I was dating yet another narcissist

My abusive relationships with narcissistic men

Black and white image of a persons head seemingly going backwards and forwards - confused
Psychosis can feel like this

This is the 14th in a series of My journey through anxiety, panic disorder, depression and psychosis.” You’ll also read about me and my abusive relationships with narcissists, occurring over a period of many years.

You can read parts IIIIIIIVVVIVIIVIIIIXXXI, XII and XIII for the backstory. It might make more sense.

I started writing about my journey six months ago and I only ever intended to write it in four posts. However, it’s become clear that my journey was longer and more painful than I remembered. That’s made it difficult to get the words down on paper at times. I’ve taken many breaks and written lots of other posts in between. I’ve had time to reflect and bounce back a bit stronger each time.

A year later

Coloured image of messy room
Mark’s unlivable sitting room

Mark had recently moved into a new rented flat and he hadn’t bothered to do much to it. The bathroom, kitchen and bedroom were liveable spaces but the living room was devoid of curtains and furniture. The room was just stuffed full of black bin liners of all his things.

One Friday I’d gone shopping for an outfit for a work party that night, and when I called him, Mark was acting like a petulant child. He thought I should have been helping him sort out his flat instead of preening myself for tonight. Never mind I’d moved a few months back and he hadn’t helped me. He said he would have, if I paid him the £250 he’d lose by taking a day off work. Tutting and eyes rolling, he was so full of his own bloody importance.

Mark came to the party but he made it clear wasn’t enjoying it, or the attention I was getting — from colleagues for Christ sake. He left and said for me to go back to his after the party as he lived round the corner from the venue.

The party was great despite my friends suggesting that Mark had ignored them and seemed very possessive. I hadn’t noticed it previously or, perhaps I’d ignored it. But now I felt embarrassed, and I really didn’t want to go back to Mark’s flat when the party ended. However, it was gone 2am and to avoid another argument, I thought it best just to walk to Mark’s flat.

Way before the ALS ice bucket challenge was popular

Ice bucket challenge – Image from Unsplash.com

Yay! He was asleep when I let myself in so I just snuck into bed, on my side, by the wall. But he woke, he sat bolt upright, and he yelled “You’re taking the p*ss. It’s 2.30am. Where the hell have you been?”

I stayed still and whispered “Ssshh, sorry. Go back to sleep,” hoping that would be it.

“Don’t f*cking ‘ssshh’ me. F*ck off and leave.”

“Mark. Please. Let’s just sleep and I’ll drive home in the morning?” I argued. He shot out of bed suddenly, still cursing, and I just curled myself into the far corner of the bed so as not to disturb him further. I heard him running the tap to get a drink and I heard his bare feet thud into back into the bedroom. I felt the heaviness as he got on the bed then, WTF?

He was standing above me on the bed, pouring a bucket of cold water all over me, and I froze.

It seemed like only seconds later when Mark tipped a second bucket of water over me. I started giggling hysterically and thought How ridiculous is this? But I’m soaked now, so I might as well just lie here. He left the bedroom and returned with a third and maybe a fourth (I was in shock) bucket of cold water, and threw it over me. “Now, f*cking leave. Get out. Now,” Mark screamed. I couldn’t call for a taxi because he didn’t have a great signal in this flat, and he damn well knew this.

Don’t let my son see me like this

girl crying at window
Image from Pixabay.com

There was no way I was going anywhere, when I was wet from head to toe, so I raced to his living room and blocked the door so he couldn’t get in. I dragged bags of clothing and sheets together and threw myself on top of them, shivering with cold.

Fortunately, my hair and clothes were semi-dry when I woke so I walked out to find a cab to get home before my son woke and saw me. Why the hell did I put up with this crap? What’s wrong with me? My son would be furious if he knew what Mark was doing to me, but he’d also be disappointed in me. He didn’t know and I wasn’t going to tell him.

I told Callum the following week in the pub and I laughed at the ridiculousness of Mark’s behaviour. Callum wasn’t impressed and he wasn’t laughing. He wasn’t joking either when he said that if it was his boyfriend he’d have put rotten fish in the hem of his curtains and itching powder in all his pants.

Callum and I were still laughing when Mark sent a text saying “Missed you at cricket on Sunday. Want to meet up later?” Callum took my phone from me and I watched as his nimble fingers tapped out a speedy reply, “Two words, one finger,” and we laughed some more.

Coping with a narcissist

Stressed and exhausted – Pixabay.com

Nope, it’s not easy. It wasn’t easy. I was well aware that Mark’s behaviour was inappropriate and cruel but I still loved him and missed him? However, on hindsight, I realised how many times I’d desperately attempted to appease him — trying to avoid the arguments that would surely follow. I was so stressed, and exhausted, always trying to keep him happy.

I thought back to early on in our relationship, when we had fun and passion and we laughed a lot. But I don’t remember his complimenting me or taking me out anywhere other than the local bar. And looking back, while he never bought me gifts, he often asked if I’d got him anything while I was out shopping. He’d strop like a spoiled little boy who didn’t get what he wanted at Christmas when I didn’t buy him anything.

