Genuine Suicidal Attempt or Attention Seeking?

She was told by the doctor to come to the clinic to collect her medication and for an injection, after seeing the doctor in the hospital.

When she got here she looked like she was on the phone, but nobody heard her talking at all. Staff told her to come in to the treatment room. She gave no response, made no eye contact – as if she was so concentrate on a spot in the air. Then she walked towards the door, went out, and stood by the stairs. She looked down to the lower floors. A colleague said, “she isn’t going to jump down is she?” I was going to say “Is she looking for someone downstairs?” but before I even completed the sentence, her feet were already in the air, hanging her body on the rail. we all ran out. She didn’t do it fast as her left hand was still holding the stairs handle/rail. So one of the colleagues managed to grab her legs, another her arm.

She was brought in. She continued to say that she wanted to leave, and of course she wasn’t allowed. It took some time till she was injected and given stat dose. The doctor came from the hospital to see her.

It appeared to be something related to drugs, she seemed to be taking illicit drugs, and according to her, she will be charged for distributing drugs (or bringing drugs in from another country). She said she was innocent.

She calmed down later as the stat dose kicked in. Family member was contacted to bring her home. I’m not sure how she is right now, I hope people will all stay away from illicit drugs. 

If it was one of our busy days we wouldn’t have noticed and managed to stop this. Though we doubt if she really wanted to commit suicide, or she really just needed some attention and help maybe. Because of how the stair is designed, it wouldn’t be possible for anyone to jump down straight from 4^th to ground floor (other than a small baby).  She could only fall to the third floor, though her head would have landed on the stair case below. I’m sure she was aware. So attention seeking through a suicidal behaviour?

Sometimes when it comes to mental illness (and I guess many chronic physical illnesses), family members get fed up and lose their patience after a period of time, due to the time, money and attention needed to care about the patient, but also the stigma that come with it. But without any support from close family and friends, it’s almost impossible for someone to completely recover from mental illness…

Morbid Jealousy

There was this young beautiful girl, who from the age of 16, got into her first relationship with a working guy. She then became so obsessed, and had the delusions that the boyfriend was flirting with other girls, having an affair with others etc. She skipped classes, and went to her boyfriend's working place to "watch over" him, see what he was doing, who he talked with...

Over the years the girl got into various relationships, because of how beautiful she is, guys get attracted, and when she becomes attached, she also gets really obsessed and possessive, especially when the guy having any contact with other girls, despite how faithful the guys were. The girl slowly realized this a problem, and consulted a psychiatrist. Over the years she also gained insight with her problem -- a condition now called "morbid jealousy".

Morbid jealousy is a psychiatric condition where the person holds strong belief that his/her partner is being unfaithful without any convincing or "solid" evidence that this belief is true. It tends to happen over and over again no matter how many partner this person changes and how "innocent" the partner is.

It is getting to quite a common condition nowadays. As we would probably all expect that conditions like anxiety disorders and depression would be a lot more common, now probably every 1 in 10 people with a psychiatric condition comes to the clinic due to this problem, although most of them may not understand this as their problem (but only think that they can't sleep, get anxious easily, feel unhappy, got no appetite, is bad-tempered, gets agitated easily... which can simply appear as anxiety depression).

Here it's important to clarify that morbid jealousy doesn't apply when actually you find some convincing evidence, or when you are just feeling a bit insecure whether your partner gets a bit too close to someone (yes, just a bit insecure, which does not affect your life that much, and problem may simply be solved after you speak calmly with your partner), or when it's just part of a more sensitive type of personality.

For the patient's partner to come to understand that their partner has this problem would be helpful to the patient, and being understanding, considerate, supportive and patient to the patient will be significant to the process of recovery. 

I'm Lunatic!

I learnt this word - lunatic - from one of my patients. The first time I heard it, he was saying to me "you're lunatic!" I didn't know the meaning, but I thought it was related to "lunar", so I was thinking the word may be saying someone whose emotion fluctuates a lot (just like how the moon changes every day). Of course he was just having fun by saying that.

