To start with I should lay my cards on the table as to where this blog comes from; I am a mental health nurse (currently community based although I have worked on an acute ward in the past) but I have also experienced two lengthy admissions to mental health wards. My first admission was to a mother and baby unit for five months and my second was to an acute ward for four months. I have certainly seen inpatient mental health care from both sides of the coin.
When I became a nurse I did so for the same cliche reason so many others do ‘to make a difference’ except I knew what differences I wanted to make, I knew I wanted to influence care to ensure that when enduring what is often the worst time in a persons life we as professionals don’t make that harder. My experience of being a mental health inpatient was a positive one on both occasions I had overall good experiences however it was also the most deeply dehumanizing experience in my life.
Being watched 24 hours a day is difficult beyond belief, someone watching you bathe and on the toilet, even if not on ‘obs’ you are still being observed all the time and just like I refuse to believe those on big brother who say they forget the cameras are there you don’t forget. All decisions require permission even whether you can take in some fresh air so the small things become huge, if your biggest decision in a day is whether to have jam or marmalade and then there is no jam only honey it can feel like the world might end. Seems ridiculous doesn’t it?
The noise on the wards is as deafening as the silence with other people who are unwell in their individual ways often making noise 24/7, a restful environment it is not. I wanted to disappear into silence yet the hustle and bustle of ward life punctuated the that and dragged me back into the world, into life.
On both occasions when I was admitted it was the right thing to do, I was depressed to the point of struggling to function and my cognition’s were so slow yet so very negative. I was admitted for ECT both times and both times it saved my life but whilst the admission may have saved my life the ward left me desperate. I saw things which traumatised me, especially on the mixed sex ward for my second admission, I’m so thankful care in my area has moved to single sex for a time in life when a person is so vulnerable.
Crisis services have kept me out of hospital on another couple of occasions when both depressed and when elated, I am so thankful for this. I had ECT whilst staying at home with family and plentiful jam and marmalade to choose from even when in a mental state which means that choice was not one I could manage.
When I first qualified as a nurse I worked on an acute ward and I was asked to present at an Mental Health Act Tribunal, I was nervous for my first time and you couldn’t make it up but the community clinician also presenting was someone who had nursed me as an inpatient and who had watched me on the loo and taking a shower!!!!! Mortified…
I am hoping to go back to an acute ward environment soon as a ward manager (cross everything/say a little prayer etc) so the full circle would have been completed, I would get to affect real change in an inpatient environment, to ensure real personal, individualised care is delivered. To ensure that no one else describes care as dehumanising because even the most invasive observations can be done with dignity and inpatient care can be hugely positive when needed.