Of course it hadn’t happened overnight, it was like he was slowly drip-feeding me, making unpleasant comments about how selfish I was, or how little I cared about him. I later learned that trying to please someone like Mark was futile because, for narcissists, nothing is ever enough.

So, what is a narcissist

Man in his fantasy world – Pixabay.com

According to Helpguide.org. the signs and symptoms of narcissistic personality disorder include

  • Grandiose sense of self-importance. …
  • Frequently demeans, intimidates, bullies, or belittles others
  • Lives in a fantasy world that supports their delusions of grandeur. …
  • Needs constant praise and admiration. …
  • Sense of entitlement. …
  • Exploits others without guilt or shame

Narcissistic personalities effectively mask a deep and unconscious self-loathing. To counter feelings of shame, narcissists will project their own issues on to everybody else. They blame others, insist it’s everybody else’s fault, portray themselves as victims and rarely apologise or take responsibility for themselves or their actions (Mail & Guardian, 2019).

Be careful because being subjected to narcissistic abuse can, over time, seriously affect your mental health.

We’ll look at How to leave a narcissist in my next post. But in the meantime, if you are in or think you’re in an abusive relationship with a narcissist, you might want to read Know the signs of emotional abuse here and Let’s talk about domestic violence here.

If you are, or someone you know is in a relationship with a narcissist, then seek support from people you can trust — friends, family, peer support groups and, if necessary, a professional.

Over to you

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I’d love to know your thoughts on Mark, his narcissism and me putting up with it. Does it make me look weak? In what ways would narcissism affect your mental well-being? As always, I look forward to your comments and any questions.

If anxiety was a person I’d punch it right in the face

My journey through anxiety and more – Part XI

dark skinned lady with white wrap covering her most of her face, tears in her eyes
Anxiety and panic attacks
broke me

This is the 11th in a series of “My journey through Anxiety, panic attacks, depression and psychosis. Please click here for Parts I, II, III, IV, V , VI, VII, VIII, IX, and X if you wish to read the backstory (It might make more sense).

For those of you who don’t know, I started writing about my journey six months ago and only ever intended to write it in four posts. However, it’s become clear that my journey through mental illness was a lot longer and more painful than I remembered. That’s made it difficult to get the words down on paper at times. I’ve taken many breaks and written lots of other posts in between, giving me time to reflect and bounce back a bit stronger each time.

I’d had enough!

……….. I told him to pack his things and leave before I got home from night shift in the morning.

Night shift on a mental health ward

Lady in red dress and white sandals hanging from a rope around her neck
Shocked? You should be! Female patient strangled herself

After our patients had had their night medication, the support nurse went to complete the half hourly observations. This meant checking each bedroom or cubicle to ensure everyone was accounted for and alive.

I was in the office when a roar from the end of the corridor alerted me and I raced towards noise. Oh, Jesus! A female patient had strangled herself with the belt from her robe. Her face was a horrible shade of purple and she appeared not to be breathing. My anxiety levels just shot through the roof and I felt the colour drain from my face.

I helped untangle the belt from round her neck and felt for a pulse, but there was nothing. Jesus, I’d only been a mental health nurse for two months and I was near paralysed with fear. “Get the crash trolley,” I yelled down the ward to Maria the third nurse on duty. Sarah was a favourite of mine and there was no way I’d let her die, not on my watch.

Cardiopulmonary Resuscitation (CPR) on a mental health ward

Down on my knees now, I fumbled, trying to find the right place to press (the breastbone is pushed down firmly and smoothly, so that the chest is pressed down between 5–6 cm) then started CPR (at a rate of 100 to 120 chest compressions per minute – that’s around 2 per second, British Heart Foundation).

I could feel the sweat dripping down my back and the trembling in my arms as I continued 1.2.34.5……… 30, for what felt like a lifetime. All the while, I was trying to keep calm, as this was no place for my impending panic attack. Concentrate, concentrate Caz, you can do this, concentrate. Finally Maria arrived with the crash trolley and I asked her to take over while I ran to call the Crash Team.

Crying with relief

I turned to sprint back to the office but stumbled and fell forward with a thud and landing awkwardly. I immediately felt searing pain in my right shoulder. Still, I got up as quickly as I fell and dashed to put a call out “Cardiac arrest on Violet Ward.” This relays a crackly radio message to the Cardiac and Rapid Response Teams. When they get that message, they race from the general side to the Mental Health, side pretty damn quick.

Four doctors dressed in scrubs, running down a corridor
Emergency Crash Team running to
an emergency

I’d all but forgotten my own burning pain as I ran back see what was happening. On my way, I guided any inquizitive patients back to bed and tried to reassure them all was well.

I took over the CPR and rather stupidly, wept with relief when Sarah started showing signs of regaining consciousness. Her eyes were flickering and she was trying to catch her breathe. She now had a pulse, albeit a weak one. Just then, the Crash Team arrived and took control.