But that day I heard it a second time, and checked it online later, the online free dictionary says:

1. Suffering from lunacy; insane.
2. Of or for the insane.
3. Wildly or giddily foolish: a lunatic decision.
4. Characterized by lunacy or eccentricity."

At the same time coming out from the search is a BBC News - "How offensive is the word 'Lunatic'?" and it mentions that the word originally "referred to a kind of insanity that recurred according to the cycles of the moon". Hahaha so I was right to think about the moon, but still get the meaning wrong. It reminds me of Dragon Ball (hahaha) and other werewolf movies.

Anyway, it was inappropriate to use the word to "normal" people. But when my patient said that to me [jokingly], I [jokingly] said back "You're lunatic too!" He just laughed and continued to repeat that I was lunatic...

My whole intention of this post wasn't actually about introducing the word "lunatic". In fact it's an introduction...

I realized there have been quite a number of this so-called "mad" people in my life, mainly due to my work. I have also been talking quite a lot about stigmatization people hold towards those suffering from mental health problems. Whenever I thought about helping and standing up for these people, my patients come across my mind.

I thought I no longer hold these stigma and prejudices like everyone else. And I was wrong. The other day I went to Wood Green, and there was this man, I probably have seen him a few times, who was talking loudly in front of Morrisons, what he talked makes no sense. I avoided standing too close to him like everyone else, but undeniably I think he was mad, he was dangerous. (although I work in a forensic ward, but no, people with mental health problems are no more likely than "normal" people to commit crime, to hurt others!)

No matter how many "mad" people I have met, and how much fact about "mad" people I come to know, when I walk on the street I behave like everyone else. I'm not saying that I'm wrong behaving this way. But I realized I can only be confident to work with people with mental health problems, in a safe environment or, with patients I already know for a period of time, in any environment. I don't have the ability to approach a ["mad"] stranger on the street and attempt to help him/her.

What can we do about this? Create a safe environment any and every where, change everyone's attitudes towards the mental illness and the people who suffer from them.

How do we achieve that? I dont know... 

Just got to Moan!

I returned to work after a few days off yesterday, after some discussion with a colleague I decided to take up the response, and this little decision made yesterday the record of my life. I went to the female ward twice, and physically restrained and put two persons in the seclusion rooms.

For the first one, she was kind of abusive and fighting back when I got there. I had to restrain her on her feet (which I think I did it correctly), but my right arm was hurting awfully. After some struggles of 20 minutes as she wouldn't cooperate, we got her there. I got 4 bruises in both of my hands, and when I got home I found one big bruise on my thigh.Another staff even fell over. I thought the incident was bad, and so decided to take a break after that. After I returned, the alarm went off again, so again I went to the same ward. I saw a patient standing by the garden door completely naked, stood by her was a male staff and another female staff who was just about coming to help. I took over the male staff, and we tried to cover her with a bed sheet, and brought her to the therapy room. We helped her to put on some clothes there. She was still crying, shouting that she was very scared, and describing what happened to her in the past. The charge nurse then decided to put her in the seclusion on our ward (this ward is next to us). Although I see completely no point of doing so (why would you put someone who was scare and crying, and not harming/hurting anyone in the seclusion room?!), I did what we were told. She was crying and saying she was scared throughout.

So that was what happened to me as a response nurse, within 3-4 hours. I went home feeling sorry for them, tired, and telling myself I wouldn't want to be on this job for anytime longer than this. It wasn't that I don't like my job, it was just that I don't think we're helping them, and this is bad. This is of a caring job, we're supposed to be helping them.

