The Nurse’s Part in Helping the Newly Admitted Patient to Settle Down
MENTAL HEALTH 53 LORD MEMORIAL PRIZE ESSAY, 1945
By SISTER A. M. ROSE (Mapperley Hill Hospital, Nottingham) Winner of the ” Lord ” Memorial Essay Prize, 1944
- Reference-type:
Journal Article
- Record-number:
18349
- Author:
Rose, A. M.
- Year:
1945
- Title:
Lord Memorial Prize Essay: The Nurse’s Part in Helping the Newly Admitted Patient to Settle down
- Journal:
Ment Health (Lond)
- Volume:
5
- Issue:
3
- Pages:
53-54
- Epub-date:
1945/07/01
- Date:
Jul
- Short-title:
Lord Memorial Prize Essay: The Nurse’s Part in Helping the Newly Admitted Patient to Settle down
- ISSN:
0025-9632 (Print) 0025-9632
- PMCID:
PMC5092792
- Accession-number:
28908997
- Notes:
Rose, A M, Journal Article Ment Health (Lond). 1945 Jul;5(3):53-54.
- URL:
- Author-address:
(Mapperley Hill Hospital, Nottingham) Winner of the “Lord” Memorial Essay Prize, 1944.
- Language:
eng
Although it may well be unreliable and illogical, is a well-known habit to form firm, lasting, and definite first impressions. That they are often ^accurate and always superficial is to be admitted, but nevertheless they frequently form the basis of our later estimations and prejudice our views for good or evil, the more so when the situation is a new one to us, or one whose arrival we have been dreading. Those first few hours of contact are often the most important of all, and never is the Patient more prone to form a judgment than in her first few hours in the new and, to her, worrying atmosphere, of a hospital. Since, too, it is the nurse who has the first and, in many ways, the most Ultimate contact with the patient, she can well make or mar the patient’s outlook; she can, in those first few hours, settle for good or bad the patient’s degree of co-operation, her contentment of mind and with these her v^iole attitude towards treatment, which, ln psychiatric cases most of all, may mean a big Point in the outlook for recovery. If the nurse can gain fully the patient’s confidence and make her feel that a wise decision has been made in her c9ming to hospital, she will have made a great and Vltal step towards both the patient’s peace of mind, and her response to later handling. If she fails, she may soon have to deal with that most difficult of problems, the unco-operative patient. Despite the great advances that have been made, there are still unfortunately many who think of Mental Hospitals in terms of the old asylum days, as a place where one is kept locked up in cells and cruelly used. It is fortunately much less common to hear this viewpoint nowadays, but it is still heard, and the nurse’s duty thus starts long before the Patient’s admission, in that she should always try to show in her personality and in her ordinary round ?f life that a Mental Hospital is a Hospital, and that she is a nurse just as is her colleague in a General hospital, and not just some sort of wardress. Some of the new patient’s first impressions will, ?f course, be of the hospital building itself and of |he room where she is first received, and most of these are beyond the nurse’s control. The nurse, however, will no doubt be called upon to go down t? the hospital entrance hall to receive her patient, and the impression of this first contact is very lrnportant. There is often an atmosphere which suggests that the patient is being ” handed over as one might transfer some article, and this is increased if there is too obvious a show made of the ^gal documents which the relative or Relieving Officer has brought. In the case of Voluntary Patients, who, thanks to Nerve Clinics and more modern views, now fortunately form a large percentage of admissions, the nurse can be a great help in tactfully discussing the matter with the patient, though the responsibility must, of course, rest with the doctor. The patient will now probably go down to the ward with the nurse, and it is most important that she should be received into a bright cheerful room. A separate room with a bathroom leading out of it is ideal, for then the patient can be examined by the doctor, given a warm bath, unless physically ill, and then taken to a bed in the ward. When the patient is being prepared for examina- tion on admission, great care should be taken that she is not unduly exposed, as in many cases it will be the patient’s first visit to a hospital and she may well feel embarrassed when being undressed by a stranger, even though it may be a nurse. She should be put into a clean bed, warmed beforehand in cold weather by a hot water bottle, and given comfortable pillows. Her nightdress should be as nice as is possible in the circumstances of a hospital, for such apparently small points as this will often make a great]deal of difference to her feeling of comfort. It is very important also that the position of the patient in the ward should be chosen with care. If she is physically ill she should be put in a quiet corner of the ward; if depressed, she should be put into a bed next to someone who is cheerful and will talk to her and reassure her. Young people are usually much happier, too, if they are next to one another, for they will have more in common to discuss. The nurse