Archive for psyche nursing blog

Changing Sides

Posted in Biographies and Inside Stories, Blogging, books, journals and diaries, mental health with tags , on June 2, 2014 by leovineknight

When I did wake up, I was still disorientated, and the room hung around me like a pointillist painting, with dots of colour forming half-familiar images on a dazzling white canvass, forcing my eyes firmly closed again.
The word brought the room vaguely into focus, and now I could make out three people looking down on me, in my white sheets in a white room with white light.
I was back.

For a while I felt bewildered and numb, with my memory mercifully dim, selective and distant. I was drained rather than refreshed, and my mind seemed to stall whenever it met the past, and the problems preserved there. Drugs had obviously put out the fireworks, but when I tried to refocus my mind, uncover the causes of my collapse and get things back in perspective, I struggled. It was difficult enough for the therapist to help me revisit past events, but it was impossible for him to change the world which had created those events, and would create them again – if it got the chance. Therapy could only help me ‘adjust’ to things I thought were wrong. In a sense, it could only help me fail.


Reaction Formation

Posted in Biographies and Inside Stories, Blogging, jobs, careers and work, mental health with tags , on April 23, 2014 by leovineknight

In the mood to take all before me, I flew downstairs and entered the dining room, where Sidney appeared at my shoulder wearing an immaculate waiter’s outfit, red carnation in his button hole and hair slicked back with pomade.
“Would sir prefer the larks tongue, or caviar vole-au-vents, this morning?” he mewled pitifully.
“You can stuff that for a bunch of soldiers” I replied tetchily, looking over his shoulder.
Behind him, the residents were all sat around the dining room dressed in shooting tweeds and plus fours, barking instructions in our direction.
“Hurry up, you slackers! We’ve got a bed to catch.”
“Who do you think you are? We’ve got our rights you know.”
“Step on it, or there’ll be an official complaint.”
“Chop! Chop!”
Seeing the monstrous meal re-heating machine vibrating in the corner, I had a flash of inspiration, and armed with my new superpowers I quickly reprogrammed the fan-assisted warmer to ‘turbo suck’. Pointing the machine towards the carping crowd, I opening the aluminium door and watched them all disappear into its welcoming bowels, each delivering a parting comment as they went:
“It’s too hot in here!”
“It’s too cold in here!”
“Where’s the juice?”
“I didn’t order this!”
“These chairs aren’t very comfortable!”
I then whisked the machine down to the postal area, and taking a large white address sticker from my utility belt, wrote:
Please deliver this urgently to –
The Workers’ Co-operative Community,
Somewhere in Wales.

Mass Debatable

Posted in Biographies and Inside Stories, Blogging, jobs, careers and work, mental health, social work and social policy with tags , , on January 21, 2014 by leovineknight

Cecilia’s downfall didn’t cause much of a stir with the night nurses, because things of this sort were always happening, and there was a constant shuttle service of ambulances from our psychiatric hospital to the General, often running on a more regular basis than the local buses. After she’d gone, we sat around the biscuit tin and justified ourselves a bit. One nurse said:
“Well, something was bound to happen to Cecilia. She was getting more and more agitated and the drugs just didn’t do anything for her.”
“I’m afraid it was a bit of poetic justice really” I said.
“Yes, she got away with bloody murder” said Alec. “It would have been different if she was my daughter.”
“She’s got a basic personality problem, and the drugs don’t make a scrap of difference to that.”
“A bit more discipline earlier in life might have helped.”
“Or even now” I commented. “She’s already kicked a pregnant woman in the stomach and broken someone’s arm on this unit, but the police don’t want to know about it.”
“On the acute unit, one of their nurses got a broken nose, so they took the person to court. The judge threw the case out, even though the Consultant told him the patient knew exactly what they were doing at the time.”
“Yeah, being in a mental hospital gives you more immunity than a foreign diplomat with seventeen inoculations.”
“No wonder it’s becoming so popular.”
“One tearaway I know makes for the community team every time he assaults someone. By the time the police get to him, he’s always incoherently ‘hypo-manic’ in hospital – case dropped.”
“Yeah, it’s easy to forget that some people are mad and bad.”
“ And some people are just plain bad.”

