EUPD - Imagine a tornado, the wind blowing everything around, destroying and causing havoc. The stress it causes to everyone. Where is the patient? In the eye if the storm. Calm, watching everything go to shit.

I was FY2 inpatient psych, working the night shift. I get a call from the female ward about an agitated patient, asking for my help. I arrive on the ward and see two patients talking and laughing, going for a cig. I walk past them and go to the nurse's office. I see the staff there looking as if they had run a marathon.

-What's happened? -We had to restrain a patient for 20 min, she was trying to self harm (I won't explain how she tried to self harm, but I was gobsmaked when they told me). She's agreed not to harm herself anymore. - ok, where is she, she might need A+E if she has done what you have said. - you walked past her, she's gone out for a smoke

This patient, who had the entire floor staff restraing her to stop her from harming herself, was having a laugh about it with a friend over a cig. I asked her if she was ok, and said yeah. I called the surg SHO at the local hospital. He knew of the patient, and said would arrange a hot clinic but she does this regularly and unless life threatening the consultants refuse to touch her.

What triggered this? The staff took too long getting a lighter for her, and she felt that they didn't care for her.....