to wonder if geriatric and psychiatric patients should be put onto specialist wards

[hardhatdonned]

I'm just watching dispatches and pairing it up with my own experiences of being a hospital in-patient several times I am wondering if IABU to wonder if geratric psych and psychiatric patients in general should NOT be placed on general wards with other non-psych patients? I had the misfortune of being on a mixed ward after two operations mixed in terms of gender and mixed in terms of psychiatric history and age - basically a general surgical ward and whilst recovering from quite serious surgery was witness to bed blocking dementia patients who required quite intensive specialist care from non-surgical wards.

IABU and selfish aren't i. But it really is distressing and upsetting when you're at your most vunerable. The rational side of me says IABU because everyone deserves fair and equal treatment but then part of me is petrified of ever being stuck on a ward with several patients with dementia again terrible isnt it.

You know, I think being on a group ward is always a bit unsettling, if distressing. Especially if you're feeling rotten. I remember waking from an operation around mid-night on a ward with 5 other women. One of them was shouting down the phone to relatives overseas because of the distance and time zone difference, not giving a hoot for the rest of us recovering from surgery. She was selfish, but not geriatric or needing a psych ward.

Do you mean in general ie for all inpatient care? or only for physical care?

How would you define a 'psychiatric patient'

Generally they are aren't they?

And I think it's a bit unfair to pick on those two groups.

I spent a week in hospital at 20, there were 4 miscarriages in the 3 other beds in that time so it was 24hr crying in my ward. Absolutely awful for them, and a bit scary for me, but not their fault. And probably also a bit scary for them to be around my projectile vomiting and collapsing. I wouldn't want them to have to be shipped off to a miscarriage ward on their own.

No good answer I suppose.

I suppose anywhere where the stay could be traumatic - surgical inpatients for instance.

By Psychiatric patients i mean those who could possibly be distressing to other people such as dementia patients or similar. People prone to wandering or making distressing noises.

I don't know, i'm just throwing it out there really.

I have real issues with what you say about psych patients in general having to be segregated. why ? they're not all stabby psychopaths you know. I've looked after massively depressed nuns, they're psychiatric patients and aren't really a risk to you

I can understand where you're coming from with disorientated dementia patients needing specialist nursing environment, but for their own safety.

Better training and updates and more staff would be my answer!

I think it is only natural to want a restfull place to recove from an operation.

Do you know if these patients were there because they were having surgery or because there were not beds elsewhere?

Psychiatric and demented patients often have other health needs which may need them to be admitted to medical or surgical wards. Ideally there would be enough staff to cope with this but I know this is often not the case. This is often when there are problems for all involved

What is sad and should not happen is patients needing care for their dementia, psychiatric problems being stuck on general wards becouse there is no where else to go

My sister is an inpaitent in a psychiatric hopspital, She is currently recovering from breast cancer exactly the same breast cancer that 'sane' people get. I couldn't care less if it offended others having her on the ward, where do you think she should of been hidden?

I really think that wards have had their day for myriad reasons. Contamination, privacy, dignity. I loathe them and hope that they will be phased out. (unlikely due to financial constraints know)

I suspect that by choosing to define 'psychiatric patients' as 'those who could possibly be distressing to other people' you are inviting trouble, but I guess you knew that from your namechange

I have been an inpatient of a psychiatric hospital myself so i do know the ins and outs of psychiatric care before you all get up on your high horses. But i really do think you know the patients I mean, the wanders, ramblers, screamers, wailers, the more severely disturbed that need specialist care.

And yes I agree this does nothing but highlight the serious lack of care for psych patients out there - specifically in the geriatric sector.

I haven't had a name change but thanks for trying to cause trouble stealth :)

My fil had a stroke and was unable to move, he was in a ward with lots of dementia patients who stole his belongings, pulled at his various tubes, machines etc, shouted and screamed at him and generally terrorised him.

They were not physically unwell, bed blocking as hospital had no where to discharge them.

General trained nurses mostly don't have the training in dealing with these types of patients, nor on a busy ward are they able to give them 1-1 supervision which is often needed.

I really don't know what the answer is.

Not trying to cause trouble, just surprised by the stigmatised approach to people with mental health difficulties.

A dementia sufferer is likely to find being in hospital away from familiar surroundings and routine extremely difficult. The priority must surely be that his or her needs are met and he or she is given as much support as possible. Yes, it's hard to be in hospital recovering from surgery, but much much harder if you suffer from dementia - when the NHS has limited resources, your post operative sensibilities are going to come far down the list of priorities and in my view rightly so.

They may have had medical/surgical needs as well, these needs cannot be catered to by mental health nurses and psychiatrists. People may think that the "ideal" is side rooms, but this actually compromises care in my opinion (as someone who actually is a nurse!) because patients are less visible. I have cared for many extremely irritating, selfish and noisy people who are not old, have no diagnosed mental health issues and in some cases no genuine medical problems - should they have a specialist ward too?

What Ramblingmum and still thinking said.
Yes dementia patients can be difficult to manage on surgical ward because the symptoms are often significantly worsened by removing them from their familiar environments.
Saying that most wards which specialise in dementia care are not equiped to care for complex surgical cases and poor post op management worsens outcome. Having dementia does not mean people should be excluded from having surgical intervention should they need it. The same applies to psychiatric patients ( almost all of whom will have a RMN specialling them to provide the care for their mental health needs)
However I also see your point about the need to recouperate in a peaceful environment. There is no easy solution.

YANBU.
I as hospitalised twice last year, and both times spent some time on wards with dementia patients.
I'm used to dementia, I work in a Care Home when I'm well, but being stuck in a hospital bed with people who wouldn't leave me alone, an a poor woman who couldn't use the loo, got no help with it, and then the loo wasn't cleaned was bloody horrible.
Saying that, I was in 6 different wards in the first hospital and met 2 nice nurses and one nice doctor, the rest were pretty awful and the food was like swill.
They made things up and wrote it in my notes, and wouldn't listen to me.
I refused to go back there and my GP had me admitted to a different hospital when I needed to be admitted for a second time.

I'd always imagined hospitals to be caring places.

Fannyfifer - yes general nurses DO have training in looking after dementia patients and it's very rare to find a medical ward with no demented patients on it. Any one with any knowledge of the condition knows that the best will and all the "training" in the world is not always enough to prevent the behaviour that can sadly arise from having it!

Stealthcat, I only wish I was surprised by what you call the stigmatised approach! Sadly it is all too common.

An uncomfortable situation for all parties I suspect.

Not ideal for anybody, but the nhs has very limited resources and the patients have very diverse needs.

If somebody wants to be more particular about the company they keep in hospital then they need to pay private.

well said stealthcat

the amount of times I've had to nurse vulnerable people being 'terrorised' by 'normal' members of the public just because they have a mental health issue.

blueberry: I was surprised because the OP said that she had had psychiatric inpatient care herself, which presumably makes her one of the 'psychiatric patients' that she thinks should be segregated?

I think i've missed a couple of posts somewhere

what do you mean?

Please don't refer to people with labels in the way you do in your posts. 'Bed blocking dementia patients', 'Ramblers', 'Wailers' and 'Screamers' does nothing except dehumanise and patronise. You would certainly be more careful of referring openly to someone as a 'bed blocking cancer patient', but don't be under the illusion that dementia is any less of a life sentence or less worthy of empathy, care and attention. If someone were screaming with physical pain would that be more acceptable to you? The mental torture of dementia or severe psychosis is certainly comparable.

The majority of the people you refer to would be in non-mental health wards because they have physical health needs that require specialised care and they have no less right to it than anyone else.