NHS, are you helping them?

Took a patient out on grounds today, had a very thoughtful conversation with him, or should I say, he has told me about his thought regarding the way this place treating mentally ill patients, and whether or not this is helping them.

I have had this thought probably since the second month I work there - are we helping them? are they progressing? should they be here or in the community? You wouldn't believe it until you actually work there, that how much money NHS is spending on them, and what is actually coming in returns.

Well, I'm not a qualified nurse, neither am I a clinical psychologist (yet), I might not give the most accurate fact that reflects the truth, but the patients, they are the central of the whole system (the hospital, the treatments, the multidisciplinary team, the nhs), shouldn't their thought count and be deeply considered? I know, some of them are really not that well, what they say might not be beneficial to themselves, and they might be saying all these simply because they want to get themselves out of the hospital. But this particular patient, he just spoke out what I think, that there is no point of keeping them there, for years and years, doing nothing every day, not knowing when they will be discharged, not being involved in the outside world etc etc. If we want to give them treatment and make them better, we should do it every day, every single day, not like once a week. If we were to organize courses, make it a daily one, not like once a week. The thought of not knowing when they can leave is simply depressing - and I strongly agree with this. They all know they are wasting their time, their lives, missing many important parts of lives, losing contacts with theirs loved ones. I actually feel sad when I heard these, because I know he is right.

Unlike yesterday when another patient told me that he has wasted too much time in the hospital, he wants to get out and carry on with his life, I was still aware that this patient will still have to stay for longer, as I know his condition isn't really good, especially when he first came, he was so unsettled. But patient that I took out today, I deeply hope that he would get himself out asap and never come back.

You know, I don't mean that all the patients should be discharged in 2-3 months.. There are always cases taking few years until they really recover. The thing is, when we keep them in there, why are we keeping them in there? And are they progressing? Are we helping them? I mean if we were to keep them for 10 years, make sure they are getting better in these 10 years, but not getting depressed not knowing when the stay would come to an end. Like what the patient said, they would have to be very strong, very tough, to be able to stay there for that long without any suicidal thought. I could imagine that, it's not easy, at all.

And guess what, I will listen to him - the day and the time when I become a clinical psychologist, I would do my best to make sure myself, also including the system are helping these people (just that, by the time I wouldn't be in the UK anymore). I know how advance this country is, but it doesn't mean their methods are always right and good, and sometimes, things keep on developing, and it could simply and blindly not developing to a right direction.

Patient Kicked off

It was my first day doing response in the ward yesterday.

Firstly I think I'd explain what is "response"? Basically every single staff and visitor would carry an alarm whenever they are in the ward. And when emergency cases happen (e.g. patients trying to attack you, patients fighting, patients doing self harm etc), we would press the alarm. In every ward, there would be one staff who is doing response in every shift. They carry a radio, a bunch of keys and a pager. So when someone presses the alarm, it would first come on the pager, saying, for example XX ward, staff base (or games area, or dining room, or west corridor etc, wherever the emergency case takes place. and yes, the alarm would locate where the person who presses the alarm is).

My first ever experience doing response yesterday was in another ward down stairs, which is an acute ward. I was the first two arriving there, and saw a patient was kicking off, but was restraint by 2 female staff (which apparently was from that ward itself), so the male response team took over the restraint (we learnt this during the TAMVA course, see my previous post).

The patient was very very unstabled, apparently he was responding to external stimuli, asking "why are you doing this to me? come fight me! you coward! come fight me. you spoilt my life. i lost everyone in my life now. now! come fight me" etc etc. For 10 minutes, he was talking with another person who doesnt exist. Staff trying to calm him down, but he couldn't listen to any of us and just carried on shouting. He tried to hit his head, tried to kick (his hands were restraint, and at the end so were his legs) and refused any medications.

About 15 minutes later, he stopped. And I could see his hands really trembling, he asked, "what happened?" The staff said they would discuss it later, they want him to rest for a while first, and calm down first. He said "I'm really scared. What happened? What just happened? Did I hurt anyone? I'm really scared" Despite staff stating that he did not hurt anyone, apparently he was so worried and scared about what just happened, he had entirely no memory on what just happened, and his hands were really shaking. At this point, he took his medications, but still asking what just happened. We left his room after he took the medications.

I went back to my ward after that, about 3 hours later when I was on another response in the same ward, I saw him, and he looked really fine, calm and steady, pacing in the ward. (This second response was another patient refusing depot and got a bit aggressive).

I'm happy he wasn't sent into seclusion room. I guess one main reason was because their ward seclusion was occupied at the moment, if they wanted to send this patient to seclusion, it would have to be the seclusion in my ward.. and that would really keep my ward busy and more unsettled. But I'm happy not because of this reason, I think sending patients like this into seclusion room wouldn't help them, when you're in an total empty room, four walls, one mattress and nothing else, for 24 hours every day, that would just make their conditions worse. They would simply become more unsettled.

