Contents -

Editorial
Attitude Survey VI
Fire Safety
Around the Hospital
Round the N.H.S.
In the Group
Miscellany
Sports News
Regional Board News
Nursing News
Fare thee well

EDITORIAL

This month's J.C.S.C. Meeting will not take place as planned. The cancellation is due to precedence being given to important meetings arising out of the present N.H.S. Disputes and their repercussions at this hospital.

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PSYCHIATRIC HOSPITALS VIEWED BY THEIR PATIENTS. Report of an attitude Survey by W. Raphael and V. Peers

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PART 6

Patient Care

It seems probable that the first two direct questions, "Do you see the doctors enough?' and, 'Do they tell you enough?' stimulated more criticism than would have been given spontaneously - indeed, it came from about one-third of the patients. The question on nurses' care produced many enthusiastic tributes. In addition, answers to the question, "What do you like best about the hospital?' frequently referred to the staff in glowing terms and included doctors, nurses, social workers and others. There was considerable difference between the views of the short-stay and long-stay patients on the question of feeling free. It seems from certain of the answers to the questions 'Do you see the doctors enough?' and 'Do they tell you enough' that many patients did not realise that, in some cases, part of the treatment is to reduce their dependence on their doctor and also attempt to get the patients themselves to discover the cause of their illness rather than for the doctor to tell them.

Seeing Doctors Enough

Percentage Critical: whole group 31
short stay 41
long stay 25

This question produced surprisingly critical answers from all hospitals even though some of the patients seemed to think that it was only necessary to see a doctor for physical ailments: 'no reason to see him', 'get enough doctor'.

The survey suggests that most psychiatric patients had a great dependence on their doctor, and felt a need to see him at regular intervals. They greatly appreciated him when they did, and doctors were described as, 'sympathetic', 'civil', 'courteous' 'pleasant', 'marvellous' and even more revealingly, 'doctors can give you reassurance and confidence', 'can explain feelings to him', 'can see him any time when it is urgent', 'will listen to you', 'see the doctor every day'.

However, there was a heavier volume of complaints from patients who felt that they were not able to see a doctor often enough. 'Desperately need to see doctor more often', 'Haven't seen a doctor for months.' 'For years,' 'Think cases should be reviewed more frequently.' There were many similar remarks especially from the short-stay patients, though in fact the doctors tended to see them more often. Patients who worked outside the hospital sometimes found it difficult to have an evening appointment to see the doctor,

The attitude of some of the doctors was criticised. 'Doctors hardly look at us or speak'. 'Discourteous'. 'Examine us in public,'

Many patients, realising the low ratio of doctors to patients, understood the difficulty. 'Too many patients to each doctor', 'Doctor overworked', 'Doctors have little time to interview patients properly and are constantly interrupted.'

On the treatment of physical conditions, some said, 'only see the doctor if I have physical complaint' but more felt that physical conditions were neglected. 'Don't see the doctor for physical illness.' 'Neglected physically.' 'No treatment for foot.' And several referred to a lack of dental care.

Some criticisms concerned the type of psychiatric treatment. 'Would like private talks instead of meetings.' 'Incessant talking, would like to solve my problems, not just talk about them.' 'Too many soporifics.' 'Should be allowed to refuse ECT.'

No dissatisfaction was expressed about the great number of foreign doctors, except by one or two patients, who said that 'they are unable to understand English' - this suggests a tribute to the doctors from overseas.

Doctors Telling enough

Percentage critical: whole group 39
short-stay 44
long-stay 34

More criticism was expressed on this topic than on any other, although it may be that the nature of the illness and its treatment sometimes tended to make the patient forget much of what had been explained.

However, it is interesting to ask why there seems to be so little communication between doctors and patients. Is it entirely because the doctors think it unwise to give information to the patients on their diagnosis and prognosis? Is it because they are too hard pressed to spare the time? Again is it because still so little is known about some mental illnesses that doctors hesitate to commit themselves, or do they think the patients would not understand or want to know? If it is possible to remedy the situation so far as therapeutic to remedy the situation with, at any rate, some of the patients, much mental anguish might be avoided.

Very many patients stated that they wanted to be told more about their condition. 'Doctors ask questions but don't tell anything.' 'Don't give satisfactory answers.' 'Don't bother to tell one.' 'Would like to know my diagnosis in precise medical terms.' 'Would like to know how I am getting on.' 'Would like to know if I am crazy or not so I could improve.' A few comments just described the doctor as 'evasive' or 'reticent'. However, some replies to this question were less critical. 'They tell if asked.' 'Tell me anything I want to know.' 'My doctor knows exact diagnosis and is very helpful.' 'Know only too well myself'.

