2nd July, 1971
Vol. 1. No. 5.


We stand rebuked, and acknowledge our transgressions.
Mr. Wyatt quite properly draws our attention to the
continuing length of our Editorial Comments. In
mitigation could we plead that we had interpreted
our terms of reference as being extendable - to
comment on current happenings not otherwise
dealt with by contributors, as for instance
the note on vandalism, which, before the
suggestion is offered, could have stood
on its own as a topical item.
How, lest we offend again
in the same particular,
we will come to the
point as requested,
as the French
once said


Under the heading "Social Therapy, News, Views and Reviews", Mr. Jolley makes his introductory statement, which describes the function of the Social Therapy Department and which is in no way controversial, and is acceptable to any responsible person! But arising from this statement, he goes on in a manner that is certainly provocative, inasmuch as, his implication, about staff views of patients vis-a- vis 2nd class citizens, and asks why there is still a very great distinction between "them and us".

I presume them equals patients, us equals staff. (All staff from management level?) I am surprised, to put it mildly, that Mr. Jolley should feel that he has to describe the situation in these terms; perhaps I am presuming wrongly and that, the intention was to equate them = staff, us = patients, after all patients, are the prime factor involved.

Posing the question, "Do we feel deep down, that a great majority of our patient population are just 2nd class citizens?", is too easy, for (in this context), how are we to define 2nd class citizens. Is it meant that, anyone entering a psychiatric hospital is looked upon as a 2nd rate person, in the eyes of the community at large, or are staff to be singled out as being of this opinion; is it meant that, 2nd class citizens are such, because they are unable to cope in .. the community, because they are unfortunate enough to be mentally ill: is it meant that, certain patients, have mental illness to a more severe degree than others, and if so are they not 3rd or 4th class citizens? Or perhaps we should rest the criterion on length of stay; I wonder if patients who are discharged, automatically become 1st class citizens again.

I could go on in this vein; however I am merely illustrating that, simple statements and questions, sometimes promote a deal of thought, (and this I think would be Mr. Jolley's objective) and sometimes research, to answer. Mr. Jolley was probably generalising and describing a situation as he sees it; but generalisations are never satisfactory.

Personally, I don't believe that, "them and us" (what a derisory and incomplete description, of a most important facet of psychiatric nursing ), describes the attitude of staff towards patients! There is an understanding now, that emanates from staff towards patients, which not too many years ago, did not exist. I think this attitude is reciprocated by patients to staff, except when the nature of a patient's illness, deprives him/her of this advantage; to anyone with enough years of experience to compare, it is evident, that on most wards, the atmosphere is more relaxed, than it has been in the past; this present state of affairs, surely indicating that, progress has been made in staff/patient acceptance of each other's roles; unfortunately (I can comment only on the male division, as at present, and hope that integration will resolve this problem to a certain extent), there are not enough staff to bring about a more complete understanding between patients and staff, more could be achieved in this direction if more staff were available.

Staff are professionals, with a vocational interest in their job; the foregoing being a most important aspect of their work, However as professionals, staff must guard against becoming too deeply, emotionally involved and should therefore, balance their emotional involvements, against their own ability to withstand stress and tension that may emanate from a patient in an acute phase of illness; the role of a psychiatric nurse can be sometimes difficult; and as the term role appears more and acre frequently in professional jargon it nay be helpful to quote notes by writers in the field of psychiatry.

"The necessity for an awareness of identification, of the roles enacted by a nurse and patient, is an important aspect of the psychotherapeutic nurse/patient relationship. The nurse needs to know, in what role he/she perceives the patient, in order to facilitate, the accomplishment of the therapeutic goals of the relationship." ANITA M.WERNER.

Stanton and Schwartz define "role" as an "organisation, of human behaviour", they also stress the important point, that roles are not isolated, but must be related to counter-roles.

Hindesnith and Straus put down the process of role enactment as:-

1. An identification of self.
2. Behaviour in a given situation, which is appropriate to this identification
3. A background of related acts by others, which serve to guide specific performances
4. An evaluation by the individual and by others, of the role enacted.

The foregoing quotes, from various authorities, if studied, are very pertinent to our roles as psychiatric nurses, and should enable us, to see more clearly, into ourselves, and into our relationship with patients, with the clear aim in mind, that our function, through our roles as psychiatric nurses, is not only to administer treatment as in the treatment and rehabilitation of patients. It is also to fulfil ourselves, by using our personalities and knowledge, in our relationships; in order to personalise patients, to bring then to a state of maximum remission; to help and care for then, and ultimately to achieve a norm, in our environment as near as possible to any standard that idealism suggests we may be capable.

