Wednesday, 2 December 2015

The Locked Ward and NICU

I became poorly a few weeks ago. It's anxiety and I can't go into great details about the causation suffice to say I have had anxiety issues throughout my life however I have never experienced anything as intense as this. A psychiatrist at the hospital felt an inpatient stay would be appropriate so I was admitted.

Ten reasons why a locked psychiatric ward is like NICU

1. You have no idea how long you will be there.

Just like when your baby is admitted it's only best guess how long your stay will be. For procedures like hips, knees, even heart surgery there are TLOS (target length of stay) guidelines and generally you can plot how long your stay will be. For NICU babies and psychiatric inpatients the guidelines are much broader and more variable.

2.  You cannot go outside

When Joseph was on the ward what I wanted more than anything was to take him for a walk in a pram. It was impossible So to with my stay on the ward. I was admitted on a Friday and grand round wasn't until Tuesday and until then I was not permitted to leave the ward (although I was there as an informal patient not sectioned).

3. You discover the NHS is not a 7 day a week, 24 hour a day service.

I hate admitting that Jeremy Hunt is right. Although doctors and nurses work every hour, many services do not exist at weekends, things like Occupational Therapy do not happen at weekends. Medication reviews can't really happen at weekends. If anything goes wrong staff need to be brought in. Weekends feel unsafe, both in NICU and psychiatric care.

4. Lack of budgets affect care

I was often told that things on NICU couldn't happen due to budgets, such as access to donated breast milk, even access for kangaroo care. It was the same on the unit. Our psychiatric unit had a well equipped gym, but no staff to supervise it so it was locked and unable to be used. We had a great OT room equipped with crafts only open 90 minutes a day due to staffing. And that was weekdays.

5. Support comes from your peers

On NICU I found a great camaraderie in the trenches. We all supported one another, the same is true of psychiatric care. I arrived late one Friday night, there was no food, all the patients rallied around to ensure I had food, they brought me books and hugs. On the Sunday when I was desperate for an apple and there were none to be found, a patient brought me two of his.

6. Discharge is swift

On Tuesday we had the grand round, I was expecting to get my leave plan allowing me time off the ward, instead I was told abruptly I was going home. The same happened with Joseph, discharged, on a Tuesday, after 10 and a half weeks, 3 less than we were expecting.

7. Community services suck

We had a lovely nurse when Joseph was discharged but once he reached his due date that was it. I was discharged to the home treatment team. I wasn't seen until the Sunday and they saw me and then discharged me from home treatment immediately. I had gone from being poorly enough to a section being suggested to being well enough to have no ongoing treatment. It brought back memories of being mum to baby only just 5lb, with a long NICU history, with very little support.

8. The memories remain

Like my NICU stay, often memories pop up in my day to day life and in my dreams. I am scared of my experiences and also intrigued by them. Fortunately my stay this time was 4 days not 76 so hopefully the processing won't take long.

9. It felt like home really quickly

Initially when I first saw the NICU I thought "I can't do this, not weeks and weeks of it" but quickly fell into a routine and when I left felt a bit bereft. The psychiatric unit was the same, I went from "No I can't stay here" to "yep this works for me" within a day.

10. The staff are amazing

I met the best staff during my stay, people who do this job because they are passionate about mental well being, just as neonatal staff are passionate about baby well being and families.

And a bonus 11th reason

I have no desire to return as a patient to either setting!

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