I Cared For Serial Killers And Psychopaths In High Security Hospital | Minutes With | @LADbible​

Summary

The script recounts a nurse's journey in mental health, starting with a dramatic incident of assault during his first week and leading to a career at Broadmoor Hospital, where he encountered high-security patients with severe mental illnesses. He shares experiences of violence, the therapeutic use of art, and the emotional impact of witnessing self-harm and suicide. Despite challenges, he found joy in humor and the privilege of making a difference in patients' lives, ultimately continuing his commitment to mental health through voluntary work after retirement.

Takeaways

• 🏥 The interviewee started a career in mental health nursing after a life-changing incident at a cash and carry store where a customer died.
• 🌱 He felt compelled to pursue nursing as a way to cope with the guilt and helplessness he experienced after the incident.
• 📚 Initially without qualifications, he took a job at St Lawrence's Hospital in Cornwall, where he was exposed to a variety of mental health conditions.
• 🤝 He emphasizes the importance of building therapeutic relationships with patients and the challenges of managing violent incidents in a psychiatric setting.
• 🚑 The interviewee recounts a harrowing experience of being attacked by a patient, highlighting the physical risks of working in mental health care.
• 🎨 Art therapy is mentioned as a crucial tool for communication and trust-building with patients who struggle with expression.
• 🛡️ Training in control and restraint, as well as the use of shields, was essential for ensuring safety in high-secure environments like Broadmoor Hospital.
• 🏥 Broadmoor Hospital is portrayed as a last resort for patients who cannot be managed elsewhere due to the severity of their conditions or criminal backgrounds.
• 👮‍♂️ The interviewee describes Broadmoor as a place for criminals with mental health issues, who may move between prison and hospital depending on their treatment progress.
• 👀 He shares anecdotes of infamous patients, including celebrities, and the impact of media attention on their mental state.
• 💔 The most disturbing experiences mentioned include witnessing self-harm and suicide, which deeply affected him and raised questions about the limits of care.

Q & A

What was the initial incident that led Paul to consider a career in mental health nursing?

Paul's initial consideration for a career in mental health nursing came after witnessing a man collapse and die from a heart attack while he was working at a cash and carry store. His manager, an ex-retired mental health nurse, suggested that he pursue nursing due to how the incident affected him.

How did Paul's first experience at St Lawrence's Hospital impact him?

Paul's first experience at St Lawrence's Hospital was quite harrowing. He was attacked by a patient on his first week, which shook him up and taught him not to become complacent in such an environment.

What types of mental illnesses did Paul encounter at St Lawrence's Hospital?

At St Lawrence's Hospital, Paul dealt with patients suffering from schizophrenia, manic depressive disorders, depression, OCD, anxiety, and in some cases, individuals who were considered as 'village idiots' due to their disruptive behaviors.

What was the significance of Broadmoor Hospital in Paul's career?

Broadmoor Hospital was significant in Paul's career as it was a high-secure hospital where patients with severe mental health issues, who could not be managed elsewhere, were sent. It was also where he encountered high-profile patients and criminals.

Why did some patients at Broadmoor Hospital move between the hospital and prison?

Some patients at Broadmoor Hospital moved between the hospital and prison because they were initially sentenced to prison but experienced a relapse of mental health issues that required treatment in a high-secure hospital setting. Once stabilized, they would return to prison.

What kind of training did Paul receive for handling violent situations at Broadmoor Hospital?

Paul received training in control and restraint techniques, which originated from British Airways for managing unruly passengers. He also underwent shield training, similar to what prisons use, for situations involving weapons.

Can you describe a particularly challenging incident that Paul experienced at Broadmoor Hospital?

One challenging incident involved Paul being accidentally locked in a seclusion room with an aggressive patient. He had to think quickly and was eventually pulled out by other staff members, an incident that is still talked about.

What was Paul's approach to building rapport with patients?

Paul built rapport with patients by providing unconditional positive regard, which meant putting aside any preconceived notions and connecting with the patient. He also emphasized the importance of silence for reflection and challenging patients when necessary, but always with support.

What did Paul find most rewarding about his job as a psychiatric nurse?

