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.

My dfil was recently on a general ward in a large hospital because he had fallen down the stairs and had a bleed to his brain plus bruising. He also has dementia and terminal cancer. Where should he have been put?

As someone who has paid into the system with tax and NI since the 1950s why should he not have the kind of care he needs?

Scary, nobody has said that patients in a situaution such as your fil shouldn't recieve the care he needs. The fact that he has paid tax and NI makes no difference, so do most people! And even those who haven't should still be entitled to recover from surgery without having to put up with certain things that people with dementia can sometimes do!

If your fils dementia is causing him to behave in a way that is distressing to others, surely it would be better for all concerned if he was not put in a situation where he could be upsetting other ill, vulnerable patients.

ScaryTeacher everybody should get the care they need, but not many people are in the current system. We are an ageing population with all the problems that it brings. We can't care properly for the huge scope of patients in our hospitals anymore. Their needs are too diverse and thanks to wonderful scientific advancements their treatment is too expensive.

We need to go back to the drawing board.

ScaryTeacher, your FIL should have the care he needs-specialist dementia care on top of the general care for his injury and cancer and that's not possible on a general ward.

I am genuinely shocked by this thread. People with mental health problems should not be treated differently from others. Where precisely should someone with demetia and a physical health problem be placed? I am a mental health nurse, so I know that most psychiatric wards would not be able to provide post-surgical care or whatever. The patient would need to remain in a general ward until their physical health issues are treated. To suggest anything else to to say that their health is less important than the comfort of those who may be distressed by seeing them. I would suspect that the level of distress someone experiences from hearing or seeing someone with dementia is much less than the level of distress the dementia sufferer would experience being in hospital. Is it too hard to show some compassion for them?

Of course if one patient is disturbing another then the nurses present should intervene, but the assumption here seems to be that mentally ill patients always disturb others, those without mental health problems don't. I think this is rubbish.

Perhaps if there wasn't such a culture of hiding mental health problems and being ashamed of them then people wouldn't feel threatened when placed in a situation when they encounter them.

There simply isnt the money for wards for when people with dementia or mental health problems have medical or surgical needs.

I do love a good generalisation!

I did say 'geriatric psych' which mis my misguided term for patients with dementia. I also do love how people have picked out points from my OP without reading it in its entirety.

I have said that I know IABU with my attitude as a rational, non-inpatient, type person. My normal head is telling me that everyone is entitled to equal care. My experiences though are making me go the other way.

Everyone is entitled to a decent standard of care and NO patient should be left feeling vunerable and neglected but that very often happens where a ward is predominantly occupied by people with additional psychiatric needs. As i said earlier, perhaps the answer would be to have one or two nurses per ward who are there specifically to cater for the MH side of things?

I don't know what the answer is, which is why i asked the question. But currently there is a global substandard care package happening for ALL patients.

When I was 15 I had my appendix removed. The woman in the bed next to me had a different meal to the rest of us. She had beef and a glass of red wine. I asked her why her meal was different.

Her reply to me was:

"Because I am dying from stomach cancer, and as I only have weeks left to live, I get to eat what I want, and drink wine with it".

It is not only dementia or psychiatric problems that can be upsetting to other patients.

Adventuremouse - This is not about being ashamed of the mentally ill. This is about protecting vulnerable people, both those with psychiatric problems and normal people.

It is scary when you are on a ward; late at night, without any family, wearing pyjamas/hospital gown and in pain. Unfortunately, someone does 'act out'. The Nurses, as lovely as they are, do not have the ability/strength to help these people; so many times the 'mentally ill' person is left 'confused', and inadvertently terrorising the ward.

Yes, we should not be ashamed of the mentally ill, but why do we have to remove our right of peace in hospital? Why do we have to remove our right of not being terrorized?

Of course, I am talking about the worst case 'scenarios', those who have NO idea who they are, those who are violent and lash out. In my experience it seems that the Nurses let them walk the wards, offending other patients, without realising that the other patients are scared. Shouldn't everyone have the right to a 'relaxing' stay in hospital, not just those with serious psychiatric difficulties?

Sorry if I offend anyone

By normal I mean people without psychiatric difficulties, sorry for any offence

The problem here is the lack of nurses on the wards.

I regularly go onto wards and find a few nurses totally and utterly run off their feet.

As NHS bed numbers have come down the proportion of very sick patients on any given ward have increased which makes considerably more work for the nursing staff than in the halycon days where people stayed in for days and days after routine surgery.

Introducing single rooms (where patients can't be easily observed by staff/ other patients) will only enhance problems. I worry a lot about patients deteriorating and this not being noticed. At present if someone becomes really unwell in a multi-bedded bay one of the other patients will generally alert nursing staff (if they aren't already aware).

When you are stuck away in your own private room this won't happen. One of my colleagues and I (looking after a sick patient in a ward with exclusively single rooms) were only speculating about this on Saturday as we felt that our patient was at more risk than if she had been on an open ward.

I watched dispatches with interest i am a psychiatic nurse and i work on a male only dementia ward if any of our patients needed specialist physical care and it was felt their physical needs outweighed their mental health needs they would need to be admitted to a medical ward as the nurses on psychiatric wards are generally only trained in mental health [a few are doubly trained but not many] i cannot speak for the general wards but we certainly dont force feed patients or leave them in agony or not help them to sit in a more comfotable position.

For the benefit of the person suffering dementia maybe - they get put on Psych wards inappropriately when their care needs are quite different from others hospitalised under mental health act. and they have to lump it sadly.

