The patient enters the emergency room of the psychiatric hospital. Hospitalization begins with a medical examination. The doctor must determine the severity of the patient’s mental state. On the basis of this indication for hospitalization, the type of the department in which the patient to be treated is defined. With obligatory somatic neurologic examination, a patient, especially aroused, needs to identify bruising, dislocations and fractures, severe internal or infectious diseases that prevent hospitalization in a psychiatric hospital. The combination of mental and somatic disease causes the doctor to make a choice:
- in some cases, a somatic (non-contagious and not requiring special therapy) disease can be treated in a psychiatric hospital by means of medications from Pharmacy Mall;
- in other cases, it is necessary to send the patient to a specialized psychosomatic department of another hospital, and in case of an especially severe pathology, to the appropriate hospital (with the organization, if necessary, of an individual psychiatric post).
When the decision on hospitalization is made, a medical history containing ID data, a brief anamnesis, the results of the examination, a description of the mental and physical status and a presumptive diagnosis are made out. Reception of the patient in the department is preceded by sanitary treatment. If parasites are detected, additional treatment is performed as well as removal of the entire hairline.
Documents, money available at the patient, the clothes are kept in the hospital before the treatment is completed. The patient should not have any tools by means of which he can cause damage to himself or surrounding people. The doors of the entrance compartment must always be locked.
Doctors’ and Patients’ Behavior
Already in the emergency department, the patient first comes into contact not only with the doctor on duty but also with the middle and junior staff of the hospital. The medical worker serving the mentally ill should be polite and affable, have sufficient restraint, coolness and resourcefulness, be able to remain calm and self-possessed in all situations.
The attitude of staff to patients should be equal, caring, humane, but at the same time devoid of familiarity. It is important that the staff should always care for them. Employees of departments for restless patients should not wear earrings, rings, bracelets at work, which can be thrown by sick people.
The department has a mandatory daily routine with a precisely fixed time of morning affairs, food intake, medicines from Pharmacy Mall and other medical procedures, walks, occupational therapy, cultural entertainment, going to bed. The regime contributes to the normalization of the patients’ behavior, the restoration of the often disturbed rhythm of sleep and wakefulness. Night sleep should last 8-9 hours, after-dinner the rest lasts at least 1 hour. The duration of medical work depends on the profile of separation and the patients’ state. Patients take a hygiene bath weekly, after which they are changed bed and underwear.
Medications are issued by medium-grade medical personnel strictly according to the doctor’s prescription. A single dose of medication should be taken in the presence of a nurse. Otherwise, there is a danger of accumulation and administration of drugs for suicidal purposes. When applying bandages, compresses, it is also necessary to ensure that the patient does not collect bandages and gauze since they too can be used for suicide.
If there are no special contraindications, the patients are regularly, at least once a day, taken out for a walk under the guidance and supervision of the staff. The list of patients for a walk is comprised by a doctor. The staff must know the number of patients being taken out for a walk. During the walk, special attention is paid to patients with a tendency to escape and suicide. The same rules are observed when accompanying patients to medical-labor workshops, to outdoor work, to a club and other events.
Relatives and acquaintances visit patients at specified times on certain days of the week. The attending physician can, according to the indications, increase the number of visits. Previously, the doctor informs the relatives about the patient’s condition and possible topics of the conversation. During such meetings, visitors should avoid unpleasant or traumatic conversations. Visitors are prohibited from transferring sharp objects (knives, forks, etc.) to the patients, as well as products in glassware, stimulate drinks (coffee).