Paul found the humor and connection with patients rewarding. He enjoyed making patients laugh and appreciated the small victories in improving their day or mood, even if it was just a little bit.

Why did Paul decide to retire from his career as a psychiatric nurse?

Paul decided to retire after 35 years of service, having reached the point where he was eligible for a good pension and lump sum. Although he retired from his position as a ward manager, he continued to work voluntarily in mental health organizations.

How does Paul feel about his past experiences and the skills he acquired as a psychiatric nurse?

Paul views his past experiences as a privilege and believes that the skills he acquired, particularly in connecting with people, have not been lost even after retirement. He still visits units and finds that patients recognize him as a nurse.

Outlines

00:00

🚑 Beginnings in Mental Health Nursing

The narrator recounts their entry into the mental health nursing field after leaving school without qualifications and working at a cash and carry store. A traumatic incident where a customer died in front of them prompted a career change. The narrator's manager, an ex-mental health nurse, suggested nursing as a career path. They applied to St Lawrence's Hospital in Bodmin, Cornwall, and were accepted as a nursing assistant. Despite initial shock and the challenging nature of the work, including dealing with violent patients and various mental illnesses, the narrator found the work rewarding and grew both personally and professionally.

05:02

🏥 Transition to Broadmoor Hospital

The narrator discusses their decision to move from St Lawrence's Hospital to Broadmoor, a high-security psychiatric hospital known for housing patients who pose a threat to society or are in need of constant psychiatric support. They explain that Broadmoor treats not only criminals but also individuals with severe mental health issues who may have been sentenced to prison but require specialized care. The narrator shares experiences with high-profile patients like Ronnie Kray and others who, due to their mental state, ended up in Broadmoor. They also touch on the use of art therapy as a means for patients to communicate and build trust with staff.

10:03

🛡️ Security and Training at Broadmoor

The narrator describes the security measures and training at Broadmoor, including control and restraint techniques derived from British Airways' approach to handling problematic passengers. They underwent training for various scenarios, such as using shields to restrain patients with weapons. The narrator emphasizes the importance of safety and preparedness, highlighting an incident where they were accidentally locked in a room with an aggressive patient. They also discuss the use of seclusion rooms as a last resort and the importance of teamwork and support among staff.

15:03

😢 Disturbing Experiences and Humor in Nursing

The narrator shares the most disturbing experiences they witnessed at Broadmoor, including self-harm and suicide attempts, and the emotional impact these events had on them. They also reflect on the importance of building rapport with patients, using humor as a coping mechanism, and the challenges of transitioning back to everyday life after a difficult shift. The narrator recounts a humorous incident involving a patient and a misunderstanding of medical advice, highlighting the lighter moments amidst the serious nature of their work.

👋 Leaving the Nursing Profession and Continuing Involvement

The narrator explains their decision to retire from their 35-year career as a psychiatric nurse, motivated by the opportunity to enjoy a pension and the lump sum from their service. Despite retiring, they did not leave the field of mental health, choosing instead to continue their involvement through voluntary work and support for various organizations. They express a sense of privilege and satisfaction from their career, emphasizing the importance of making a positive impact on patients' lives, no matter how small.

Keywords

💡Mental Health

Mental health refers to an individual's psychological and emotional well-being. In the video, it is the central theme as the speaker discusses their career in mental health nursing, dealing with various mental illnesses and the impact on patients' lives. The term is used to describe the overall focus of the speaker's profession and the challenges they faced.

💡Nursing Assistant

A nursing assistant is a healthcare professional who provides basic care and support to patients under the supervision of registered nurses. The speaker mentions being accepted as a nursing assistant at St Lawrence's Hospital, indicating the start of their career in mental health care and their initial responsibilities in patient care.

💡Schizophrenia

Schizophrenia is a chronic mental disorder characterized by delusions, hallucinations, and disorganized thinking. The term is used in the script to describe one of the severe mental health issues the speaker encountered while working in the hospital, emphasizing the complexity of the patients' conditions.

