Contents -

Editorial
Attitude Survey VIII
Around the Hospital
Round the N.H.S.
Miscellany

EDITORIAL

The Gala Day plans are to be considered by the H.M.C. at their meeting on Wednesday, 28th March. As soon as the details are known we shall give them in Tne Standard.

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

PART 8

Life in Hospital

An assorted list of topics were loosely grouped together as "Life in Hospital", to include such varied matters as food, clothes (if provided by the hospital), patients activities, whether work, occupational therapy or recreation, and patients views of their fellows.

As the table below shows, on all the questions, except that on occupational therapy, short-stay patients were much more critical than the longstay: obviously, in time, patients get used to life in hospital and fret less at its limitations. Whether this is a good or a bad thing is hard to say.

Question 21 was different in nature from the rest of the questions. It asked for facts - whether the patients took part in social activities. It was assumed that patients took part because they wanted to; social activities were always voluntary. All the other questions asked for views - whether they liked what they had or did. Therefore, the statistics on Question 21 are not comparable with the others.

Critical Answers to Questions about Life in Hospital

No.	QUESTION	% CRITICAL
		Whole Group	Short stay	Long stay
5	Do you generally like the meals?	22	31	14
6	Are your clothes satisfactory (if supplied by the hospital)?	19	24	15
19	If you do work whilst in hospital, do you like your work?	13	19	8
20	20 If you do occupational or art therapy, do you like doing it?	14	11	15
22	Do you find life in hospital interesting with plenty to do?	36	41	26
23	Do most of the patients in your ward get on reasonably well together?	15	18	13
21	21 Do you take part in any social activities such as concerts, games,	PARTICIPATING/NOT PARTICIPATING
	dancing,bingo,etc.?	47	42	39

Meals

Percentage critical: whole group 22
short-stay 31
long-stay 14

Views varied considerably in the nine hospitals; in three, about a third of the patients were dissatisfied, but two had a fine record; only 9% were dissatisfied. Long-stay patients were much less critical than short-stay.

Individual preferences about food naturally varied, but general criticisms included, "Food appalling', 'Badly cooked vegetables', 'Potatoes unappetising'. As in general hospitals, many comments centred on the stodginess of the food, and the shortage of fresh fruit, salads and vegetables. 'Less starchy food'. 'Too much carbohydrate'. Not surprisingly, some of the women mentioned that they were putting on too much weight. There was also some adverse criticism about the meat - 'tough', 'unappetising', 'tasteless' - but on the whole the puddings were well liked.

Supper was the most criticised meal, partly because of its timing. It was considered to be too close to tea, and also, 'Supper needs to be more substantial', 'Supper boring'. Patients also mentioned that breakfast eggs were always boiled, never fried.

On service and presentation, most were satisfied but a few said, 'Got to have meal quickly or miss it', 'Scramble like a rat race', 'Have to queue for food'. It was also mentioned occasionally that 'food was cold'. It is difficult to prevent mass cooking from becoming monotonous in any institution, and psychiatric hospitals are no exception - 'the meals lack variety'. Some patients said that a choice of menu such as some general hospitals offer would solve many of the problems. Patients mentioned that diet meals and food for the aged tended to become dull and monotonous, and deplored the absence of a dietitian.

In most hospitals, the meals also received a lot of praise: 'marvellous, tasty, fruit three times a week, meals varied, always an alternative, meals always hot.' and one enthusiast wrote, 'Like meals.in a luxury hotel'. Nearly always food was said to be adequate in quantity: 'We can always have second helpings'.

Patients appreciate being consulted about the food: 'Group discussions have improved the food.' 'Now get fish as well as stew' . In other hospitals however, patients said they had no chance to complain about the food. 'We never see the catering manager'. Last, but not least, the odd cup of tea was said to be always appreciated. 'Can go and make tea when we want to'.

Clothes

Percentage critical: whole group 19
short stay 24
long-stay 15

In one hospital, the proportion of patients who wore clothes provided by themselves was as high as 61%; in another, as low as 29%. The median was 50%. Cf course, the figures are much higher for short-stay than for long-stay patients and exclude those in the senile geriatric wards. Many factors seemed to influence the proportion of patients who provided their own clothes:

emphasis in the hospital booklet' on bringing own clothes
adequate wardrobe accommodation
provision of washing machines and drying facilities, especially in the women's wards
opportunities to buy clothes either in boutiques in the hospital (some of which had occasional fashion shows), in outside shops or in jumble sales of good secondhand clothes, organised by the hospital's League of Friends
encouragement from the ward sister or charge nurse to buy clothes, taking patients to shops and occasionally helping - 'Sister adapts clothes lovely.'

These points were raised during the interviews held with patients at the first three hospitals rather than comments from the written questionnaire where the question was confined to clothes supplied by the hospital. They are included in this report because buying and owning clothes seemed to be important aids to feeling normal. Hospital clothes even when specially supplied for use by only one person, did not stimulate the same feeling.

Few comments were made in the questionnaire about the clothes provided by the hospital. A scattering of people were appreciative. 'Fit well because they were made for you.' 'I've got two suits'.

Several people appreciated the care of the clothes, particularly the fact that they were washed regularly. 'I get clean knickers every night.' More people were critical but still not many. They complained of poor fit and workmanship: 'short of large sizes', 'gave me 38-inch trousers, need 32-inch', 'clothes worn out', and especially that the clothes were out of fashion, 'look institutional', 'unattractive'.

(To be cont.)

PC

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AROUND THE HOSPITAL
Union Meeting
There will be a meeting of the Winwick branch of COHSE on Wednesday April 4th at 5.30 p.m, to discuss general business.

