Monday, 15 March 2010

Tackling The Mental Health Minefield Part 11 - Being Admitted The Second Time Around

As regular readers will know I have recently spent a week in hospital again. I thought that I would write a post in the Tackling the Mental Health Minefield series detailing how this second admission went and how I found things on the Admissions Ward four months after my first admission.

I had found things becoming too much for me and thoughts of suicide had started to crowd in again. Having got to this terrible place, I knew that the only thing to do as it was Sunday morning was to make my way to A&E. I'd previously been told if I found myself in this position that I should phone for an ambulance but I felt that this was inappropriate as I could probably get to the hospital as quickly by bus, so that is what I did.

Once I arrived at A&E I booked in at the reception desk, telling them that I wanted to see the duty psychiatric team. I waited on the terribly uncomfortable seats for about 20 minutes and was then called in to see the nurse who was doing assessments. She asked what the problem was, so I told her that I wanted to see someone from the duty psychiatric team. That didn't stop her from taking my blood pressure (which was sky high), pulse (again very high) and temperature (which was normal). then it was back to the waiting area until someone came for me.

It was a long wait. Even the CPN from the duty psychiatric team commented on the length of time I had to wait. It seems that that A&E weren't in any hurry to call her, because she had responded to the call immediately. It seems that mental patients come way down on the list when it is necessary to call someone in. I find this rather strange because you would expect that they would want to get a mental patient out of the way as quickly as possible.

The CPN took me to the room set aside for them, and learning that I was known to the mental health services she proceeded to call up my records. I should perhaps explain here that this is a separate computer system to the hospital's because the mental health services are provided by a completely separate trust. After talking me through what had been going in on my life and had led me to coming to A&E she decided that I ought to be admitted.

There now comes one of those incredible little ironies that can only happen in the NHS. It seems that as a member of the psychiatric liaison team she was allowed to discharge patients but not to admit them to hospital; that needed to be done by a doctor. So she went to the desk in A&E and removed me from their computer then bleeped the duty psychiatric SHO. As with my previous admission, I struck lucky with the doctor who took care of me at this stage of the proceedings.

We had a long talk about how I was feeling, about the lack of sleep (even though the dose of antidepressants that I take at night ought to knock me out pretty quickly), about not wanting to eat, and when I did eat it wasn't the right things, about the nightmares, about the noises that I hear and the visions that I see. It didn't take him very long to decide that admission to the psychiatric hospital was necessary.

After a couple of quick phone calls, we left the hospital and walked to the psychiatric hospital. Then it was into the lift and entry into the Admissions Ward. This time admission onto the ward wasn't the frightening experience that it had been the first time. There were two members of staff waiting for me when we arrived at the airlock, a nurse and a care support worker, both knew me so everything went very smoothly.

Once the formalities had been done, it was through the airlock and onto the ward proper. There was no need to explain to me where everything was and what the procedures were as I had been through it all before, so it was straight to my room, which incredibly was the same one that I had occupied when I was on the ward before, to drop off the belongings that I had been allowed to keep, then into the treatment room for the usual blood pressure, pulse, temperature and blood sugar tests. In the intervening period my blood pressure and pulse had dropped from their excessively high levels although they were still much higher than normal.

With this taken care of, the next priority for the staff was to find me something to eat as I had not had anything since Saturday lunch time. A salad was presented which I half-heartedly ate but the cup of tea that was also provided went down a treat. Then it was back to my room, where I was joined by the duty SHO who took down details of my medication, doses, and when they were taken. He was about to carry out a physical examination when he was called away to an emergency on another of the wards.

So, I was on the ward again. What differences did I see? Most of the staff were the same as when I was on the ward before so little had changed there. Unfortunately, they still seemed to spend the majority of their time in the office and rarely ventured out to interact with the patients. I was berated a couple of times for self-harming and told that I should have asked to speak to one of the nurses, but in my defence I have to say that the reason that I resorted to the self-harm was frustration at never being able to get to talk to a nurse when I needed to. there was also significant evidence of excessive use of force being used on patients, so significant that one of the patients was badly bruised and unnecessarily drugged when her only sin was to not be in her bed at midnight. She made a formal complaint to the consultant psychiatrist when she saw him the following day at ward round, and was discharged a few hours later because it was recognized that excessive force had been used and that it would be better if she were not on the ward when the night staff came on duty that night.

The other change that I saw on the ward was something that surprised me and made me wonder whether there were staff in the hospital, particularly on the Admissions Ward who had been reading my Tackling The Mental Health Minefield posts. And if they had, were they aware that I was Madsadgirl? At my first ward round I asked the consultant if I would be granted leave. He said yes, as I was an informal patient, without any hesitation, but did ask if I would do anything silly if I went out for an hour or two. I said that I wouldn't, but that getting out for a while was the only way that I could get the exercise that I needed (walking does help free up my hip when it is really bad) and that I wanted to be able to go to the shops to get myself a few bits and pieces that I hadn't brought with me. After I had been into ward round, the nurse who was doing that day's ward round went to the office to report that I had been given leave and could have it whenever I wanted it. When I went to inquire about when the next cigarette break would be I was handed a lighter and allowed to go out into the garden by myself. When I had asked for this when I was in hospital the first time, although the consultant had said yes, the nurses had said that it was not possible. Can my posts have been responsible for the change? It's possible, and if they were then I have at least managed to make one change to the way that patients are treated on this ward, for it was not long before another of the patients was able to also partake of this little luxury.


DeeDee Ramona said...

I'm glad things went better for you this time.

The A&E thing is - in Dublin anyway, they used to triage A&E folks based on "most likely to drop dead or get worse if not seen right this second" - ie those who are bleeding, have chest pain or head injuries get seen first, everyone else waits.

my great-aunt waited for 24 hours to be seen about 10 years ago with a broken arm for this reason as all the Sat-night-specials went first, then Sunday morning sports concussions.

I suspect your blog has been read. In fact I'm pretty sure you were in the same area as that Frontier Psychiatrist practices in and I bet he reads your blog.

Anonymous said...

Wow, in the hospitals there they mental patients lighters and let them go outside alone? That's unheard of here...

But waiting around forever in the ER seems to be pretty much universal.