It's the first time I really noticed one patient actually kicked off, it was really a shock in me, especially when I saw how he trembled and scared not knowing what himself just did. and am glad how settled my ward patients are. Though it's good, that I start doing response and see what is happening in other wards.

When I went back to my ward, passed by my manager's office, he asked how it was and I told him what happened. He said "good stuff", I thought that was just his habit of saying it. But when I went back to office, they all asked me how it was. Haha, the charged nurse told me, Phil worried that I couldn't handle it, but she said I look like I could survive everything, and I'd proven her right. =)

Accommodation During Greece Trip

All About Greece 4: Where to stay?

I think I had never really stayed in an apartment while travelling with friends and this was probably my first experience. And guess what, I'd strongly recommend it if you have got enough number of people to share it (an apartment) with. As its facilities and services were far better than 2-3 stars hotels in general.

The apartment that we stayed in Rethymno, Crete was Aloe Apartments. The location is good, very close to the beach and mini markets. The facilities were superb. The only thing which isn't that good was probably their reception isn't 24 hours, so the help is not there all day long. And also the hot water seems to be limited and I showered in cold water on the first night. However, these did not really affect. On the last day when we checked out, the receptionist even offered to give us a lift to the bus station, how nice was that! And during the journey, he wished that we would write a review of the apartment in Mandarin. Hahaha. (Prices were 96 euro for 2 nights, 4 persons/apartment, breakfast not included)

Two single bed in the living room. - Aloe Apartments.

Room. - Aloe Apartments.

The kitchen and the dining area. - Aloe Apartments.

We stayed in Irini Hotel in Heraklion. To be honest, I can't really think of anything good about this hotel. It isn't that bad, just that, it wouldn't be what I will recommend (Prices were 132 euro for 2 nights, 4 persons/room, breakfast not included).

We spent three nights at Lion Apartments, Athens. We got into quite some troubles finding this apartment, asking pedestrian, police, ambulance until we finally found it. Its service and facilities were really good though. We get there before 9am, and the room service lady get the room ready and let us check in at early morning without putting any extra charges. She was really friendly and helpful, explaining every single things in the apartment, helped us with our luggages, and worked really efficiently, without hoping for tips (we planned to give her but didn't see her again after that first day). (Prices were 270 euro for 3 nights, 4 persons/apartment, breakfast not included, free wireless). I'd recommend it if you don't mind that the location was a bit far from metro stations.

View from our room.

Also, if you're travelling between islands and mainlands, I'd say taking a night ferry would save you some money and time, the only disadvantage is that you would hardly sleep comfortably on the ferry unless you get a room (but then it'd be costly). We bought "deck" tickets which cost us less than 30 euros per person (Anek Lines). Although we did not get the chance to try, I think they served good food as well.

The ferry we took.

More:

All About Greece 1: Airport Taxe/Cab in Crete

All About Greece 2: Athens or Islands?

All About Greece 3: Restaurants "Customering" and Culture

Restaurant "Customering" in Greece

All About Greece 3: Restaurant "Customering" and Culture

When we were walking in Greece, one thing we found is that there would always be someone standing in front or at the door side of the restaurant, and trying to get some customers into their restaurant, or at least look at their menus.

Remember on the first night at Rethymno, when there was a man trying to convince us to try their Greek dishes, we were just being polite and said we have eaten, at the end we picked another one. The next day we passed by it again, the same guy, recognizing us, saying that we should really visit him this day, as we sort of lied the day before, and he saw us dining in another restaurant etc etc.

What do you think about this? For me, we were just trying to reject him in a polite way (as our apartment receptionist recommended us some restaurants already), and he was being very rude to say that to us. We're the ones paying, shouldn't we get to choose what we want? =S

Just be aware of this, and if you're not going to eat anything, just try not to walk pass one whole row of restaurants.. you'd probably get tired saying no!

The other thing is about tips. On our first night in Athens, after finished dining, we asked for the bills and paid the total. One first man came by our table and "reminded" us that service charge wasn't included. When we were still discussing whether to pay tips and how much to pay, a second man came and collected the money on the table, counting, before leaving our table, he said "put the tips on the table! put the tips on the table" Imagine our expressions. =.= I was a bit pissed off and said we shouldn't be paying tips to people like this! How can he ORDERED us to pay him tips?! And guess what, at the end we left €0.10 on the table!

Just remember this restaurant.. it's close to Athens Monastiraki metro station..

More:

All about Greece 1: Airport taxi/cab in Crete

All about Greece 2: Athens or Islands?

Athens VS Greece Islands

All About Greece 2: Athens or Islands?

