psychiatric hospital not going well

Discussion in 'General Parenting' started by Christy, Jul 29, 2008.

  1. Christy

    Christy New Member

    So I had high hopes for this facility. It was well reccomended and the reason we chose it over a much closer facility. The place is beautiful and the program looks good on paper (ie, the parent handbook). The problem is that no one seems to know what is going on!

    difficult child was admitted on Thursday. I met with social worker and difficult child on Friday. I also met briefly with doctor at my request. SW informed me that prior to discharge there would be two extended visits. One is a four hour on ground visit, follwed the next day by an 8 hour off ground visit. If all goes well on the visits then he's discharged. There is also an outline in the handbook of the things we would be working on with difficult child in the SW sessions. We visited difficult child on again Sunday and things went well. It is my understanding that Saturday was a difficult day where difficult child got into a fight with another patient and spent some time in the quiet room. (I asked, no one offered this info). So Monday is the next scheduled SW session, I show up and she informs me that I am going to do an on-ground four hour visit. Not that I mind but there is nothing to do on grounds and if she would have called me I would have brought a picnic lunch, some games, books, etc... I was expecting a counseling session. She then tells me that if all goes well, we will do the 8 hour off ground today. I say, does this mean he is being discharged? She says possibly. So I would be hapy to have difficult child home but I am leary about a switch the psychiatrist made form clonidine to a larger dose of tenex, as we had problems with irritation/agression on the one and from what I've read could expect problems with the other. So I ask SW if difficult child is any more stable than when he arrived? She says, how do YOU think he's doing? How would I know? I've seen him a for only a few hours since Thursday and no one calls me. She goes to get his chart which she had not read before hand and discovers that he had a rough day Saturday. Well maybe he's not ready to go home she says. Let us know how the visit goes. The visit went fine but no one was available to talk to me afterwards. No one scheduled an 8 hour vist with me and the discharge coordinator listed in the handbook has not been in touch. I call last night at the hours appointed for the nurse to take calls and ask, how was the rest of the day? The nurse replies that she thinks he did fine but let her double check. She comes back and says that actually things did not go fine, he crushed another patient's art project, hit a patient, and knocked over a bunch of chairs. He spent some time in the quiet area, calmed down took a shower and went to bed. I tell her what the SW said earlier about the visits and she says that she has not heard anything and SW should contact me. Yeah, right!

    So as of now. I plan to call difficult child at phone hours, call the nurse at nurse hours, ask for a call from the psychiatrist, and not visit today as this place is pretty far away and we had planned to visit every other day. I am curious if the SW will call me. Maybe she has had a chance to read the file. I am begining to think she had us mixed up with someone else who was scheduled for an on ground visit.

    Thanks for letting me vent,
    Last edited: Jul 29, 2008
  2. TerryJ2

    TerryJ2 Well-Known Member

    Oh, dear, Christy, I think you may be right. What a screwup. I would be very angry.
    I am so sorry for you and your son. I hope he gets at least a teensy bit of of help there.
  3. luvmyottb

    luvmyottb Guest

    What a bunch of screwups! Geez, I certainly hope you can talk to someone who knows what is going on! How frustrating! Hugs to you and family.
  4. Christy, I am sorry that it isn't going well. It sounds like the left hand doesn't know what the right is doing! I hope you are able to get some answers. It certainly doesn't sound like he is close to being ready to come home.

    Big hugs for you,

  5. flutterbee

    flutterbee Guest

    I think you're right...they got your son mixed up with another kid. How frustrating.

    Keep us posted.
  6. gcvmom

    gcvmom Here we go again!

    Sounds like they're not paying attention over there. I'd be irritated too.
  7. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    This has been my experience with phsopitals. What did you expect from this? The child is not going to change in a few weeks or sometimes even years. Have they at least re-evaluated your child? Foster/adopt kids can often had hidden problems that are organic in nature (I know first hand). Are they equipped to check for this? I feel your frustration. I have encountered this myself. Please take care.
  8. You know after reading MWM's response, I was thinking about something my son's therapist said yesterday at our session. She said that stays in psychiatric hospital are like going to a doctor for a cut on your arm - all they do is put a bandaid on the situation.

  9. Christy

    Christy New Member

    Thanks all.

