Implode or Explode!

Day 27 —Make up a near-death experience (unless you have a real one).

It was a busy day in the clinic.  The waiting room never really emptied out, just the people sitting in the chairs changed.  We passed through on our way to outpatient calls on and off throughout the morning.  After a quick lunch on the run we headed out for one more outpatient visit.  Walking past I noticed that a thickly set male with an anorak coat and a large back pack appeared agitated.  When he was seated his foot was constantly tapping. But he appeared to spend more of his waiting time pacing the small area.

The waiting room serviced a number of health teams.  The size was negatively impacted on by the number of chairs that had to fit the high number of clients that passed through there.  It meant at any time there could be adults and children of varying ages waiting for their appointments.  The area was watched over by the same two receptionists.  However their primary job was answering the phones and typing up reports.  Once the clients were signed in they were pretty much on their own, until their names were called by the person they were here to see.

There were no security guards on the premises.  If there was a problem we had to rely on ourselves and call the police.  I was still waiting on my restraint training and there was always a variable number of staff present that might be able to assist a dangerous situation.  The problem with relying on the police is that this area was rural and had no one permanently assigned to the station.  It could mean more than 20 minutes before outside help arrived.  There had been a few random acts of violence that had required police intervention but to date the issues had been dealt with by the staff themselves.

Myself and D were writing our reports when the receptionist came rushing in.  She was visually disturbed.  She said she had heard threats against the doctor from behind the closed door.  The person in with the doctor was the young man whose agitation I had noted previously in the waiting room.  D and I listened in at the door and attempted to make contact with the man or even the doctor.  We were alarmed enough by what we heard and what we did not that we instructed the receptionist to call the police and request urgent assistance.

D and I attempted to breach the door against the resistance of the client who tried to keep us out.  The other staff were behind us but had chosen not to intervene.  We felt that we had no choice.  We got into the room and in the first few moments could see the doctor sitting on the far couch looking terrified.  The young man was yelling at us and D attempted to restrain him.  My initial attempt to help had me thrown against a picture frame on the wall.  I felt a trickle of blood down the side of my neck.  For a few seconds the adrenaline was replaced with the fear that this man could really hurt me but I returned to assisting D because what choice did I really have?

We got D on the ground and were attempting to calm him when the police arrived.   In the aftermath the doctor explained that he was sure he was going to die.  When the back pack was searched it was found to contain a number of very sharp knives.  The client was very clear that he intended to kill the doctor and any one that got in his way.  He said it was because no one ever listened to him and his needs had been ignored.

When it all settled down, which took a while because we had police interviews, internal investigations and debriefing, I read through his notes.  There was a case for the complaints of the client.  I am not saying how he went about making that complaint was in anyway acceptable but when desperate a person can make some really dumb decisions. This situation did not have to happen but it is sadly a common part of health care.

People that are quiet can often be shuffled behind those that make a fuss.  It is not right but it happens in Services that are over loaded.  However, much like an emergency situation triage those that are quiet but obviously injured  should be assessed over the people in your face and noisy as all heck.  Eventually the quiet ones can explode or implode.  In this case the client exploded.



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