In his morning blog, Cro talked about the state of psychiatric care in the country, discussing its efficacy especially when dealing with the sad case of the recent Devon Shootings.
I trained as a psychiatric nurse back in 1983, just as the big asylum system was closing and the relatively new community nursing system was being set up and greatly expanded.
The nurses, especially on the acute admission wards, were becoming much more psychologically focused in their care and training, like most branches of care, nursing was becoming more academic, research based and professionalised.
It was an exciting time to be a nurse, in many ways but after just three years training and three years staffing on an acute admissions ward I left to become a general nurse. I was burnt out, jaded, and a little cynical.
I was also just twenty seven years old
Very few of our patients were the Conrad Jarrett type. (Conrad was the lead character in the book Ordinary People , the character played by Timothy Hutton in the film version, who was wracked with guilt and depression after his brother’s death) Conrad was cured by the intervention of a kindly old Psychologist after his discharge from psychiatric hospital.
Our patients where the acutely ill psychotic and depressed. Patients that were admitted time and time again when meds were not taken, home stressors remained unchanged and when life too a turn for the worse.
I was a patient in a big old institution about as 42 years ago-I had been addicted to valium as a teenager and as my local doctor was useless my desperate parents took me to a private clinic where the doctor stopped the valium immediately-alas I imagine he wasn't aware my local doctor was allowing me or no one was checking that I was presenting myself at the practice far too frequently for repeat prescriptions and the withdrawal was bad-This really screwed up my life unfortunately x
ReplyDeleteMy mother was prescribed Valium like smarties in the 1970s she medicated herself with alcohol after that
DeleteMy mum was and my best friends mum too x
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DeleteMy mother was prescribed Valium when I was 15. I told her not to take it. She listened to me and didn't. She was prescribed Valium for headaches. I told her to burn the prescription.
DeleteI wish my mum had
DeleteYour post is so very well put this morning I was on the receiving end of psychiatric nursing many years ago (deep insulin therapy) - with gentle care from a very new husband (himself not long back from The Death Railway, 16 weeks in a good private hospital, a caring GP when I came out and a long road to recovery I came through it, but it was not easy. I was one of the lucky ones.
ReplyDeleteThank you for sharing this pat.
DeleteFor those that don’t know insulin therapy was an untested unreasearched treatment where patients were forced into an induced coma and subsequent neurological fits with insulin.
Barbaric and dangerous
I don't think I could ever work in psychiatric care. I think I would have a negative effect on people that were already troubled! We are all mentally flawed in various degrees. I am not surprised at the reasons that you left psychiatric nursing.
ReplyDeleteI was too young
DeleteI valued the training I received and that has made me a better general nurse
The skills I learned helped my work within spinal injuries and made me think laterally when I was a nurse manager
General nursing has its challenges but psychiatric nursing has even more challenges. The progress of a broken bone can be reasonably predicted, the progress of a broken mind can't. xx
ReplyDeleteI think they both have unique challenges.
DeleteI worked in a psychiatric hospital for 20 years, not on the nursing side but in admin. We did have a few locked wards for the violent patients, but generally all other patients could wander around the hospital and grounds as they wanted.
ReplyDeleteThe majority of the offices were located in the main hospital, but our office, Supplies, was located a short walk away joining on to the actual Stores. It wasn't unusual for a patient to come into the office for a chat or just for a wander around. Most were friendly and you could tell the ones who were sedated for whatever reason.
There was only one who was scarey, his eyes were always wide open and staring and when he spoke it seemed quite threatening and I always tried to make a hasty retreat especially if I was on my own.
Bt saying all that I loved my time there and have some happy memories with both patients and staff. I only left in 1990 to move down to Devon because my husband had a new job there. Sadly that hospital, St Crispin along with the grounds is no longer there as it was sold off because they were sending the patients out into the community.
Would that be St Crispins in Northampton? If so it has been replaced by a new much smaller hospital called Berrywood. It is purpose built and a lot less frightening than the St Crispins buildings, Some of the original buildings are now apartments! I can't imagine living in a place of such despair.
DeleteThe staring eyes , was a side effect of long standing medications
Deletehttps://pubmed.ncbi.nlm.nih.gov/20443647/
I feel sorry for him now, but he was scarey at the time.
DeleteYes Lisa It used to be known as the Berrywood Lunatic Asylum. Apart from the red brick of an old building St Crispin was far from frightening. I don't know what you've based that on.
Thank u
DeleteMy fear of the place comes from my vile mother telling me that I would end up at Berrywood if I was Naughty. As a favourite aunt was admitted to the place and only talked about in whispers afterwards, My childhood fears felt justified. Fortunately my experience as a patient at the new hospital has literally been life saving.
DeleteI'm sorry to hear this, but SCH was not as your mother painted. There was a childrens psychiatric hospital in the same grounds called Princess Marina Hospital and they were tragic cases. Some of the children had to wear crash helmets all day as they would bang their heads against a wall. I heard that some of these children had been abandoned by their parents. I don't know if PMH carried on or what happened to the children if that hospital closed too.