This morning I came back for a long day (a 14.5hours shift with an hour break which you don't get it sometimes). I was supposed to take someone back to his parents' home (in theory this is meant to be part of therapeutic recovery). Because of what happened in the past, I came prepared. As we left, he was getting abusive to me... I couldn't convince him to come back with me, so I had to call the ward and they got the unit coordinator and the response team in a van to come to the train station to pick him back (we walked there). So all I had to do was to convince him to stay there, and wait for another escort as such (given that he thinks he was annoyed by me). It then went okay as things go and he came back. He was becoming remorseful and kind of apologized (but that is him, the fluctuation of his mood and behaviours). I got to say I felt fully supported by this qualified nurse who picked up the call and supported me throughout. She clearly knew what happened in the past and was imagining if that was going to happen to me, I was almost in tears. But later as things go I feel much better. (Other than those occasionally awful incidents, there are many other who can often cheer me up)

I'm actually on my break now. I don't know what I'm feeling and thinking, about this job, about working here, about the patients here. I'm not angry at or upset by any patient as far as I'm concerned, but I slowly realized what annoys me was the staff (the pm shift staff), and it had nothing to do with the patients who are not well (that's why they are here; although for many instances I'd say it was actually the system here that drives them unsettled).

It's a lot easier to in fact deal with the so-called mad people, then those who are "normal", but lazy, sarcastic, ignorant  and uncaring (especially when they are in a caring job!). 

Behavioural Experiment for Social Anxiety - Walking a Banana

I have long heard about behavioural experiment in the CBT. We used to have a guest lecturer in the uni who shared quite a lot different types of behavioural experiments she has done throughout her life as a therapist. One of them that I remember quite well was working with a woman with OCD (Obsessive Compulsive Disorder), who was very obsessed with hand washing. And in short what they did, was putting their hands into the toilet bowl, reaching the water in it! then what? Without washing hands, they used their hands to eat!!!! It was like OMG, REALLY?! But yes that's what was done, the therapist was going it with the client, and really, nothing happened afterwards, and the client realized her obsession with hand washing really wasn't rational (of course this is kind of simplified, you should assume that they have done a lot of work in identifying irrational/negative thoughts, doing relaxation techniques and also discussing the rationale of designing such experiment etc).

Guess what I did today? Hehehe, oh the title tells - I walked a banana in Croydon, London. YES I BLOODY DID IT. Me and Krishna did it together, initially we didn't quite get into the state, and we were laughing and stuff. But after that we realized we really need to be so serious, so people know, yea we're serious about it. Believe it or not, so many people looked at us! (Well refer to the video below although it wasn't quite obvious in it). Some people asked Pei Man (she was following behind us and taking video). Some just stared, some tried to look covertly Haha. We went into the McDonalds, and obviously people were looking. I saw a guy taking pictures of us. I heard the staff saying "people coming with a banana on the string". At the end a guy approached us and asked whether he could take a picture, even asked for their names and age. LOL. The staff in McD also asked us. We left, another black woman on the street was like "what's this for?" Another two women walked past and we could overhear them saying "look at these stupid people". Hahahahaha. Stupid, I kind of enjoy this stupidity!! There were also quite ignorant people, who walked past like nothing happened. In front of the hotel, there were 4-5 teenagers, some just stared at us, while one who was obviously more extrovert approached us, and patted on Bobo (Krish's banana, and my banana is Nana), although another friend of his almost gave Bobo a big kick!

Okay up to this point you probably going to ask me, why were we doing this for? The idea came from Donald, our lecturer on the hypnotherapy course, who treats people with social anxiety. Oh yea this was one of this behavioural experiments with his clients. The idea is to do something and make people really look at you. In fact some people are often so self-conscious, being worried about what other people think about them, whether they look stupid, look anxious or too awkward etc etc. With experiment of this sort you probably find out the reaction could be quite different from what you think. But even if it was what you think (that "you look stupid", "you look so anxious", "you look like an idiot"). Those are just their thoughts! So what?? It's nothing catastrophic. Let them think what they want.

It's like people who are overly anxious doing public speaking, worrying they might make mistake. Well okay there are a lot of thing you could do to present your best, but what if you make mistakes? What if... you make a mistake deliberately?? Laugh it off? Chances are you are going to survive it anyway, why worry? This is my way of seeing it, though Don said people can test by making a mistake deliberately and see what happens, see what's so catastrophic about it. Of course this doesn't mean that I'm no longer anxious, and no longer worried in public speaking, but when you really analyze your reason of being nervous, rather than focusing on hiding your nerve/anxiety, the results are most likely going to turn up better.