should introduce her to the neighbours in the next beds, give her the paper, or a book from the ward library to look at, and chat with her for a few minutes before leaving her. A hot drink before she is left is often a comforting thing. The patient should be asked about her appetite and how she is sleeping, since both these are so commonly affected in nervous troubles. Her meals should be given to her on a dainty tray with a clean napkin and pretty crockery. They should be served as daintily as possible, and it is usually much better to give a small portion and a second helping if required rather than pile the plate with food, hoping that it will all be eaten. If the patient complains of sleeping badly, the doctor should be informed; he will then probably order a sedative, which should be given with a hot drink, either just before the day staff go off duty, 54 MENTAL HEALTH or be handed to the night nurse with instructions that it be given at a stated time. For the first night especially the patient will be feeling very strange and a good night’s sleep is thus doubly important. She should be reassured that she will get better and that she can do much to help herself by taking an interest in books, in making friends with the other patients and in eating and sleeping as well as possible. All attentions to the patient should be made when the patient’s bed is carefully screened off. The ward should be bright and cheerful with plenty of flowers, and the dayroom should have attractive curtains, cushions and pictures, for with the modern early treatment of patients in Mental Hospitals it is safe to say that the majority are fully in a condition to appreciate their surroundings. The nurse should appear calm and unhurried, for not only will such an attitude inspire confidence, but an air of rushing, bustling activity may often bewilder and confuse a timid, nervous patient. The nurse should always show the patient that she takes a great and special interest in her case, and encourage her to discuss her worries and troubles, but, of course, she should never let the patient hear herself being discussed with the other members of the staff” or with the doctor. In this connection it is often wisest to discuss these intimate personal worries with the patient in the privacy of the Ward Clinical Room, just as the patient’s case notes should always be kept there. The patient should be encouraged to write to her relatives as soon as possible, just as they should be asked to write often to her, so that she may best retain her interest in her home and family and not feel that she is entirely cut off from all her outside world and interests. The visits of the relatives are often an individual problem requiring all the nurse’s tact and skill, but in general the patient should be encouraged to have as many contacts with her outside world as possible. The reassurance of her relatives, too, will often help the patient herself to feel more settled, and a word of admiration for her baby or her child on visiting days will help to show that personal degree of interest, which is so important. Often there will be a dread of treatment, and, as in all discussions in this connection, honesty is by far the best policy. A simple and reassuring discussion of any special treatment which may prove necessary will prove its value many times over, just as it is essential that special treatments such as Cerletti electrical treatment, should be done in a separate room away from the ward, so that those who are waiting should be given no occasion for alarm. It goes without saying that in a special admission ward the anxious worried patient, who has greatly dreaded her admission to a Mental Hospital, should not be exposed to the noisy, excitable and sometimes sordid phases of the acute psychotic, just as the newly admitted acutely confused or maniacal patient will need especial handling and nursing technique. It is above all the nurse’s whole outlook and manner which must play the biggest part in those first few important hours in hospital, for it is on the impressions gained of those hours that her future feelings for the hospital will be founded, and no amount of subsequent attention or kindness will ever wholly take away the effect of tactless or careless treatment during those first few hours. If, after her first night in hospital, the patient wakes up with the thought that a Mental Hospital is not such a bad or terrible place afteP all, a great deal will have been achieved. And if with the continuation of tactful and careful handling, of pleasant and happy surroundings and of a sense that all are ready and anxious and willing to help her, she continues to hold firmly and widen those same views, then the nurse’s task will have been well done, and a firm foundation laid upon which to build up the patient’s recovery and a sure start made towards the day when she will be able to leave the hospital, and take up her normal life again. But the foundation must be firm and good, and the foundation is built in those first few important days and hours and by the impressions that the patient forms as she is helped to settle down.
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