Check-in at an Inpatient Children's Psychiatric Hospital (Chapter 4)

Check-in at an inpatient children's psychiatric hospital was a much more bearable process than I anticipated.  I did cry a few times, but it could have been much worse.

After all we had already been through the traumatic experience of the police being called to our home, the most horrible ER experience ever, and then the second ER experience that brought us to where we were now.

The check-in process took several hours, but this was a good thing, at least in my opinion.

The staff asked so many questions about Sunshine.  Some had to do with behaviors and medications, but others had to do with her preferences, interests, daily routines, rituals, and basic needs.

They were sincerely interested in making the situation as pleasant as humanly possible for all involved.

I was calmed immediately.  My biggest worry was that Sunshine would not be taken care of well and I would feel even worse than I already did leaving her there.

Working on Attachment While Separated

The only challenge we would face during Sunshine's time in the hospital was that they could not accommodate Sunshine's food allergies.

Understanding the severity of them quite well, this was not unexpected.  We agreed that we would bring meals and snacks for them to store there.  This was not the easiest thing to stay on top of but I still was so thankful we were able to do it.

Bringing Sunshine's meals to her meant that I was still able to take care of her in some way.  Food is EXTREMELY important to Sunshine and is entangled in her attachment issues.

For her to know my husband and I were preparing her meals meant that we were still connecting in some way every day, even if we weren't there with her in the moment.

The Facility

Sunshine joined us during check-in after she had settled.  I hadn't expected this, but was so thankful to see her again.  Parting in the elevator as she was strapped in wasn't how I wanted to say goodbye.

After I had finished with paperwork and locked up any personal items I had with me,staff led me to Sunshine's room on the main floor, locking every door behind them as we went.

I had been warned about this process, that I may be disturbed by how other children looked, how the place presented itself etc.

Surprisingly, the experience did the opposite for me.  The main floor was beautiful with murals painted on the walls.

Sunshine had her own room.  It was clean, bright and accommodating.  Staff quickly learned they would need to move the desk and chair, but other than that it was perfect for her.

I saw other children.

I saw other parents.

No one was distraught.

Nothing I saw was disturbing.

Our New Normal

The hospital gave me a daily schedule that Sunshine would follow if she was able.

I was given information about visiting hours held twice a day and times that I was permitted to call if I would like to speak to Sunshine.

Staff explained that Sunshine would have a one-to-one aid with her at all times due to her age and behaviors.

She would have daily check-ins with at least one therapist, a psychiatrist and more.

In my mind there was no doubt that this was exactly what she needed.  To be observed so closely for an extended amount of time...

Doctors appointments every six weeks to three months that last only 90 minutes just weren't cutting it.

Part of the paperwork process was setting goals for Sunshine and what we would like addressed while she was there.

We were informed of ways they may need to intervene if she became aggressive or dangerous in any way.

Nothing on that list was anything we hadn't had to do at home under the advisement of our developmental pediatrician.

The most difficult part of check-in was that Sunshine needed to be searched.  They used a metal detector but also required her to remove her shirt etc.

Sunshine was not having this AT ALL.

In the end they were accommodating which we appreciated.

I was introduced to the one-to-one Sunshine would have for the night and was allowed to help settle Sunshine before leaving.

When it was time, the staff distracted her with a preferred task after our goodbyes and that was it.

After Goodbye

I  was leaving my six-year-old daughter at an inpatient psychiatric ward.

Walking out of the doors of the hospital without Sunshine was an experience that I still can't put into words.

Even more awkward, I didn't have a vehicle with me.  My husband needed it for work and transporting the other kids.  Our therapist had brought Sunshine and I to the ER the day before.  The ambulance had brought us here.

I was waiting for a ride to pick me up.

So I sat on the front steps.

It was a beautiful day.  I had not been outside since the beginning of the week and couldn't help but soak up the beauty around me.

Having a few minute before my ride came, I called my husband and I gave him an update about all that had gone on.

And that was it.

By the time I left the hospital my body was pretty numb to emotion.  My stress level was through the roof.  It seemed I was in auto pilot mode when it came to basic functioning.  And as far as eating was concerned, I wasn't the least bit hungry and when I was, all I wanted was ice cream.