I also forget to mention, at this very same day when Don realized we're going to do his banana walking experiment, he was also interested in joining. So I gave him a string and he got himself an apple to walk, but that apple fell off. And what did he do?! - he went to a toy shop, got himself a pink piggy soft toy, which could fart if you sat on it - and he MADE the shop assistant showed him how the pig fart in front of a long queue / big crowd of shoppers. Then he put the string on the big pink pig and walked it back....... You probably going to say he's such a weirdo. Hahaha well he is... not. I suppose it can get addictive, so additive. But to go to shop and ask for certain things to be done, is part of assertiveness training (and other things). And doing all those things can get quite addictive! Well, in fact at the same time you're also helping your clients and being a problem-solver.

I just have got to say, I have really enjoyed it. And Krish did too - know what? She's a mum of two, and she was as passionate as me if not more, in stuff like this. Hahahaha.




P.S. I just think it's important to give credit to Donald Robertson, given how much of his ideas I quoted here (you can google about him if you're interested).

Certificate in Hypnotherapy

I completed a Certificate in Hypnotherapy last week. There are still stage 2 and stage 3 to get myself a Diploma in Cognitive Behavioural Hypnotherapy.

I'm not going to say how Hypnotherapy was defined academically and practically, just would like to say it is really nothing like how the TV or medias depict it. Yet it is something really powerful, to help people think positively, to treat phobias and minor clinical depression, to manage pain, to relax and release stress etc etc. One thing worth noting is the pain control and management. There have been people who gave birth or had their teeth removed without any anaesthesia yet feeling completely good and positive throughout the process and after it. We tried it with some minor pain in class and shockingly it worked (we had a clip on our hand, that didn't cause that major pain although it wasn't really anything comfortable). At one point I could feel no pain at all. But what's important is the way you see the pain. I'm still going to do an experiment myself at one point with similar sort of stimuli without self-hypnosis and see if that pain-free feeling was due to habituation.

From the class I also learnt meditation. With his lead I really enjoy meditation, and at times I did it on the train while we were on our way to the class. But after that I started to fail, because of my ability to really focus and concentrate. It's now getting better. I probably need more time. To be really focus and concentrate is always my problem anyway. I also did a self-hypnosis yesterday due to my sore arm. Of course I didn't come out from the hypnosis pain-free, but I was able to see the pain differently and soon forget about it.

I will share more when I have time. Ask me anything about it if you want (and surely it doesn't mean I will always have the answer). If not then try to find some more established site to learn about it. It's something very useful and interesting. At one point I hope I can learn about then practice it more and really let people benefit from it. 

Another Leaving, this time a Discharge

先前写过一篇一名病人因癌症去世 今天我送走了另一个病人
可是这次他是被 discharged 了!! 这是我的 ward 里最年轻的病人 是我比较喜欢的一个
可是后期因为他有很多 overnight leaves, 外加我减少工作时间所以不常看到他
看到他被 discharged 真的很开心... 虽然其实有点不舍得 可是我还是不断告诉他请他不要回来
不管要做什么都要 think twice before doing any things that might bring you back
希望他有听进去吧 毕竟他还年轻 (才大我一岁) 大把前途 没道理把一生困在医院里 (话说爸爸在英国是医生 妈妈在美国是律师 父母我都见过 我一直不明白他怎么会在这里!! [医院])
话说在这个 ward 里工作已经一年十个多月 这才第三个被 discharge 的
话说第二个被 discharge 的还回来了 (不过没有回来我的 ward)
其他大部分离开的 有的回去监狱 有的去了更 high security 的医院 虽然也有两个去了更低 security 的ward 可是他们到现在都还呆在那里 每次在 grounds 看见他们都会问他们怎么还在
虽然这样问其实很残忍 (谁不要自由?) 可是其实我也很心疼看这些人把大把青春耗在这个地方

今天送走他 我在想其实我或许不适合这分工
不喜欢离别 虽然有的病人比较不熟 可是相处久了 送走谁都会有点不舍
当然还是最希望他们的离开是好的 希望他们不再碰不该碰的东西 不再做不该做的事 病也不再复发...
还是庆幸今天能送到他 衷心祝福他 也希望其他病人会慢慢好起来并被 discharge.