There could be a great deal more to be said about "them and us"; however to summarise, I would contend that we are moving towards a more enlightened state of affairs in Winwick Hospital. Ultimately it is the individual that counts, in the nature of the development of attitudes and relationships; in the knowledge that we nurses are in a profession second to none, given inspired leadership, and encouragement from informed management, we could more efficiently benefit our patients, short, medium, or long stay.



We arrive on duty just before nine,
Read the report all going fine
Say hello to patients old and new
Any strange faces? Oh just a few.
Introductions are made with a quiet chat
Telephone rings (am I on the mat?)
Expect an admission may come anytime
May be a problem Sect 29.
Prepare the bed, and what is required.
Can I go to bed nurse I feel very tired?
Please wake me up when its time for night pills.
She's on two placebos they can cure all ills.
Key in the door night sister appears
The patients are quiet and look little dears.
Are the ladies settled? Its all nice and quiet.
When night sister leaves its just like a riot.
Another pillow, a blanket please.
Cant sleep next to her she's got a disease.
Night sedation given that pleases I know.
A lady is weeping and feeling quite low.
For treatment tomorrow can't understand why.
Don't need treatment she says with a sigh.
All patients asleep it's now twelve o'clock
And off for your supper who's in for a shock.
Look on the menu it says chicken curry
Bell rings emergency quick please hurry.
Rushing to ward and it's false alarm
Once more we return all quiet and calm,
Relax for a while and have a talk
Then back to the ward enjoying the walk.
Your nurse leaves the ward just after one
try to keep busy few things to be done.
Observation of patients we keep through the night
Around 4 am we see morning light.
Some patients awake very early you see
And then they require cigarettes and tea
A few ladies need assistance to dress
After toilet wash and brush up they feel quite refreshed.
Remove the linen and tidy the place
Report book completed, keep up the pace.
Clock creeping round to a quarter to seven
Then home to bed just like heaven.
Day staff appear right on the dot
All happy and smiling bright little lot.
Glad to be off nights over you see
All night we don't sit and drink cups of tea

J. Potts,
    Night Staff.


Too often we hear the cry from officials and some staff, that Sisters and Charge Nurses have to be on duty on week days, so as to deal with Doctors visits, but who takes charge of wards when the Ward Sister and Charge Nurses are sick, on holidays, relieving Night Superintendents, etc? Of course, any Tom, Dick, Harry, Dolly or Jane. Surely the time has come when sisters and charge nurses should work shifts like the rest of the staff, with the exception of perhaps the Intensive Care Unit and Admission wards. It does not take a genius to see that there would be better coverage for the wards, especially at week-ends. It would also give Charge Nurses and Sisters a better opportunity of communicating with the patients' relatives and other visitors. This I understand is an important aspect of a Senior Nurse's work.


At Winwick we are striving to form a therapeutic community for the ultimate benefit of the patients. There is no doubt that the environment within which we work and live affects us all - staff and patients.

Can anyone explain to me how we intend to make such a society work within the framework of a tyrannical, hierarchical system? I wonder if we are all waiting for a modern Phillipe Pinel to come along and free psychiatric nurses from their chains.

Here is a little story.

A, B, C, D. are all nurses above the level of Staff Nurse. And we have one Nurse, below the level of Staff Nurse, who is within the normal limits of emotional stability.

There comes a day in our Nurse's life when she needs to change her shift. She enquires politely of Officer B if this can be arranged. "Yes" says Officer B. (Nurse feels satisfied.) Officer A. hears of this. "No, No, it can't be done". (Nurse feels insecure.)

A few weeks roll by, and our Insecure Nurse needs to change her holidays. She approaches Officer B. "Under no circumstances can you change your holidays." Insecure Nurse: "But I only want to know how to apply for a change in my holidays. Other people are allowed at least to apply." Officer B. " They shouldn't have been allowed." Our Insecure Nurse develops an Anxiety state.

Our Nurse, who hasn't been away for a holiday for X years because she couldn't arrange then at the sane time as her husband, stays at hone and cleans behind the stove, and under the eaves of the house - due to either her anxiety state or sheer boredom.

Our Nurse moves to another ward, and changes her shift. Her day off gets lost in the process. Officer C tells her in no uncertain manner that it doesn't natter if she has worked eight days without a day off. "What you lose on the swings, you gain on the roundabout." Roundabout? Our Nurse feels dizzy. Words like Magna Carta, Fair Play, Democracy and Factories Act, spin madly around in her head.

Our Nurse develops a severe neurosis.