I had never been so thankful for a ride home with people I had known for years, who knew me before kids, before marriage, and before Sunshine.  It was the perfect distraction.  And I'm not sure I would have been in a place where I could have driven myself.

Yes, they asked questions and made comments.  Yes, they expressed their sincere and loving emotions about the situation, but all of this was so much better than being in my own head with my own thoughts alone.

The reality was I had just left my daughter at an inpatient children's psychiatric hospital by herself.  Never had she ever spent a night away from home.  Never had she ever spent more than a few hours with others.

Distractions were good.

If you enjoyed this post, you want to know what happened that put our family in the situation we were in, or know what happened next, feel free to read the posts below.

What Should Happen When Your Child is in the ER for Mental Health Reasons (Chapter 3)

It only took a day to realize that the experience of riding in a police car and two days in the ER did nothing to help Sunshine's behaviors.

She was still in crisis.

There was nothing anyone could do to make this madness stop.

It was time to return to the ER.

After our experience in the first ER, several therapists and specialists recommended taking her to an ER over the mountain nearest our home, only 45 minutes away.

That's what we decided to do.

So the arrangements began.

This time we experienced what should happen when your child is in the ER for mental health reasons.

Our intensive in-home therapist drove Sunshine and I to the ER while my husband stayed home with the other three kiddos, packing lunches and getting them ready to be shipped off to friends' homes for the day until he could pick them up after his shift around midnight.

I had already packed everything I knew I would need before Sunshine woke up.  It was all ready to go.

Admittance

At the ER, we were immediately taken back to check in.  During that check-in process Sunshine made it clear she was not happy to be there.

No one questioned what we were telling them.

We were escorted back to a room designed for someone who is a danger to herself or others.

They were taking us seriously.

To be believed was such a incredible feeling.

The Room

The room had one chair, a hospital bed, a sink and a TV encased in a protective shell high up on one wall close the ceiling.

One wall was metal, as if it was a pull down door.  The main door to the room had a second smaller door inside it with a lock, in case it was needed.

All of my things were locked in a set of drawers right outside her room.  I was permitted to have my cell phone so long as I could prevent her from reaching it.

Care

Nurses immediately came in to get vitals, obtain information about behaviors and help us settle.

They were compassionate. They were caring.  They were respectful.

Seeing Sunshine's agitation, the head nurse, who happened to be male, immediately set up a plan of incentives and reinforcers to prevent any unsafe behaviors.

A security guard came in with a metal detector to make sure Sunshine wasn't hiding anything under her clothes. Having traveled by airplane, Sunshine was familiar with this process.  We called the wand a "magic wand" so she was a bit more excited when it happened.

In less than an hour a medical doctor with a nurse was in Sunshine's room to do a full exam and once again ask about behaviors.

A psychiatrist came to the room shortly thereafter to speak to me.

There was no question that Sunshine needed help.

Everyone believed me.

Behavior Protocol

In between people coming in and out of the room Sunshine was extremely agitated.  She tried to elope several times.  When I would block the door she would become aggressive.

I was unaware that there was a camera in the room when this first started.  It took only seconds after her aggression started that nurses were in the room trying to calm and redirect her.  They had been watching at the nurses station.

All of use knew that Sunshine was not herself. She was in crisis.

The nurses were kind and loving towards her, knowing she needed help and that this was not her normal.

There was no judgment towards Sunshine or me as her parent.

I broke into tears of relief for the immediate help and support.  No longer would I have to do this by myself like we had in the other hospital.  These people really cared and wanted to help Sunshine receive the help she so desperately needed.

These episodes of aggression happened several times with multiple interventions.

Realizing that it was not safe to leave Sunshine in the room with me or by herself, the nurses made a plan to have a third person join us in the room to try to distract her, with a security guard outside the door.

Our helper was an EMT. She brought in crayons, coloring books, stickers, and fun activities to do with Sunshine.

No restraints were permitted in this hospital.

A request for a sedative was put in to the doctor.

The approved request took a couple of hours.  Our helper stayed with us the entire time.

The oral medication was given with applesauce.

There was no trauma.

There were no needles.

As far as Sunshine was concerned, she just needed medicine to help her feel better and was having a yummy snack.

