darryl cunningham (tallguywrites) wrote,
darryl cunningham

Four Female Patients

Currently on the psychiatric ward, we have two women who have both threatened to kill their children. Both these woman are personality disorder sufferers, and both have claimed at times, that their lives are so awful that they'd prefer to kill themselves and their children too, rather than go on living. In each case the general opinion amongst the nursing and medical staff, is that they are both somewhat histrionic, and that this is a gambit to gain more power and attention from the services. The two women spend a lot of time together and, we suspect, pool ideas to further their interests.

However, it goes without saying, that we have to take these threats deadly seriously, and the police and social services are fully involved in the care plans of both woman.

Another lady, who came in last week, had been devastated by grief. Her husband was recently killed in a motorbike accident, having been hit by a car driver. He'd not long recovered from a previous accident, after which the wife had pleaded with him not to go back on the bike. Oblivious to her fears he did anyway, and was killed a month ago.

The patient was admitted to the ward informally, after an overdose. For the first couple of days she barely came out of her room, mostly sleeping. We had her on visual observation for the first day, which was then reduced to once every five minutes.

Today she was determined to take her discharge, having been visited by her family who were worried about her being in a psychiatric hospital. After the doctor had assessed her, we convinced her to take leave for a few days, rather than discharge, coming back in a few days to see the consultant.

Depression like this can be tricky to treat safely. At first people can too unmotivated to do any harm to themselves, but once their mood begins to rise, they can often be at serious risk. The depression is still there, but now they have a little motivation and may impulsively act on it. I've seen this before in patients and have witnessed with my own eyes suicides on the ward. So I'm acutely aware of this danger.

However the lady in question has got good support from family, who assure us that returning home would be best for her, and it's also what they want.

A factor that certainly triggered this patient's request to leave, was the fact that another female patient who she'd become friends with, had also decided to discharge herself. This particular lady, a thirty-something woman, had got herself into a terrible relationship crisis. She'd left her husband and two young children for a man she'd met at work. He too had left his family to be with her, but now both of them were struggling with the new relationship, and she in particular, was racked with guilt over leaving the children behind.

This patient had also come in after a suicide bid, but her mood had lifted after only a couple of days. When I left the ward yesterday evening, after a twelve-hour shift, she was also about to leave.

That, in a nutshell, is just a few of the typical patients we have on the acute ward at any one time.

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