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Old Dec 02, 2010, 04:25 AM
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SenatorPenguin8081 SenatorPenguin8081 is offline
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Member Since: Nov 2010
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When I was a medic in training I did a clinical rotation on an inpatient locked psychiatric ward that was in a normal city hospital. Actually, there were 3 wards--- one for "less volatile/less violent/less escape risk" patients, one for the ones that were, and one for the elderly.

You do intake at a intake window outside the unit (at this hospital it is like a lot of other ones in that intake is a part of the psychiatric section of the hospital but not inside it). You are accompanied by either hospital guards, cops, nurses, psych aids, or psych nurses, depending on your behavior and how you came into the hospital. Usually intake happens at night for some reason. This ends your privacy right here and you are never left alone from that point forward.
Then you are accepted into the unit and your belongings, if any are taken and searched, your clothes are taken and you are given slippers and hospital PJs (tops, bottoms, and a robe). They are then put in secure lockdown and will be given back to you (barring the non-safe contraband items) once you get off restriction (except for the shoelaces/belts). You will be given your clothes back or allowed to have them brought in once you get off of the initial restriction (because people are less likely to escape if in hospital PJs and are also easier to identify as level 1--different levels different treatment). An attending physician who was in his psych rotation or was the psych resident (the attending who was actually going to be a psychiatrist when his residency was over, which is a 3-4 year residency) does an initial assessment and brief non-intrusive physical although they might take a UA and blood as a matter of course. They have medical rooms for this in the ward in a different locked hallway. This was a teaching hospital with resident md/s and student md's and intern md's were always around more than the full blown psychiatrists on staff, which I also think is a detractor, but I digress...

Hmm okay so the nurses and psych aids are who you will spend most of your time with. Checks--visual observation of everyone on the unit are done every 15 minutes no matter what you are there for. Some people are on 1/1 because they are active self-harmers, or dangerous active suicidal, or other type of immediate risk to self or others. This means they have a person assigned to be with them at all times and these patients are usually in isolation and sometimes restrained depending on the case. Some people have eating disorders and are highly monitored, including having to have someone check in on them whenever they use the restroom because of those behaviors. Like I said, no privacy there. People are assigned to group therapy on a daily/weekly schedule and are given individual therapy. The actual board certified psychiatrist or ARNP-psych (Advanced Registered Nurse Practictioner in Psychiatry) you will see very little of. Mostly it's the residents, but you can always demand to see the board certified pdoc if needed and they have to let you see him.

I don't know, I wouldn't find it particularly restful, but I consider it necessary sometimes. Everything by schedule, which was posted on a board in the morning. Everyone was on different security levels. Some could sign out for 2 hour passes and such. Sometimes you get to go to the gym. Sometimes there were art therapy or whatever for the day. Meals on a schedule. Rules rules rules. Had to watch the eating disorder patients eat (a lot of them try to purge or won't eat at all in which case they are eventually moved to med-psyche for medical intervention if they get too weak). Some people were nice and some were not really all there but nice. Mostly the place is laid back but still the transition can be hard for some people. There is a day room, a lunch room, and 2 bed rooms for the patients. I think the wards had about 28 rooms each but they weren't usually all filled up. Girls and guys in the same ward but of course not in the same room. There was a laundry room too. Games, and a small TV room for people who want more quiet or whatever. Some people get recommended for involuntary commitment for longer stays (more than 3 weeks usually) and there is an informal court process for that with a real judge.

Usually the anxiety about the place subsides once people are there for a day or 2.

I think your T probably wouldn't recommend anything harmful to you.