A security guard and helper remained with us until everyone was sure the sedative took affect.  They would not leave until they knew Sunshine could be safe.

I thought I would be more upset with my child being sedated, but after so many days of continued aggression I had nothing left in me to give and knew this was the only way to calm her down until we could get help.

The sedation was a tremendous help when it came time to get blood work later on.  It took three of us to hold her down even with the sedation, but we were able to make it through it.

Blood work was the most traumatic experience of our stay at this ER.

The Waiting Game

Once all of the doctors and nurses had finished their jobs, the waiting game began.  There were still no beds available.

The head nurse placed an order for Sunshine's dinner when it was time.  Her food allergy diet was followed to the T.

After dinner Sunshine quickly fell asleep.

My husband arranged for a friend to bring me dinner and visit.  It was so nice to have someone to talk to.  Otherwise I was just watching TV alone.

While at the hospital I couldn't charge my phone except for at the nurses station, so I had to stay off it as much as possible.  No outlets were in Sunshine's room.  Cords were not permitted.

Sunshine woke up briefly. The sedative made her extremely agitated.  We laid in her hospital bed together. I rubbed her back until she was down for the night.

Staff did bring in a reclining chair, but the hospital bed was far more comfortable so we slept together all night long.

Night staff were great.  They would watch Sunshine if I had to run to the bathroom.  If I needed my drawers unlocked, they would do so.

During the night they did not wake Sunshine for vitals.  And in the morning, they let me know they had ordered both Sunshine and I breakfast trays.

By morning the sedation had warn off.  Once again we went through the same series of attempts at elopement and aggression.  A security guard was brought into the room to help until the sedative arrived and took effect.

Once again there was no trauma related to the experience. The security guards and helpers were so wonderful bringing in activities to do with Sunshine.  Everyone was so kind.

Sunshine and I then spent the day watching TV, walking back and forth to the water cooler and to the bathroom still waiting for a bed.

At lunch time, once again trays were ordered for both Sunshine and myself.

And then it happened...

Transport to a Children's Inpatient Psychiatric Hospital 

At about 1 PM, a nurse came in.  She had come to announce that a bed had opened up at the child psych ward closest to the hospital where we had prayed Sunshine would be admitted.  (It was the closest one to our home and so many had raved about it.)

The psych ward had initially wanted to take another child waiting but the nurse pushed them to take Sunshine.  I cried tears of joy and gave her a big hug.

Sunshine was sleeping again at that point.

I was in shock and so relieved we didn't have to spend another night at the hospital.

More paperwork had to be filled out.  More vitals needed to be taken.  Another physical exam was given.  A security guard swiped her again with the metal detector.

By 4 PM, paramedics arrived for transport to the inpatient facility.

Sunshine was quite anxious about this process.  One of the paramedics was amazing with her, walking her through the process of being strapped into the stretcher, helping her adjust to the movement of the stretcher while walking her through the halls to the ambulance.

I never would have thought that the ambulance ride would have bothered me so much, but even as I write this I tear up.  The emotions I felt in that moment as she was loaded into the ambulance...  It was so hard to hold back tears.

I was unable to sit in the back of the ambulance with Sunshine, but her favorite paramedic was with her.  My spot was in the front.

The paramedic driving could sense my emotions.  He spoke with me the entire way to the inpatient facility.

Never have I been so thankful for the kind and gentle voice of a stranger who could not imagine what I was feeling, but could keep me calm in the moment.  He had a special needs child at home too.

The ride was short.  We were met at the door by nurses who took me one way and Sunshine another.  And that was it.  My daughter was officially being admitted into an inpatient psych ward after four days waiting in two different ERs.

If you enjoyed this post and/or you want to understand what brought us to this point or what happened next please read the posts below.

What You Don't Want to Have Happen When Your Child is in the ER for Mental Health Reasons (Chapter 2)

The police had already arrived with Sunshine when my husband and I made it to the hospital. I was taken back to see her as my husband filled out admissions paperwork.

When I was brought back to be with Sunshine I thanked the police officer for his help and asked how she was on the way.

He quickly replied that she was great and walked away shaking his head.

Next came the nurse, bringing Sunshine something to eat.