DeleteIt's got to be an incredibly difficult field, given then intractability of the illness (at least in severe cases) and the sometimes frightening manifestations.
ReplyDeleteIt has its challenges. I do remember the teams I worked in were incredibly supportive
DeleteNot something I could ever have done. Hats off to those who do.
ReplyDeleteYes I agree
DeleteThere was one lady who I was very afraid of and I think for good reason-when visitors were sitting around tables in the evening she would stomp around shouting aggressively wearing makeshift religious style robes possibly she had wrapped herself in bed sheets holding a wooden notice-I think she was led away-later on we as I recall quite sane patients-one a teacher who I sat with most of the time heard her banging and shouting very loudly and the small curtain on the door of the padded sizeable room was open and she was crazy running at the walls-I think the nurses who were with her saw us peeping and closed the curtain-next day word got round she died of a heart attack x
ReplyDeleteModern meds now prevent the physical exhaustion that often used to kill patients
DeleteDon't you think most are vulnerable to experiencing some sort of mental health issue? Life events can be hard and people are vulnerable. It is unfortunate that care is hard to come by and only the lucky ones get the help needed and come through okay.
ReplyDeleteSusan, that was my point , so many of us are only a pebble throw away from mental illness problems
DeleteMy husband's mother spent much of his first ten years back and forth to in-patient psychiatric hospitals. His memories were of sleeping one winter on the warm floorboard of his father's truck when they traveled back and forth to visit her, his infant brother boarded with another woman in the community. He remembered her being physically abusive when in between hospitalizations. I had a different take on what she had endured because I'd never been a young child in her care. Her sister took her away from their mother at three or four when her sister was told that my future mother-in-law was going to be put in an orphanage. When my mother-in-law fell and broke her hip, she descended immediately into violence with the nurses and visitors. My husband had great difficulty, as it revived all those memories. We tried music from her era--she loved music--and everything we could think of to calm her, but it was as if we'd all been put on a runaway train and were barreling toward disaster. I was months away from my first brain surgery at the time and couldn't take on her care, and my husband declared that he could not endure having his childhood repeated anyway, which it would be, he felt, if we were to try to take care of her.
ReplyDeleteShe routinely tried to break nurses' fingers. Such sadness.
Mental illness within a family can be catastrophic
DeleteI think that is the truest statement I've ever read. My daughter is bi-polar and I feel as if much of my 65 years has been devoted to trying to help her sort things out. It's always something, always, and even when it's not, you are waiting, holding your breath. I cannot tease apart my issues from hers because they are so entwined. I love her, but it is exhausting. It is lonely.
DeleteI have happy memories of some of the patients I nursed during twenty years as a psychiatric nurse , I trained at a big old Victorian hospital in the countryside . Most of the patients were long stay and sometimes the reason for their admission was vague , but there were some real characters some of whom I grew very fond of . The authorities were moving some of the patients out of the hospital into accommodation in the community whilst I understood the thinking behind the policy it was sad to see how upset and disoriented they were by leaving the only home so many of them knew . And of course by eventually closing the hospital the health authority were able to sell the lad and building for a large sum of money .
ReplyDeleteI too have such memories, many of them shared here
DeleteMy Mom studied for and became a psychiatric nurse at Dixon State Hospital in Dixon, Illinois! I was just into high school when she started doing that work ... 3 of her lady friends also went through the schooling, so they all worked together and, for the most part, I think she enjoyed it! She always worked the Graveyard shift and all the ladies went with a fellow worker who drove them every night!! One morning, however, my Mom came home with scratches to her legs, arms and I believe on her face ... one of the patients [a female] went off the deep-end and attacked her! Upset her but didn't deter her ... that job gave her some independence from my Dad!
ReplyDeleteOn April 21, 1960 ... all 4 ladies were killed in a head-on accident on their way to work! The fellow worker driving their car -- paralyzed for the rest of his life! The driver of the other car was drunk and uninjured and my Dad was able to make sure he never got another driver's license!
Not good memories ... but life does roll on!!
Oh Marcia, what a sad story. This is going to stick in my mind all day.
Delete❤ ... Thanks, Jan.
DeleteYes it’s so tragic, I’m so sorry
Delete❤ I was 16 when that happened! I will be 78 on this Saturday!
DeleteWhen do any of us become fully cooked? I like to imagine that when we are we die.
ReplyDeleteNicely put mave x
DeleteI’ve had a few friends over the years who began in psychiatric nursing and had the same experience. I imagine it’s not a career path most people would follow long term. I’m glad it didn’t put you off nursing. And working in hospice care is another very demanding choice. I admire you for choosing it.