Patient Rites

Posted in Biographies and Inside Stories, Blogging, jobs, careers and work, mental health with tags , , on August 27, 2013 by leovineknight

One of the patients asked me for access to his huge stock of sweeties. Although on a diet care plan, he had recently returned from a shopping trip with two large bags of jelly babies, two bags of sugared bon bons, four tubes of mints, two cream cakes, and a lot of receipts for the cash book. He had preceded these purchases with a fish and chip lunch, one can of non-diet coke, and a ‘ninety-nine’ ice cream with extra “sprinkles”. His laboured breathing now followed me down the corridor and after five minutes of key juggling I was able to release the requested items into his sticky grasp. I had a pang of conscience as I observed the folds of his painfully obese form rock and roll back to the lounge, but I knew that to refuse him access to ‘his own property’ would have brought opprobrium down on me from all sides. I was even more regretful that we continued to treat many of the patients like children, and wondered if it was strictly necessary to unload sack loads of sugar and fat on them every week, and then foolishly remark on their disappearing teeth and scale-breaking weight.
As part of this approach, all the patients received a large ‘Walt Disney’ type of birthday cake every year, which was usually so sickly and garish it would have turned the stomach of Billy Bunter. Unfortunately, staff seemed to forget that the recipients of these cakes were often forty to fifty years old, and that the patients were already keen enough to see themselves as life long dependants without the staff reinforcing it with organised puerility. Some of the patients were actually suffering from a psychotic ‘regression’ which had taken them back to their adolescence, and in their cases it was even harder to see how Walt Disney icing was going to reverse the process. Often the patients in question were in need of a new electric razor, a hairbrush or even a basic clock, suggesting perhaps that a more constructive approach to gift selection was well overdue. Anyway, at least I always knew what the key workers wanted for their birthdays; but would it be a cheeky Donald Duck or a cuddly Minnie Mouse this year?

Filing the Prison Bars

Posted in Biographies and Inside Stories, Blogging, jobs, careers and work, mental health with tags , on April 22, 2013 by leovineknight

I grimaced at the patient’s file in front of me; the great wedge of admission forms (eight pages), global assessments, risk assessments, Care Programme Approach assessments, Health of the Nation Outcome Scales, SCART assessments, bed sore assessments (altogether twelve pages), care plans (four pages), care plan daily record sheets (twenty two pages), multidisciplinary team meeting sheets (eight pages), blood pressure charts, weight charts, pathology test records for possible urinary infection, blood counts, drug levels, and physical examinations (in total ten pages), Care Programme Approach records (Six pages), Correspondence (Seven pages), personal finance receipts (four pages), a pair of broken false teeth in a plastic bag, and the seven cardboard dividers which attempted to structure this ridiculous monster.
I then thought about the patient in question; a fifty year old man who had a long standing inadequate and manipulative personality, no suicidal ideation, went on home leave every weekend, was physically fit, who had been on the unit for almost a decade without significant change, and who would have been transferred to a private sector hostel years ago if there had been the funding available to do it. This man was not acutely ill and he didn’t really belong in hospital at all, and yet we continued to treat him as though he had just arrived as an emergency admission on a stretcher.
He didn’t need the heavyweight ‘everything but the kitchen sink’ nursing care plan, because he didn’t need the hospital environment at all, yet instead of making a common sense adjustment to his care we continued to submerge him under a sea of medics, tests, re-assessments, specialist referrals and weekly multidisciplinary meetings, simply because that was our professional ‘role’ and we were too inflexible to change it. Due to the absurd overkill involved, the man had slowly become conditioned to think of himself as a desperately ill and permanent hospital patient; one who could no longer conceive of a future beyond the unit, even though one day he would no doubt be rocketed into the private sector where no such attention would be given.