Caught wearing a tired grey bra

Male Doctor, white scrubs and stethoscope
Duty Doctor —Image from Freepik

Sarah had survived, but was still taken over to the general side to be observed overnight. The Duty Senior Nurse was in our office making sure we were all okay when someone let on that I’d fallen. The cute young Duty Doctor came to see me and all I could think was “What bra have I got on” when he asked me to undress to assess any damage. Only I could be wearing a comfortable but tatty old bra that looked like I’d washed the floor with it! The shame.

Despite the agony, I didn’t complain too much so the Doctor suggested I go home and return to A&E tomorrow if the pain got worse. It was just past eleven p.m. and I called to let the boys know I’d be on my way home. Only it was Ian who answered, drunk and stoned, so I hung up and got a taxi home.

He should have been gone. Aaarrgghhh……. I sure as hell was in no mood for more of his spiteful crap. Once home, I ignored him and went straight up to our bedroom when I got home. I managed to sleep with some pillows propping up my right arm and woke at dawn, in agony.

A slap in the face

Lady with right arm in a sling
Broken collar bone — Image from Amazon UK

Back to the hospital, where they confirmed that I’d broken my collarbone and torn my rotator cuff tendons (muscles and tendons that attach the arm to shoulder blade). I was put in a sling, given strong painkillers and sent home to rest up. But before I left, I went to see how Sarah was. I got a slap in the face, albeit a light one, cos she was mad that we’d saved her. Of course, I told her, I’d do it again.

My painkillers were starting to kick in and I was feeling kinda woozy so any anxiety I’d had about facing Ian all but disappeared. For f*ck sake! The whiff of beer and cannabis about knocked me out as I opened the front door. It was just two in the afternoon, for crying out loud.

Still, I was delighted to see all his boxes stacked in the hall, “Wakey, wakey, time to go,” I sang cheerfully.

The drunk driver and a mad man

Ladies face with tears of pain
Crying in pain

“Can I borrow the car?” slurred Ian as he staggered towards me, hand out for the keys. It would have been funny if he hadn’t been so serious. “Nope! Get a taxi,” I smiled. With that, he lunged at me and grabbed my wrist viciously. “Aaarrgghhh!” I screeched in pain and anger, hanging onto my arm and cursing under my breath.

At that, I heard “Mama,” and Nic was hurtling down the stairs behind me, “What did he do, did he hurt you Mama?” I hadn’t realised he was home from school. Ian shot out the front door and Nic was charging round the kitchen like a madman, cursing furiously. He yanked the front door open and threw out every one of Ian’s carefully packed boxes. Ian looked on helplessly as glassware, cd cases and electronic equipment crashed down onto the road.

The neighbours were out, wide-eyed at the the scene unfolding and I don’t know what was funniest. Ian’s look of helplessness or Nik holding every last piece of luggage high above his head before throwing it as far as he could. The door thudded shut! Nic was trembling and pale with anger, he turned to me tearfully, whispering “I’m sorry Mama.”

We hugged and cried, but this time we cried with laughter. Ian was calling across the road “Can you get us a taxi?”

Over to you

Big red question mark with little white character leaning against it, pondering
Clipart.com

I’ll end here for now and hope you’ll stay with me for the next part. In the meantime, I’d love to hear your thoughts and please feel free to ask any questions.

Who’d have Anxiety, panic attacks and psychotic depression?

Have you ever had anxiety, panic attacks, depression or psychosis?

woman walking on gray asphalt road in between trees and rock formations
My long journey through psychotic
depression – Image by Mitchel Lensink

This is the 9th in a series of “My journey through Anxiety, panic attacks, depression and psychosis. Please click here for Parts I, II, III, IV, V , VI, VII and VIII if you wish to read the backstory (It might make more sense).

I don’t know which is worse; the anxiety, panic attacks, depression or the psychosis. But to have them altogether, spelt H.E.L.L.

For those of you who don’t already know, I started writing about my journey some six months ago. I only ever intended to write it in four posts. However, it’s become clear that my journey was a lot longer and more painful than I remembered. That’s made it difficult to get the words down on paper at times. I’ve taken many breaks and written lots of other posts in between, giving me time to reflect and bounce back a bit stronger each time.

Even when it’s over, it’s not

……………. The boys eventually settled but still refused to see their dad or even talk to him on the phone. However, Tony was still bothering me, as was his girlfriend. She’d call and ask to speak to him then hang up on me. I knew it was her and her ugly sister cos I could hear their brats yelling in the background. I was like, she’s got him now, so why she’s bothering me? I’d later find out (via her friend and my mum) that she was p’d off cos all he did was talk about me and the boys. Oh dear 🙁

Tony called one evening on the pretext of speaking to the boys, who happened to be at my aunt’s for the night. On hearing this, Tony went ape! “Why ain’t they at home, why ain’t you got them at home with you? You got a bloke there? In my house?” he screamed down the phone. “I’m coming round there, I’ll effin’ put petrol through your letterbox. I’ll effin kill you and him, you effin whore.” and the phone went down.

