Strangulation, real and metaphoric. Meeting with Ward Matron (J's care, Bradgate Unít update)

I'm trying to remember what was said today in a meeting we'd called with the ward matron, except that my mind keeps straying to the fact that J tried strangle herself in her room with a towel this evening. Back in town, I missed a text from her to call and so I phoned and her voice was hoarse, so I immediately phoned the ward office and told them she was "ligaturing".  The person on on the other didn't  inspire confidence, there was no urgency, no "thanks, don't worry, we're on it". Later J tells me that the rolled towel had been around her neck for 45 minutes whilst she was in her room.  There's some confusion over the length of time at which the nurses are expected to check on her. No-one seems to be registering that we both feel she is very unwell this week.  Apparently one nurse offered to talk to her after they had taken the towel off her and checked her oxygen level, but J, declined, not feeling that that many of the staff have the skills for a sympathetic chat, and then they just left her, alone.  Later a nurse had come back regarding an issue with meds, but I don't think this was good enough. I was on the phone with her telling her to stay in line of sight of nurses, but she wanted to stay in her room and didn't trust the HCAs, because they hadn't even checked on her. I don't believe anything was taken from her room or a proper discussion about risk was had (ironic because yesterday a charger cable was removed from her  without her knowledge room without so much as a note left between staff by way of explanation). Later a nurse said he might be suggesting that she be put on a higher level of observation. Apparently when they were coaxing the towel from her he had said something along the lines of "doing this will only make them discharge you earlier" since she is terrified of the prospect of being sent home in two weeks without anything in place, or her still being too unwell.

In relation to this, some of the meeting with ward matron was useful for sharing perspectives.  Apparently the locum doctor had actually /added/ a week to the discharge date.  And since there was a belief that J was apparently doing well three weeks ago that this was all in line with their plan, the discharge date having been set in stone a long time before.  J and I have no memory of being told a discharge date, and we assume that if we had we would have written it in at least one of our diaries. Nonetheless, one would assume that a plan of recovery would be measured against this date and professionals working with Jo might have mentioned how far or not she was within this arc of recovery.  I'm pretty sure the discharge date was news to the her Named Nurse this week, and is definitely not written on our copies of the care plan.  Anyhow, J was asked to list reasons why she should stay longer than the discharge date, but yet again, we feel like we're fighting for things and having defend very basic rights to basic care.  

The ward matron conceded that there had been a communication problem regarding J's room being given away and her possessions being put into storage, apparently on the Tuesday of a week, whilst other staff told her the room was still hers right up until the moment she returned to the ward.  The plan had been not to tell J of the change, so that when they did, when she returned, they could do so in a sensitive way and control the situation.  I think we agreed (J and I, at least) that this had been the absolute wrong decision, and that even the touching of a patient's property shouldn't occur without their awareness.  The ward matron seemed disappointed by our relating of the dismissive nature in how J was told, and that she had been told she was "lucky" to still be on the same ward. She also didn't seem to understand why staff had been reassuring her (possibly lying?) that the room was still hers to use.  This explanation unfortunately is worse than my excuse for them, i.e. that they'd just screwed up at the last regrettable minute.   I think that there was actually an apology here, a brief moment of recognition of why J was aggrieved.  She said that she would be bringing up the issues with staff, especially those caused by poor communication.  This feels like a sort of "training feedback" topic, as opposed to something which might repair J's relationship with staff in the short term, which is what I wanted an outcome of the meeting to be.  

I do not get the sense that the staff are prioritising J or her risk in any way at the moment, and frankly, from what's she's quoting to me, I'm not surprised she believes the nurses just want rid of her.  One explanation is that they are very busy, but knowing this can make it much worse when trying to ask for help, which J is doing, i.e. asking for help, sharing her level of risk, or at least she is informing them that she "wants to die".

Apparently there has been some real concern about the mention of a "suicide pact" between J and I, which made me laugh, since normally they infer that J isn't even suicidal.  I pointed out to the ward matron that when I with Jo, I'm usually looking out for her safety and that this had come from a lonely and physical unwell place.  They were treating it as a "safeguarding" issue, whereby I could be perceived as coercing J into killing herself.  I told the matron that most of my own desperate thoughts had been brought on by the shitty time J was having in the Bradgate Unit.  Perhaps what I should have said is that the wards have probably coerced many patients to suicide through neglect and prejudice.  I also pointed and that giving away J's cat would take a lot of planning.  So, instead of, "her carer is unwell, how can we help?", maybe it's "the boyfriend is a dangerous influence, get him on a register".   Again, the issue of the crap time J is having in their care isn't discussed, and now they'll think she's mainly triggered by me.  Thank god we don't have children.  Can you imagine what a social worker would have made of this?  J talks about suicide, attempts suicide on many occasions and she's lucky if she can get an appointment to see her CPN; I mention (in a hypothetical context) suicide, is reported second hand by someone they don't always believe, and they hit red buttons without a second thought.  We found this funny (just very surreal), and I was surprisingly reassured by the fact that they actually have safeguarding policies.  It's a shame they don't have policies on self harm, or training, or a sense of continuity, compassion, communication, people skills, ethics, I could go on, but I'm too tired again.  

I got to chat to the lady from Rethink today about my own woes, and she had some prompts and pointers for (in the community- ) care packages.  You know, that thing the Unit thinks it can magic out of it's arse in a week, and then it fails because no-one knew the meeting was happening.

There was other stuff I need to record here, but I think that's all I can stomach to share for the moment.