💡Manic Depressive

Manic depressive, now more commonly referred to as bipolar disorder, is a mental health condition that causes extreme mood swings, including emotional highs (mania or hypomania) and lows (depression). The speaker discusses this term in the context of the illnesses they were dealing with at St Lawrence's, highlighting the range of mental health challenges faced by patients.

💡OCD

OCD stands for Obsessive-Compulsive Disorder, a mental health condition characterized by recurring, unwanted thoughts (obsessions) and the urge to repeat behaviors (compulsions). The script mentions OCD as part of the spectrum of illnesses the speaker encountered, illustrating the diversity of mental health issues in their work environment.

💡Anxiety

Anxiety is a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. The speaker refers to anxiety as one of the illnesses they dealt with, showcasing the broad spectrum of mental health conditions present in their nursing career.

💡Broadmoor Hospital

Broadmoor Hospital is a high-security psychiatric hospital in the United Kingdom, known for treating patients who are considered a danger to the public. The speaker discusses their decision to move to Broadmoor, indicating a progression in their career to work with more complex and high-risk patients.

💡Control and Restraint

Control and restraint refer to techniques used to manage aggressive or violent behavior, ensuring the safety of both staff and patients. The speaker mentions being trained in control and restraint, reflecting the challenging and potentially dangerous situations they had to navigate in their role.

💡Seclusion Room

A seclusion room is a secure space used in psychiatric care to isolate a patient who is at risk of harming themselves or others. The script describes the use of a seclusion room as a last resort, demonstrating the measures taken to manage extreme aggression or crisis situations.

💡Hostage

A hostage is a person who is seized by an individual or a group and held captive, often in a threatening context. The speaker recounts an incident where they felt like a hostage during a patient restraint situation, highlighting the potential dangers and high-stress aspects of their job.

💡Unconditional Positive Regard

Unconditional Positive Regard is a term from psychology, meaning to accept and value a person without conditions or judgments. The speaker describes building rapport with patients using unconditional positive regard, emphasizing the importance of empathy and understanding in mental health care.

Highlights

The narrator's first week on the job involved a life-threatening encounter with a patient attempting to strangle them.

The narrator's career in mental health began due to a life-altering incident at a cash and carry store and advice from a former mental health nurse manager.

The narrator's experience at St Lawrence's Hospital in Cornwall exposed them to a range of severe mental illnesses and challenging behaviors.

The narrator describes the harrowing nature of their work, including dealing with violence and the constant need for vigilance.

The narrator recounts a chilling moment when a patient, suffering from psychosis, claimed voices were telling him to kill the narrator.

The importance of empathy and care in nursing is highlighted, with the narrator discussing the discernment required in recruiting staff.

The narrator's move to Broadmoor Hospital was influenced by their desire to work with the most challenging cases in mental health care.

Broadmoor Hospital is depicted as a place for individuals who cannot be managed elsewhere, including criminals with mental health issues.

The narrator shares anecdotes of infamous patients at Broadmoor, including well-known criminals and a patient who became psychotic after a career in acting.

Art therapy is discussed as a crucial method for breaking down barriers and building trust with patients.

The narrator describes the security and training protocols at Broadmoor, including control and restraint techniques.

A dramatic incident is recounted where the narrator was accidentally locked in a room with an aggressive patient, highlighting the risks of the job.

The narrator reflects on the most disturbing experiences at Broadmoor, including witnessing self-harm and suicide.

The importance of building rapport and connection with patients is emphasized, even with those who have committed serious crimes.

The narrator shares a humorous anecdote from their experience, demonstrating the need for a sense of humor in their line of work.

The decision to retire after 35 years is discussed, along with the narrator's continued voluntary work in mental health after retirement.

The narrator expresses a sense of privilege and satisfaction from their career, highlighting the importance of making a small but meaningful difference in patients' lives.

Transcripts

I remember the first week, my charge nurse said,

"Can you go up to the toilets there

and just check on that patient?"

And I went up and the next minute he had me by the neck,

and he was trying to strangle me,

and it was fight or flight.

[MARYANA] How and why did you decide to start a career in mental health?

I'd left school with no qualifications,

and I just took a part-time job at a cash and carry store.

