Friday, March 4, 2011

What's in psychiatric ward

Finished my second week of clerkship. Was at psychiatric ward.
I'm not blogging about the drugs or diseases in the wards or else you guys would just walk off. I just wanna share with you something that is actually on-going in the ward.

How does psychiatric ward look like?
Erm...physically nothing's much different from normal ward. White beds, white walls except that the ward has an open yet confined area for the patients to wander around (Yeah, they will wander around aimlessly).
Anyway this is psychiatric ward and those patients who are admitted to the ward are normally not aggressive.If aggressive, i think diazepam (tranquilizer) stat (immediately) will be injected. Actually you seldom have the chance to see the patients going berserk at least for me, i saw none of these cases.

So what about the patients?
Most of the cases are having schizophrenia. (In simpler word, schizophrenic patients are the ones who couldn't differentiate between real and unreal experiences). And some other cases would be depression, bipolar disorder etc. They sing Negaraku every morning and sometimes they play games too with the student nurses - Music Chairs. Not many patients are playing this out of their willingness. C'mon some of them are already geriatrics. Walking might be a problem for them, still want them to play such a hear-attack game. But no choice, they have to play or else they will be labeled as "Not following instruction". Might be restrained on the bed. Haha.

How do these patients look like?
Erm...the appearance wise, they look just like us maybe not that tidy (I think the students who are in study week will look more terrible than them). Behavior wise, some of them are in depressed mood, some of them are in "excited" mood, but most of them are "mood-less". When you talk to them, they are very thrifty in speech. Their speech are disorganized. No focus. Their thoughts are normally not on your track. Some delude and hallucinate about people trying to harm him/her, hearing the voices talking to him/her and all sorta of stories which might interest us.  Their stories are fancy anyway. To the left, genius, to the right, psycho. Just a thin borderline between genius and psycho. Of course, if you are health care provider, you have to be professional enough. Sometimes the story stimulates you to laugh (I know if i use the word "amusing" you people will say me cruel or bloodless), but you need to suppress your "desire".

Those who had suicidal ideation or attempt are sent here too. You can see from the cases that quite a big proportion of the patients are having suicidal ideation or attempt. It might be due to the drugs that they're taking. But on the other hand, one thing we need to look into is the environmental stressor which deposits the risk or tendency.

They are having mental problems. Something within their brains had gone haywire. It's out of their control to have suicidal thoughts. They don't want too. I heard a patient said this to the psychiatrist, "Dr, I have the thought of killing myself, but I don't want to die."
Most recently you can see those so-called Silly Love Saints committed suicide due to all sorta fancy relationship problems. They acted as if they were actors or actresses. In movies, they have NGs, but not in our lives. Basically I just wanna say, you can't regret it when you're dead. They will mourn for you.

To know more about schizophrenia in a more scientific way, you can visit here