How to survive a psychiatric ward

I haven't been in a psychiatric ward in years, but I once wrote this in a journal and everytime I go back to read it, it makes me laugh. I hope that it finds you the same way.

Rule #1- Sign yourself in. If the man in the white coat threatens a court case you have 3/100 chance of winning. In these, even your own defender takes the other side. Unless of course you're sane. But that's nobody...

Rule # 2- Know about psychiatric illnesses- One minute you and your friend are doing crosswords together, talking about how great it would be to piss without permission and the next she starts talking in a satanic voice and inscribing her skin with a staple from the couch. Don't be alarmed, retrieve staff. DO NOT TOUCH OR TALK TO ANYONE WITH A SHARP OR LARGE BLUNT OBJECT NEAR THEM. Even if you "know them".

Rule # 3- Don't be scared. Seriously, don't show fear, they're like a swarm of bees. kidding. The likelihood of the above person hurting you, is slim to none. The likelihood of getting hurt by another patient at all is slim to none. Most dangerous or violent psychiatric patients are housed in state psych wards, on special units. You are more likely to be harmed by staff. Which goes to rule # 4.

Rule #4- Avoid getting restrained- Pick a hospital who doesn't participate in 4 point restraints. (or 5 or 6 point), the practice of using restraints has dwindled a lot. The likelihood that this would happen is small. However along with physical damage (broken bones, etc) It can also cause psychological trauma. The medications they administer are known to cause permanent damage in some people.

Rule # 5- It may taste decent, but that's not chicken. - Don't assume because they're a hospital they'll give you healthy food. Psychiatric facilities, especially could care less. Despite evidence that a healthy, balanced diets helps improve mood. You could insist on a healthy diet, ask your family to bring you in meals in advance or pick and choose out of what's there.

Rule # 6- Watch yo' back- Be smart, if your roommate starts talking to herself, saying things like "NO I won't kill my roommate, she's nice to me, go away!" You might not want to take a sleeping pill that knocks you out. You should probably inform staff. This is not tattling. She is suffering from effects of a mental illness and they may not even be aware of the risk she may be to others.

Rule #7- Look for support- While you're in there why not grab a few people and make supports out of them? In or out of the hospital? I've met some of the most well meaning, supportive friends in a hospital. Even if we don't talk everyday, I know that they are there.

Rule # 8- You're not leaving in three days- Upon admission you may be told you will be going in for a "a few days". Only to find out you are freed 2 weeks later, pasty and atrophied. "We'll see about Monday" will turn into Wednesday and Friday and next Monday. When you stop asking, they'll tell you. They all sit around a table and discuss things like "Surely when a patient wants to get out this bad, it means they're still ill. It's absolutely amazing in here and these raccoon nuggets are the best". If you push enough, asking him in the hallway, through the nurses station door and while he's eating lunch, causing a psychiatrist to pull out his own hair, you may win. Or you may have to result to rule # 1.

Rule # 9- Don't get too up close and personal with the furniture- I have seen too many people leak their bladders on them. And by leak I mean water fall. So don't fall asleep there and let your tongue fall out of your mouth.

Rule # 10- Groups repeat. Despite Rule #8, they think it's funny or amusing to repeat groups every 3 days to make you suffer. In cause of this, do crafts. Even the worst psych wards have craft supplies. Even if it's just non toxic glue and butchered magazines. Be creative! ( no there's no scissors. Ripping paper is a unique skill I have in light of this).

Rule # 11- Don't Run away- Having a bright yellow tag on your wrist marking you an "elopement risk" makes everyone cautious of you, everywhere. Don't be surprised if while taking a poo a staff member of the opposite gender comes to swing open the door to make sure you haven't burrowed down the drain in your shower.

Rule # 12- Don't look your psychiatrists resident in the eye- He's insecure and you could challenge him, but he has control of your every function right now. From what medications you take, to whether you get to eat with a fork at dinner. Act like he's the boss and if you think he screwed up, tell the actual boss.

