R. N. Katy is one of the badies. She has been working nights here for about two decades. She had a reputation for being rigid, morally judgmental, and sitting in the nurses’ station reading her bible. I slept most nights and had little contact with her. [When I stopped taking psych meds in 2001, I started going to sleep at 10:00 p.m. and waking at 6:00 a.m.]
Now Nurse Katy comes to my bedside and refuses to do an Accu-Chek. Because it is 6:30 a.m. and blood sugar checks are done at 8:00 a.m. by the day shift. I explain to her that my doctor wants fasting blood sugars. What is that, she asks?
Fasting blood sugar? That’s when you get up in the morning and before you have anything to eat or drink you check your blood sugar. When I am on a medical unit, I wake up, get a glucose check, and then my juice. Katy can’t deal with the concept.
So she moves on to telling me that I should not drink juice because yesterday—14 hours ago—my glucose was 250! Those are the words of a genuine moron. Absolutely no competent medical person would base today’s diet issues on yesterday’s glucose numbers.
We talk/argue for nearly half an hour. I try to explain things and answer her questions. She refuses to listen. At one point she tries to physically grab the juice away from me. She does not appreciate it when I liken her to a prison guard. On any medical floor, the patient has the right to choose, no matter how badly. Only on inpatient psychiatry is the patient denied all rights, all freedoms, all choices.
I have a 4 oz. cup of cranberry juice, half a cup of pineapple pieces, and a breakfast sandwich. At 1:00 p.m. my glucose is 257. Exactly what would Katy have me forego to lower my blood sugar? We are way past the point where diet changes will have any impact. Katy is too stupid to understand, and too certain that she has a God-given right to tell other people how to live. And St. Joe’s has empowered her by putting her on permanent nights without adequate supervision. If she worked days once in a while, do you think she would have heard of “fasting blood sugar?”
- Kristin (charge nurse) comes to tell me that I have a visitor. As she empties my drainage bag and helps me on with my pants, I comment that she sounds terrible. She’s hoarse, her chest is congested, etc. She replies, “I’m awful sick.” I ask her why she came to work. Kristin replies that “they” get really upset if you call in.
I have a compromised immune system. If I catch a cold it means two weeks in bed and considerable suffering. If my sinuses get congested then I can’t breathe with the BiPAP, which means I can’t sleep, which leads to a progressive downward spiral.
On inpatient psychiatry, sick employees are forced to come to work and put the entire patient population at risk.
Instant Sanka made with tap water
St. Joseph’s Hospital has 431 beds. Patients in 401 of those beds can get a cup of hot coffee any hour of the day or night. Between approximately 6:00 a.m. and 6:30 p.m., they can call Dietary and request coffee. When Dietary is closed, they can ask their nurse who will bring them coffee from somewhere in the back of the nursing station.
On inpatient psychiatry, patients are not allowed to call Dietary. They can only order coffee on with their meals to be delivered on their tray. Other than that, they only can have instant Sanka made with tap water. Staff has hot coffee in the nursing station, but they will not let patients have any. For years there were microwave ovens on 3-6 that patients could use to heat water for hot coffee.
According to a staff member, a year or so ago one patient, on three occasions, used the microwave to make hot water and scald herself. Administration thereafter made the decision to remove the microwaves. Any lawyer will tell you that one case makes bad law. Approximately 1700 patients go through Unit 3-6 every year—and they go without coffee because one patient engaged in aberrant behavior and Administration focused on the machine, not the patient. Pay attention to the patient! Why didn’t they lock her in the back, away from the microwave?
Why aren’t psychiatric patients allowed to call Dietary? Why weren’t the microwaves under the control of staff, as they are on every other floor? How can human beings who get up in the morning and go for their coffee deny that to other human beings are under their control?
What happened to treating human beings with civility, regardless of whether they’re on medical units or psychiatry? Instant Sanka made with tap water is not coffee by any normal standard. I wake at 6:00 a.m. and cannot have coffee until breakfast comes at 9:00 a.m. Who else in this hospital—staff or patient—has to wait three hours for their first cup of coffee? By what right are psychiatric patients treated worse than every other patient?
Tuesday 23 April
And a new day begins. What I miss the most—most desperately—is music. At home, my day begins with WCNY classical, moves on to WMHR Christian, and then Pandora—Harry Belafonte, Nine Simone, Celtic Thunder, Cat Stevens, Bette Midler, Paul Simon, John Denver, Neil Diamond, Miles Davis, Willie Nelson—and ends with WAER jazz.
Here I have had five solitary days in confinement (we call this “treatment”): no telephone, no radio, no television, no groups, no bedside visitors, no other patients. All I have are staff to talk to, and the staff has decided I am a bad person. By word of the head psychiatrist, I do not need psychiatric treatment. So they give me no treatment at all, and call me rude and manipulative; they say I’m playing games.
How can they be so mean? This is the ultimate question.
arose out of the civil rights ferment of the late 1960s and early 1970s and the personal histories of psychiatric abuse experienced by some ex-patients rather than the intradisciplinary discourse of antipsychiatry.
In other words, the patients are changing the system, not the doctors.
In institutionalised adults with learning disability, caffeine challenge following a period of abstinence resulted in an increase in disturbed behaviour ( Searle, 1994 ). It has been reported in a naturalistic study that higher doses of phenothiazines are prescribed to in-patients supplied with caffeinated coffee than to those given decaffeinated ( Shisslak et al, 1985 ). However, a double-blind crossover study found no correlation between caffeine consumption and anxiety, depression or behaviour in long-stay patients with schizophrenia ( Mayo et al, 1993 ). Caffeine may antagonise the effect of benzodiazepines such as lorazepam and diazepam ( File et al, 1982 ; Roache & Griffiths, 1987 ; Kaplan et al, 1990 ; Kruger, 1996 ); it has been suggested that patients may use caffeine to reverse the effects of sedatives, so creating a vicious cycle ( De Freitas & Schwartz, 1979 ).