Before the Community Meeting

Many of the patients were in the habit of going to bed directly after tea, so we decided to invite them downstairs again for one of our rare community meetings. In times gone by, when the unit had followed a ‘therapeutic community’ model, we used to hold these meetings every evening to sort out the domestic jobs allocation, receive feedback on the day’s events, discuss any complaints and ideas that people might have, and give credit where it was due. These, of course, had slowly fizzled out as the patients became older, the staff got tired of doing it, and the unit reverted to form as a continuing care hospital ward again.
Occasionally, though, the community meeting idea was reintroduced by either industrious students or ‘new broom’ managers, who would both employ short-lived democratic outlooks, and then move on. Indeed, just as the staff were becoming more ‘unwell’ than the residents (e.g. judging by psychotherapy appointments), so was the turnover of nurses becoming much greater than the throughput of patients. This sometimes led to an illusion of progress on the unit, because new staff would launch ‘fresh initiatives’ which were actually recycled old and failed ideas, while the overall decline from community care unit to hospital ward was too slow for the rapidly changing staff to notice. Therefore we had the paradox of patients becoming less and less able, at the same time as temporary managers deluded themselves that things were getting better and better. A radio in one of the patient’s rooms, announced:
“Buses ground to a halt yesterday as drivers walked out over a colleague who was dismissed for winning a martial arts competition while off work sick.”
“Oh well, there’s always a job for him here” I thought. “I hope he’s got plenty of storage space for the manager’s ‘get well soon’ chocolates and flowers.”


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