Panic stricken, I called one of my best friends, the one who lived the closest and she was round within minutes. We sat on the kitchen floor, watching shadows dancing on the wall as people passed by in the dimly lit street. We glugged our way through the cheap wine Jane had brought and smoked endless cigarettes. Our hearts leapt every time we heard a car door slam. With her constant digging and questioning, I explained bits of the sorry saga. Much as we all loved her, she got off on gossip and it wouldn’t take long for this news to spread.

Visual hallucinations

White lady with long blonde hair and two horns appear to be growing on her forehead
Psychosis; visual hallucinations

After a few hours, there was no Tony and no petrol the the letterbox, and we realised it was all just bravado on his part. Jane left, somewhat disappointed there was no drama, and I got ready for bed. And then it started.

As I brushed my teeth I caught sight of the lumpy horns, peeking through my fringe. No! Just please, no! Nooooo, I screamed at length, but there was no sound. Perhaps I’d imagined screaming? Urgh! The horns looked hideous against my now pure white face and I thought I was going to throw up. However, I only dry wretched; probably because I hadn’t eaten anything in days.

I felt clammy and shivery, and hot, all at once. I was so confused – I didn’t know if all this was real or was it a dream – tho’ I knew perfectly well that physically, I was in the bathroom. The walls were closing in on me and the room spun wildly. Staggering to my room, I felt out of myself, almost like I was floating alongside my physical self. My heartbeat thudded in my ears, and tho’ I lay down, I knew sleep wasn’t going to be kind to me that night.

I wanted someone, anyone, to help me. It felt like I was drowning in quicksand and at any moment I’d be dragged right under. I couldn’t move and felt cemented to my bed. I just lay there as wave after wave of panic swept over and through me. And despite the weekly counselling, this continued each night.

Pleading poverty

Clear glass jar tipped on its side, with loose coins around it
Struggling with anxiety and lack of money

Some three to four months in, Tony suddenly stopped giving me money towards the boys upkeep. The boys and I were gobsmacked, hardly believing he would do this. It was soon time to start getting their school uniforms and money was going to be even tighter than usual anyway. When I called Tony to ask why he’d stopped, he almost boasted “I got two kids to bring up here, so I can’t afford it.”

“You’ve got to be kidding me Tony. You’ve got two sons of your own and they come first. Surely?”

“Well, her ex don’t pay anything toward her kids.”

“That’s not our problem,” I muttered and he repeated it so his ugly sister girlfriend could hear. So she joined in, shouting in the background, “We ain’t got the money. You can’t have what we ain’t got.”

I was so p’d off and told Tony I wasn’t happy, adding “The boys’ school uniforms need to be bought soon.”

The selfish git growled, “You put them in them posh schools, you effin’ pay for it, and their uniforms.” and the phone went down. This was becoming a habit!

Bring in the big guns

Young woman with straggly long hair, chewing her nails, peering out of a window
This is what anxiety looks like but it feels so much worse!

I nearly jumped out of my skin when Dan came up behind me, gave me a hug and said “You need to take daddy to the Child Support Agency (CSA) mama. It’s not fair on you. He needs to give us some money.” To be honest, it’s not something I’d ever considered but the boys were adamant they wanted me to. So I did. And guess what? When Tony received a letter from the CSA, he packed his job in! He was working for my brother at the time and my brother was p’d off with me ‘cos he needed Tony at work.

He returned to work after a few weeks and he delighted in taunting me, “The CSA’s off my back now and every time you effin’ call them, I’ll jack my job in. So you’ll get nothing!” I was fuming, how can he not want to support his sons? And boy was I cheesed off with my brother keeping him in employment, knowing that he was refusing to pay for his children. He knew everything I’d been through. He knew how Tony had been hitting and cheating on me and now this.

Reduced to charity

I was struggling financially, which didn’t help the anxiety and panic attacks. My aunty mentioned a charity who might be able to help – you just had to be a single-parent from Scotland, living in London, with a parent who had armed forces attachment and had no head. Okay, I made the ‘no head‘ bit up. A lovely little old lady with a Scottish accent turned up at our house with her clipboard and some forms to fill in.

Having taken down some details, she insisted the organisation would provide a substantial grant for the boys’ uniforms. Furthermore, they’d give the boys have £100 each per month towards their books and other needs, right up until they left school. She hadn’t even asked to see any forms of identity or proof that my dad had actually served in the Royal Navy. I could breathe again and this, together with the feeling of relief, far outweighed the considerable shame I’d felt at having to accept charity.

Back to normality

Four young people outside bar enjoying drinks
Relaxing, free from anxiety —
Image by Clipdealer.com

The boys seemed settled, and happy to be back at school in their shiney new uniforms. They were popular boys and constantly had a stream of friends over to stay. I was back at uni and started to go the the local pub once a week with my peers. They were all 10-15 years younger than me but they didn’t make me feel out of place. I laughed when they said I was known as the yummy mummy, way before it was fashionable.