I remember a chap coming up with his family

to look at a radio,

and I went up onto the ladder to get this radio down.

And just as I came down, the chap collapsed

and banged his head on the glass cabinet,

and unknown to me, he'd had a heart attack

and he had died right out.

And I thought throughout that

for quite a few months after,

I felt that I could have done something.

And it was my manager, who was an ex-retired

mental health nurse, who said to me,

"Paul, it's really playing you up, you know.

Why don't you go down the route of nursing?"

And it was a hospital called St Lawrence's

in Bodmin, Cornwall.

And I applied for this job.

I didn't tell my family because they probably thought,

"Oh my gosh," 'cause I was a bit of a rebel in the family.

And I went for the interview,

and a couple of days later, I received this letter

to say that I'd been accepted as a nursing assistant.

As I went in on my first day, I really grew up.

It really made me think, "Oh my gosh,

this is a different world altogether."

And they put me on a ward that was extremely busy.

It was an admission ward, where patients came in

and they were assessed.

But eventually, I worked on most wards in St Lawrence's.

[MARYANA] What kind of illnesses were you dealing with at St, Lawrences?

The kind of illnesses patients had

were schizophrenia, manic depressive,

depression, OCD, anxiety.

And of course, not forgetting, back then,

you know, some 40 years ago,

you would have what they called back then

by the layperson as a village idiot

who maybe has gone out and smashed up a telephone kiosk

and has become a bit of a problem in the community.

They were actually sent to St Lawrence's,

and they'd been there for a long time.

[MARYANA] You were very young when you started.

How did it feel to be there surrounded by people with these quite severe mental health issues?

It was quite harrowing, to be honest with you.

I remember the first week, my charge nurse said,

"Can you go up to the toilets there

and just check on that patient?"

And I went up and the next minute he had me by the neck,

and we had white coats on,

and he was trying to strangle me,

and it was fight or flight, you know.

It really shook me up, and I came out and I thought,

"Well, one thing here, don't leave yourself..."

you know, "don't become complacent".

There was a lot of violence.

I mean, it didn't happen every day,

but you got to realise that on each ward,

with that volume of patients living under one roof,

there would be tension, and of course, the illnesses.

If somebody's paranoid or delusional,

there are cases where they think that you're after them,

you're gonna attack them, so they would attack you first.

And I remember talking to a patient

who I had a good therapeutic relationship with.

He just stared at me and I thought,

"Something's going on here."

And I said to him, "Are you okay?"

"No," he said, "The voices are telling me to kill you."

And it was so real to him, you know.

You have to be a certain person to go into nursing.

And those that aren't the certain people,

they stand out.

I often had that as a ward manager recruiting staff.

You could just tell if somebody's empathetic

and they're a caring person.

There's a line, you know. You've got to be strong.

There's boundaries with patients etc.

But it's all a skill.

All these are skills you learn over time, you know.

When you leave your shift,

it's about leaving it all behind and not taking it home.

[MARYANA] When did you make a decision to move to Broadmoor Hospital, and why did you do that?

On my last ward at St Lawrence's Hospital,

we had a lot of patients who had been

at Broadmoor Hospital for some...

I mean, back then, people were there for 30, 40 years.

Some were there for life.

I thought, "Well, you can't go any higher than this."

I've worked in a few hospitals,

but this is the hospital where patients

can't be managed anywhere else.

That's why they go to high-secure hospitals.

[MARYANA] So basically, Broadmoor is the place where a lot of criminals are held just because they otherwise present a threat to society

and they need constant psychiatric support, is that right?

Well, that is correct, but not all of them.

I mean, what you get is you get,

say somebody was sentenced to prison for 10, 15 years.

If they had a relapse, if they had any mental health issues

and they were category A etc,

they would come to a high-secure hospital,

whether that's Broadmoor, Rampton, Ashworth etc.

And there, they would be treated

under that security with medication.

Once they became well, they would transfer back to prison,

so it's hopping from one to the other.

And some people just continue to do that, you know.

People who have been sentenced to life.

[MARYANA] What kind of criminals did you meet at Broadmoor?

Well, I mean, everybody knows who's been at Broadmoor

and who was there.

