Sometimes I am like a fly on the wall, well hopefully much prettier and a little more noticeable, when visiting Chris in hospital, whether it is psychiatric wards or general wards. I am not there to do a ‘job’ and I am not the patient, so I get to see things from an outsider’s point of view which I think many people forget. It is while making visits to different psychiatric wards, in different areas with different layouts and staff that I have noticed an array of differences, some of these will be just circumstantial, like visiting a ward that has more acutely unwell people in it than perhaps at a time when it is quieter. Despite all these wards being in the same trust, there really is a big difference in the care. Obviously this is all based on my opinion and what I have seen whilst in and out.
One of the most noticeable things is environment, I have been to a ward through two heavy duty metal doors on the first floor with a long corridor, multiple bedrooms leading off it, two TV lounges dotted amongst them and the nurses office plonked in the middle. The corridor doesn’t see daylight, it is artificially lit and quite frankly depressing despite the obvious paintings and decoration to try and brighten it up a little. The only access to outside space is every two hours for smoke break down a set of stairs to an enclosed little garden around the back. It is a mixed sex ward, patients have their own bedrooms and shower/toilet room as well and they have recently added a female only lounge.
The other ward I have visited, also on the first floor through two wooden doors with nice little windows in them, has a more communal feel, you walk into a huge communal area, with tables and chair, a comfy area with television, the nurses office overlooks it all and more importantly windows letting in sunlight, none of this artificial light business. It is mixed sex but unlike the last hospital I described it has female bedrooms off one way and male bedrooms off the other, the females also have a female only lounge. The only access outside is again for a smoke break and then patients are taken down to a square garden area in the middle of the building. This has a slightly nicer and less isolating feel to it than the first one.
Finally the last hospital ward was set on the ground floor through a single wooden door had a mixture of artificial light and daylight coming into the corridor, it was another mixed sex ward with bedrooms off the corridor and multiple activity and lounge rooms. There was a nice size dining room with doors going out into a secure area in the middle of the building but patients were not allowed to come and go and again had to wait for allocating smoking times to be let outside. There was a range of notice boards and displays and the nurses’ station was again plonked in the middle at the end of the corridor.
Each gave a very different feel, some more welcoming than others; some just made even me feel more miserable to be there even if only visiting. The other massive thing I have noticed is staff, they too make the place what it is, if you have a miserably laid out ward with amazing cheery staff who act like they love their jobs even if they rather be elsewhere then it takes off the doom and gloom you feel about the layout.
Staff from the first hospital are a mixture of really amazing, welcoming and friendly who really try to do their best while running around like headless chickens because of the pressures being thrown at them, to those who rather be anywhere else, huff and puff at having to do something so inconvenient as letting me out of the building and walk around with a face of thunder. Let’s just say I don’t think I have ever seen them quiet, relaxed and able to just have friendly banter with patients, sad fact but true.
The second hospital, staff sit in communal areas even if just in a corner while they fill in paperwork and fill out observation sheets, they seem to engage more with patients because they want to, rather than feeling they HAVE to. There is always someone around so you don’t have to go looking for anyone and they encourage patients to be there with them rather than isolated in their rooms with nothing to do. They don’t rush around like headless chickens and they feel more relaxed so in turn so does the patients they are looking after. It was rare you found one who wanted to be anywhere but work even if that’s how they were actually feeling, I never got that impression.
The last hospital has a calm atmosphere and while the staff tend to only be found at the nurses’ station they seem to be relaxed and chatting, no one seems busy and they seem to have the time to chat with patients and make sure everyone is ok. They on the whole look happy to be in their jobs and don’t look in a hurry to be anywhere but. They were always available to answer any questions I had and if they couldn’t they always went to find someone that did.
So it wouldn’t surprise you now if I told you the first hospital had the most amount of unsettled patients, also seemed understaffed often, the alarms are always going off, staff are always everywhere and while that isn’t the case all of the time it is more often than not. The second hospital had the occasional incident, the alarms rarely went off, patients seemed more settled and relaxed. The third hospital, I never once heard the alarms go off, never saw a staff member run anywhere, patients were more relaxed and the one occasion that someone did get distressed it was quickly dealt with in a very kind and caring manner which meant it didn’t escalate.
Ok I get it, this is all based on the circumstances at the time I visit and obviously things will change depending on patients, staff at the time, staff numbers, the only thing that remains consistent is the layout. I do believe layout plays a part, if only because I feel very differently from one to the other as a visitor. I just thought I would write my observations down. I know which one I would rather be in, Chris is currently in the first one. Wouldn’t it be lovely if everyone had a ward well lit with sunlight, access to outside space to come and go as they please for fresh air, friendly staff who don’t feel rushed off their feet because they maintained a well staffed ward and in turn want to be at work every day because they were able to take care of their own mental wellbeing. This would allow patients the space to improve and go home. Would be lovely wouldn’t it?