I got chatting with one of the guy on my course, ten years my junior, on yet another evening out after uni. Long story short, we started dating and within months we were talking of marriage. Urrgh, I could cringe now. I realise in hindsight that I got married on the rebound and I knew it would bug the hell out of Tony ‘cos I’d refused to marry him. We had a huge white wedding, all paid for by me, the following year.

Sometime in between the first and the last dance the DJ, who I’d known forever, twirled me round the dancefloor. How we laughed as we reminisced about the old days. Suddenly DJ Dan was dragged from my grasp and my new husband was roaring, “She’s my wife! Get the f*ck off her!” What the? His Geordie accent rising way above the cockney chatter and Aerosmith’s “I don’t want to miss a thing.” All eyes turned as they both stumbled out the front door. DJ Dan’s brother hot on their heels. I followed, knowing that despite my oaf of a new husband’s lunacy, two on one just wasn’t happening.

Was the honeymoon period over?

After wedding gate and Sunday pub lunch with all the family and close friends, off we went on honeymoon to the beautiful Greek Islands.

Big red question mark with little white caricature of a man
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Unfortunately, I’ve got to rest up. I’ve been ill again and can only do things in short burst. I’ll be back and in the meantime, I look forward to reading any comments and I’m happy to answer any questions, as always.

Does Mental Health Rehabilitation really work?

Early shift

memesmonkey.com

As I parked up my first morning, even above Slade’s Noddy Holder screaming “It’s Chriiiiiistmass”, I could hear a female screeching “Medication. I want my medication. Where’s my medication? I need my medication.” The poor neighbours either side of the building must have been well p’d off. It was six forty-five, pitch black outside and the streets were eerily quiet — other than the high pitched screeching coming from the Mental Health Rehab Unit piercing the air.

Someone in the office by the front door pressed a button to let me in and I was greeted by this tiny little lady who grabbed both my hands and panted “Help me. Help me please. I need my medication. You’re new. Are you an Agency Nurse?” Will you help me? Please?”

I spoke calmly but firmly, “Listen to me, I can’t help you right now…” I was trying to placate her enough so that she could hear me and take in what I was saying. At the same time I was trying to get her to take a breath as she was panicking and was as white as a sheet. I really felt for her.

“Please, please. I’m begging you,” she continued to screech, now in my face, as I tried to disentangle myself from the tight grip she had on my wrists. The office door opened and a nurse yelled “Cindy, stop it, leave her alone. Cindy!” I’d now managed to get myself free but Cindy had grabbed the nurse and was pulling on her cardigan, all the while screeching “You’re a bitch. You’re a fucking bitch! Get my medication you fucking black bitch.”

The nurse eventually pushed me into the office and she followed, turning to slam the door in Cindy’s face with a kiss of her teeth “Oh Lordy Lord. That Cindy. She will be the death of me. I am Ayo. Who are you?”

I breathed a sigh of relief and introduced myself as the Student Nurse. “I don’t know. See how it is here. I pray to God for her sins,” humphed Ayo. “Hmmm. Take a seat. Ah! Here come the staff.” and I turned to see two females and one male puffing away outside, the ciggie smoke belching through the office window. “Tsk, Tut. I don’t know. Smokers, heh!” moaned Ayo as she reached to slam the offending window shut.

Seven o’clock on the dot the three members of staff traipsed in, throwing their coats on top of a filing cabinet. Lisa was first to introduce herself as the RMN, the shift coordinator and my supervisor, and said “That’s Lorna, she’s a qualified (RMN) and that’s Graham the NA (Nursing Assistant).” Where’s the fourth member of staff? I thought to myself.

Morning handover

“Okay.” started Ayo, above Cindy’s screeching. “The lady herself. Cindy, she slept and now she has been shouting before six thirty. Lord help me! Everybody still in bed. Only Sasha, she awakes all night but she stay in her room. Somebody needs to clear her room. I saw the mouse there.” My feet moved on their own, up off the floor as I sat on a desk, and I shuddered involuntarily when I was looking around for the said mouse.

Ayo continued and ended with “Moses needs to see a Doctor and his toenails need to be cut. It’s in the diary for this morning. Now I’m going home. Goodbye!” She pulled off her slippers and put them in her bag then huffed and puffed as she bent down to put her shoes on. She grabbed a large woollen blanket and shuffled out of the door.

Lisa went through the diary, handed out tasks to the other two and said she was doing medication and that I should shadow her. Lorna went off to wake up the other nine patients that lived in the ten bedded unit and Graham wandered off to the kitchen to prepare for breakfast.

Medication

With our coffee, Lisa and I went to the medication room, we were met with Cindy who was still gulping in great lumps of air, wringing her hands and saying “Thank you Lisa.” and “Thank you nurse.” to me. Yes, I could get quite used to being called Nurse.

“Right Cindy. You know we start titrating down your Diazepam today.”

“No, please Lisa. Not today. I can’t cope. I can’t cope!” Cindy screamed.