ReplyDeleteI find hospice work rewarding and not stressful , as long as I balance my work with downtime , I try to make sure I have a holiday every two months or so
DeleteAfter university I entered an NHS Management Trainee Scheme and spent 18 months in psychiatric hospitals in Norwich (we had two very big asylums in this city at the time). I dropped out of the scheme because I did not like what I was involved in. The two trade unions, Nupe and Cohse, ruled all decision making with two extremely powerful shop stewards who had representation on every committee. Patient care was not always at the forefront of the trade unions, placing importance on job descriptions and demarcations, reducing it to shipyard negotiating. I saw the Huntington's wards here, where we had a high incidence of the disease, locked and padded, and the elderly who were just beginning to die in the 1980s who had been admitted in the 1930s. The first family I met said that their cousin had been admitted for lifting her skirt on the road side in front of passing traffic. They said there was nothing else they could do with her but put have her sent to the asylum and they looked at me questioningly and nervously. They were all in their 80s. That was in my first week. There were many things wrong in the old days of psychiatric care and there are still many things wrong.
ReplyDeleteApart from poor nursing those things wrong seem very different ….
DeleteToday even basic counselling can be rare as hen’s teeth to organise for those desperately in need it.
Psychotherapy is available but mainly utilised by those than can pay for it privately .
Isolation and loneliness compounds the issues as does unemployment and lack of self worth
The asylum farms provided these and structure for the lives of many psychotic patients.
On reflection I was too immature, too young to deal with life as a psychiatric nurse..though I benefitted tenfold by the experience
The asylums were not the answer to mental illness care. They were not the reason I left, but they were wrong, I could see that. I left because of the politics with a small and a big p. I have often written about the money that I saw wasted and poor management decisions.
DeleteI agree they were a Victorian answer to a problem. The structure and confinement helped a little
DeleteI would find your experience from the other side interesting to hear
I have frequently made it clear what I think of NHS management, and why.
DeleteI agree with u
DeleteBut I’d still be interested to hear
DeleteI've always been concerned that psychiatric hospitals were closing even before I started nursing school in 1969. Those in need of help were all too often left alone or for their families to deal with. As has been written, too little money is available for actual assistance and proper care and that's to our shame as nations.
ReplyDeleteHugs!
The states have a worse record than most for quality psychiatric care
DeleteWell written John.
ReplyDeleteHow many of us think "there but for fate go I?."
Thank you x
DeleteI find it both rewarding and heartbreaking. But I am fortunate to be in a job where I see more success stories than revolving doors.
ReplyDeleteThere is a big problem with lack of access to skilled psychological help however. And the policy makers keep prioritizing cheaper quicker "fixs" that don't necessarily work for all.
We are also on the brink of a big nursing shortage with a lot of our most skilled nurses (as well as the bulk of the workforce) on the precipice of retiring at 55 (which won't be an option for me when I get there unfortunately)
Funny dan, I was thinking of you today
DeleteYou are one of the good guys
You stayed x
It's very difficult to deal with people who suffer from delusions. I know from working in a nursing home and having a husband who had a psychotic break.
ReplyDeleteLove,
Janie
Like you and Cro I also wrote a post about psychiatric care today. Coincidence!
ReplyDeleteLet me look
DeleteI think you're right that most people just manage their demons, so perhaps there are few capable of giving long term psychiatric support. A friend of mine was a psychiatric nurse; she was also overwhelmed by the problems of her patients, and still struggles with her own mental health, many years later.
ReplyDeleteWe all just get on
DeleteI have a shorter answer to your title - because it was driving me mad.
ReplyDeleteLol I know
DeleteStress and burn out are real. My boss is retiring and I was asked to write a tribute, the draft tells him that he rescued me from a job I was about to walk away from.
ReplyDeleteWorking with seriously disturbed patients must be one of the most stressful occupations on earth. I admire all nurses, but those who look after mentally ill patients especially.
ReplyDeleteI have done just a tiny bit of reading about trauma recently and it seems to me that trauma need not result from a huge life event but from any situation where we feel powerless. When I think of it that way, it's surprising that anyone at all escapes mental illness.
ReplyDeleteThis whole post and replies were so interesting. Has really made me wonder how best these people and their poor carers and families could be helped better. As you say it is a complex and heart breaking issue. Also that we are all so close to some form of mental problems ourselves for several reasons. I always feel very bad that any nurse, carer or family member is having to cope with situations which are so stressful, frightening and sometimes dangerous. And sometimes alone and at night.
ReplyDeleteThswnk you for your post ,John. I find that the sudden swing from 'normal' to 'out of balance' the most difficult situation and the most tiring. Situations always occur at the 'wrong time'. I find the coping without outside advice the most difficult thing.
ReplyDeletealthough our time working in hospitals was not concerned with mental health, I do find our experiences then , help me cope now.
I can understand people being unable to cope with caring someone with problems and am fortunate in being able (most of the time) in being able to do so.
Kathy
I can imagine the particular strains that nursing the mentally ill can bring. In comparison, general nursing is much more straightforward - often with happy solutions and the associated satisfaction that health professionals are entitled to feel. Interesting that you imply we are all on the spectrum when it comes to mental health. I agree with you.
ReplyDelete