Parkland 4: Psych

In the 80’s, Parkland’s “Psych Pit” included patients who were mentally ill, suffering from alcohol and/or drug dependency, the homeless, the hungry, and those involved in messy divorces.

Yes. Messy divorces. It was trendy back then that in order to “stick the knife in and twist it” you could have your estranged spouse served with a Mental Illness (MI) Warrant.

The procedure was a simple one…

1. Complete the appropriate paperwork and attest that your spouse is a danger to themselves or others.
2. Have the document signed, before a notary and sealed.
3. Courier the affidavit to the Dallas County judge who would review your claims and then endorse the “MI Warrant” with his/her signature.

Dallas County Sheriff’s Deputies would then be dispatched to your estranged spouse’s home or place of business, handcuff them and take them to Parkland’s Psych Pit. At that time, Texas Law gave the state the right to hold the above-mentioned spouse for 72 hours in order to determine their competency.

Needless to say, we had some very pissed off estranged spouses.

Staffed with one Registered Nurse and one Psychiatric Intake worker – I had been warned by my peers that Psych was "each man for himself". The Psych Intake worker usually hid out in a small booth in the back of the Psych office - the ER Nurse managed the "Psych Pit" and was responsible for ...

• Meeting and Greeting patients, police, sheriff’s, paramedics.
• Crowd control
• Searching pockets, removal of belts, boots, matches, guns, knives and/or anything that could be used for inflicting injury or used as a weapon.
• Initial Psychiatric Nursing Assessment and Documentation
• Medication Administration
• Self Preservation

During my orientation, the topic of “self-preservation” was addressed by the more seasoned ER nurses at lunch…

1. Buy a pack of cigarettes before starting your shift – it will make it easier on you (it was the eighties and smoking was allowed in hospitals).
2. Make friends with your psych patients. They’ll help you out if somebody goes ‘nuts’ on you.

Oh God.

I soon learned that the cigarettes were not for me, but to be used as a way to entice the psychiatric patient into being my friend.

Manipulative? Yes.
What can I say? We did the best we could. We survived.

Parkland: Pedi ER - Part 1