“Nought point five milligrams Mandy. You won’t even notice it.” Lisa tutted and turned to me. “She’s been on thirty milligrams three times a day for years and you can see it doesn’t reduce her anxiety. So we’re going to try titrating down while she’s in Rehab.” Cindy lived in a one bedroom flat and had apparently relapsed over a period of six months prior to admission to an acute ward. Once stabilised she was transferred to rehab.

Cindy had generalised anxiety disorder (GAD) which is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event. 

People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue. Titration looked like it would go on forever, reducing her Diazepam by nought point five mg three times a day. However, Cindy eventually accepted the reduced dose and greedily swallowed down all her medication, followed by gulps of water, then scurried off to the dining room.

Breakfast

We continued until each patient had had their medication then joined everyone for breakfast in the dining room because, on rehab, we were encouraged to eat with the patients each mealtime. Lisa waffled something about nurses having a responsibility to role model table manners and eating with the patients was supposed to encourage healthy eating. I wasn’t sure that this was an evidence-based intervention but I went along with it anyway.

Coffee and toast with jam was just what I needed but as I sat to eat I was immediately struck by an offensive odour. One older lady to my left had obviously not washed or brushed her teeth, yet there was another disgusting smell.

Graham screwed his nose up and said “She’s just sat there and shit herself and carried on eating!” to nobody in particular. “That’s Elsa.” he whispered with an Aberdonian accent. “She normally goes to the toilet but she uses her clothes to wipe herself and then hides them down the back of the toilets, eh Elsa?” he now boomed. “Elsa, say hello to Nancy, she’s our new student.” Elsa’s face was buried in the huge breakfast she was picking up with her teeth. She raised her head and gave me a toothless grin.

None of the staff got up to help Elsa so I offered, but Graham told me “No. Wait til after breakfast!” And this is rehab? I wondered — does it really work?

Around the table, there was belching, farting and one young chap was trying to snort back the snot that was threatening to hit his top lip. He eventually gave up and wiped a huge glob on the sleeve of his t-shirt leaving a silvery snail-like trail.

Coffee finished and my toast in the bin, I helped clear the table and took my time in the kitchen. I was hoping someone would deal with Elsa, as I was already feeling queasy. Fortunately, she’d gone by the time it took me to do the dishes but she’d left wet poop dribbling down the chair legs. Gloves and apron on and ten minutes later the chair was scrubbed and left outside in the back garden to dry.

Activities of daily living

To the bedrooms on the first floor now where I tried encouraging patients to wash and dress before attending any appointments or activities. Oh my word! I’d knocked and opened the door to Sasha’s room and was aghast at the cereal boxes piled as high as the ceiling. At a guess I’d say there must have been over two hundred boxes and the only other floor space was filled by her bed and two or three black sacks.

“Get out of my room.” stormed Sasha as she pushed me and slammed the door. I stood for a few seconds, stunned, then knocked and called out “I’m a student nurse Sasha. Is there anything I can do? Would you like me to help you clean your room.”

“Get lost.” Sasha muttered. I went to find Lisa and asked what I could do to help Sasha. “Not a lot,” Lisa laughed. “Her room’s been like that forever. She won’t let us in.” That can’t be right. Surely we have a duty of care? I went to the office to look through Sasha’s file and her painstakingly completed but outdated care plans to see if I could find ways to engage her.

I read that she was single, had no children and had been in care since the age of eleven when her mother couldn’t cope with her chaotic behaviour. She was thirty one and was diagnosed with Schizophrenia at eighteen. Sasha heard voices and was often heard talking back to them when alone in her bedroom. Apparently Sasha had no insight and didn’t believe she had a mental health problem. She’d been on the unit for six months and was awaiting housing but it was proving difficult to find a place that would meet her needs.

I decided then that I’d be really firm with Sasha right from the start, telling her that we have a duty of care to ensure that her environment is habitable. If she wouldn’t clean it herself, then we would have to do it! It annoyed me that staff had let her live like this for months. Even if Sasha had refused to let them clean it, surely the staff could have come up with a plan between them.

It was exhausting and often thankless, but I worked hard with Sasha for the next twelve weeks, updating her care plans and engaging her in meaningful activities; things that would both interest and help her rather drum banging or painting by numbers. I appreciate that one of her care plans previously stated ‘Engage Sasha in activities.’ But, while these particular activities may help with dexterity and fine finger/hand movement, I wasn’t sure they would support her development. It was clear that certain staff had intermittently tried to push Sasha into any activities and wrote in her notes ‘Declined to attend.’ I wondered why!

I’d eventually learned more about Sasha, along with the other patients on the unit, and had managed to form a professional bond with each of them. As I got to know them better, often by engaging them in friendly banter, I was better informed about their likes and dislikes. It was easy to see they weren’t interested in particular activities and that they had their own ideas about how to spend their time.

Mark liked football so I’d have a kickabout with him in the gardens – he was quite good – so encouraged him to attend the local leisure centre where he could access different types of exercise and look out for a local football team to join.