还有一个老人家 一个超烦的老人家 超喜欢烦我的老人
他是个很挑战我的耐性的人 可是我这么久以来就今早差点对他"发脾气"
因为其实他很可爱 他只是很"病" 外加牙齿掉光 今天又拔了几颗 现在只剩三颗 所以他说话的时候很好笑 (也很难明白)
他的病情不轻 常常在 ward 里叫 要不是因为他年纪大 早被其他病人殴打了 (话说病人虽然是病人 敬老这件事 他们其实还真的是会的...)
昨天就告诉我他 700 岁了 后来又问我要不要做他的 sister (我想他 700 / 60 岁 怎么能做我 brother) 他还继续说 这样也就做了 Obama's daughter... 原来他是 Obama 的儿子 所以我要是做了他的 sister 我也就是 Obama 的女儿了 XD 能说他不可爱吗?
不忙又有心情的时候 耐心听他讲话其实很有趣... 他心情好的时候也会在 ward 的走廊上唱歌 然后会害我(们)也不自觉的跟他哼起老歌...
当然他凶起来生起气来还是很恐怖的 只是他不 violent 他也还是会对我还有几个他比较喜欢的 staff 很好...

有时间的话 我或许该多写这些 因为我想以后的我 会觉得这一切像梦 也会很怀念这一切... 

Good Bye

I have been thinking to write about this, but haven't really got the time for it. I work in a forensic mental health ward (as most of you would know by now), had never thought I'd have to face that - we have a patient that passed away last weekend.

Perhaps it's not right to say that I never knew I'd have to face this, because when he was sent to our ward he was already terminally ill. We spent a lot of time making sure he was okay. And this is a man with great sense of humour, I mean - a nice companion. Guess what, maybe it was such a coincidence, I blogged about him before, back then he was so, so unwell that I had to share my experience with him (Blog post: I want sex!!). Oh yes, he was the one who first saw me, told me "I want sex! I want sex", he was also the man who didn't use the toilet and slipped on his own poo in the seclusion room.

If you still remember, he was sent to highest security in the country because we couldn't have him there. He was then diagnosed with cancer and deteriorated. Staff there decided that they couldn't keep terminally ill patient in such high security, so they sent him back to us.

This man only saw me once a week, sometimes once in a fortnight, but he never forgot my name. On my first shift with him, he directly commented that I must be very hardworking at the end of the day when I went to sit by his bed. Slowly he deteriorated on our ward, up to a point he was so ill that they had to send him to A&E, and was then transferred to CDU (Clinical Decision Unit). I went there for about 8 hours last weekend. I met his twin brothers and had quite a long conversation (or according to him, it was more like one of the brothers "lecturing" me. hahaha). I walked him to the bathroom, and I gave him my right arm telling him this was his walking stick, he then hold my arm and dance, while humming a song that I didn't know. Of course he couldn't even walk properly, leave alone dancing.

But it was beautiful. I came to realize I brought this man laughters. Despite all the pains he was in, he was always positive. At times I found that too positive. I have to say this is the kind of experience I probably wouldn't forget. Unfortunately the rapport was built, then we lost him.

I didn't think about it at all when I was told the news that afternoon after he left. It was a "noisy" shift with some nice staff, nobody really mentioned it, I didn't think about it either. But that night I couldn't sleep, I thought about him and my tears dropped. I suppose it wasn't sadness, at least he is now no longer in pain.

In fact he is a "legend". I wish someone can study him in depth. Because back then he was so, so ill, so unwell mentally. But the physical health problem "took over". Don't ask me how this can happen. Nobody knows. We all wonder. Because most of us met a version of him that was so crazy so mad so unwell so... you name it. But we all met this "version" of him who's so grateful, so positive, so friendly. He was always grateful, with the time with we spent with him, with the help we offered him.