    Yes I agree with what you are saying Christy about the bandaid rather than a solution to the problem. In fact after the overnight stay in the ER due to the petition the therapist completed, I asked, what good will this do? His therapist, the psychiatric nurse, the therapist at the regular hospital, and his psychiatrist all felt he should go inpatient so we agreed. Now I'm still asking what good will come of this?

    MM, I agree. I do feel ther is more here going on with difficult child than meets the eye. Results of a neuropsychologist by Childrens' hospital completed in Novemeber says he is NOT on the autistic spectrum but I strongly suspect Pervasive Developmental Disorder (PDD) of some type? I will ask this psychiatrist to reccomend what further testing can be done. I did a little research on my own today of neurologists in the area. Only one takes children and he's not accepting new patients at the moment. I will broaden my search.

    Thanks again!
  10. CrazyinVA

    CrazyinVA Well-Known Member Staff Member

    I found inpatient stays to be really hit or miss, it all depended on the psychiatrist assigned to my difficult child. Many of the units are understaffed and the staff overworked, and I'm not surprised they got your difficult child mixed up with someone else.

    As for the bandaid fix, that's right on. The goal of many (most?) inpatient stays is to "stabilize." I found this to be almost exclusively a term used for the convenience of the insurance companies; i.e., once they're no longer an immediate danger to themselves or others, out the door they go. On more than one occasion, this decision was communicated to me with a phone call saying, "she's being discharged today! When can you come get her?" with no discharge planning whatsoever.

    I found that if I had a psychiatrist willing to work with me, to listen to me, and to give the insurance folks the right words to keep my difficult child where she was until *I* was comfortable with her coming home, it made all the difference. Only a handful of times did I find a doctor like that, unfortunately (both my difficult children were hospitalized multiple times at multipal local hospitals). Those were the times a difficult child stayed out of the hospital longer, and stayed stable for longer. I'm not saying I in anyway was able to dictate how long she stayed, but I had some input as to my comfort level with her coming home, and what I was concerned about.

    Good luck.. I know it's frustrating!
  11. susiestar

    susiestar Roll With It

    Soundfs like the visits to the "nice" (read expensive) shoort term psychiatric hospital we had with my difficult child. ONLY with the 4month stay did anyone have any CLUE what to tell me over the phone. That is the ONLY place where I could call, ask for the nurse, and get an accurate report - THAT was only because I was there 3-4 times a week (at a facility almost 2 hours from home!), husband was there 1-2 times a week and other relatives also went. It was the only place tat DIDN'T bring hte WRONG flippin' KID out to me to "take home" at least 2 times - and his visits in the short term psychiatric hospital were never more than 72 hours!!!!

    So, no, it doesn't sound odd, sounds very typical. At the short term psychiatric hospital I took a "Visiting" nurse to coffee off grounds and she told me she is called to cover shifts for more hours each week than many of the nurse's actually work. Working as a visiting nurse paid much more, and they didn't have to take all the BS from patients and toher staff members - she actually had QUIT our psychiatrists office about 6 mos before I met her - because he was a P-I-G to older teens and to his staff. We did let difficult child stop seeing him when a few of the girls in the psychiatric hospital told difficult child that he just stared down their blouses and difficult child should feel LUCKY that I insisted on being in all the appts with him - even if he disagreed with what I told hte doctor or did with his medication.

    We filed complaints on the psychiatrist and saw a new one - who is totally not following any protocol but since I don't live with difficult child's behaviors I won't complain about him unless my parents ask me to. Gpa feels this doctor is OK, even though he won't spend 10 mins with difficult child every 3 months. As I said, I don't live with the boy and after some of the behaviors will not live with him - though I love him dearly (but equally to my other kids - and that WAS my choice - him or them - for those of you who are newer than 2 years ago.)