“She has food allergies.” I said as quickly and as kindly as possible.

“I know. She told me.” That was all the nurse said and walked away shaking her head.

This.

This was exactly what I feared most.

No one believed me.

Sunshine was acting like a perfect angel. And I was the crazy parent. I was already being judged harshly for seeking help for our family.

My husband came in at that moment. I asked where Sunshine’s therapist was as she had also followed us to the hospital.

They weren’t letting her come back.

“Go get her now! Do whatever you need to do. I NEED her back here with me.”

There was a cross between panic and anger in my voice. I couldn’t do this alone.

Already the story of what you don’t want to happen when your child is in the ER for mental health reasons was unfolding.

Sunshine’s therapist did join me shortly thereafter. My husband had to go to work and we knew it was going to be a long night.

And it was, but nothing happened as I thought it would

Just the Beginning

We changed rooms three times. The last time being at 10 PM right after Sunshine had finally settled down. Only the first room was set up for those with mental health issues who were a danger to themselves or others. Talk about making a difficult situation worse!

I thought we would at least meet with a doctor or something, but that wasn’t the case. A nurse practitioner spoke with us for less than two minutes and then I was asked to skype with a psychiatric on call nurse.

She looked at Sunshine for less than 30 seconds and then asked me a couple of questions. From there she said she would seek voluntary placement at an inpatient psychiatric facility for children.

After that we were literally left alone, shut up in a corner room as if we didn’t exist.

I asked about dinner for Sunshine.

“Sorry, the cafeteria is already closed.”

I asked if someone could watch Sunshine so I could make a phone call. Sunshine doesn’t let me talk on the phone. I needed to figure out what was going on with my other three children who had been shipped off with friends and neighbors.

With a look of disgust the nurse said she would try to find someone. A security guard eventually came in.

While I was on the phone, Sunshine pushed the code button sending the ER into a frenzy.

Sunshine takes her medications every evening at 8:30 PM. At 6 PM I mentioned this to nurses. It was at 9 PM that they informed me they didn’t have her medications and could not get them. We would have to have them brought in from home.

I wanted to cry.

So this is what it’s like when a parent seeks help for their child with mental health issues.

We remained in the ER for about 36 hours. While there, nurses brought Sunshine food she was allergic to. They showered her with gifts of stuffed animals, bubbles, balloons, and more. That’s on top of the unlimited TV time.

Sunshine thought she was on a vacation where everyone catered to her.

Meanwhile I couldn’t leave her room to go to the bathroom, get food or drink for myself, or do anything. Sunshine was my problem and everyone in the ER made that very clear.

I wasn’t sure if I should keep her as calm as possible or let her loose on hospital staff. As I spoke with other community resources, they said to keep her calm, as it wouldn’t speed up the process of finding a bed for her. None were to be had.

And that’s how it went. My husband switched off with me as he had the next day off. But still we made no progress. He petitioned the magistrate for involuntary placement, in hopes that we could speed up the process of getting help. The magistrate granted the petition, but then it just went downhill again.

More Defeat

Instead of a police officer simply standing outside of the door when the petition was granted, the captain of the police department along with an officer came and spoke to my husband. They were not on board with this.

Their concern being how traumatic it would be for Sunshine to be transported in a police vehicle to whichever hospital was selected for her placement.

As my husband explained behaviors, the police officers just shook their heads.

To be the parent that no one believes is terrifying, especially as you try to protect your other children.

In the end the woman screening Sunshine decided to deny involuntary placement for two reasons.

1. The transport to whichever facility was selected would be too traumatic for such a young child.

2. She was worried about Sunshine being safe in the state facility if that was the only option, as they’re required to take her.

My husband was literally handed discharge papers as Sunshine was beating him up.

We were furious and felt so broken.

What Now?

As we left the hospital Sunshine accelerated again. We had to wait for 30 minutes in the parking lot before leaving because she wasn’t safe.

Other mental health professionals had told us to take her to another ER if things didn’t work here.

My husband and I literally parked at a gas station for another 30 minutes to figure out a plan.

That’s when we decided if nothing else, we needed sleep and we knew Sunshine would sleep through the night with all of her medications.

After a police transport, 36 hours in an ER, and no progress made, we brought Sunshine home.

