calm the f--- down!

I will not lie: 

I have the urge to say this phrase to any number of people in a given day.

Loved ones, strangers, my kids, clients, other parents, colleagues...

But I don't.

Well, not out loud.

And certainly not at work - 

until last week.

We had a patient who came in - reeking of alcohol and raising a verbal ruckus.

We experienced her as uncooperative and belligerant; she was verbally aggressive and everyone was frustrated with her.

She was asking for help but then refused to let anyone touch her, talk to her, or provide any care.

She lobbed insults and accusations and she was sucking up what felt like valuable time.

The physician made numerous attempts to break through her chaos but her riot was impenetrable.

The physician ordered Haldol.

Our patient was screaming and all I could hear and feel in her cries was trauma.

This patient was not in her right mind and completely out of line {she was drunk, after all} 

but what she expressed were fears born of trauma.  

And here we were, trying our best to care for her, but our best was only fueling her anxieties and fears.

I was standing at the room's periphery; my heart started to race, my palms started to sweat, and I walked closer to the action.

"Okay, everyone take 2 steps back," I said quietly.

The nurse stood at bedside, poised with the needle, trying to find a break in her flailing.

"Please, take a couple steps back," I repeated - this time with more authority.

I stepped into the bedside space the medical team had vacated near her left hip.

"I know this is overwhelming and I hear that you want to get out of here.  But we cannot do that until we are able to clear you medically."

More yelling...but she stopped flailing.

I fixed my eyes on hers and said very slowly:  Right now, You. Need. To. Calm. The. Fuck. Down.

"We cannot help you if you do not calm down.  I will sit here with you and I will listen and I will help you get the support you need but that can only happen if you calm down.  I am going to start some deep breathing and I want you to join me..."

I inhaled and exhaled.  

Inhaled. 

Exhaled. 

Inhaled. 

Exhaled.

She started breathing with me...and talking. 

Talking about her night, about her life, about her trauma(s).

The nurse capped the syringe, started an IV, took her vitals, and began charting. 

The physician took a deep breath and went to see another patient.

The ruckus was over.

 

I am still not sure it was appropriate or professional to engage her like I did but seriously, 

sometimes, 

you just need a little eye contact and a firm reminder to:

 

Calm the fuck down.