|WINWICK HOSPITAL WARRINGTON|
EDITORIAL COMMENTThe Standard seems to have gained unqualified acceptance and the demand for copies increases as the weeks go by, this week for instance came a request for copies to send to a former member of the staff now resident with her family in South Africa. Unfortunately overall capacity as well as cost places a ceiling limit on our activities at the moment and we must not be slow to acknowledge our debt to the young ladies who form the Secretariat and who, despite the high level of their performance in other directions,, quite readily accept the superimposition of the onerous task of publishing the Standard against the time limit set. Our effort to reproduce Mr. Yate's splendid cartoon is the best we can do with the materials at our disposal, and whilst regretting our lack of ability to reproduce the technical excellence of the original, we suggest that even as published the clever portrayal of an idea and concept in such humorous form would do credit to many who have long practised the art.
FROM SMALL ACORNS:At last we have have made a start. Small, maybe, but a start nevertheless. Sister A. Rigby and her staff are to be congratulated for their sheer persistence, badgering Social Therapy staff, persuading ward medical staff, generally nagging us all into becoming involved. Their combined efforts have succeeded in providing her patients (true - only a few yet) with, to quote then, "A wonderful experience and a most enjoyable evening" - a visit to Warrington Baths. Why all the fuss, you may say, about a simple little thing like going to the Baths? Well, it is the first time for our long-stay people. There have been barriers in the past, and even now new ventures are often viewed with suspicion and resistance. Our patients, as they so often do, responded wonderfully to a new idea. They insisted on buying their own costumes, choosing their own styles, and even obtaining towelling from town to make towels for themselves. Surely this is real therapy. I make no apology for repeating myself. - Well done all, including Dr.Walsh, Dr. Khan and Mary Morris, Supplies Department, who stood in at the last minute and accompanied the bathers in her own time - and thoroughly enjoyed herself.
VISIT OF HOSPITAL ADVISORY SERVICERecently the first annual report of the Hospital Advisory Service was published (an excellent resume of which can be seen in the "Nursing Mirror" of the 14th and 21st May). It is interesting to read the report and study the comments in relation to our own hospital, particularly as the visit last year of the Hospital Advisory Service seems to have promoted little discussion amongst the ward staff. According to Dr. Baker, head of the H.A.S., it is "essential for reports to be fully discussed by all those concerned, including ward staff", if they are to be of value. In fact, he considers that a representative of a group such as junior medical staff, or ward sisters and charge nurses should receive a copy of the report, in order to fulfil the ideal of the whole hospital's working together to solve its problems. In their visits to this and other large mental hospitals, such as Horton Hospital, Central Hospital, Warwick and Springfields Hospital, Dr. Baker's team found that most hospitals of over 1,000 beds have "major problems in providing anything like individual care for each patient, a good communications system, or a reasonable staff morale". He finds it distressing to see wards of 50 or 60 patients being cared for by only one or two nurses per shift, and quotes the maximum number of patients per ward, if care is to be satisfactory, as 30. Also the concentration of difficult patients from within the hospital into large 'disturbed' wards he considers to be undesirable causing chronic aggressiveness and frequent incidents. Breaking the hospital down into smaller areas, each unit consisting of admission, re-habilitation and geriatric wards (in effect, a mini-hospital, related to a particular part of the catchment area), and integration of the sexes, are high on the list of H.A.S.-approved remedies for the sick psychiatric institution. Stress is laid on the need for organisation of the medical and nursing administration into functional units, to abolish the system whereby an Admission ward may have several consultants each with his own policy, and therefore no effective team approach. Later, Dr. Baker considers the problem of geriatric patients in mental hospitals and sees the most serious aspect as the syphoning off of fully trained psychiatric nurses to care for them, with staffing ratios which are designed for active psychiatric patients, and thus substantially lower than the reorganised ratio for geriatric patients. He frequently found the lack of a co-ordinated therapeutic approach. "It is possible to find a 2,000-bed mental hospital that has no physiotherapist at all and very limited rehabilitation services for the hundreds of elderly within the wards". Not only do the geriatric wards suffer from this problem - Dr. Baker considers that, after failure in communications, the lack of a team approach is the second serious defect in many hospitals: "The general principle of involving in discussions of policy and future methods of working, those who will be responsible for putting plans into operation, is one which is sadly neglected in many hospitals." Dr. Baker and his team must be congratulated on their work. Reading the report allows an honest appraisal of the difficulties faced by all large mental hospitals and should help staff to understand the changes taking place in Winwick.
KN0WLEDGE OF FIRE APPLIANCESIn reply to Mr. Bayliss's letter of the 9th July, 1971 regarding items 1 and 2. First regarding; item 1. We have always been under the impression that the charge nurse on each ward should introduce new staff members to the ward and in doing so should point out all the fire points, doors, appliances and emergency bells. Item 2. All the part-time hospital firemen, of which there are 20, have a good knowledge of these points and there whereabouts and if indicator boards were in use what advantage would they be without the fire tenders and hoses, etc? It is at present common knowledge that staff, on hearing the fire siren should report to the assistant matron's office to see if their assistance is required and if sent to the area or ward of the fire should wait for instruction by the fire chief before entry into the area of the fire.