The impatient inpatient

For the benefit of those who aren’t on Twitter, I’m currently a patient on a psychiatric ward for the first time in my life. Although it feels like I’ve been here for years it’s actually only been a week. After the events of my last post Tom and I had a couple of conversations with the Home Treatment nurses and I did a lot of agonising. In the end figured that  even though part of me felt that I wasn’t sick enough to justify hospital, if things continued as they were I was likely to find myself compelled to go in. And so here I am as an informal (not detained) patient, a choice that at the time felt that it wasn’t really a choice.

Initially I experienced a huge wave of relief. My mood shifts kind of went on the back burner and I felt that surrendering the burden of keeping myself alive to the professionals had been absolutely the right choice. This was reinforced by the ward environment, which is far, far more pleasant than I expected. It’s pretty much like a budget hotel, including en suite bathroom facilities with a shower that’s hot and powerful, just the way I like it, and even a safe, although the bed is small and rubbish. There’s a pin board but of course we’re not allowed pins, so I have to beg Blu Tack from the nurses.

That’s the hardest part about being here really, the incessant need to ask for or queue for stuff. Phone need charging? You’ll have to ask the nurses. Got a headache? Have to see if the nurses have time to give you some paracetamol. You must plead your case to take your meds at the usual time; you’ve managed them yourself for five years but now they want you to take to ward schedule. You must ask if you have various doors unlocked so you can wash your clothes, have a bath, have somewhere to sit with your visitors (there’s no dedicated room).

Some of you may know that I worked in criminal justice for about eight years until I lost my job to this current epic breakdown. Despite the modern surroundings, when I first arrived on the ward it immediately reminded me of a prison. I’m not in any way blaming the unit or its staff. There’s no way of occupying a ward full of patients all day. There’s just not, and from friends I know that units up and day have the same problem. So there were people wandering aimlessly up and down the corridor in tracksuit bottoms, or queuing for meds, or queuing for for food that smells like school dinners only not so appealing. And of course the locked ward door. I’m an informal patient, but having come in with the kind of suicide plans I had, no one is going to just let me walk back out on to the street and down to the tube station. Then there are the unannounced searches for “contraband”.  The logic’s sound, I get that people can and do harm themselves with dressing gown belts and plastic bags and headphones and razor blades,  but it still feels infantilising and infuriating.

I’ve seen a psychiatrist once, a experienced doctor who I think of as Hipster Doc on account of his beard. He seems decent and interested. I told him that part of what got me here was a feeling that my treatment plan was not working, causing me to lose hope that I could be helped, that my existence was just not liveable. He latched onto the idea of a new treatment plan, his mind almost visibly working as he threw out ideas. I said I was open to any and all suggestions but that if I was going to come off some meds I’d rather face the withdrawal as an inpatient, something he agreed made sense.

This is a triage ward, something I’d expected to be a kind of clinical sorting hat, deciding who needed a longer admission than one or two weeks and who could be discharged. I guess I kind of thought I’d only be here a few days. But this (Sunday) is my seventh night and I don’t get to have my treatment plan reviewed until Thursday.

I’ve never been a patient person but the tempo of the ward is frustrating the hell out of me. For all I know this ward moves more quickly than longer start wards, but to me progress seems glacial. There’s also a vagueness about what will happen, something I struggle to cope with.

Yesterday my friend Michael surprised me with a visit and a lovely bunch of flowers. I started off by griping about the pace of the ward to him as I have been to Tom and other visitors, until he asked me why I was still here. Aside from personal safety, what was keeping me here? I was an informal patient; I could just pack my bags and leave. So why didn’t I? What was my objective?

He reminded me that we had last met face to fact in September and even then I was talking about the bed for a complete medication revamp. And if that was what I really wanted I had to stick around, and sticking around meant accepting that for now, and maybe for the next few weeks, this ward is my home. And as it’s my temporary home, I need to make it as pleasant as possible, both physically and in terms of my interactions with staff. Regarding my room flowers and cards of course help, but I’ve also been displaying my completed colouring book pages and results of art therapy. Weirdly for such an untidy person I keep my room very tidy, bed made, towels folded, a place for everything and everything in its place. I guess that as my control is so limited I need to control my space.

In terms of ward culture, I have to learn to go with the flow. This means trying to learn the names of the ever changing nursing staff and working constructively with them, even the ones I find difficult. It means accepting seemingly random blood treats and physical health checks (it seems implausible that my height really needs measuring every few days, but if that’s what they want). It means accepting that most requests I make, like asking whether I get to go out, or asking if I can come off intermittent obs (being checked on every 15 minutes) so I can use the gym or go to tai chi class, will be met with, “We’ll have to see what the doctor says.” I need to accept that I can’t use many of my home coping mechanisms, like headphones or aromatherapy oils, and that my legs will get very hairy.

I need to become a more patient patient.