H is for...

So, I've got my next placement sorted...I'm going back to where I work. I'm choosing to see it as the logical progression given where my interests seem to lie (i.e. forensics) and not just that I'm taking the easy route. Which I am. I've really enjoyed some of my other placements, and if the local acute wards ever go to 12 hr shifts then I would seriously consider applying to work there. But for now I just want to not be stressing over starting somewhere new and having to go there five days a week whilst also fitting in bank shifts and trying to do a dissertation. Being at work means 4 days off a week, first choice of bank shifts (cause I'll be able to hunt down the almighty Rota Woman and harass her) and the absence of freaking out with those 'new starter' nerves (ohshitohshitohshitwheredoIparkwheredoIeatluncharetheygonnabenicetomearghhhhh!).

Sound like I'm trying to justify it much?

Also, work is probably the only place in the area that is going to be taking on staff when I qualify since they are expanding and are about 40 RMN's short.

Yeah, still justifying it.

So, while I wallow in the feeling that I should really be making more of my training, here's H...

Hygiene (Personal and Environmental)

I may have mentioned before, but patients have a varied relationship with hygiene. Some border on obsessive in their bathing, whilst others prefer to moulder in their own filth until their clothes become physically attached to their skin. Most fall in between. If a person becomes so dirty that it is offensive* (usually about the time you start to gag when they enter the room...or even the building) then we bully them into the shower in the nicest possible way. On these occasions HazMat suits would be useful, and it would be nice if in the summer months we were just allowed to hose them down in the courtyard. Damn Human Rights Act.

Strangely, some of the people who would prefer to kill rather than change their clothes tend to be fastidious about their environmental hygiene. Patients are expected (read: nagged, usually fruitlessly) to clean out their room at least once a week, but all other areas are cleaned - again, with varying degrees of success - by domestics provided by a contractor. Some of the long stay wards absolutely reek of lavender-air- freshner-with-a-hint-of-stale-urine.

We have a lot of mice, which provides endless entertainment on a night shift when you're teamed up with the type of person who screams and jumps on a chair at the sight of something two inches long and furry. A well-placed dustball in a draught can have hilarious results at 4am.

*Which, to be fair, can apply to some staff as well. Wonder if the Human Rights Act prohibits hosing them down in the courtyard.

Hostages

We get a very basic level of training in ‘how not to piss someone off when they’ve taken a hostage’, from both a negotiator perspective and a hostage perspective. Role-play is often a great experience for staff, giving them as it does the opportunity to vent any frustrations they may have on the poor bugger who gets to play their hostage. All in the name of realism, of course.

Actual hostage situations are very rare, but are obviously very serious. One staff member who was involved in a pretty nasty incident 20 years ago never worked again after developing PTSD. Basically, we always, always phone the police; they have better training, and weapons, and body armour. Apparently they are going to be giving people proper hostage negotiation training soon, which is the kind of thing it sounds fun to go in for until someone barricades themselves in the quiet room with a pool cue and a terrified member of staff and it's you they call...

Hostel

Scary places where patients are discharged to in the hope that they won’t offend again. Quality varies massively, from the 'this is fantastic I want to live here forever' to the 'you can just kill me now, there's no fucking way I'm spending even a night there'. The quality of the supprt they give can make or break a patients chances of surviving on the outside. They are always, always underfunded.

Handover

This is when the nurses huddle in the office and talk about the X Factor for half an hour. Occasionally a patient may get a mention if they did something particularly exciting, although usually little short of murder and/or suicide will warrant interrupting the argument about the merits of Jedward. If you need their attention during this time, you best come armed with biscuits.

High Security

Where patients go when they are very naughty. There are three high security 'special' hospitals in England; Rampton, Broadmoor and Ashworth. We send them our most violent patients and they keep hold of them for a few decades years until they are burnt out/medicated into a less threatening state, at which point they send them back and we attempt to resocialise them into not being afraid of the outside anymore.

The hospitals themselves have security more akin to a prison. They have been subject to massive investigations over the years, with complaints ranging from the mass abuse of patients by staff, to the staff being completely under the thumb of the patients to the extent that sadistic paedophiles were being left alone with child visitors (see here for a snapshot, but the entire report makes for disturbing reading if you have the inclination). Things have allegedly improved now. Certainly, a lot of our patients that come from there seem to want to go back.

And on that cheery note, I'm off to revise antipsychotic drug classifications. Diphenylbutylpiperidine, anyone?