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Salient: Victoria University Students' Paper. Vol. 30, No. 7. 1967.

"Humanity my concern"

"Humanity my concern"

[unclear: "W] Involved?" they all say to does not concern you so other getting involved?" [unclear: Thi] is far too prevalent in Zealand and I say in [unclear: resi] these queries: "Humanity concern and should also be that is why I am getting [unclear: in]

I moral obligation to in-[unclear: forn] public of the conditions that at Porlrua Hospital. I do [unclear: n] the hope that some [unclear: men] of the public will be [unclear: spur] action by this article. [unclear: Pori] [unclear: pital] is a public institution [unclear: efore] the public has a [unclear: resp] [unclear: ity] to ensure that it is run [unclear: cient] modern lines. It is [unclear: n] is time that the public was the truth about Porirua [unclear: Hos]

[unclear: S] the nursing staff, it is true [unclear: genuinely] trying to help the [unclear: nt], but because of in-[unclear: ad] training, staff shortages, lack [unclear: tilities] and the constant [unclear: cha] of staff on the wards, they [unclear: ng] little success. The [unclear: sta] the whole, however, are ill-[unclear: e] for this type of work and reflected in the condition the majority of the [unclear: pati] within the hospital.

[unclear: E] within the hospital is [unclear: pla] the custodial aspects of care physical needs of the [unclear: pat] are fairly well looked [unclear: aft] in this protective-custodial [unclear: tion] that exists at [unclear: por] the role of the patient [unclear: ten] be a passive dependent one

[unclear: O] struck by the artificial [unclear: fri] and "co-operation" of [unclear: whelming] majority of the [unclear: ts.] Those patients who do Individualism in any [unclear: for] promptly labelled as difficult that is behave as [unclear: uals] and not inmates. Her am not reffering to Her [unclear: ents] who can genuinely [unclear: tho] as unco-operative, but to those who retain some of their former character while a patient in the hospital.

Acts that would be considered normal outside the hospital are here taken as signs of mental instability and further reinforce the idea into the nurses' minds that the patient is truly "mad" and in the right place. Examples of this would be tantrums in the children, outbursts of temper in the adult patients, and defiance of adult authority by the teenagers.

It is presumably a serious offence to use threatening, insulting or obscene language within hearing distance of patients. This is not observed in many cases. The staff take advantage of the dependent, passive role expected of patients and use this as an excuse to speak to patients however they wish, and to address them in a manner that they think appropriate to a mental patient. Many of the patients' wishes are merely brushed aside; the patient is in no position to complain because he is "mad."

Most patients were not violent unless provoked. There was provocation at times and then those responsible complained when the patient reacted in a violent manner, which any normal person would have done. Punishments for females were generally degrading and demoralising. The neurotictype patients had the threat of electroconvulsive therapy, or not being able to go home held over them if they did not do as the staff demanded: the threat of being put into "seclusion" was more subtle, but ever-present. This was specially used as a means of ensuring that the younger, teenage patients behaved.

None of the patients knew exactly what "shock-treatment" was (this is the common term given to electro-convulsive therapy). Most of the patients thought that it waa the injection mark in their arm. Many thought that they were being punished when they appeared on the treatment list. One patient said to me, before being given shock-treatment. "I don't want shock-treatment; I haven't done anything wrong."

The patients used to dread ECT. It is a very inconclusive type of treatment. Once patients had ECT, nothing else was done for them: it was considered a complete treatment. One patient was having her thirtieth lot of ECT in well under a year, and as she was still a patient at this time, this shows only too well the limited use that it has in psychiatric treatment.

The admission ward, Rauta "Kl," is an extremely depressing place in itself. Admittedly, the ward is to be changed over to a renovated one, but meanwhile the same ward is being used. The dayroom is very small and the patients are expected to sit in there all day. There are no group therapy discussions at all in the hospital, and when a Staff-Nurse tried to start some, she was promptly ordered to stop them. Nurses who talked to patients were, on the whole, considered lazy.

The patients' health was generally placed second to such things as window-cleaning, wall-washing and toilet-scrubbing. In the children's ward, as was the case in most other wards, only one nurse was permitted to be in the dayroom at any one time. To try to teach the children something when you have about 40 other, mostly chronic, patients to care for is an almost impossible task. The most junior nurse on the ward was placed in charge of the dayroom and generally she knew less about psychiatric nursing than any of the others. By the time she had learned anything slightly resembling treatment, a more junior nurse would take over and so it would start again.

As there are no toilets off the dayroom in the children's ward, it is almost impossible to toilet train the children and toilet the other patients. Consequently, one's time is spent in cleaning up patients who eat their faeces, or someone else's. In this ward, there is no treatment other than drugs.

A couple of the children do go to a school for the intellectually handicapped, but this training is not continued once they are back in the ward. Also, over the school vacation period, little, if anything, is done towards improving the children's mental health.

If you spent some time with the children and showed them some affection, you were told to stop spoiling them. Once, when one of the children was having a tantrum 'they only had these for the same reasons that normal children have them) 1 was told by a senior nurse. "Don't let him get away with it!" because I was not smacking him. Most of the nurses seemed to think that all of the children were untrainable and that it was a complete waste of time even attempting to teach them anything. They were proved wrong many times. Several of the children showed great potential which few of these nurses recognised and even fewer exploited.

Several of the children have adoptive "mothers" who are also inmates of the villa. They are thoroughly institutionalised and of childish intelligence themselves. They have a detrimental effect on the mental well-being of the children. One of the children was speaking until he was taken over by a deaf-mute and as this "mother image" became impressed upon the child's mind, all meaningful verbalisation stopped. These "mothers" would physically oppose you if you interfered with their "child," so it was hard to teach them anything; the nurses condoned this situation because it meant less work for them.

The children's main meal every day was mince. When I commented that the children were not learning to chew as a result of their diet, I was told that many of the patients were epileptics, and I received no reply when I stated that these children were not. One child would not even eat stewed apple because he could not chew. The children were not given fresh fruit and their teeth were cleaned very rarely. The kitchen in the children's ward is dirty and old-fashioned. Cooking is done on a coal range which does not operate if there is no wind. Patients wander in and out of the kitchen all day.

Only two of the female villas had central heating: the rest had open fires. Nurses are required to collect the coal for these fires from outside, no matter what the weather is like. These fires heated only a very small portion of the ward. In a ward like Nairn (the children's ward) where the dayroom is not closed off, these fires are useless. The old ladles' wards, Waiora, Moata and Montrose, had no heating in the dormitories. The elderly patients complained frequently of the cold. Heating in the dormitories was nonexistent also, in Nairn and "F" ward (for chronic patients).

The majority of the patients were dressed in ward clothing. This was not very pleasing to the eye, but K was clean and practical. Patients in "F" ward did wear canvas petticoats and frocks, however. If a patient was incontinent, she was changed almost immediately in most instances, but it was not uncommon to run out of certain clothing in such wards as Montrose and Nairn. In these cases patients would have to go without such articles of clothing.

Patients in psychiatric hospitals like Porirua lose enough of their sense of identity upon entering the hospital without having their own clothing taken from them. When they are dressed in hospital clothes any feeling of individuality is lost and they become truly a part of the mass.

With mental institutions, it is important for the patient to retain as much of a sense of identity as possible. In such hospitals as Porirua, the patient, because of the custodial orientation present, has almost all of his concept of self destroyed instead of built up. This is the meaning of becoming "truly a part of the mass."