Officer D to Patient (she was our Nurse, until she developed this severe neurotic reaction.) "We'll soon get you well and back to work."

Patient suffers an immediate relapse.

Officer A visits. "Stay in bed this morning, get up after lunch". Our Nurse/Patient thinks - "She's given me an afternoon instead of a morning." Officer B happens to pass. She smiles at our Patient. "A good holiday will do you good." Patient is sick-noticed.

A few weeks go by. There is a distinct improvement in our Nurse/Patient. She is working on the ward. "Now, now," smiles Officer C, "don't go doing too much." Patient develops a severe psychosis.

She has now lost interest in Democracy, Liberty and Equality. Such things as Therapeutic Communities and every man's right to freedom of speech are like birds flying off to

horizon - -
going -
going -

she doesn't
even remember
came here in the first place.



I would like to ask Mr. Parkinson -

1. How long is it since he bothered to visit Industrial Therapy?

2. Has he any knowledge of how orders are obtained and fulfilled?

3. Has he spoken to any patients who work in Industrial Therapy or asked their views?

The money they receive is not a great deal but they are hospital patients, and if they receive a large wage they will be subject to tax and to pay part of their keep in hospital.

What money they do receive goes some way to giving them more independence, e.g. being able to buy their own clothes. The work gives them an outside interest, a wider range of people to meet and pride in their work. It gives then some hope for the future. These benefits cannot be measured in money alone. Independence and Pride in self is the greatest gift in all the world.

P.W. McManus.

There is a wider and acre interesting variety of work in Industrial Therapy than on the wards, where the patient can benefit from a change of environment.

I. Turner. P.N.

The patients I have spoken to in Industrial Therapy tell me they dread the week-ends coning as they miss coning to work. Obviously this means the patients do not regard their work as slave labour. Please don't take our word for this, come and see for yourself. Visitors are always welcome in I.T.

P.N. Walsh.


Dear Sirs,

While as a publication "The Standard" is still in its infancy - can it really achieve its true potential if over 25% of its space is devoted to editorial conmments? For an editorial column to be effective it should be short, sharp and to the point! Perhaps the staff on "The Standard" should review their second issue which was by far the best issue to date.

Sincerely Yours,

M.C. Wyatt.

P.S. I consider the second issue the best because
the editorial comments were contained on one page and the views and ideas of five different staff members were published. No other issue has equalled this record.


Point taken - Record beaten.

Nine staff contributions this week.





Since starting work at Winwick Hospital nearly six years ago, I have always thought that surely the most prized possession amongst the elderly patients is a set of dentures, real or false, and the ability to use them. Spare a thought for the poor "B" diets and the stew pot that is theirs by divine right.

No doubt a lot of foresight and imagination goes into the planning of the daily menu, but surely what is also needed is a little more insight as to the patients' needs. For instance a ward like M.8D., where the "B" diets outnumber the "A" diets by nearly three to one, and the majority of the patients are mostly sick and feeble old men, surely something light and tempting and equally nutritious could be served perhaps as an alternative! Far be it that I a mere nurse should tell the dieticians and cooks what is nutritious and sufficient for old people's diets, we only serve it and brave the looks of disgust.

As the saying goes the proof of the pudding is in the eating and the state of the swill buckets on this ward at least, is proof enough.

J. Mort.
Suggest your Charge Nurse invites the Catering Officers down at lunch time.


When I became an acting deputy sister, in the late part of my third year, I was highly delighted. I looked forward to the challenge it presented.

For this is the time that we realise our work as a psychiatric nurse is just beginning. This is our great chance to put into practice all that we are taught in the teaching department.

I was fortunate in that I was allowed a great deal of freedom in putting ideas forward. I never did this before discussion had taken place first.

At times frustration creeps in and we wonder whether we are wasting our time, this we must bear and overcome

. The added responsibility helps the student to realise the importance of trained staff on a ward.

Once the exam is passed, the student finds that she is often still treated as the student. Once a request is made that does not suit, the remark of "she's gone in blue now, who does she think she is?" This does not happen frequently and has not happened to me.

This situation may be helped if the student was moved to another ward as a staff nurse. Also to gain experience qualified staff particularly newly qualified be moved away 6 or 9 months so they become acquainted with all spheres of psychiatric nursing, so being able to where their devotion lies.

M. McKendrick.
To Deputy Charge Nurse Bob Florer seconded to Chester Infirmary. He will be leaving us on Thursday, 1st July, 1971.




Mrs. N. McKearn, Nursing Assistant
Mrs. B. Habourne, Nursing Assistant
Mrs. M. Hart, Nursing Assistant.