A good relationship with the nursing staff is obviously a great help in this matter, 'Nurses more reliable in telling you things.' 'I have to ask nurse to explain it all afterwards.'

PC

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FIRE SAFETY

Secretary Of State visits Fire Research Station

Sir Keith Joseph, Secretary of State for Health and Social Security, visited the Fire Research Station on January 10th to 'see work on flame resistant and flame retardant materials.

It was pointed out that furnishing fabrics such as curtains can sometimes be placed in such a position that they may accidentally be ignited. A selection of treated curtain materials was on display, showing that relatively fire safe materials can still be attractive in appearance.

A major contribution to the rapid growth of a fire can be made by large exposed surfaces such as walls, partitions and ceilings which may be lined with materials contributing to the flame spread. Sir Keith was shown how these materials are tested and classified as to their capability to spread flame, particularly in relation to decorative surfaces for hospital wards, corridors and escape routes.

Other work seen was in connection with the toxicity of fire gases and smoke, and. the application of detectors to hospital wards.

The aim is to provide a guide to the application of fire detectors to typical existing wards, particularly geriatric mental and children's wards.

Quote from a report on 'The behaviour of people in fires'.

"Since. for any given person a fire would appear a rare event, the majority of people never consider what actions they would take if they were involved in one."

Those concerned with the problems of fire prevention, fire protection and fire fighting must operate in the context of this general indifference, ignorance and variability of behaviour.

C.P. Evans

AROUND THE HOSPITAL

Technical Nursing Library

New books available on loan -

'Hospitals: Communication, Choice and Change' - R.W. Revans
'Psychiatry for Nurses' - J. Gibson
'Psychiatric Nursing' - Matheney and Topalis
'Behaviour Therapy in Clinical Psychiatry' - Meyer & Cheser

NURSE TEACHING DEPT

BROADGREEN DISCO
22.3.73
Please note that the time should have read 20.00 hours to 24.00 hours.

AROUND THE HOSPITAL

In common with hospitals throughout the country we are experiencing the results of staff dissatisfaction in the form of a ban on overtime by the Catering Dept. staff, coupled with a stop to meals other than for patients and resident staff, and the disappearance of the tea-trolley. In addition only essential calls are being handled by Telephonists.

PC

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OPEN DAY & GALA
16th June, commencing 2.00 p.m.
A Working party has been formed to re-think and re-shape what used to be called Patients' Sports Day.

If you would like to assist in preparation and/or help on the day, please give your name to your Dept. Head.

Mr. French

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Welcome to
Mr. T. Jolley, who has been appointed Deputy Fire Safety Officer for Winwick Hospital

PC

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ROUND THE NHS
DANCE AT WRIGHTINGTON

Wrightington Hospital's League of Friends held a 'Grand Dance' in the hospital's recreation hall on Friday, March 2nd.

With dancing to the Harold Stephenson Band and a buffet meal, the tickets cost £1.50, Proceeds, like the profits from a recent jumble sale, went to the funds for the new rehabilitation unit being built at the hospital.

COLOUR TV FOR BILLINGE

Patients on the geriatric ward at Billinge Hospital recently received a new colour television set, presented by Miss M.E. Birchall, chairman of Billinge, Ashton-in-Makerfield and Pemberton League of Friends.

PC

CNO AT WHISTON TO ATTEND ICN CONGRESS

Miss Mary Riddoch, Chief Nursing Officer to the St. Helens and District Hospital Management Committee, is to attend the world congress of nurses at Mexico City at the beginning of May. Miss Riddoch, who is based at Whiston Hospital, was selected for the trip by the Liverpool Regional Hospital Board.

Readers of 'The Standard' will remember that Mr. A. Haughey, of the United Liverpool Hospitals, will also be attending the International Council of Nurses' World Congress.

PC

IN THE GROUP

Mr. Bernard Eaves, Chairman of the Warrington Hospitals' Group HMC, presented prizes and certificates at Warrington Infirmary's annual prizegiving.

The prize for the best nurse in two years State-Enrolled Nurse training was awarded to Miss Neva Donalson. First year progress prize was gained by Mrs. Margaret Atkinson, and Mrs. Patricia Mannion received the 1972 Introduction Course prize.

23 nurses received their SEN certificates and badges from Mr. Eaves.