Rule # 13- Stand up for your rights- If a woman with thick eyeliner and furrowed brows tells you to she's going to call the doctor at midnight to have you committed, because you're asking for some tissues and waking everyone up. Tell her nicely and pleasantly you happen to be an educated human being, that knows no doctor in his right mind would commit someone for that and she should stop trying to manipulate you.

Rule # 14- Fight = Flight. If you live in a city and are entering an inner city psych ward, you're bound to come across at least 15 fights in your "3 day stay". Otherwise it's not likely. There's higher crimes in inner cities, so there will be higher prevalence of fights, people trying to pass you meth, and the occasional man running naked down the hallway covered in Vaseline, so he slips out of the guards grip. Don't break up a fight in a psych ward even in they're women who weigh 100 lbs and are 4 foot 8. They're eating raccoon, they haven't had cigarettes, and the meth is fake.

Rule # 15- What to bring- Nothing you thought you could. No strings, jewelery, conditioner, perfume, make up, sharp objects, ipods, razors, stuffed animals, your own pillows, your new xacto knife kit, any mirrors, cell phones, credit cards, iguanas, (keeps listing things for 6 hours) Some psychiatric wards only allow you to wear scrubs. Wait no. "Scrubs". Paper blue things that make every other part of you "breezy". "Here's some paper clothes, you're things are in a locked safe, now lets find out why you want to kill yourself." Some places let you have everything, even cell phones. And then one day some one eats deodorant, trying to get drunk and it's all over... back to paper scrubs... some people try to sneak stuff in. DON'T DO THIS. When you get caught, you ruin it for every goodly, honest person out there!

Rule # 16- Don't pet the geese- Although this may not apply to most of you, especially those of you stuck in the city, but don't pet the geese. I have been too many places that had geese and many patients who find it necessary to try and pet the geese. Geese who live and breed on psychiatric ward territory know this. And they have special powers that allow them to beat the crap out of any ill prepared person that nears them. I think it goes with people being manic. It's how I know someone is manic. They think they can pet geese. Even when they hiss at them. Even when someone says "Joe I wouldn't do that". But no Joe has a bit of irrational thinking, related to grandiose. But I am here to tell you if you are Manic, that goose does NOT want you to pet it. Goose Floggings 101 is a course in psychiatric nursing. I tell the truth.

Does anyone have any to add?

Sounds pretty sane to me. I would add that

You must follow the rules. Don't take the rules personally, it's mainly to help the staff do what they're supposed to be doing and allow the supervisors to be sure they are at least working at it.

Don't expect to spend the day in your room. Don't expect to be able to return to your room for anything, as they often lock the rooms when patients are supposed to be in a therapy group.

Don't show upset if you can at all manage it. Upset is written down as a negative and will go against you. Try to discuss all grievances as an adult, even though it's YOU who are struggling dealing with the way the real world operates (through no fault of your own) you must act normal while confined.

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Never admit that you want to self injure. Staff will try and fool you into thinking that they're supportive and that you can talk to them about anything if you need to talk. This is simply not true. Admitting you want to self injure will simply get your room taken apart searching for anything sharp that they haven't already found. You'll be made to sign a contract saying you won't self injure (totally useless), and you'll be viewed as a problem and as a risk. Depending on the institution, admitting that you want to SI may be interpretted as not cooperating with treatment.

Never try to get the nurses' attention when they're on shift change. This is true of all institutions I've ever been in. At shift change they'll huddle in the nursing station and close and lock the door. Yes they are talking about you, but don't take it personally. It doesn't matter how urgent your situation is, you'll be told to come back in 15 min, and they'll hate you for disrupting them. Nothing short of physical violence on the ward will get them out of their shift change meeting.

Always participate in as much group therapy as possible. Even if you've been in the same group 5X before participate. It breaks up the day because being in a psych hospital is really boring. Plus you might actually learn something useful. As an added bonus staff really like patients who participate and appear to be making an effort to get well. It never hurts to have brownie points with staff.

