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The main thing is not to stand with your back to the patient


Psychiatric nurses, also known as psychiatric psychiatric nurses, help patients who are mentally ill with a diagnosis of schizophrenia or psychosis, or who suffer from mental disorders caused by traumatic events, such as the death of a spouse or diagnosed cancer. Psychiatric nurses can work in hospitals or in the community that are specific to their patients' mental health needs and help meet those needs. To become a psychiatric nurse, you must first obtain a nurse degree.

"Many patients are hospitalized repeatedly."

People with a wide range of disorders fall into the 4th female psychiatric ward of the Republican Center for Mental Health. Most often it is depression and schizophrenia, although there may be many options, says the head Irina Shot. For example, it is here that women with postpartum psychoses are treated. During our conversation with the doctor, one such patient approached the manager several times and hugged her. She is very anxious in her soul, Irina Anatolyevna explains, and presses a woman who has recently given birth to her breast as her child.

Head nurse Galina Chuchneva shows us the compartment. She is a midwife by training, she has been working here for over 40 years and knows in detail the personal drama of most patients. The department, designed for 65 beds, serves the Frunze district of Minsk and several regions of the region. Many patients are hospitalized here repeatedly, and therefore close acquaintance with doctors is inevitable.

There are no bars on the windows in the rooms. "They would not hurt"

The department, which allowed journalists to visit, is closed. Patients cannot enter the center without escort of medical staff. Chambers were located on the right side of the corridor, on the left - office premises (relaxation room, bathroom, treatment room, dining room). The busiest traffic is in the corridor. Despite daily walks along the street, patients walk along the wall with a distant look.

In the wards, contrary to stereotypes, there are no bars on the windows. Although, according to nurses and nurses, such precautions would be out of place. Even in a hospital hospital, it is not always possible to save a person from suicide, although cases of suicide occur much less frequently than in ordinary life. "How many cases were when they rushed out the window"- say the nurses. "Sometimes they try to hang themselves on towels, on bathrobes, on tights," - the nurse recalls Irina Krupnik. That is why here, even at night, they do not turn off the light and never close the doors in the wards.

Always on duty: "We are watching all day"

Not far from the front door there is the first post of nurses - there are only two of them in the department. The medical watch, at first glance, seems uncomplicated. One of the tasks is to monitor the condition of patients and keep a diary of nursing observation. "Look, there’s a woman in brown," - explains the principles of work of nurses Galina Chuchneva. "She’s still, as we say,“ raw. "That is, she arrived recently, and the treatment hasn’t worked yet. She can stop and start talking to herself. It is imperative to pay attention to this and write in the diary."

Based on the notes, the psychiatrist decides on the further treatment of the patient. Observation should be carried out round the clock, as the condition of patients can change at any time. Sometimes experiences are described very plausibly. The head nurse recalls the case when the patient convinced the doctor that a piglet was left to die in her village house. They contacted the village council, raised everyone "to the ears" and found out that the woman had no pig at all.

Some patients constantly come to the post to talk, ask how they can help, call for a walk, share their life stories. There are those who do not talk about anxieties and worries to doctors. It’s more difficult with them. Despite a special medical education, only experience helps to understand the situation: "Theoretically, it’s difficult to teach how to work with the mentally ill, it comes with practice."

Princess of Ukraine and the missile defense system: “Sometimes it is not possible to return patients to an adequate state”

To make it clear in what atmosphere doctors have to work, they offer to talk with the “Princess of Ukraine”. This is not the first time that a girl has received treatment in this psychiatric ward. She was supposed to be discharged the next day. The girl’s frustration is not innate, behind is unhappy love. She in detail, observing the cause-effect relationships, describes her position: “I am the princess of the state of Ukraine. And if you look globally, then Germany, too. I was born that way. “I don’t perceive milk, kefir, cream, and therefore I am the princess of some state.”

Turning to the doctor, the girl reminds her of several obvious signs of slavery. First of all, these are dropped earlobes, which the patient really wants to lift back. “If you have been trying to lower them for me for many years, then you can somehow raise them so that I can live and work. I cannot work with my ears down.”

There is also a "missile defense system" in the department, which protects the earth from nuclear threats. Another patient begins the conversation with an adequate greeting. But then her thoughts get confused, and she begins to chat about everything in the world. Moreover, according to doctors, a woman can do this endlessly. All described patients have already received treatment and do not belong to the "acute". Nevertheless, they are not always able to return to a fully adequate state. Therefore, in the case of the "princess", doctors simply control the girl for aggression towards other people.

- I had a patient who flew through space and talked with aliens,
- says the head of the department, Irina Shot. - When I returned it to reality, she said: why did you do this? She was good there, but bad here. And so you stand and think: who knows?

Sharp ward: “A nurse can't go away for a minute”

We move deep into the corridor and find ourselves in the “acute patients” who recently turned up in the ward and have not yet received treatment. A separate room has been allocated for them, from which patients themselves cannot leave. They are in a state of acute psychosis or have suicidal thoughts. When the patient's condition improves, he is transferred to other rooms.

Next to the "sharp" is another junior staff post. Due to the lack of people, a nurse is on duty here today. She is strictly forbidden to leave her seat without replacement. "When patients come here, sing songs, cry, laugh," - the nurse complains Irina Krupnik. "You’re lucky that it’s quiet now. Sometimes there’s a scream all over the house."

