Comments on Qld Mental Health System cont...
Inpatient treatment at hospitals
The final issue I raise is the treatment of inpatients on psychiatric wards. In the past two years, I have spent approximately 12 weeks on psychiatric wards at two hospitals in the Brisbane area. I have also visited friends at other hospitals, and have seen similar attitudes reflected in the staff on these wards.
It is difficult to know where to start in writing about these attitudes. Perhaps they are most clearly illustrated in decisions made about my treatment on my most recent stay in hospital. At this time, I had self-inflicted a number of second and third degree burns on my arms and legs.
The nursing staff were aware of these injuries, and the doctor who had examined them had ordered that they be dressed three times a day. I knew from past experience that dressings once a day was a reasonable expectation from the staff, if I actually went and reminded them. This was embarrassing for me, as I didn’t like to draw attention to myself or be seen to be bothering the nurses.
However, I didn’t really expect the decision delivered to me by one of the nurses the next morning. I was told that I could dress my own wounds once a day, and that I should come and ask them for the appropriate dressings and creams. I’m still not sure why this decision was made, but my inference at the time, given my state of depression, was that I was a bad patient being punished for my weakness.
The outcome of this “ruling” was that within two days my wounds were not being dressed. I was too scared of and upset by the nurses to approach them for dressings, and not one of them sought me out to check on the progress of my injuries. At the time, I assumed that the blame for this was entirely mine.
On numerous occasions, I was advised to come and talk to one of the nurses if I felt like hurting myself. I wasn’t convinced that this would help, but anything was worth a try, so I spoke more than once with various “trustworthy” staff members about my distress.
Their response was unvarying - to provide me with valium and antipsychotic medication, to “help me control my thoughts”. My thoughts, unfortunately, remained unchanged, although I felt too sick and weak to make any more fuss.
I never questioned them on the medications they gave me, even though I suffered some distressing side effects such as nausea, stiff muscles, a terrible thirst, and weakness in my legs. I never questioned that they were giving me antipsychotic medication when I had never complained of any symptoms of psychosis. Consequently, I’ll never know if they were treating my symptoms, or just trying to knock me out so they could go about their business.
I have seen many other shocking things on psychiatric wards. Perhaps the most distressing are the chemical restraint of patients, and the lack of future-focussed development of coping strategies. It is sad to see how many patients keep coming back to hospital over and over again, and how often hospital admissions and medication are used as substitutes for future-focussed managment strategies for their illness.
The staff who show patients kindness and care are far outnumbered by those who use their positions to meet their own needs to feel powerful and control others. The overwhelming message to patients is that they should do as they are told and not make trouble.
If the strategies used by professionals in these hospitals were effective, there would be no problem. If patients were leaving hospital having made lasting gains in their health and wellbeing, then I could not object, despite my personal feelings.
However, I have learnt from experience that these things are not effective. Rather than working through past and present issues, and learning how better to cope with life, patients learn to keep their heads down and their mouths shut to escape the monotony and ill treatment on the ward. And when the next crisis hits, they return, having gained nothing overall.
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