2. I was assigned to [an ED] patient who had overdosed
on antidepressants. Although he assured
the staff that this was not a suicide attempt, they
still wanted him to be observed. The doctor was
in the room with him and informed me that it
would be a while, so I went to the activity room
and obtained a few magazines, a checkerboard,
and a book of crossword puzzles. Once the doctor
left and I had him settled in, I asked him how
he was feeling. He told me he was feeling very
anxious and . . . depressed and had taken too
many pills to try to make himself feel better. He
told me about all the bad things that had happened
to him in the past few years and the more
he talked the more upset he appeared to get. Since he was on a cardiac monitor I was watching his
heart rate and blood pressure rise as he appeared
more and more anxious. I asked if he would like
to play a game to get his mind off of things. He
looked relieved and gave me a very enthusiastic
“yes!” He wanted to play tic-tac-toe, but after
beating me four times he decided I wasn’t very
good and we moved on to checkers. He beat me
in checkers as well and the game had us laughing
and making fun of my terrible checkers skills. After
about a half hour I noticed that his vital signs
had returned to normal, and he appeared much
more relaxed. He was enjoying himself and having
a lot of fun, even though he was not in the best
of situations. . . . I went home that day happy,
knowing that I had made a difference. Although
I could not change his situation or fix the problems
in his life, I could at least help this man to
find something positive in the situation which
was probably one of the darkest days of his life.
3. The patient was a 70-year-old female displaying
agitation and resistance to care. Her initial preintervention
ABS score was 28. After listening to
Christian music, the patient became more calm
and cooperative with medical treatments. Her
ABS score was 19 during the music and was 18
one hour later.
4. The patient was displaying impulsive behaviors,
specifically trying to leave the unit, and was having
trouble expressing thoughts in a clear manner
with [an] ABS score of 19. While playing cards
(War) with the observer, the patient became calm
and was now able to express self more clearly.
The ABS [score] decreased to 14 (no agitation)
and remained that way following the activity as
the patient went to sleep for the night without
awakening.
5. The patient was an 80-year-old gentleman with
hearing impairment experiencing delirium. He
displayed repeated attempts to leave the bed and
became angry when not allowed to do so. The observers
took the patient for a walk in the hallway.
A rolling walker was used to increase stability and
safety. While walking the patient became less angry
and actually began to reminisce about his life,
sharing his past occupation as an architect. When
he returned to his room, he was given colored
pencils with which he drew a plan for a building.
6. The patient was a 40-year-old male with alcohol
dependence. He began expressing fears of being
shot. The preintervention ABS score was 38. The
observer offered to play cards with the patient,
which resulted in a calming effect after only a
few minutes. He began smiling, laughing and expressed feelings of trust. The ABS [score] while
playing cards was 21 and was 14 one hour after
the activity.