It's the usual, Ronnie Kray and Peter Sutcliffe.

There's quite a few of them what you would call

the infamous patients of Broadmoor.

But I have to say, if I'll give you an example,

you know, we had one patient who was filming.

He was in a lot of soaps etc, with no names given.

And he went off set, he became quite psychotic,

and he went off and he killed somebody on the street,

and he was sentenced to Broadmoor.

And I remember all the work we did with that chap,

and then there's some coverage that came up

about five years later in one of the tabloids.

You could just see how he deteriorated

through that coverage.

It was just like, "Oh my gosh,

this is having a real effect on him," you know.

[MARYANA] There are quite a lot of examples of different criminals that were in psychiatric hospitals who created a lot of art, like Charlie Bronson or Ronnie Kray.

I think that's the only means at that time

that they can get through to people, especially the staff.

I know a lot of psychologists have said

art is a huge theme when it comes to breaking down

those barriers with a patient and building that trust.

That's why an art therapist is so paramount on a unit.

And it's about somebody who, if I give you an example,

is quite depressed and they won't speak.

There's no communication going on.

They'll do it in their picture.

They draw something and you can ask,

you can go in depth with it.

You know, "What does this mean?

You put this here. What does that mean?"

[MARYANA] What was the security like, and what was the training like?

You're trained to use what was called

control and restraint back then.

And that I believe came from British Airways

at the very beginning, because of passengers on flights

who were becoming problematic.

That carried over, and the high-secure hospitals

did that first.

So you are trained in that.

And so if somebody attacked you,

you have those different holds that you put on etc.

It's all because it's safe, you know, as nobody gets hurt.

And then I went on to do the shield training.

So that's like what the prisons do.

So if somebody did have a weapon,

you would bring the shields out

and restrain somebody with a shield.

That was very interesting,

because nobody likes violence.

Nobody wants violence.

And somebody who's unwell who doesn't realise

that they're doing these things,

it's about making it safe,

because people many, many years ago

have actually died through restraints.

You've always gotta think a couple of steps ahead.

You would never go in a room first, a patient's room.

You would always have somebody with you.

You would never leave yourself in a corner.

There's been times, and I know there were two patients

one morning fighting in the day room,

and the alarm bells went and everybody came in.

And I actually ended up on the patient's...

holding the patient's head.

This is all through your techniques that you were taught.

And we went into the seclusion room,

and the seclusion room's used at the last resort.

It's about bringing somebody down

who's maybe gone from 0 to 10

in an arousal state with aggression.

And I remember holding the head,

and you always numbered everybody.

You wouldn't call them, the staff, their names,

because you might have somebody with the same names.

And I said, "Number one, leave the room."

And they went out the room,

and I had the head and we turned them around,

so I had the legs then.

"Number two, leave the room."

And just as I was about to spring backwards

to be caught by the staff, the door closed.

And for whatever reason,

nobody really forgot this there,

they thought I'd actually got out,

I was out of the room, and they shut the door.

And of course, there's the patient,

who jumped up off the bed.

And to me, all I could think of is like, "Hostage.

You are now a hostage."

Now, it seemed like forever, but it wasn't.

It was maybe 10, 15 seconds.

But that was enough to make me think,

"Oh my gosh," you know.

[MARYANA] How did you manage to get out of that one?

That one there, I actually... they pulled me out,

and they went back in and restrained the patient again

and all came out.

I think the staff just couldn't believe it,

but it's still talked about today.

It's one of those incidents,

which I've seen a few and been involved in,

that always stayed with me,

because we had hostage training as well.

When you go deep into that, it can be quite scary.

[MARYANA] What would be the most disturbing things you witnessed at Broadmoor Hospital do you think?

Cutting, when somebody's cut their throat.

It doesn't have to be at Broadmoor.

It can be at any other hospital.

But that's quite something.

You deal with it, but it's something.

And obviously, when somebody's hung themselves.

That's quite...

Especially when you've got somebody so young.

I've come across a few that have been very young,

and you just think, it makes you feel how lucky you are

when you leave a shift.

When you've got somebody talking to you and smiling

and having a good joke, there's no indication

that they're gonna go and do something.