On my last shift with him, he was in the bathroom when a member of staff came to take over me. I insisted to wait till he came out so that I could tell him I had to go and a goodbye (no, in fact I always say "see you later" rather than "bye"). With him you never knew when it would be the last time you can see him. I'm glad I waited, because that was indeed the last good bye.

Rest in peace.

‎"Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around."
- Leo Buscaglia

Virtual World

It's the last day of term. No, not yet. I have yet to graduate. It's the last day of Spring term, I still have Summer term! Had quite an "interesting" lecture day in Mill View Hospital today, which is really not what most of us had expected. We thought we were going to get more practical kind of things but who knows?! They made us travel there then what? Sit in the lecture theatre for whole day!

And I'm going to talk about the final talk "Projected Research and Business Developments" by Susan Conboy-Hill. Let me try to be unbiased and say what this talk is about. They are trying to bring in technology to "do" treatments. So here she talked about the people who are hardest to reach, people who stay at home all the time, people who are scared of human interaction or touching, people who hate leaving home, people who are scared of crowds (perhaps, I added some of these myself), yet all are people who need psychological helps. And they proposed (or in fact are going it already) this "virtual world" where people can learn about interaction, get support, feel "well-being".

Before she even finished introducing the whole ideas of it, my colleagues already started to raising hands objecting how this can probably work, then I joined the debate... We are psychologists (or "worse", we were trained "critical thinking" so much that we criticise everything all the time lol), we emphasise human interactions and think it's incredible central to human lives, well-being, contentment, satisfaction, recovery etc etc.

So I asked her, if Yuko (she just happened to sit next to me so I used her name) had problems interacting with people and thus is prescribed with "Virtual World", how is this going to help her with her situation and to get back to normal life? She answered, "how do you know she wants the interaction?" and carried on with her whole idea of how this can work. I agree, recovery quite often doesn't mean get back to "normal" or "how it used to be", and recovery can simply mean "a sense of well-being" very subjectively, but does she mean Yuko is going to spend the rest of her life in "virtual world"?!! Sometimes in Psychology, even Yuko doesn't know that she wants the interaction, at least not until we help her to do it, then slowly she realizes she really enjoys it and gets the most benefits out of it.

I'm so against technology in some ways. Of course I love technology too. I remember seeing a quote on the train, saying if the world hadn't invented mobile phones, we'd all interact more. Yes, so true. It was meant to assist communication, but nowadays how often do you sit in front of a friend but s/he is using phone on facebook/whatsapp etc?!

I appreciate the kind of convenience technology brings us undeniably. Or I wouldn't be able to Skype with my mum whenever I want. I also appreciate that technology can help with recovery, for example if you have a spot above your eye you google and find out what it possibly be then only decide whether to seek help. But technology can't be a treatment as a whole. Just because we're human... People can often read self-help books and understand more about themselves, can learn how to make themselves feel better etc. There can also be an iphone or android application to help people understand depression or monitor alcohol intake. But how are we going to treat someone with bipolar personality disorder with......... an app? with virtual world?!!!

She acted as if she's very "in" and initially perhaps she also kind of thought she'd get all kind of agreements and acceptance from us because we're the generation who have used and benefit most from the technology ever since. I suppose she was quite shocked to have heard us and turned really defensive, and didn't really make obvious points to answer most of our questions. I don't mean that I don't see the potential of their proposal. But I hate spending so much time in front of the laptop, with the phone. I still do it because there's this habit/addiction/whateveryoucallit. I certainly don't hope to see in the future facebook/twitter/smart phone apps replace all part of our social lives. (She loves twitter so much..) Oh let's go out for dinner... I mean in virtual world?!

