February 24th, 2005

Yellow head

All About the Psychiatric Ward

Had a pleasant and stress free first day of my twelve week placement on the acute ward. I've not worked much on this particular ward before, but I do know most of the staff reasonably well, which always helps. The ward I worked on as a Health Care Assistant for years, is just down the steps, so I'm very familiar with the environment.

The F-Grade who was doing my induction told me not to worry about doing much on my first week. "Just chill," she said, and get to know the patients and the ward routine. I did as ordered.

A few of the patients were known to me already through previous admissions. An acute ward always has a mixed group of patients. This particular ward takes people of both sexes from eighteen to sixty-five. All the usual illnesses are on display, depression, bipolar-disorder (manic depression), personality disorders, and drug and alcohol dependency.

Here's a brief run down of four of the patients.

A thin, thirty-five year old man: an alcoholic, who'd fallen unconscious through drink at his home. He'd not been found by anyone until the following day. Throughout this period he'd been lying on his left arm, cutting off the blood supply. As a result of this, his arm is now completely paralysed. He lives in hope of using the arm once more, even though the specialist has told him that he'll never have feeling in it again.

A very confused fifty-something lady, suffering from schizophrenia, who can hardly string a sentence together. We've been keeping her cigarettes in the office for her as she tends to chain smoke and would burn up twenty fags in a couple of hours if we let her. Every five minutes today, she came to the office, asking for a another cigarette. We've tried to restrict her to one cigarette every half an hour. The difficulty here, is of course, that they are her cigarettes, and strictly speaking we have no right to stop her having as many as she wishes. The ethical dilemma, which I may explore in my upcoming Ethics Assignment, is that her family have instructed us to restrict her smoking. It's worth noting that when this lady is well, that she hardly ever smokes, so this behaviour could be seen as part of her illness. I'm not sure whether this patient is informal or being held on a section of the Mental Health Act. It does make a difference to any treatment she is given.

Admitted today was a young French woman who'd not long been discharged from her last admission. A very lovely and articulate woman, as far from a stereotypical psychiatric patient as you can get. Well dressed, amusing and very sociable. In talking to her, you'd be hard pressed to know that there was anything wrong, yet she is deeply disturbed, tormented by the belief that her home is infested with surveillance cameras, that watch her every move. This lady is one hundred per cent convinced that these cameras are real and won't be moved from this point of view. Her belief is that she's in hospital for depression rather than this false delusion. She has a husband and two children. She has no idea who is watching her, but the cameras are there, even though they can't be seen and have never been found.

A thirty-five year old blonde woman: a personality disorder sufferer, who as is typical with this type of patient, is extremely difficult and demanding. She definitely sees the staff as the enemy to be thwarted whenever possible. PD's like this, always strike me as grown-up toddlers, who can only ever see their own needs, which are always more important than anyone else's. It wouldn't matter what else was happening on the ward, there could be a riot, but this lady would still want her allotted time with the staff, and if she didn't get it, she would be on the phone to her husband, who'd be ringing the Chief Executive. Staff have to be extremely careful with her, as she continually takes notes on all her interactions with staff, detailing everything said, the date and time, and the attitude of the staff members concerned. Huge amounts of time and effort are spent on this lady, to the detriment of the other patients who don't get anything like the same attention. However, it is the nature of the personality disorder sufferer to act this way, and they don't have any real control of their emotions. In many ways, PD's could be seen as the most tormented patients of all, as there is no drug easy drug fix. Only long term psychological therapy can make a difference