I come to the next patient. She was admitted earlier in the week “happily psychotic” (as opposed to “aggressively psychotic” – which will lead to the nurses locking you in the side room and laughing at you through the window). As such she was allowed a bed in the main ward - in which she sat and smiled and giggled.
She looks a lot quieter now. I have been slowly winding down her sedatives trying to get her settled. Sister looks over my shoulder as I re-write the drug chart.
“I think we can reduce the haloperidol now sister. She is looking much quieter now.”
Sister puts her hands on her formidable hips.
“Ah – no doctor. We cannot do that.”
“But I have been halving the dose each day all week – and look at her, she is still quiet and probably over-sedated. We can reduce again now.”
“Ah – but at night doctor she is different. In fact doctor – I have been giving extra haloperidol – same dose as on admission.”
“But you have signed on the chart where I wrote 2.5mg?”
“Yes doctor – but I gave 10mg.”
“Why?”
“Because at night doctor, she gets up. And she sings and does Zulu dances in the middle of the ward. And then she goes to the male ward and does the same."
I think of raising the point with sister that perhaps she should have told me rather than ignore the drug chart entirely – a loss of temper might be justified. But instead just meekly write on the chart as instructed.
I don’t want to end up locked in the side room being laughed at through the window.
She looks a lot quieter now. I have been slowly winding down her sedatives trying to get her settled. Sister looks over my shoulder as I re-write the drug chart.
“I think we can reduce the haloperidol now sister. She is looking much quieter now.”
Sister puts her hands on her formidable hips.
“Ah – no doctor. We cannot do that.”
“But I have been halving the dose each day all week – and look at her, she is still quiet and probably over-sedated. We can reduce again now.”
“Ah – but at night doctor she is different. In fact doctor – I have been giving extra haloperidol – same dose as on admission.”
“But you have signed on the chart where I wrote 2.5mg?”
“Yes doctor – but I gave 10mg.”
“Why?”
“Because at night doctor, she gets up. And she sings and does Zulu dances in the middle of the ward. And then she goes to the male ward and does the same."
I think of raising the point with sister that perhaps she should have told me rather than ignore the drug chart entirely – a loss of temper might be justified. But instead just meekly write on the chart as instructed.
I don’t want to end up locked in the side room being laughed at through the window.
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