Jenny loved knitting so we bought her knitting needles, a few patterns for baby clothes (that she requested), and some wool. She wasn’t great, dropping more than a few stitches, but that wasn’t the point. She enjoyed it. Other staff who could knit helped her unpick and start again. Eventually, with the help of staff, she started her own small weekly knitting group on the unit.

We also got a group of patients to go swimming once a week, with a member of the team. We also went to the local pub once a week so that some of the young lads could have half a pint and a game of pool. They’d never felt comfortable going into a pub previously, because they were worried about what other people thought. We quite often did get some odd looks but as a rule, the regulars were great – helping the lads with their game and showing them trick shots.

At the end of my placement I loved seeing Sasha and the others laughing, smiling, engaging and growing in self-confidence and once again, I was sad to leave.

I would later bump into some these patients in various settings i.e. in the community or on the wards and I was either saddened by their relapse or delighted by their continued improvement.

Note to self: “Public service must be more than doing a job efficiently and honestly. It must be a complete dedication to the people and to the nation.” Margaret Chase Smith.

Anxiety on placement on an acute in-patient ward

My first morning on an acute in-patient ward

Staff photo board on an acute inpatient
mental health ward

Beyond the door, people were milling about in all states of undress, one lady baring her breasts as she had a hospital gown on backwards and the ties were undone. Fortunately she had knickers on, albeit they were large white paper ones, which covered her modesty. Others had hospital-issue pyjamas bottoms on, some bare-chested and barefoot while some had on what looked like their own dressing gowns, clothing and footwear.

I could see more dusky coloured walls, on the left was old artwork, curling at the edges and hanging precariously with tattered tape. A large perspex covered board with photographs of unsmiley people and nametags, who appeared to be staff, hung on the right. Alongside, was a wonky shelf with welcome leaflets and other ward related information. Looked like someone had a fallout as they’d scribbled on the perspex over one particular nurse’s face.

Which one is the nurse?

Heart thudding and having pressed the buzzer to get in I watched as this guy, who looked like an all-American Quarterback sporting a huge white smile, sauntered lazily towards the door. He unlocked it with one of the keys from a large bunch and nodded me in then he locked the door behind me. I guessed that, because he had keys dangling from his belt, he was staff.

Other than the pyjamas, it was difficult to identify who was a patient and who was staff. Man mountain was wearing jeans, a sweatshirt and trainers. He introduced himself as Adeola and pointed me toward the nurses office where, because the door was locked, I stood for a few seconds, hoping one of the three people in there would let me in.

“Hello. You must be Nancy, our new student. Come in now, come sit. Moreblessings get up and give this wee lady a seat now, will ye?” A young Northern Irish guy also in jeans, t-shirt and trainers raced on “I’m Derry, that’s Moreblessings and there’s Abimbola, Nancy. Would ye like a wee cuppa tea Nancy, would ye? Give us a wee minute and we’ll get ye one, eh”? I loved him already and despite some humphs and tuts from Moreblessings, I knew I was going to like it here.

The office was tiny. There was a rickety desk with some stacked filing drawers, a telephone and some office paraphernalia on it, and two old swivel chairs. Two battered-looking four-drawer filing cabinets stood opposite each other, a formica top stretched along one side of the office and held a fax machine, photocopier and few loose files.

Above was a couple of  flimsy shelves holding lots of precariously balanced files and some nursing books. Dressed in a neat flowery jumper, a calf length skirt with thick black tights and flat black shoes, poor Moreblessings huffed and puffed her bulk out of the chair in the far corner, between the filing cabinets, to give up her seat. Derry slid into her empty chair, leaving his for me.

The troops arrived

Just at that, the office door burst open and in bungled two others, out of breath and laughing as they attempted to get their coats off in such a small space. “Yer late again Alison, Fadhili. Come on now. Hurry up.”

“Keep your hair on, I’ll just grab some coffee.” giggled Alison as she winked at me.
“You’ll just not. Come on. Some of these folks want to go home this morning.” said Derry. “Anyway, this is Nancy, our new student.” he added. Alison smiled and Fadhili nodded at me.

The heat from the six of us steamed up the office window and I was getting a rather icky whiff of body odour, badly covered up with strong but not unpleasant cologne. However, as Alison sat her neat bum on the table edge, she was closer to me and the sweet, floral scent that she wore helped mask the other smells. She too was wearing faded jeans with a striped shirt and trainers while Fadhili had on trousers, a shirt and tie and shiny black mock croc shoes.

Derry looked towards Abimbola who started to read out names from  a large whiteboard on the wall. “Helen, slept all night, no problems. Peter, he’s okay, just waiting to go home. Isaac, restless and sat in the day area most of the night.” He went on, discussing the twenty patients on the ward that morning. This was called handover and it happened at the beginning of each shift. It was brief and didn’t give me too much information, but enough to begin with as I had to memorise the staff names first.

Finished, Abimbola snatched up his coat and heaved his large frame through everyone and left the office, waving wearily as he went. It was like a mass exodus then, as everyone else made a mad dash too.

Was it still only 8 o’clock?

