WARNING : Long entry, lots of medical jargon.
3 days at Emergency assessment centre / acute assessment centre, Chase Farm. this is an emergency mental health centre who offers assessment on possible mentally ill patient, new or relapse case. Operates 24/7.
Monday&Tuesday:
Bank holiday, ataupun cuti umum, bukan cuti untuk org yang kerja bank sahaja.
Wednesday:
first day at EAC. gugup dan gagap. tapi orang disini seperti biasa, super nice. I met Mohamad, who was a charge nurse there and he introduce me to other staff, sheeba who is another nurse, Dr Black the Psychiatrist, ( his a white guy anyway), Rob (Admin worker), and the receptionist whom I forgot her name. aiya! I was expected to learn more about how this unit function, their routine and liaison with other unit and they would like me to participate with assessment on patient, of course with a senior nurse assessor. oh ya, here, nurses here are called nurse assessor because basically, they do assessment on patient.
what I learned?
- the flow of case referral. there were registration (for first contact patient), fill in form and rio, record in referral book, assessment, triaging of case. triaging is where they decide whether the patient is really acute or not.
*
more of social problems and need support system : reffered to service line e.g. Bureau of drug alcohol
service, or other social services.
*
Not acute, able to be treated in community : Primary Community Mental Health treatment (PCMHT)
*
Acute : will be assessed again with members of HTT to see if patient need
ward admission or can be
seen at
home basis. HTT is basically a gate keeper to ward admission.
achievements:
- observed mental health assessment
- written patient observation and assessment outcome on RIO.
- Written the risk assessment on RIO.
Thursday:
was a productive day. I was introduced to Judy and Neela, whom both are nurses.
learning:
1. Mental health act.
- how patient are to be sectioned in different2 setting.
- there are one clause that lined the nurses authority to detained pt in ward if he/she wished to abscond. for Psychologist, only those approved by sectioned 12 (which they need to sit for exam) are allowed to section patient.
- The act can be used with one another. and if there is a need to detained pt for a longer period, sectioned must be renewed before it expires.
- patient are sectioned because they refuse assessment and treatment eventhough they are at risk of harming self and others. they are detained for further assessment in wards and/or treatment.
- there are other section for forensic cases where i don't really read in depth, nice to know je, kat malaysia pakai law lain.
-Patient dan carer sangat tahu tentang hak mereka kat sini.
2. Assessment at ward setting with Psychiatrist. sama jugak dengan assessment kat EAC cuma lain sikit approach.
3. Assessment patient yang ade personality disorder with Kwadwo (nurse). haish, penat dengar orang yang putar belit cerita ni. Tapi menarik jugak la. kene pandai assess betul2. next, assessment on suicidal patient, who intoxicate self with pills and alcohol.
Achievements:
- Neela help me a lot today. I was able to go through all the documentation from scratch!
- jejak kaki kat wad medikal. ya, macam wad hukm. baju nurse pun warna biru jugak. tapi patient sini pakai baju sendiri, xde uniform. doktor pun x pakai da white coat. infection control maybe...
Friday :
Mohamad was in today and he asked me to start the assessment of one of the patient. arghh..ketaq lutut tapi excited! tunggu punya tunggu sekali patient tu abscond dari A+E. ape da nasib. Had lunch with Neela today, she tells stories about her hometown mauritius. turns out that Mauritiius sound familiar with Malaysia, in terms of its diverse ethnicity and religions, like she is christian and Mohamad is Muslim. kat sana pun ada orang cina dengan india, melayu tak sure. also learned that UK used to import a lot of nurses from Mauritius, patut la ramai nurse dari mauritius kat sini.
learning :
- had chance to communicate with patient during assessment, asked few questions. though is not a full assessment, tapi ade la something. huhu.
- decided to stay back late. sedih tak dapat tengok mental health act section 136. last week banyak case, minggu ni xde pulak. ape yang best sangat section 136 tu?? sebab meriah. tengok patient di escort oleh polis, ade ambulance, ade keta polis. tapi yang penting nak tengok macam mana law itu di aplikasikan. yang lain2 tu entertainment je.
section 136 ialah kuasa yang ade pada polis untuk menahan siapa2 yang membuat kacau di tempat awam, yang mana siapa2 itu mempunyai contact dengan mental health service. bahasa inggerisnya:
power held by police to detained a well known mental health patient who caused ruckus or imposed threat to community or to self in public area. Lasted for 72 hours, so pt need to be reviewed by psychiatrist within that time, to decide whether he/she need to be put under other section or not.
achievement:
-x dapat tengok 136, section 2 pun jadi la.
section 2 Mental heath Act ialah right to detain patient for 28 days for assessment in wards. meriah la, ade polis bawak patient in handcuff. woo, rupanya dari pukul 1tgh hari patient tu da kene tahan dalam ambulance dengan polis, pukul 7 baru sampai hospital. Polis yang bawak patient tu pun semua baik2 belaka, ade nak dekat 6 orang jugak la.
Masuk ward untuk pinjam kerusi roda. staff sana garang. Diorang tanya kenapa tak ada tag. I said I was temporary student, but they were still unsatisfied which is sooooooo obvious in their expression. well, though they were right to inquire identification from me, they could ask it in more 'friendlier' manner. dah la noob gler td nak bukak pintu pun tak reti. adeh malu nye.. huuu, takut plak nak posting kat ward.
Overall, best posting kat EAC sebab tak tahu kes apa yang akan datang. ade yang manipulative, ade yang betul2 aggressive, ada yang sihat wal afiat je, ada yang betul2 disturb dengan suara. yeah I like it here. staff sporting, siap buat appoinment lagi nak ambik gambar sebelum balik malaysia. hmm.. sayangnya 3 hari je ade kat sini. Dah kenal dengan ramai staff, makin berat hati nak tinggalkan Chase Farm hospital.....
