope to be lasting.
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