Social Integration

Posted in Blogging, jobs, careers and work, mental health with tags , , on March 18, 2013 by leovineknight

“Buzzz” went the doorbell.
“I’ve just come to pick up Mrs. Brown with the broken leg” said a dripping wet man wearing a Robinson Crusoe outfit and large silver earrings.
“ I’m afraid there’s nobody of that name or affliction here” I replied. “This is a psychiatric unit.”
“Are you sure?” he said (looking closely at my eyebrows).
The dripping wet man then ambled off and started peering through one of our side windows. He was no doubt in search of Mrs. Brown, but instead collected a nose full of diarrhoea from the downstairs toilet and a hearty “bugger off” from one of the patients.
“Can I be of further assistance?” I called rhetorically after him.
“Er…no… no….thanks.”
“Would you like a look around?” I suggested.
“No…no….that’s fine.”
“We’re having the inaugural ‘Friends of Local Psychiatric Rehabilitation’ meeting next week, if you’d like to bring Mrs. Brown?
“Er……….I’m due to give a presentation that evening”.
”A presentation!” I gasped.
“Yes, yes…. I would have loved to come otherwise.”
“The patients have baked a number of interesting cakes.”
“Sorry……..I must go now……urgent appointment.”
“I quite understand” I said.
I really did.
“By the way.”
“Why are you dripping wet and wearing a Robinson Crusoe outfit with large silver earrings?”
“Oh…yes….ha ha…..I wondered whether anybody would notice. In fact, I’ve just been diving off the pier for a hospital charity. It was an absolutely brilliant day – lots of fun and only two deaths through heart failure.”
“Well done. I do admire really mad people like you.”
“Ha ha ha ha” we chuckled.
Until he realised where he was.

The Club

Posted in Biographies and Inside Stories, Blogging, jobs, careers and work, mental health, satire and humour with tags , , on March 10, 2013 by leovineknight

Seeing the in-coming nursing assistant, I said:
“Welcome to our exclusive club”
“What? The mile high bestialism club you mean?” he replied with razor sharpness.
“No. The ‘I actually turn up for work’ club.”
Office culture probably wasn’t as advanced at the unit as in a bank, building society or insurance office, because we were too anarchic and self-seeking to really have a discernible culture. Nevertheless, it was impossible to escape the working day without some form of badinage, plenty of ritual complaints and a pot-pourri of petty politics, as people strove to gain their little psychological advantages. We also had some classic many-skirted princesses and multi-shirted heroes, including two chaps who came to work like eighteenth century aristocrats visiting a bordello, reeking of so much after-shave that a naked flame would have blown the walls out. Generally speaking, if you were a fully paid up member of a witches’ coven (or the warlocks’ equivalent), you would fit in seamlessly.

You would be welcomed, hideously.

However, one activity which we certainly had in common with other offices, was the ritual of gift ‘collection’ for staff who were leaving, and because we had such a high turnover of disaffected personnel, these collections occurred with blurring frequency. At one time there were so many going on, and the anticipated donations were so high, that we were almost working for a net financial loss. Even temporary staff were expecting to go away with a 100 piece Crown Derby dinner service, or a day at Silverstone in a Ferrari F1 car, and they even had the cheek to demand a product change if they didn’t like what we gave them. I mentioned the current collection to my new colleague, who was notoriously parsimonious, and he said:

“I’d love to contribute, but unfortunately I’ve left my wallet at home.”

“Well, I can pay in £5, and you can repay me later” Sidney teased.

“Eh? Oh, w-well there’s no need to bother, I’ll probably drop it in later. N-no need to put yourself out on my account” he spluttered.

“You know, I didn’t really believe it when somebody told me that you reused your condoms” I said “ until I saw them hanging on the washing line one day”

“Get stuffed”.

“Then there was that story about you using charity collection bags for your own rubbish.”

“Well, everybody does that”.

Yes, but not everybody then puts the bag out for the charity collection man to dispose of.”

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