“Coffee Nancy?” I heard Derry say over his shoulder as he went next door to the kitchen so I followed him and said I’d have a coffee with milk. Out came the toaster, cereal and coffee mugs, clattering onto the stainless steel worktop and I watched as some staff helped themselves to breakfast. Derry just made two coffees and handed one to me saying “Do you smoke Nancy?” As I nodded he made eyes at me to follow him and we crossed the narrow hall to the smoking room.

We walked into the stench and a dark yellow fog that you get when there’s half a dozen smokers and no ventilation. The smoke stained windows were open but only half an inch, obviously so no one can escape. Several pairs of lifeless eyes turned towards us, though many remained staring blankly, either at the grubby windows or the soiled floor which was littered with fag ends, empty crisp packets, screwed up plastic cups and old cola tins.

Derry sat on one of the chairs, inviting me to sit next to him, and I hoped my fixed smile hid my disgust at the state of the stained chairs with their cigarette burns and other unidentifiable debris.

Still, I smiled around nervously and offered my introduction “Hi, I’m Nancy and I’m a new student on the ward.”
“Alright Nancy. I like students. You got a spare fag?”
Derry interrupted “Pete, the wee lass just started today. Leave her alone.”
“No it’s okay.” I said and offered the pack to Pete then watched as others eyed the box, willing me to offer them one too. I didn’t feel I had a choice so I was five ciggies down already, and it was just gone eight o’clock.

Medication. Medication. Medication.

At that, there was a loud rattling of the kitchen hatch going up and Moreblessings was yelling “Breakfast time, breakfast……” as she loped along the hall. “Time to move.” said Derry. “I’m your mentor for this placement Nancy, but bear with me and I’ll catch you up in a wee bit. I’m coordinating the shift today. Have a wee seat, chat to a few patients and see how you get on, eh?”

Moreblessings was still yelling and now Fadhili had joined in, “Medication,” he sang and I watched as he went down the hall, knocking on bedroom doors “Medication. Breakfast. Medication………” Patients trickled out from rooms, heading in various directions, some to the hatch between the kitchen and dining room for breakfast and others towards the queue for medication. One or two just flopped on chairs in the living area and gazed at the television.

I thought I’d be best in the kitchen helping with breakfast, as there wasn’t much I could offer on the medication side, being a new student. This also aided in putting a wide barrier between me and a slightly aggressive young female who was eyeing me up and down and glaring at me. However it didn’t protect me from the stale morning breath and unwashed bodies.

There was no queue as such and patients just leant over each other to reach for cereal, milk and sugar or the hot buttered toast, some burnt and some still white. Not sure if this was a defect with the toaster or the domestic, who was also busy handing out green plastic cups of hot water so that patients could add either tea or coffee. Drinks and cereal sloshed as patients shuffled to small tables in the dining area.

Soon, vacated tables had crumbs, slops and spills so I went round the other side of my barrier to wipe some of it up, but I practically flew back when Mandy, I learned, screamed, “Fucking lesbian. Stop fucking staring. You ugly white bitch.” This was the young lady who’d earlier on, had her nightgown on back to front. “Oh, ignore Mandy. She harmless really.” said Mrs Farrell, this tiny, sweet domestic lady in her Jamaican twang “She just having a bad morning.”

Meeting the patients

Breakfast was almost over and the last of the dawdlers were still in the queue for medication. I popped into the office to see that Derry had allocated patients to the four staff on duty; two qualified mental health nurses being Derry and Alison while Moreblessings and Fadhili were the  two nursing assistants. I had Supernumerary status which means that student nurses are additional to the clinical workforce and undertake a placement in clinical practice to learn, not as members of staff.*

I asked Derry what I could do to help as I was feeling a bit like a spare part and quite out of my depth, what with Mandy following me, cursing like a sailor on a drunken holiday! Derry said to just shadow one of the staff and not to worry about Mandy; she’ll be fine after some medication. Alright for you to say,  I thought as I bumped into Mandy when I backed out of the office and turned with a wobbly smile to say “Hi, I’m Nancy, a new student here. Is there anything I can I do to help you this morning Mandy?”

“Ah, you’re a student, I thought you was one of the Doctors, I ‘ate Doctors. Ask if I can have leave, will ya? It ain’t ward round today and that’s the only time you get to ask for leave, but I’m not fucking waiting ’til Wednesday. I need some clothes, look at me in this fucking dirty ‘ospital gear.” she ranted.

I asked where her clothes were, what did she come in with and whether we could perhaps find them together. “They ain’t here. Someone nicked them in the night. Jealousy, that’s what it is. Jealous cos I’m a model and I get given good gear to wear. And that’s why they nick it. Fucking poofs and lesbian, all of them. And the staff, they’re at it too. All of ’em” she rambled. I didn’t know what to think about her clothing. I offered to help find her clothes but she wandered off, still cursing and muttering. Quieter now though.

“Go and have a wee break Nancy, you deserve it.” Derry grinned.

*Nursing & Midwifery Council, 2014