And one day when I see you, I lost the ability to interact. (we all are certainly losing it... I just think we should stop before it becomes part of evolution)

A Day in the Life of a Mental Hospital Patient

Just read this:

A day in the Life of a Mental Hospital Patient

Going to a mental hospital is nothing to be ashamed of or embarrassed by and I encourage everyone to take that step if they find it necessary. Life can be overwhelming and sometimes we just need to heal.

I find that quote good - stigma-free. Maybe becoming a patient for a period of time will make me a better carer too? Anyway, that isn't the main purpose of my post..

I can't help comparing how a day of this particular person (no longer patient)'s day compared to those that are on my ward. Some parts of it are quite similar, but I just really want to point out the main difference, which is the rehabilitation activities. Similarly, we have all those structures (certain time for meals, medications, basic activities like garden breaks), but how about the rehabilitation part? Someone on my ward can sleep through the whole shift (7.5 hours) and not doing anything. Others can just get up only for meals and leaves and do nothing else for whole day. What's good for keeping them in there and not doing anything meaningful and productive? And worse, not even helping with their mental states and general health (well most of them are obese). There isn't structured rehabilitation activities, if there is, there are way too loose (e.g. one to one session that only takes place every one to two weeks, psychology sessions that happens only once a week etc). What can they do other than those?

Sleep + Eat.

And can you believe for these people to Sleep + Eat peacefully every single day, how much are we taxpayers paying for that?!!!! It's okay if it helps, but does it?

One used to tell a member of staff, when the latter told him he's good at cooking, he can be a cook when he leaves the hospital, the patient said "no I'm not going to work. I'll receive benefits for the rest of my life." So oh yeah, more money for his benefits, travel pass, accommodations etc. This is what the service leads them to. Ouch! that's my moneee :(

I despise you

I wasn't feeling very well (physically + psychologically) when I went to work today. Physically unwell was due to the weather - the temperature just dropped so much suddenly T__T

I am not very sure why I wasn't in very good mood, until before I got home, I spoke to one of the patients in games area, and that really helped. I think I helped him, and in return that has helped me indirectly.

What we discussed made me realized I am really not happy with those qualified nurses who want to work awful loads of bank shifts and long days, but come to work and sit in front of computer, surf the net and do online shopping, otherwise gossiping about others. These people think only about their pay, never have one to one with their patients, never spend time outside the office, never understand their patients. They never think how to help the patients. They never know whether their patient is happy, is feeling safe, is ok, is progressing in the ward. They care nothing but money.

I don't know how they become a nurse, a nurse without a heart of helping patients getting better. I told the patient I wanted to speak to the ward manager regarding that, and he said no. He said he was telling me because he treats me as a friend, and those are friends talk, he said it's ok, he can get himself out of there and he is progressing, he can talk to the consultant every week (or sometime fortnightly). I feel sad for this whole system, for them. Those people are so well paid to help them, yet they get no help, nobody talks to them. There was once he requested to have a one to one with his named nurse, the named nurse asked him to wait till weekend, but nothing happened during the weekend. The fact is, those named nurses are supposed to ask to have one to one with the patients! Then I told the patient, I know and have seen all these happen in front of me, yet I could do nothing. That's why I was so upset. Actually it might not be true.. I think I could do something.. =)

I don't want to see this happens

A bit of heartache. A patient was restraint to be given his depot today, and I was part of the restrain members. This patient, he had been muted for about 2 years, and when he first came to our ward, I was the first person he spoke to, and the ward manager was quite impressed that I managed to get him talked. Now that I saw that happened, I feel pain for him. He's not a difficult patient, 100% not. But this happens every week. Because he doesn't want to consent that he has got mental illness, by accepting the depot voluntarily, it simply means he has got mental illness, so he would decline, so we would need to restrain and inject him. He was strongly defending, 6-7 of us were holding him, and he still managed to move. After this, I've got no courage to look into his eyes. For no reasons, I feel guilty. =.=

This reminds me of another patient's words. At first he defended himself, he fought back. That led to more medications and seclusion, so he learnt, he learnt to be complied, because he wants to get himself out of here. Are patients actually getting better, or do they just learn to pretend better?

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.