    I was hoping you would have a MUCH better experience. REMEMBER you CAN refuse to pick him up - ESP if it will endanger another person's life. And keep a record of ALL contact with the psychiatric hospital so you can substantiate any problems/complaints - it saved us a few times over the years.
  12. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Neurologists really don't know how to diagnose Pervasive Developmental Disorder (PDD). It really IS best to go to another neuropsychologist. We've done both. There is no way to absolutely rule out Autism Spectrum Disorders (ASD). As the kids get older, more stuff shows up that can point to certain disorders. I would do that rather than the Neurologist, unless you want to test her for seizures or tumors. That's really what neurologists do best. If she is Pervasive Developmental Disorder (PDD), all these medications won't help her...they could very well be making her worse. She sure is on a ton of them. Are they trying to medicate her until she is just a zombie? Some psychiatrists do that--I've had a few like that. (((Hugs)))
  13. CrazyinVA

    CrazyinVA Well-Known Member Staff Member

    .. use caution if you choose this approach. Here in VA, it can result in a parent being charged with abandomment, and the state can step in and take custody of the child. Granted, I had to use this threat to get my Youngest into an Residential Treatment Center (RTC) when all else had failed, but ... just saying be very careful here.
  14. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I'm sorry, this is so frustrating and others have said, sadly typical. Hugs.
  15. KTMom91

    KTMom91 Well-Known Member

    So sorry you're going through all this. Sending hugs and lots of strength.
  16. susiestar

    susiestar Roll With It

    OH YES - MUST be very very careful when refusing to pick up - ASK HERE about it. This is where I learned teh important tricks - fromt he other warrior moms with hospitalized kiddoes - to use this effectively. I didn't have to go through with the threat, just let the therapist at the hospital know we would work WITH them, but not bring him home before he was safe.

    I think timerlady or Nomad maybe had the info way back when.

    I will dig it up if I can find it and it becomes needed.
  17. Christy

    Christy New Member

    Thanks Everyone!

    Suz, I appreciate your offer to look up the info. on refusing to pick up a child. Hopefully it will not come to that but I do want to be sure he's safe.

    I had an 8 hour off ground visit with difficult child yesterday. It went very well :) It was the most mellow I've seen him in awhile. Because the psychiatric hospital is far from home, I took him to a mall for lunch and a haircut and a movie. The mall has always been a very overstimulating place for difficult child with a lot of "I want that!". He was easygoing and accepted the word no with little fuss so I am hopeful this was more than a fluke. He wanted me to tell the doctor immediately how well he did on the vist so he could be discharged! Two days before, he seemed pretty hopeless and said he thought he would be there for a long time. I worried that he was too accepting of this fact and not motivated or able to work on his goals. So I was really happy to see him so proud of himself and wanting to go home!

    As I suspect discharge will be soon, since insurance is now wanting day to day approval, I told the staff that I wanted to withdraw my written permission to give PRN's and asked them to call on a time by time basis so that I would know when they were administered. Nurse was annoyed by this and said that they only give them as a last resort. I said that I understood but if it takes a PRN to calm difficult child when he's upset, I don't feel he is stable enough to come home and I want to be able to get the full picture of how he is doing.

    I am waiting for a call back to see what the plan for the day will be. At the least, I suspect it will be an extended visit again.

    Thanks again for your support,
  18. susiestar

    susiestar Roll With It

    Very good move on taking away permission to give prns. I can remember finding out difficult child had been given 3 prn medications the day before discharge at one facility. We ended up back there a week later.:mad:

    It sounds like the mall trip was good. One thing to know - other kids will tell difficult child what to do/say to be released. My difficult child learned how to play the system to get the "vacation" in the psychiatric hospital when he wanted it, then say the right thing with-o meaning it to get out.

    ONLY the head nurses at the longer stay psychiatric hospital picked up on this. So many just took him at face value.

    I hope things go well and he really becomes stable during this psychiatric hospital stay!

  19. Andy

    Andy Active Member

    Great idea about withdrawing PRN's until you are called. When my difficult child was in a psychiatric hospital, he had the ability to refuse a PRN. When I confronted the weekend staff regarding an incident that upset difficult child, they said, we tried to give a prn but he refused. I told them that I was so proud of him for refusing because they were not handling the situation correctly. I don't care what time of day or night it is, as a staff member, when a kid is upset, they need to talk to my difficult child and find out what it going on. This particular group of staff just wanted to medicate the problem away. For my difficult child, once they gained his trust by finding out what was upsetting him and letting him know they will do what they can to help, he would then have accepted the prn. I know that doesn't work with all kids and some may need the prn without the step of figuring out what is going on. The staff need to know what needs to be done for each kid and not just follow a black and white process for all issues.

    You are totally correct about the prn and if he needs it daily then he is not ready for discharge. Document everything in the event you may need to get involved with the insurance authorizaiton.