We went to an island called Crete in Greece, spent 4 nights over there (2 nights in Rethynmo, 2 nights in Heraklion), and then took a night ferry to Athens, spent another 3 nights in Athens.

For me, before I had been there, Athens is a place that I must go, for the history that we have learnt about it since young, for the name "雅典"! It simply sounds like a "must go" to me. While Greece at the same time, is famous with its islands and beaches.

Whether you want Athens or an island, it really depends what kind of trip you're up to. Rethymno is such a relaxing place, very blue sea and sky, nice hot weather, long beach (we even play monopoly card games on the beach xD), great Greek food with very reasonable prices.. There are also some historical places if all day beach time is too much for you.

While Athens.. to be honest, what you see is stones and pillars.. We can spend whole day at and around Acropolis and Museum of Acropolis. Are you interested to learn about their history, their Gods, the wars etc?

I'd say depending on your holiday mood and state, go to either one (but pure Athens visit sounds quite dry for me =X). But if you want to be like us, visiting both, go to Athens first and then the islands! You'd have the Greek specialist food and seafood crazily when you arrive the island, and enjoy the weather to the fullest!

Also, if you're not so into great sunshine and sun bathing, I would say September and early October is a good time to visit Greece.

More:

All About Greece 1: Airport taxi/cab in Crete

Airport Taxi/Cab in Greece (Crete)

All About Greece 1: Airport Taxi/Cab in Crete

The first ever lesson we learnt from Greece when we arrived in the airport in Crete, is the money faces of the taxi drivers surrounding the airport. They approached us and asked where we were up to (Rethymno). And then I asked him whether he could provide me with information about getting there, with the cheapest way, he said yes. He first analysed about taking bus-

*€2 to Heraklion town centre

*€12 to Rethymno

*€10-20 to your hotel

*Took you 4 hours

However, if you use a taxi, we could get there in an hour with about €80 (€100 at first), which is a huge saving for the four of us. He was right - four persons is the perfect number to take a cab.

We decided to consider and said that we would come back to him. I was thinking, he must be right to say that it costs €2 to go to Heraklion, since it's 2mins away from bus stop, I can ask for the price how easily. But that isn't the case! We asked the bus ticket to Heraklion and it costs only €0.90! and the truth is

*€0.90 to Heraklion

*€6.90 to Rethymno

*€1.25 to accommodation by cab (€5 for 4 persons). We walked towards the wrong direction (due to an google map error) and decided to take a cab from the old town to our apartment (Aloe Apartment). Or we could have saved this money.

*3+ hours (because we spent time walking towards the wrong direction)

See the difference?? (4 of us spent €36.20, compared to €80) They simply doubled up the prices and exaggerated the duration and convinced you to take taxi. They know you're carrying your heavy luggage(s) and just want to get to your hotel/apartment and check in asap. So, beware of those taxi drivers at airport, whether or not they are licensed, whether or not they look/act professional, whether or not they sound reasonable.

Greece!!

Ah Ah Ah!! I'm feeling so strange now! bloody strange! when I'm supposed to be very excited but I am not! why?!

Tomorrow night I will be off from Enfield to Greece!

But my holiday mood just ain't here yet =(

where're you?!

Athens in Greece, it's on the top of my list! How can I not feeling excited? =S

This week has been "a week" for me..

Worked on Monday, had a bad shift as I was sent to Sage ward, which wasn't very good experience as they placed me to do the obs in seclusion room, I was so depressed by the end of the shift.

Tuesday I attended the TAMVA (Team Approach in Managing Violence and Aggression, if im not mistaken) training course. Not easy, many to pick up, a lot of physical activities! Get to know some nice friendly people from other wards too. Phil came to find me and told me that my supervisor has been changed! I was bloody happy. =) Not that the old one isn't good, but I really like the new one, who works the same style like me.. =)

Wednesday again attending the course, legs started to be sore.. But I started to enjoy the course and the process, despite so many bruises on my body =S

Thursday.. The assessment day of the training. I was damn bloody brave to be the first to be assessed as a team leader, and guess what? I got full score being a team leader! =D I was a bit too nervous when doing the team member part.. but still, I passed the course! One of my colleague did not make it though... hope she will be fine next time =)

Back to ward again on Friday, with super sore legs, can't even walk on the stairs! Was nearly sent to Sage ward again, but thanks god Phil was in this day, and he was right, no point exchange me with an agent nurse who can't do anything! Took one of my favourite patients out for a walk, in the rain - wasn't romantic though.. xD.

And here I started my 13 days off! =D But it was a bit of rush.. the holiday mood isn't here, and I just don't feel like get things packed! =S Didn't do any pre-trip "homework".. But! I'm quite excited and expecting good weather over there... rather than staying in this bloody London weather =S

Hope it would be a great trip! I haven't been leaving this country for a trip for long!!!!