Resourcing, culture issues found in 9B stay

Emma Simmers has spoken about her recent experience. Photo: Christine O'Connor.
Emma Simmers has spoken about her recent experience. Photo: Christine O'Connor.
When Emma Simmers knew she was becoming unwell, the former architect asked her psychiatrist to ensure a bed was on stand-by at Wakari Hospital.

The "quite cheeky" request was declined, but she ended up in ward 9B in May after turning to the emergency psychiatric service.

"He said it’s full, [so it is] either respite or home. But I ended up presenting to EPS."

Patients are referred to the EPS team from the emergency department.

Miss Simmers said it was not an ideal route into an inpatient stay.

The stress of being in a crisis situation, feeling like an "exhibit" performing tests, made her symptoms worse.

Police were involved, and she said they treated her with respect and professionalism.

Miss Simmers (45), who has bipolar disorder, has spoken out about the recent stay in Wakari Hospital.

She said staff were clearly struggling to cope with the numbers in the ward.

Concerns about Ward 9B were aired recently in the Otago Daily Times when the nurses’ union complained about a rise in assaults on staff and between
patients.

Miss Simmers did not see any assaults in her two-week stay, but staff seemed "completely challenged by what’s going on".

"I think the way it is at the moment is not satisfactory."

A senior nurse told her the ward was short-staffed.

"The ratio of staff to patients meant they couldn’t spend quality time [with patients]."

Staff tended to stride around with "clipboards", constantly checking patients’ whereabouts.

It was not just a lack of resources — although that was part of it — but an issue around staff culture and training, she believed.

A firm non-smoker, she spoke about the "drama" around cigarettes, in which everyone, even non-smokers, became involved.

Smokes were a kind of "currency" in mental health wards.

"So many people take it up. It relieves boredom and it’s something to look forward to.

"It’s terrible. I know quite a few people who have taken it up [in the ward]."

Patients are allowed to hold on to their cigarettes, but access to lighters is restricted.

"It becomes this culture around who’s got the lighter."

It was a relief to be in a place where she felt accepted.

"It’s almost like you are bonded by the one thing you can’t be that sharing and open with in society.

"You get this camaraderie that you don’t really get anywhere else.

"You don’t have any pretences about who you are in there.

"The discussions sometimes are quite robust and interesting."

There were some good-natured interactions between staff and patients, adding to the sense of  community.

But some patients, particularly men, became frustrated and staff needed to work alongside them, rather than waiting for a problem to arise.

On one occasion, patients’ doors were kept locked over several days because a patient was stealing. Preferably, staff would work with that person rather than disrupt other patients, she said.

She would have preferred to be admitted to 9C, but it was full.

Ward 9B was somewhat dated and old-fashioned in layout.

"9B is a whole different experience.

"9C is pleasant; I wouldn’t say 9B was pleasant."

When she arrived, she assumed a banging noise was construction.

"It kept going, and after a while, I saw the solitary area open. It was a person [in seclusion]. It was frightening. It was so close."

It was a "noisy and active place" where there seemed to be a television or  radio blaring in every room.

There was little structure to the day, and the ward could do with more therapeutic activity.

An occupational therapist led baking classes once a week, and there were always art and drawing materials around.

As in most mental health wards, there was a piano; one nurse was a "fantastic pianist".

Some patients were gifted musicians on a variety of instruments.

Miss Simmers moved to Dunedin last year from Queenstown, where there was a dearth of mental health services.

Patients in Queenstown were sent to Invercargill for inpatient care, and Miss Simmers did that a few times. There were even fewer ward activities for patients in Southland, she said.

An intelligent and articulate person, Miss Simmers worked professionally as an architect for a short time, and has worked in hospitality and as a production assistant in the film industry.

"I would have bowed out in the first year [of architecture] but everyone encouraged me. 

"It was tough. I’m bright, but you’re really applying yourself a lot.

"It’s a professional degree; it comes with the territory."

A new job at the Otago Mental Health Support Trust allows her to use her personal insight to help others.

Miss Simmers’ first admission to a ward was in Sydney in 2001. It was a scary and difficult time.

"You’ve got nothing in your experience to know how to be in a psych ward."

Mental health medical director Brad Strong, in a written statement, did not respond directly to the resourcing and staffing issues.

"It’s true that wards all have different ‘flavours’ or ‘personalities’, and we agree that 9B has one look and feel, and the Invercargill ward another.

"It’s important to share that, in contrast to some perceptions that people may have, mental health wards are rarely highly institutional environments.

"They are often hives of activities, with great characters, and staff genuinely concerned to support patients to manage their conditions and live fulfilling and independent lives.

"While mental health services have been under intense attention recently, it’s also true that many people are very positively supported, and experience significant and quite humbling transformations in their lives, with the support of knowledgeable and empowering staff who work in these services," Dr Strong said.

Comments

Brave. Good that Miss Simmers is working in the field. Great characters, maybe. Miss S seems to be of great character.