B is for...

So continues the tongue-in-cheek (aka it’s all meant in good fun, please don’t shout at me) ABC guide to secure mental health services.

Today’s words are brought to you by the letter B.


Bedrooms

Most modern psych hospitals have individual rooms, whilst some of the older ones still have bays (e.g. 4 beds to a room, divided by the worlds shittiest curtains; discussing suicidal feelings whilst the person in the next bed lays there farting is very difficult). As far as I’m aware, secure units all have individual rooms; obviously volatile patients need their own space, also, they used to be locked in them on a night. We’re not allowed to lock patients in their rooms any more, and in fact can’t; the doors are all unlockable from inside. If you want to keep someone in, you have to stand outside with your foot against the door. The locks these days are mostly used to keep people out of their rooms; some of the patients on the long stay wards have completely kitted out their bedrooms with the latest 37”, high def LCD TVs, DVD players, games consoles, freeview boxes and stereos (your tax dollars at work, folks; people on some sections get £90+ a week, pay no bills and for some reason get the winter fuel allowance. Others get naff all except £16 a week off the hospital for fags.). They don’t want to come out; in fact, the doors all open outwards to prevent patients barricading themselves inside. This does mean that many an unexpecting nurse has been smacked in the face by a well-flung bedroom door whilst doing the obs, however. One of the lesser-known hazards of nursing.


Banned Items

Lots of things are banned, either for security or just for fun. I mentioned alcohol, obviously, and drugs. Some of the others are a bit odder. Chewing gum and blu-tack are verboten (can be stuck in locks, used to model keys or cover alarm sensors) as are matches, lighters (arson, obviously), mobile phones* and any bottles or packets that aren’t factory sealed (drugs, alcohol risk). Oh, and anything sharp/breakable/sniffable (razors, glass bottles, deodorant etc) needs to be handed to staff for safekeeping. Patients are only allowed to keep £20 on them at any time, to reduce the chances of them getting very far should they try and do a runner. Of course, you could argue that this just increases the chance that they’ll mug someone on their way out, but nevermind.

* The only patient phones are the payphones in the communal areas, where staff can listen in. It’s been known for patients to ring other wards to co-ordinate riots on occasion, or just arrange beatings for people that owe them money/fags. It has also been known for patients to arrange retribution for assaults against popular staff members…including against patients that have since been sent to higher security hospitals. Kinda makes you feel all warm inside knowing a patient is willing to have someone beaten up for you.


Birthdays (and Christmas)

Inpatients get an NHS birthday cake (which is actually quite nice, considering they need defrosting when they are delivered) and, usually, a special buffet tea stocked with Aldi’s finest. They get to make requests for what they want, and a sample menu might be as follows; ham/cheese sandwiches, scotch eggs, sausage rolls, beefburgers, hotdogs, nuts, pickled onions, crisps, fizzy pop. Health promotion consists of the staff keeping back half the crisps for the night shift to eat. Sometimes things get really wild and they break the Karaoke out. At Christmas, each patient gets a present to the value of £15 from the ward. Many of them, it’s the only present they get. For a substantial minority, it’s the only new set of underpants/socks they’ll get till next Christmas. They get a slightly healthier buffet, and what passes for Christmas dinner in the NHS, and some of them get phone calls from family since visits aren’t allowed on Christmas day (each ward can only accommodate 2 visits a day, and it was felt it wouldn’t be fair to allow some if they couldn’t allow all). It’s quite sad, really, but the staff usually do their best to cheer people up. How successful they are, given that they don’t want to be there either, is debatable.


Bathing

Always seems to be one of the first things to go out the window when people get ill. Wards tend to get…unpleasant…if hygiene isn’t enforced prompted. Fourteen overweight, sweaty men who don’t change their clothes (ever)* and are less than diligent with their toilet hygiene are more than a match for any housekeeper with any amount of NHS air freshener. Sometimes, threats and bribery are employed to get them to bathe. Sometimes they are physically dragged under the shower. Sometimes all it takes is a pretty young woman offering to scrub their back…then, once they’re in the tub, you send in the nursing assistant affectionately nicknamed Tiny who happens to be built like a concrete plinth. Repeat weekly/fortnightly/monthly/yearly (delete as applicable depending on how often your unit gets inspected by the Care Quality Commission).

*Incidentally, what is it with people with schizophrenia and layers? I’ve met so many who will wear multiple pairs of trousers and tops and will refuse to take their coats off even when the temperature tops 30 degrees. Mentalness is strange.


So that was B. If anyone thinks of something major I’ve missed, give me a shout. Or write a bit for it and I’ll stick it up and put my name on credit you :o)