Monthly Condemns

Following discussion at the Nursing Area Meetings the Hospital Secretary has agreed that there is no longer any necessity to produce broken crockery, mops etc, at the general stores each month in order to obtain replacements. However, cutlery, teapots and kettles will still be returned as these items are sold for scrap.

The present system of using condemn books and submitting them each month will continue, as this considerably reduces the work of the General Stores' staff.

PC

The following letter was passed to us by Miss Coppack. We are sure it will give many people pleasure.

Having learnt today that I have passed the State Final Exam for the Register in General Nursing, I wish to thank all the doctors, nurses and other staff whose help and care for me while I was in this hospital has helped to make this day and achievement possible.

I hope that this may be an encouragement to all in their work.

Thank you
Anita Blackburn

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SOCIAL CLUB

D I S C O
April 6th, Friday 9.00 - 12.00
in the Club.
Featuring the return of the Cuddly Dudley Disco Show.

Club Entertainments Cttee.

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TECHNICAL NURSING LIBRARY
New books available on loan -
'Bacteriology and Immunity for Nurses' - R. Hare
'Biological Psychiatry' - J.R. Smythies
'Psychiatric Emergencies and the Law' - F.E. Kenyon
'Human Aggression' - A. Storr

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ROUND THE NHS
Warrington Lions aim for £4,000

An appeal has been launched by the Lions Club in Warrington and the Mayor, Councillor Bill Avery, to bring the Mayor's Kidney Machine Fund up to £4,000 before it closes.

The sum of £3,500 has already been raised with the help of clubs and organisations throughout the town.

After recent meetings between the Mayor, the Lions - who have helped organise the appeal - and representatives of the Warrington General Hospital, it has been decided that not all the money will be spent on kidney machines.

One machine, costing £1,200 will go to the receiving ward at the General, and a number of other machines connected with the treatment of cardiac arrest will now be provided.

The fund is due to close in two months time, and it is hoped that the official presentation can be made early in May.

PC

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DAVID MATHER UNIT OPENS

Professor J.C. Brocklehurst, Professor of Geriatric Medicine, Manchester University, recently unveiled a plaque to declare a new £500,000 geriatric unit open.

It was the David Mather Unit at Billinge Hospital, the first purpose-built. geriatric unit in the Manchester Region.

Housing 169 patients, the unit replaces two older hospitals at Frog Lane and Pemberton.

PC

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HOSPITAL CHANGE FOR NEWTON

Under local government re-organisation, Whiston Hospital will become the new district general hospital serving the Newton-le-Willows area.

Newton Health Cttee. heard recently that Whiston will serve the Knowsley and St. Helens districts, including Newton-le-Willows, even though Newton has looked upon Warrington General as its district hospital.

However, the Deputy Divisional Medical Officer of Health, Dr Jean Bond, said that people would have freedom of choice, and would be permitted to cross boundaries to a certain extent.

PC

'IDENTINEED' CAMPAIGN IN WIGAN

Wigan Social Services Dept. are running a massive campaign to identify chronically sick and disabled people in the town.

In the fortnight from March 26 to April 9, the town's 30,000 homes will each receive a leaflet explaining what 'Identineed' can mean, and what can be done for chronically sick and disabled people in Wigan borough.

People who think that they could benefit from the scheme are asked to complete and return a confidential tear-off slip. Neighbours are also asked to help if they know of people who ought to be included in the scheme, and this will enable an up-to-date register to be kept by the Social Services Dept.

Already, from stage one of the campaign, which began late last year, 500 people are being interviewed by 10 part-time workers in the Dept.

The 500 - taken from the survey covering 3,500 homes, will form the nucleus of the register. Once the stage two names and addresses are returned the Social Services staff will be able to start more interviews.

The Town's community development organiser, Mr. Warwick Steels, said that, from the initial survey which covered one in eight homes in the Wigan area, there could be as many as 4,000 cases requiring interviews. It was hoped to have the register completed by the end of the year, and this would assist in planning what services are needed in the town.

People who send for information about services under the Chronically Sick and Disabled Persons Act, 1970, and who request a visitor from the Social Services Dept. are assured that all information will be completely confidential.

MISCELLANY

Regional Athletics

This year's meeting will be held at Rainhill Hospital on Saturday, 9th June 1973. Staff are invited to enter, please. Training sessions will be held each Thursday evening commencing at 6.30 p.m. under the eye of Mr. Roy Mather. Please turn up.

Congratulations Emma and Joe on your engagement

Sister, staff and patients of W7

May I express my thanks to the many people who assisted in the movement of Ward 26 to Ward 38 and rendered the change relatively smooth.

D. McKendrick

Printol-D

Mr. Taberner informs us that the decision to stop supplying the above disinfectant was not in fact taken as an economy measure, and adds that the general review of expenditure in this area is hardly likely to involve ward visits.

PC

Liverpool Regional Hospital Board Billiards & Snooker
Billiards Final

The final of the Regional Board Billiards competition was played on Monday 26 March between Warrington and Rainhill at Winwick Staff Social Club. The Chairman of the Warrington Hospital Group, B. Eaves, was in attendance and presented the cup and individual prizes.

WARRINGTON			RAINHILL
J. BURGIN	150		E. FOXLEY	71
S. WATSON	136		W. THOMAS	150
T. LAWLESS	82		R. TENCH	150
E. ASTON	150		J. BENNETT	75
Handicap	130		Handicap	120
	648			566

A prize for the highest break in the whole competition waw won by R. Tench with a break of 39.

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