Almost all beds in the room are occupied. Some patients are asleep, and judging by the snoring that comes, they are very tight. Nurses explain that this is a medical dream. A woman of pre-retirement age jumps on the bed and waves her hands. Galina Chuchneva suggested that the patient communicates with voices or sees some kind of vivid picture. “We don’t understand this. One night the sick woman tells me:“ Can’t you see, are the men coming with their suitcases? “Of course, I don’t see this. But she is afraid, they threaten her.”

Near the nurse's post, the girl froze in a stupor. She can keep one position for hours, and then suddenly try to leave. "The patient graduated from medical school, plays the piano, owns a computer, but the disease does not take into account either social status, age or gender." Most often, the starting point is some kind of stressful situation - a divorce from her husband, rape, and sometimes the disease occurs for no apparent reason. All this is observed day after day by strong-willed women in whose hands the safety of patients. Sometimes at the cost of his own.

"The main thing is not to stand with your back to the patient"

In a state of acute psychosis, patients are sometimes aggressive. The main rule here is not to stand with your back to the patient, otherwise anything could happen. Sometimes, patients pulled a nurse by the hair, pulled earrings from their ears, scratched them, and kicked them. "If a woman sees, for example, that there are tanks, a war, and she needs to protect her children, she will destroy you all! And you, probably, participate in this attack, here it also is protected ", - the senior nurse explains the actions of the patients.

Aggression sometimes causes the need to take medicine or get an injection. When patients refuse to eat and try to feed them, the nurse can get a spit in the face or a plate on the head. “We don’t have male orderlies, we have to cope on our own. As soon as something happens, we all immediately run to the rescue.In exceptional cases, it is allowed to gently fixsick. Reassure with medication and conversation. The hardest thing with beginners. Then, during the treatment process, we will already find out who has what problems and what can be expected "- says Galina Chuchneva.

"Baby, life is bitter, but sweetie is sweet."

Over 40 years of working in psychiatry, the head nurse of the department has seen a lot. But most of all she was impressed when, back in her youth, a sick woman came up behind her, took her by the throat and said: "Baby, life is bitter, but sweetie is sweet." And then she put candy in her hand and let it go. Galina Chuchneva emphasizes that this does not happen every day. Most patients behave well.

Nurse Ekaterina Tchaikovsky recalls his "special case." When I got a job, I escorted patients to the kitchen. One man suddenly approached her, hit her in the face and moved on. So her acquaintance with the profession happened.

Olga Berezovik I remember the "Mowgli girl" who ate everything. It was necessary to watch her every second. A cigarette butt, a piece of paper, a belt from a dressing gown — she could send everything that caught her eye to her mouth. "Sometimes you tell me this at home, and after that you don’t want to be allowed to work. Therefore, we try not to tell anyone."

Surcharge for "harmful" and truncated vacation

For "harmfulness" to workers of psychiatric departments pay 120 percent of the rate of the first category. Depending on the number of hours worked, nurses here earn from 2.5 to 4.5 million. Nurses are paid from 3 to 5, 5 million. Everyone tries to work at a rate of a quarter or more.

Women are on duty after two or three days. "Day" was allowed, explains Galina Chuchneva, because there is no one to work. Invite nonresident. "A woman comes to us, sits a bit near the observation chamber and leaves. She apologizes and says:“ I can’t. "Only those who really empathize and sympathize with patients who are interested in helping these patients remain."

Previously, doctors working in psychiatry had another bonus - long vacations, 56 working days. "Now cut, - the nurses complain. - 38 calendar days left. Coming from vacation - as if you weren’t resting. They are also going to remove the preferential pension. We have been working out for 10 years - and at 50 we are retiring. And now, they say, this will not happen. Therefore, people leave here. "

Patients treated in the male ward help nurses

In the men's department, doctors have even harder. Ideally, men should work as orderlies here, but they do not want to go for a small salary. On the day of our visit, there was only one nurse and a nurse - they watched several dozen patients. And three policemen guarded one patient who committed an offense and fell into delirium. When he leaves the state of psychosis, he will again be taken to a pre-trial detention center, and the nurse and nurse will remain alone with the patients.

Patients themselves help women - those who have already been treated, says the older sister of the department Tatyana Sirik. She has been working here for 30 years. He says that now it has become more difficult to carry out their duties. “Random people come who still need to be trained. And not everyone will be able to work here. And the tables here were smashed by the patients to pieces, and they made an escape, and they will blow it, it happens.To communicate with patients, you need to be able to sympathize.".

"We are considered strange because we understand patients."

It’s impossible to throw what is happening in the hospital out of my head, nurses are frank. Even in the city, they try not to let anyone in from behind. "Sometimes you walk along the street, your eye stops, and you see that this person was with us. Or you checked out, or you still haven’t reached us."

There are no cases where doctors in the process of communicating with patients themselves began to behave strangely. But do not hide: such a stereotype is present. “We may be considered strange because we understand and excuse patients. We can hug them, listen to them or stroke them on the head. These are people, first of all.”

Over the past decade, the increase in the number of new patients with mental disorders in Belarus has exceeded 50%. Each year, the number of new cases increased by 5%. According to 2013 data, 291 thousand patients are registered. According to the director of the Republican Scientific and Practical Center for Mental Health Alexander Startsev, one out of every three in his life needs the help of a psychiatrist or psychotherapist.