Usually you can see triggers with somebody.

You see triggers, like their hands

or the way they're looking.

You know that patient inside out, really.

But when somebody doesn't do that

and they're happy-go-lucky,

and then five minutes later,

they've got a sheet around their neck,

you think, "Well, there's no indication there."

You wouldn't have put that person on observations

'cause they didn't need them, you know.

And what I learned through my career

with hangings etc is that

if they're gonna do it, they'll do it.

They really will.

Whether it's in the hospital or the grounds, they'll do it.

But there's been lots of things

throughout the career where you thought,

"Oh my gosh," you know,

you just wouldn't see that anywhere else, you know.

And then you'd finish your shift after a horrific shift.

I mean, not every day's like that.

And you'd go into the supermarket

and you'd have a young lady going,

"Afternoon. How was your day?"

You think, "Oh, if only you knew."

And you do have a bit of guilt.

You think all the time,

all the input we've given that person

and you feel like you've let them down.

[MARYANA] Has it ever happened to anyone who you were kind of connected to?

Yeah. Oh yeah, yeah.

Especially at Broadmoor, when you're nursing there,

you are given so many patients to look after.

So that would be care plans, reviews.

You're their named nurse,

so you do build up that rapport.

They call it unconditional positive regard,

where you've gotta put everything to one side,

and I'll give you an example of that.

If you know a patient's being transferred up to you

and you have read the notes, that can have an effect

before the person's walked on the unit.

If you haven't read the notes and you build a rapport

and read them later,

you seem to have more of a connection.

It's all those different things,

like silence is the most powerful thing.

Whereas some people would be so uncomfortable with it,

that's a time for reflection for the person

to think about what you've said or for me as well.

It's about all the different things you would ask

and what you wouldn't ask.

You have to challenge some patients,

but you wouldn't just go in on your own

and challenge them whatever it may be.

You'd make sure that you had support with you.

[MARYANA] What would you say you liked most about your job?

There's lots of funny things over time.

You've got to have that sense of humour.

And I have to say, the patients

would have a real laugh with you as well, you know.

And that's what it was all about.

But the chap who went running to the toilet,

and I said, "Are you alright?"

"Oh," he said, "I've got the runs."

And he went off to the toilet

and I thought, "You've been gone a while."

So I went up to the toilet and I shouted the chap's name.

We'll just call him Joe.

I said, "Joe, are you alright?"

He said, "Well, no."

He said, "The doctors have given me some salts,

and that's not working out very well."

And I said, "Salts, what do you mean salts?"

"Well," he said, "I went to the ward round

and instead of prescribing me medication, he said,

'Just take some salts.'"

I said, "Open the door a minute."

So he opened the door.

Of course, there's faeces all over the walls and that.

And I said, "What kind of salts did you take?"

He said, "Somersaults."

And I thought that was really, you know...

from somebody who's... yeah, yeah.

[MARYANA] Why did you make the decision to leave your career as a psychiatric nurse?

Through 35 years I could retire,

and I had a good pension and a lump sum,

and I thought it was time to go,

but I didn't leave mental health.

I left as a ward manager.

I retired, got my 35 years

and continued to work voluntary

in lots of organisations.

I've always been linked to mental health, always.

And by going around doing surveys

around the United Kingdom,

meeting so many different people.

It's fantastic, yeah.

[MARYANA] Do you miss being at the hospital?

Sometimes I do.

When I go and visit units and support staff,

it takes you all back, being on the units.

And patients will always come up to you

not even knowing you.

They'll say, "Oh, hello, Paul. Pleased to meet you,"

and all that.

"You can tell you're a nurse.

You know, it's quite amazing, really.

But you never lose those skills.

You can have that rapport right away.

You can converse, and that's the biggest thing in nursing

is getting through to somebody.

But I always see it as a privilege

to work somewhere like that, absolute privilege.

If you can just change somebody

a little bit like that each day,

that's good enough for me,

because you can't expect everything.

People don't get well over overnight.

But if you can make that little bit of happiness

and make their day worthwhile, that's good for me,

and that's why I was in the job.