I get what you are saying but my concern would be for the mentally ill rather than a patient such as you - your needs are adequately met on your average ward whereas a physically and mentally ill patient will only likely have their physical needs met.

We have to remember that being in hospital is not something one would look into via tripadvisor.com

the idea that their shoud be a couple of mental health nurses on general wards to help people with mental health needs is a nice idea but i,m afraid their ar nt really enough mental health nurses to staff our wards let alone work on general wards however we do have link nurse to offer advice but how long that will last is any ones guess

Hobbgoblin, I asked on here back in October which was the best hospital between two.
I wish there'd been a Tripadvisor for them.
I knew I had to be admitted, and was terrified because of my experience in the previous place.

As it is, I struck lucky and after being admitted to one hospital, was transferred to another and had brilliant care on the respiratory ward there.

It was so different from my so called 'nearest' hospital (nowhere near) which I am still convinced is a staging area for the Hostel films based on the treatment I received there.

As a nurse I think it also needs saying that some people (often elderly but not always) become utterly disorientated if they have had a general anasthetic. They are not demented - just reacting to the effects of a drug. I have been on a ward (as a patient) where this occurred. The two night shift nurses spent a night trying to calm a distressed elderly lady not helped by a fellow patient who threatened to "report" them if they didn't "shut her up"

I'm all for going back to the days when everyone got a sleeping tablet at night, I bet the nurses would be up for that too.

SmartyHan - how fucking dare you stigmatise those of us with mental illness by saying we are not 'normal'.
Alouiseg - what is your healthcare solution then??

Smartyhan - using 'normal' for people who don't have a mental health problem is a bit tactless, and is stigmatising. 1 in 4 people will experience a mental health problem in their lifetime, so it isn't abnormal or rare. I appreciate you didn't mean to offend anyone.

I agree with gasman that many of the problems come down to staffing levels. But without further investment and the higher taxes this would involve then I'm not sure how things will improve. My trust, like many others, are significantly cutting frontline nursing jobs, so I think often the nurses left just have to do the best they can. I would love for everyone in hosital to have a relaxing stay, and for no one (with or without mh problems) to feel frightened or uncomfortable, but with limited resources I can understand why nurses have to prioritise essential care, like keeping patients fed, wounds clean, etc.

Had to laugh at the 'hospitals are for rest and recuperation' line , you are not being serious are you ? HOME is for rest and recuperation ,hospital is for caring for the acutely ill ,once you are well you go home to have a nice rest , to expect rest in hospital is ridiculous . Lets have a look at the ward environment shall we , ok , lets start with the night shift coming on at nine thirty , it will probably take the four (if they are lucky) staff at least three hours to give out medication , do obs , check blood sugars , sort out IVs , put up feeds ,empty catheters ,put on convenes , help people on and off the commode /toilet , answer the phone to concerned relatives wanting an update ,admitting patients sent up at a ridiculous time of night , double checking the patient who is very ill , changing syringe drivers , giving fresh water , giving mouth care , ensuring patients are clean ,dry ,comfortable ,warm enough , bleeping the Dr to ask them to see the patient who is very ill and has deterioated , going to Xray with the very poorly patient . That is not the full list ,but i cannot be bothered to keep going . So we finish those jobs at say twelve thirty , then you start the iv antibiotics , you keep going back into a room to check someones blood sugar hourly because they are on a sliding scale insulin infusion , hourly urine volumes , the pump their iv fluids is running through keeps alarming , people who need a wee get up and become disorientated and try to get back into the wrong bed ( or so they say!) , then we start the 'turns' ,where we come round and reposistion people who are unable to move and are at risk of pressure sores , then we discover a patient is critically unwell , we bleep the Dr (again) , we do thier obs with the nosiy machine , we discover they are really very unwell and call the crash team , we have to put some lights on so we can see what we are doing ( someone in the same room complains the next day that they couldnt sleep for all the noise , its disgusting apparently ), Yay ! the patient becomes stable , but we have unfortunatlely roused a lady with dementia ,who is clearly very distressed and also very agressive , takes the next hour to cajole her back into bed and to sleep , meanwhile the alcoholic who is withdrawing and is encephlapathic has decided to abscond from the ward (you can hardly blame him ) , cue panic and much running around ,until he is returned safely. Then its time for the 'turns' again , by which time its six in the morning , the morning shift arrive onto the ward at seven fifteen ,lights on !

My solution Kallista? Personally is to keep paying for medical insurance, although I appreciate that is more useful for cataracts and hip replacements than acute conditions.

Generally I wouldn't know where to start.

Can i just add that what i posted wasnt a 'poor nurses/hca's ' rant , but that i was just trying to explain why hospital isnt the place for rest or recuperation. Oh and there is no guarantee that you would get it in a private hospital either , i remember well the night the lady who started to detox post op and ran up and down the corridors with a tin tray whacking every door , bless her little cottoney socks !

I apologise for any offence caused Kallista, However isn't, I thought, "normal" an acknowledged (perhaps UN-PC now) term for the TYPICAL person, you know, just an average person (no mental health difficulties). I apologised (twice was it?) for causing offence. This is my third apology. No need to be so rude. Enlighten me.

Next time, instead of saying what I believe (and apologising afterwards) I will either:

1. Say nothing
2. Define what I mean better, I mean normal as average.

p.s. If you don't like this post no need to swear.

p.s.s Can't believe I managed to annoy someone on my first post, what luck.

Sorry for any offence caused (again)

SmartyHan welcome to mumsnet :o never be afraid of offending people on here, damned if you do and damned if you don't tends to be the order of the day.

Thanks! I feel my un-tact-ful-ness is going to get me into A LOT of trouble!!