My Emergency Room Experience Was Different When I Was a Psychiatric Patient
My parents like to joke I got all of the bad genes from both sides of the family. From my dad’s side, I got my allergies, my asthma and my propensity to be a little on the heavier side. My mother’s side gave me bad teeth, weak bones and mental health problems. I have been through a lot more medically than most people my age, but in general, I like to count myself among the healthy. I am fortunate enough to have a college degree (with another one in the pipeline), a full-time job and a number of hobbies I can’t always engage in, but are still possible.
Through the years, I’ve been to my local emergency department more times than I’d care to count. My primary care office can identify me by my voice, people at my pharmacy know who I am and I’ve even gotten sidebar advertisements for AARP, probably because of all the medical information I research.
The other day, midway through a shift at work, I careened into my supervisor’s office and told her I thought I needed to leave early. I couldn’t breathe and my inhaler wasn’t helping. In the midst of an asthma attack, she took the signs seriously and whisked me to the emergency department. Two nurses promptly wheeled me into a room, and I was seen by a doctor within minutes. Medications were administered, an IV was started and consults were placed for a number of different doctors.
People from work visited me in my room, while I was waiting to be admitted to the floor. The doctor and my nurse checked on me frequently and a patient advocate volunteer stopped in my room several times to see if there was anything I needed. When I went to the floor, staff were just as attentive. My parents were allowed to come and see me immediately and they brought me my laptop, clean and comfortable clothes, and a few other things I asked for. I had a TV, a call bell to summon a nurse whenever I needed. I even had my cellphone and could text all my friends. Again, I had a private room.
Nurses and aides checked on me frequently. I saw two different doctors who went over my plan of care in detail and answered all of my questions. My meal requests were filled without question or complaint, and food and drink were always available to me. I had a thermostat in my room. As far as hospital stays, I was very comfortable and well taken care of.
I still closed my door around 9 p.m. and cried my eyes out, just as I had done when the hospitalist in the emergency department told me I was being admitted under observation.
Why was I crying? All I could think about was my previous hospital admission. Five miserable days I’d spent as an inpatient during my senior year of college. That time, it hadn’t been because of an asthma attack. During my weekly therapy appointment my counselor had gently suggested I consider going to the hospital. She was worried about me. As much as she made it sound like it was my choice, I knew it was less a suggestion and more an order. If I had said no, then I’m sure she would have sent me anyway and had me under a 72-hour involuntary hold. And rightfully so. I was suicidal. I had a plan.
I went to the hospital this time via ambulance. First though, campus police had to search me and my belongings for any weapons. I was taken to the very same hospital, but instead of a room, I was given a bed in the middle of the hallway. Someone instructed me to change out of my clothes and into some blue paper scrubs, clearly identifying the reason I was there. My belongings were taken and locked up. I sat for hours before being seen by a physician. It was several more hours until I was seen by one of the on-call psychiatrists and finally admitted.
This time, no one checked on me. No nurses stopped by. No patient advocate volunteer was assigned to me because it’s hospital policy that volunteers don’t need to interact with mental health patients. I was there for more than eight hours in my hallway bed, and no one offered me food or drink.
When I was finally transferred to the psychiatric unit, I still wasn’t allowed to have my things. I was given a brief overview of the unit and then shown to my room. I had a roommate, someone 30 years older than me, who I was only briefly introduced to be before being left alone with. I had missed dinner at that point and no one came and offered me food. I was far too exhausted and nervous to ask someone for food. Instead, I crawled into my bed and tried to fall asleep. A tech came by every 15 minutes to check on me, but at no point did one of them talk to me or ask me how I was doing.
The next morning, I asked if I could have my things. One of the techs begrudgingly obliged but told me that certain items like my deodorant, my hairbrush and my watch were to be kept locked up. If I wanted to use them, then I had to ask a staff member. I was frustrated, but I knew it had to be for safety reasons. I didn’t complain.
For the next few days, I moved like a zombie, shambling to get my medication every morning from behind a glass window. I went to groups. Outside of this, my only staff interaction came once a day when my assigned “one-to-one” would find me for a five minute conversation about my day. I saw the psychiatrist twice during my stay.
Meals were served buffet style and if you didn’t want what was being served, you could have a peanut butter and jelly or a turkey sandwich. There were three phones on the unit and they were only on during a few set hours each day. Visitors were limited. There was no TV, and little distraction outside of talking to other patients, reading, coloring or playing ping pong if you were lucky enough to get the paddles and ball.
As far as discharge came, things were never made clear. I wasn’t assigned a discharge planner, until I begged to talk to one. I didn’t even know I was being sent home until a few hours before the paperwork was processed. When the time to leave finally came, I was thrust back out into the world. No one from my part-time job had visited me. I was expected to keep up on all my school work and make up missed exams as soon as I landed back on campus. Maybe 10 people in my entire life even knew I had been in the hospital.
My rational mind understands many of the rules imposed on the psych unit were there for a reason. I still can’t wrap my mind around the way the staff treated me. I can’t wrap my mind around the profound differences between my stay for a physical reason and my stay for a mental one.
In both cases, I was very sick. I had gone to the hospital voluntarily, seeking help. I cooperated fully with what I was told, taking my medication and following the plan of care assigned to me. Still, the experiences were so vastly different and I can only assume it was because of the stigma still lingering over mental health.
It’s a stigma that makes me angry. It’s a stigma that makes me want to cry. It’s a stigma that makes me scared to put these feelings into words. Over the past few years, I’ve become more open about my personal struggles with mental illness, but it’s never met with the same reaction. It’s not as understood or as accepted and it breaks my heart. It makes me want to be a better advocate for mental illness.
It’s my hope now I will never have to spend another night as a patient in a hospital. That may not be in the cards. I’m in recovery, physically and mentally, but relapses are always possible. New problems are always possible. In the meantime, I want to spread information and equalize things.
I don’t want people in a mental health crisis to avoid going to the hospital because of past experiences. I don’t want illness of the mind to be seen as less important or less real than illness of the body. In my perfect world, I want compassion to be the same for either, and I want people to be able to reach out in times of crisis and talk to their employers, talk to their friends and families. I know it’s a world I’m not alone in wanting.