No one would help us.

If you enjoyed this post, you may also enjoy the posts below.

Call the Police! (Chapter 1)

I kept telling myself if we could just make it to the therapy appointment, we’d be okay.

It had been a week full of rages and aggression.

For the first time ever I found myself using the word violence to describe it.

Everyone was hurt. Some even had bruises.

It was the perfect storm of triggers.

No matter what we did, no one could make it stop.

I had cried every day.

We needed help.

But every time I thought to call the police, I knew she’d calm down before they arrived, and no one would believe me. I was just a bad parent who couldn’t control their child.

After all who could imagine that an innocent six-year-old child could be capable of so much.

Call the Police

The Therapy Appointment

The therapist arrived Monday at about 12:15 PM. She listened as my husband and I recounted all that had gone on during the past week. I cried once again.

Dinomite, Bulldozer, and Princess shared all that had happened to them.

I had taken video of one of the most mild incidents, explaining that I had replayed it over and over trying to find the magic word or action that would make it stop.

I showed it to the therapist.

If I could just figure out what I was doing wrong… Surely there was something I could do differently, even though I felt like I had exhausted all of my options.

But that’s when she said it.

“This is not okay. Sunshine is in crisis. Your family is in crisis. You need help.”

And just like that she started making phone calls.

My husband and I looked at each other. At that point I can’t recall if we were more devastated, feeling as if we had failed, or if we felt relieved and validated that what we were experiencing was as horrible as we thought it was.

The bottom line was the therapist knew Sunshine wasn’t okay and we needed help.

Phone calls seemed to lead no where as we’re just barely established here and supports are minimal.

But then it happened.

Make the Call

We were all outside enjoying the weather. The kids were playing. Sunshine had just left the porch after speaking with her therapist.

As she passed Bulldozer she punched him.

The adults intervened.

Sunshine just accelerated.

I had to go get her.

That’s when she started hitting and kicking me.

I was trying to calm her. I was trying to comfort her. But nothing worked.

She just kept punching and kicking me.

That’s when the therapist spoke up.

“Call the police!”

She led my husband inside with Sunshine, observing how the rage and aggression continued to escalate while I stayed outside with the other kids and made the call.

Even now I can’t put into words what it felt like to call 911 on my baby girl.

I was shaking, stumbling on my words, and pacing back and forth in the yard.

My other kids were frightened and emotional.

We all knew that at some point this would happen, but we didn’t expect it now.

The kids wondered if one or more police officers would show up. They wondered if they would come sirens blazing. And of course the big question was how long it would take for them to get to us as we live out in the middle of nowhere.

I couldn’t answer their questions. We just had to wait.

I took turns hugging each of them as they cried and expressed their feelings about the situation.

Princess’ words still echo in my mind.

“I didn’t believe this could really happen. I can’t believe this is happening.”

Help Arrives

It took over 10 minutes for the police officer to arrive. He came in a disguised car with no sirens.

I directed him upstairs.

By that time Sunshine had calmed down. One would say she was even excited to see him. My husband and I cringed. This was the whole reason we hadn’t called before. No one would believe us.

But here’s the thing. The therapist had seen the episode. She had seen the recording of Sunshine’s behaviors from earlier in the week. It wasn’t just coming from us.

It was the therapist that asked that the police officer take Sunshine to the nearest emergency room so we could seek voluntary placement in a psychiatric hospital for children.

Sunshine needed help.

Thankfully I was able to find someone to take my other three children before Sunshine was brought downstairs.

We weren’t sure if she would go willingly or not. We were warned she put up a fight she would be handcuffed and taken away screaming.

I didn’t want my other children to see that.

It turned out Sunshine didn’t mind going with the police officer. The two walked hand in hand to the police vehicle. He strapped her in the back and I watched as they pulled out of the driveway.

Just the Beginning

My husband and I grabbed essentials and then headed to the emergency room. I cried all the way there. Neither one of us could express how we were feeling in words.

Ultimately though we both felt validated.

This was devastating.

It was a nightmare.

But it needed to happen.

We needed help and the only way to get that was to call the police.

This was just the beginning though.

There’s no turning back after you call the police.

If you enjoyed this post, you may also enjoy the posts below.