Sunday, February 21, 2010

On the ward and out of my mind: You are nurses, right?

Back to On the Ward and out of my mind, you may also want to read this, this, this and this.

I was diagnosed with epilepsy quite a few years ago. Juvenile Myoclonic Epilepsy to be specific. As I have, moaned about incessantly alluded to on this blog, this has been a bit hard to manage at times because of my PTSD encouraged insomnia. I tend to have a lot of myoclonic episodes (aka petite mals or weird little jerks that make me look freaky) and less of the tonic-clonic seizures (aka grand mals or randomly dropping to the floor unconciously in a break-dance type fashion) At the moment with sleep being completely f*cked less than ideal, I am averaging about 1 or 2 tonic-clonics a month.

Anyhow... when I was admitted to Ward B, I had a plethora of medical health issues as well as the quite obvious fuck-uppery, what with me trying to kill myself and all. I was still recovering from aspiric (sp?) pneumonia, from being extubated, I had  a little damage to my cerbellum (a fairly important bit of grey matter when it comes to motor skills and some cognitive processes) and some pretty major damage to my vestibular system (fairly important for staying upright and balanced) and finally I had the pre-exisiting condition of epilepsy.

Upon admission to the ward, the nurses freaked the frack out. I wasn't supposed to overhear these conversations, but meh, if you are going to talk right outside more door what do you expect? Basically, they didn't feel equipped to handle my medical needs, didn't have time to do the extra time with me for the rehab exercises I needed to do twice a day, blah blah blah. Ultimately in the end, they didn't do to badly that first admission. They managed to find time for my exercises, the pneumonia resolved with antibiotics, and although I had a number of seizures they would generally just help me to bed, or if in bed change the sheets if necessary, only calling the doctor in on one occasion where the seizure was longer than average.

However on my second admission about three months later, things were not quite so straightforward. It took four days just to get the necessary equipment (shower chair and toilet chair) brought down, which resulted in some very unsafe practices. (I was using a zimmer frame at this point). And there was one old bitch nurse who decided unilaterally, and without consultation with doctors or any other nurse, that my seizures were in my head. Had she read my medical notes she would have quickly been dissuaded from this notion... or maybe not, she was pretty old school, and seemed to hold the opinion that all people with mental health issues were merely naughty children needing attention. On particular day, I went back to bed, feeling quite dizzy and unwell. This nurse (not even my designated nurse) took umbrance to me being in bed in the middle of the day. I tried to explain I was feeling poorly and possibly might have a seizure coming on. I hadn't had the aura yet, but generally in the hours leading up to a seizure I can feel a bit poorly, and either way a nap would either resolve it, or else I would be in a reasonably safe place if I had a seizure. She basically told me it was nonsense and frogmarched me back to the tv room. After 10 or 15 minutes I felt decidedly worse, and got up to tell her I needed to be in my room (I also didn't want to have a seizure with a whole room of strangers gawping) but one look at her face told me she wasn't going to listen, so as my aura kicked in I made my way to the bathroom, where I promptly fell face first onto the tiles, smashing in my front teeth and bloodying my nose, having...suprise suprise... a seizure. By the time I properly came out of the post-ictal state, she had gone home and was not back on shift for the rest of my stay. I had smashed in teeth and a swollen nose, to remember our time together though. They took me to the dental hospital and got caps for the broken teeth, which subsequently crumbled, as there was not enough tooth to adhere too. Lucky me also got to endure four root canals about 6 months later, due to the nerve damage done. My teeth are still a mess, and it will likely cost me a great deal of money out of my own pocket to fix them (there is a possibility I can get them fixed through a referral program with new mental health service district... appointment is in March) My mother hit the roof when she found out, but unfortunately we were a bit to busy trying to keep me sane-ish over the next little while, to follow through and make sure my complaint was dealt with adequately.

Other than that, my immune was rather inept at this point, due to lack of sleep and a significant weight drop, and particularly during my first stay I seemed to catch every flu and cold that patients and nurses alike carried in on the germ infested little bodies.

Nothing quite so problematic at Big City Hospital. I did have a few seizures during my stays there. One rather humiliating one in the shower, however in general they did a pretty good job responding. The only gripe I have, is that during one such seizure, I not only voided (not all that unusual), but also threw up (quite unusual). They did help me to change (embarassed much?...yup!) but they left me to sleep it off with some rather unpleasant regurgitated matter in my hair. Fair enough, they were probably allowing me to rest, but running a damp wash cloth over my face and hair... basic nursing 101. I also vaguely recall my designated nurse delegating her student nurse to clean the vomit from the floor, because she could not handle vomit. Possibly why she became a MH nurse?

In my opinion, a nurse is a nurse here in Australia. Yes, Mental Health Nurses are a skilled subset, but that doesn't mean that they should let the basics of patient care go.

End result for the most part, if you are going to be in a mental health ward, you are better off to have no pre-existing medical ailments.

NB: That being said, from a Community Mental Health perspective, both my Case Managers have been super-duper in supporting my other medical issues. CM from my time in Ward B, would drop me off to Outpatient Rehab and Physio, organised to have a safety belt custom made for me so that I could do additional rehab safely at my Gym, and also came to a number of individual assessments with me to to keep abreast of my progress, and see what ways she could help facilitate it. CM from BCH, has made sure I was getting my appointments with NeuroDoc, and has also been the one to get me the referral for aforementioned Dental Appointment in March.

1 comment:

  1. I agree with you about MH nurses needing to know/do more about general nursing. I don't know how many times I have seen people with general medical problems as well as the MH ones that are not treated properly. I am including all medical conditions that aren't MH when I say general if you know what I mean. Like for me, I get chronic pain in my neck and head and have to take gabapentin for the nerve pain. If I had one of those 4 day headaches I get where I am upset because I am in pain, I would hate to be in MH hospital at that time.