PC

MISCELLANY

INDUSTRIAL THERAPY IDEAS

A recent edition of 'Nationwide' included an interview with a Dr Brian Moores of the Manchester Institute of Science and Technology.

Dr. Moores said that Prestwich Hospital had been seeking expert advice regarding new ideas in the field of industrial therapy work. Staff at the hospital felt that orthodox I.T. work - e.g. simple packing jobs or assembly work - was unambitious and of limited therapeutic value. He went on to say that the problem had been passed on to the design staff at Manchester Polytechnic and the first and second year students had carried out a design project on the subject. He demonstrated some of the original ideas for I.T. work which had been developed by the students, and these included constructional tasks, such as making 'executive toys', children's tractors, dancing dolls, and 'clack-clack' toys (and don't ask what these are!).

PC

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SPORTS NEWS

ANGLING SECTION
Would all members please note that a general meeting has been called for the 12th March. You are asked to bring your cards for quarterly audit. I would like to see all members present. The venue is: The In-Service Training Room, by the notice boards on the Female side. 7.00 p.m.

Stan Jones, Hon. Sec.

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REGIONAL BOARD NEWS
Decisions reached by LIVERPOOL REGIONAL HOSPITAL BOARD at a meeting held on Thursday, 1st March.

Hospital Management Committee Membership

The Liverpool Regional Hospital Board at its meeting on 1st March 1973 undertook the revision of the membership of Hospital Management Committees in the Region.

Apart from re-appointments, the following new members were nominated: Birkenhead H.M.C. - Dr. W.D. Writer of Rycroft Road, Heswall; Rainhill H.M.C. - Dr. M.J. McCann of Albany Ave., Eccleston Park, St Helens.

The Board was informed that the following four chairmen of Hospital Management Committees had accepted an invitation to continue in office:-

Ormskirk and District H.M.C.
Mr. R.W. Taylor,
St. Helens and District H.M.C.
Mr. A. Foxton.
North Merseyside H.M.C.
Mr. R.N. Bollans.
North Wirral H.M.C.
Mr. A.W. Richards.

New Works

The Board decided that a £43.000 scheme to provide an intensive care unit for the Medical Unit at Wallasey's Victoria Central Hospital be started. Water storage schemes were also approved at Wallasey V.C.H. - £16,000 and Whiston - £55,000.

Other major plans to start included £86,000 for a replacement ward at Warrington General and £56,000 for upgrading wards at Sefton General.

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NURSING NEWS

Mr. P. Ditchburn, Chief Nursing Officer, spent some time at our hospital last week, talking with various groups of nursing staff.

Mr. Ditchburn spoke of the implementation of 'Salmon', and of the importance of successful communications within hospitals.

PC

NURSING NEWS

There has been a Careers Convention at Newton-le-Willows College of Further Education on two days this week and it is hoped that some recruitment will follow.

A party of students from Greaves Hall Hospital, Southport, visited Winwick for one day on Thursday 1st March, 1973, and were particularly interested in E.C.T.

Miss N. Coppack gave a talk on "Mental Health" to the members of Wigan Rotary Club on Thursday, 1st March, 1973, at the Grand Hotel, Wigan.

Mr. E.R. Edwards, a Tutor Student seconded to Bolton College of Education (Technical) from the Hospital of North Wales, is spending some time in the Teaching Department at Winwick Hospital.

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FARE THEE WELL OUR 'AIN B.J.

It's come to pass, our Brian's gone
To seek his fortune and the sun.
He's worked with us for quite a while,
And very rarely gave a smile.

His sense of humour was not lacking,
It's just he wanted to get cracking
With the jobs we gave to him:
"Give him Effico, he's too thin".

If e'er our Jacko was on call
He was always on the ball.
He'd never scream, nor fuss and shout,
Just say, "Of that, there's a lot about!"

Constipation or diarrhoea,
Send for Brian, never fear.
"If he don't go before Ten,
Give four Senokots p.r.n."

When we attempted forms of jest,
He was not at all impressed.
With wryful smile and doleful look,
He'd sign our diet sheet and our Book.

His Knowledge was good of Organs internal,
I'm sure he writes the British Medical Journal.
"Get C.X.R. and F.B.C.
Then go brew up - it's nearly three."

His daily round was never late,
His favourite drug was Modecate.
If side-effects became too grim,
He'd up the dose of Kemadrin.

And so we bid B.J. good-bye,
"Good Health, here's mud in thine eye.
Don't forget your little black bag,
Or your new Consultant's bound to nag".

UNIT 7

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