I had three mentally ill patients yesterday. One of them had a trach, which she managed to pull out, and kept biting me and the sitter. That was a scary moment, when I came in the room and that trach was sitting in her lap. I couldn't figure out the obturator, so I put it back in without it. Luckily, it went back in easily. I spent the majority of the day giving the patient lectures about biting and trying not to threaten her with restraints.
My other crazy patient escaped from the hospital in the morning. She had a sitter, who was let go right after, and took off. She was located later outside of the ER.
My third patient I have had for a while. He refuses to move. Refuses to get out of bed, turn, reposition himself, etc. So I enlisted the help of PT for that particular lecture, and it worked. He sat up in a chair for about 45 minutes out of the 12 hours.
I never felt overwhelmed though, I always felt I was on top of things. And we had NO techs. I feel pretty good about it all, although I'm hoping for a better lineup next time.