-Try to get into Art group, you will get the most access to the most types of art supplies and it is different every time, even if it ends up just reading old magazines.

- Volunteer. It makes you look better. It also keeps the nurses happy because then they don't have to pick someone and that makes everyone happier. Happy nurses mean a happy ward.

- Bring ear plugs. Sometimes the night nurses don't know where they are, and then you have to listen to your roommate snore all night.

-Remember that doctors don't come in on the weekend, if you enter the hospital on the weekend, don't expect much to happen. Or to get med changes if you are already there.

-Try to get something to help with sleep put in your records for as needed. You may not have trouble sleeping at home but it is much different in the hospital (if anything just because the nurses do checks and you may have trouble falling asleep between checks.)

-Check the meds to make sure you are getting what you are supposed to be getting. Ask the nurse to tell you what you are getting and point out what is what if you can't identify them by looking at them.

LydiaB, I had to smile at your Rule No. 2, because the second time I was hospitalized there was this schizophrenic woman, totally out of touch with reality, with a shaved head, heavy black eyeliner, and a deep voice. The first couple of days she took a liking to me and was so kind and friendly, and then she turned on me with a vengeance, getting really vicious and in my face. She scared the %#$@ out of me; I couldn't wait for my release! (In retrospect I was kind of angry about this -- I had my own issues to deal with, obviously, and I didn't need the kind of crap she was sending my way, and that staff did virtually nothing.)

I heartily second these suggestions. I could NOT sleep most of the time I was hospitalized, which doesn't exactly help one's mood. I asked for something to help me sleep the first time I was in, and the doctor (yes, and MD) authorized Advil. Not Advil PM, just plain old Advil. It was almost (but not really) funny. The second time I was in, my shrink was in the same town and was able to advise them that I was OK to get an actual sleep aid.

Second time I was hospitalized was over the weekend....BOOOOORRRING! I was so stir crazy I thought I was going to scream!

It happens every time: In the psychiatric ER, waiting to be evaluated and admitted, I notice two other women besides me. One is spouting off nonstop, cursing loudly at imaginary companions, threatening violence, and beating her fists on the walls. The other is sitting quietly in a corner, blanket wrapped around her, thumb in her mouth.

Guess which one is going to be MY roommate? (Hint: Not the quiet one.)

oH THAT reminds me.... you won't see a psychiatrist the same day, and maybe not until the 3rd day... and that means you don't get any meds...so take all your meds (no, not all of the pills; each of your meds lol) right before going in so you at least have that in your system.

Believe in Him or not --- GOD LOVES YOU!

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Yah... pretty much during shift change you better be dying to ask for something. As far as going to the group therapy 5X. That's where I draw the line. LOL. I retain information like a sponge. I will not subject my mind to that. Well and especially because I have narcolepsy. I need extra sleep that's not depression related. The best time is during repeat groups!

AvidReader....

Number two has happened to me also. More then once. Luckily it was never with anyone I got really close too, because that would feel really sucky. I'm sure I've probably been guilty of it also when I was very sick. Switching and all and not realizing it. I think my favorite thing about psych wards is that my case always tends to land me in hospitals for extended periods of time, so I get to see the positive change that goes on quickly with people with psychosis. It's like once they hit those meds right they are fine. It reaffirms in my eyes that mental illness isn't my fault (or anyones) and it's all chemical.

LovebirdsFlying... I've been pretty fortunate with roomates. I've kept in contact with a lot of them. There was one though that screamed into midair about how she didn't want to smother me with a pillow because I was a nice person and to stop telling her to. I slept with one eye open. The staff said "we check every 15 minutes". I responded "it doesn't take 15 minutes to smother someone with a pillow." They thought I was kidding. But again, I'm probably guilty of scaring my roomates from time to time.

googley- snoring roomates are the worst. because of psych wards I officially have to find a husband who will NEVER snore.

