Tick box ward round ( J's care, Bradgate Unit )

J's regular ward consultant (Dr A-ia) is on holiday so this time the locum (temp) doctor is Dr K. Incidentally, Dr K was the consultant who was supposedly filling the long outstanding vacant psych post with the community team, but he too (like several before him) had mysteriously left after three meetings, to be replaced by random locums (none of whom wanted to affect real change to J's treatment or diagnosis).

With little regard to recent set backs (recorded by patients on a "green sheet" before ward round) or any discussion with regards to medication, Dr K has decided that J will leave hospital in two weeks time. This discharge date has been set with the hope that someone can attend the next ward round from the community team, to make sure that J is adequately supported at home.

J tells me that she wants to die. I've thought about ringing the ward and saying that I plan to change the locks to her house if she is released home that early.

J has mentioned the discharge date to a nurse dispensing medication, who knows her well, the nurse seemed very surprised. I can only hope that in this case putting a date on paper is a tick box exercise and that nurses will not let J come home if they feel she is too unwell. She has had three visits home so far - mainly just for the afternoon. As always her admission there was talk about "doing things properly this time", which, as always they won't. 

Not sure what to do. I'm really hoping that nurses who know J will try to get them to reconsider their decision.

J tells me she wants to die and has told a nurse recently that she plans to walk to the nearby A50 and throw herself into fast moving traffic. We know this would be easy to do because she took that route when Dr D, convinced that she wasn't suicidal (despite what nurses were saying), allowed J to leave the ward and even walked with her to the road (see much earlier entry).

She had been improving at a moderate pace, but the Bradgate Unit always seems to find new ways to trigger her. As always, I'm completely torn, but I know she wouldn't last more than a couple of days at home at the moment. One wonders what miracles can occur in fourteen days.