Patient’s possessions

Oooooh

“allegedly”??????????????

Can’t let that pass

Tin hats on, guys!

John

Very impressive Plebby. You got a response from the famous Dr Crippen, sadly it looks like he (or the team of ranting medics masquerading as an individual) has responded to the wrong post

I always think many of the really nippy problems in nursing are on the boundary between the rights of an individual and the rights of the group.

If you decide to remove items deemed to be problematic hwo do you justify it to the clients after they have been allowed the items in the first place?

Nice to see a new face around Mental Nurse.

The main issue I have with vast amounts of possessions is the difficulties it presents with engagement. Many patients are difficult to engage with, despite concerted efforts of nursing staff, without having an argos catalogues full of stuff in their bedroom. We have tried ‘care planning’ time out of bedrooms to participate in interaction and ‘purposeful/meaningful’ activities but this has not been successful. It has led to animosity, hostility and was stopped as it was not felt appropriate to physically remove someone from their room!

Hmmm, I think it’s a tricky one. On one level I think people have a right to access to what is, after all, their own property. On the other hand a PICU is a setting where they’re only likely to be for a relatively short period of time. Therefore I think I’d probably try to discourage a patient from bringing too much expensive and cumbersome stuff that’s likely to get in the way or get stolen or broken.

Firstly can I ask what a PCIU is?

Secondly, Dr Crippen has arrived. Better put anything sharp in locked drawers!!!

Okay, to the nitty gritty. Acute units are sterile and impersonal places. Some would argue they have to be. I would argue not. but that aside people need comfort and having personal possessions, particularly things that bring some joy into their lives should not just be acceptable but encouraged. I excempt illicit drugs and alchohol from that statement. If I had my way I would excempt alot of prescribed drugs from being on a ward too.

I understand the concern in regards to ‘institutionalisation’ but what we don’t want is cold comfort..which is what a lot of people on wards are given these days.

As a contradiction to all this I actually bought my father a portable cd player for his birthday because he usually loves music and I thought that might provide him comfort. I doubt he has used it because he isn’t in a place where he can get pleasure from much of anything right now but I hope he will be able to use it and listen to music and find some comfort in that and if some ‘lacking empathy’ person would wish to take that pleasure away from him, I would want to bite a chunk out of their neck. I kid you not!

Hi Mandy

PICU = Psychiatric Intensive Care Unit. They’re usually a small ward with a very high ratio of nurses to patients. They usually take patients for a short period of time if they become too disturbed or aggressive for the acute wards, and then they return to the acute ward once they’re stabilised.

I do take your point about the need for personal comforts, particularly in settings other than PICU where people may be there for some time. When I worked on a long-term rehab ward it was suggested that we do more to make the ward more homely and personalised. When the ward manager said, “It’s not a home, it’s a ward, and we don’t want to encourage them to settle in when we’re supposed to be moving them on” it was pointed out that some of the patients had been there for over 20 years!

The PICU I used to liaise with would never have allowed so much stuff to accompany the patient. Clothes, toiletries, fags (kept in ward office) maybe a personal stereo thing and that was it. Everything else had to wait until they were back on the ward, which was intended to be very soon after they went to PICU.

Their reasoning for this was, among other things, that more stuff in patients’ rooms meant more stuff that could potentially be nicked meant more conflict, more stimulation and less getting well enough to get back on the ward.

Thanks Z

I had never heard of a PICU.

Maybe if it is very short term then having lots of stuff is not advisable. Too much carting about to be done. If I was on a PICU, I wouldn’t want all my stuff with me. Then again I don’t think I would want to be on a PICU but guess it isn’t optional.

And the point about stuff getting nicked. Well since me Dad has been in acute ward his watch has gone walkies but I am not making a big issue out of it because in his state of mind he might have lost it. But if anything else goes walkies I will be asking what internal processes they have for dealing with such things (most probably lots of paperwork bugger all to show for it).

Brings up another issue doesn’t it about stuff that does go walkies and how many people either get the stuff back or get problem resolved. Who will listen to a loony saying their stuff has gone walkies?

Most ppl requiring use of PICUs are agitated, unable to exercise self control, madly delusional or tormented by intense hallucinations.
I would question the validity of use for such clients who were settled enough to sit in their room and watch TV all day. Isn’t this the “cure” we seek with PICU?
I would also agree to a point that making the PICU a more homely place than the open ward will discourage anyone wanting to return to open ward environment.
I would far less question the large amounts of patient possessions and would seek to clarify why are people this settled being detained in a PICU?
Further, if it works in PICU to distract or settle them; is it continued in the open ward?

What length of stay are you talking about? Most AIPUs seek to treat within days or weeks. If this is longer for some (as it soemtimes is) then I suggest people with longer term needs ought be offered place in a more homely environment.

Complex, this one. Things like personal stereos can be very useful to mask/distract from auditory hallucinations. Any mains-fed electrical equipment should be PAT-tested to comply with health and safelty stuff. Some people can attach tremendous importance to personal items (this used to be called “totemising”). There is more to this than meets the eye, and I’m glad to see healthy debate about such topics - they need a great deal of consideration.

A long standing issue on our PICU; care planning out of room time for nursing assessment has always been a possibility but has generally fallen down quite quickly especially with chronics meeting poor co-operation with acute sector for transfer. Another issue we are currently finding is awaiting rehab beds and the gathering argos catalogue in anticipation.

Chronics?!!! Are you sure you don’t mean people with enduring mental health problems. Perhaps with a dual diagnosis of argos catalogue addiction!

mmmmm difficult one….. maybe I mean both. Anyway back to the subject.

With pressure on the bed managers (thats what they call themselves) a PICU with a turn over rate of less than a month must be lucky indeed; justifiably expressed sentiment that the question for referral to a more conducive environment is preferable but I’m presuming Plebby already thought of that one.

I work in a forensic unit where random room searches are carried out. On some of the long stay wards it can now take up to an hour to search a small room due to the sheer amount of stuff they have, which means having 2 staff off the ward for an hour. So from a practical side I can see the appeal in having limits, altho it’s not particularly ‘client-centred’.

On the acute ward, patients have practically nothing in their room and sign stuff they need out of the checks cupboard during the day. No personal tv’s or large items. However, given the rate at which these were getting damaged or completely destroyed by patients who were having a psychotic episode there is some benefit to this - fewer very regretful patients who don’t then need to raid the argos catalogue several weeks later when they are feeling much better. One of the blokes on the long stay ward is now on his fifth tv…