JD- Not getting my meds for three days? No way jose. I get dire sick with withdrawal if I don't have them after 30 hours. I can't remember if a psych ward has ever refused me my meds for 72 hours. I can't remember. But it never ended up like that, because I'm sure I had something to say about it. I remember once not getting the correct dosage, it wasn't even 2 hours until I collapsed and smacked my head off a blood pressure machine, which required me to get seven stitches in my head. It got me transferred to a medical floor. Which I was perfectly okay with. I say not getting your meds for 72 hours is unacceptable. That can take a huge toll, mentally and physically. Obviously you're already entering the hospital for a reason, you don't need anything added to it. DEMAND those meds. Medical floors don't deny their patients medications. Neither should psych. I would let it slide if I got in at 11pm and they didn't have my night meds. But by morning, even on weekends. They better be there.

My tip would be:

since they do not let you have floss, ask for tea instead. then rip the string off the tea bag, separate it out and wallah you've got floss. Just dont' let them catch you doing it.

oh yeah and no knocking down old ladies, that gets you the shot...just thought i'd mention that

Love and hugs,
Tara

All great advice as my first admission seems on the horizon...

Safe hugs if wanted. Best wishes to you.

Generally, a visit to the psych ward is for 3 reasons: 1) to immediately keep them and others safe, stabilize the patient in a controlled environment 2) to stabilize medication the patient might need 3) to help form a plan of action for when the patient is no longer in the ward (scheduled appointments with professionals for psychotherapy, monitoring)

Believe in Him or not --- GOD LOVES YOU!

Want to share your Christian faith? Click HERE

Funny stuff.

Last time there was a girl who'd choke the staff.

This may be the best thread I've read. Gotta love art therapy.

I will also add.

If you smoke, bring a LOT of extra cigarettes. Although smoking is prohibited in most hospitals, for some reasons, a lot of exeptions are made for psych wards/hospitals and you usually have a lot of time to "smoke em if you got em" and you will make friends easily with more cigarettes, as well as keep away any enemies. (In my first hospital stay, they actually had a cigarette lighter IN THE WALL, that you would press a button and it would light up - I was too short to reach it and had to stand on a chair or have someone else light my smokes )

If you don't participate, you don't go home. If you go into the hospital and then don't go to the groups and just sit in your room, you will stay there until you start going to the groups so you might as well start going.

Don't "hook up" with anyone that you meet there. I'm not saying that there aren't nice people of the opposite sex there, but let's face it, we're there because we are sick...and they are there because they are sick...it might feel good and you might think you are getting away with it but really, everyone knows.

If your roommate tells you she wants to kill you, take it seriously. True story...and her file said she had "homicidal tendencies" (yes, I snuck a look at it) I don't judge her, but i didn't want to be alone with her either - she hated me.

Be nice to the nurses - they are the ones that really run the place. And give you your meds, and can get things done for you. Nurses don't get nearly enough credit.

Lydia said don't pet the geese...I will add, don't feed the squirrels. They are so cute with their little squirrel hands taking the food and eating it....the last place I stayed we would all sit outside smoking and the squirrels would practically take food out of our hands. We got yelled at all the time...i'm sure someone might get bit at some point and need a rabies shot.

You will meet some very interesting and different people. Try to relax and just be there for yourself. If you make friends, great. If you don't that's ok too - you aren't there to make friends - you're there to get better.

if you have a chronic snoring problem, let the staff know right away and they will try to put you in a private so you won't piss off a roommate.
oh, and roommates...we don't snore on purpose really! It is a condition that can't be helped and we feel really badly that we keep you up because of it.
reiteration: never go in on a weekend or friday night

When they are taking down your med list, embellish your rx for ativan (double it) and ask for 3 tylenol to be on the list (they use regular strength and 2 doesn't cut it)

OMG this is too funny (and true) thanks so much for the smile. Thankfully, I have been hospitalized only once for 2 weeks-long enough-never again-but I surely appreciate the humor with this!

Good one on the ativan - never thought of that!

Was she a patient or staff?

This is hilarious...I haven't been inpatient for a few years, but all this reminds me why I want to stay out!!