When Hospitalization Goes Wrong

Sue Bergeson Health Guide
  • I had one of those calls that we all dread getting. A casual friend, who I hadn't heard from for six months or so, called me from a locked ward. "They are not listening to me", she cried. To make matters worse, she was on vacation, away from home, when her husband decided that she was in a manic state and took her to the hospital-several states away from her own psychiatrist.


    It gets worse.


    She had been there for eight days and had never seen a psychiatrist. The staff psychiatrist was on vacation. She was diagnosed and treated by prescribing nurse practitioners. My friend was adamant that she retain control of what medications she would take and demanded, to no avail, to see a psychiatrist.

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    It gets worse.


    She then demanded to be released after 72 hours so she could get home to her own doctor. She was told by the nurses that if she or her husband signed her out, they would call the police, arrest her and have her recommitted.


    It gets worse.


    She when was told she would be released four days later. How did they know she would be well enough to travel four days into the future? Turns out fours days was just about the time her insurance was scheduled to run out.


    It gets worse.


    When I called her the next day to see how she was, she had been so heavily medicated that she had slept all day.


    It gets worse.


    When she refused to take any more medication without a complete description of each med—and then refused one med because they had been doubling and then tripling the dosage too quickly to be safe—she was brought into a meeting with three staff members who told her she was being "disruptive" and so was no longer "allowed" in group.


    I get so mad thinking about this that my blood is boiling and my stomach churning. How far have we really come if this can still happen?


    Yes, I understand that I am not a doctor, and I have no idea if my friend was in a manic state or not. The point is this: she never got to see a psychiatrist, was held far longer than the norm and threatened with arrest if she left.


    Well, my friend did several things very, very right, and they're simple but effective guidelines for you, should you ever be in a similar situation:


    • She demanded her rights. She demanded her right to leave after 72 hours ... her right to maintain control over her medication ... her right to see a psychiatrist ... and her right to make phone calls. While doing this didn't result in her being let go, it did put the staff on notice that this was someone who would likely take action after being released.
    • She called someone. Now I ask you all not to call me-I will break under the burden of that many requests, I just will! But you can call a friend and make sure that friend is aware of what's going on. Better yet, give your friend a copy of this blog in advance to prepare them in case you need to ask for their help.


    So, engage an outside lifeline like my friend did. I wasn't a member of her family, but she knew I am tough and could stand up to nonsense. Not every hospital staff team is bad. Many are very caring and very ethical. But if a bad staff knows someone is watching—even from a distance—it's likely they'll be more careful and attentive. When she handed the phone to me, I made sure she knew I would kick butt, if needed!


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    • She took names. While on the phone with me, my friend got every staff member's first and last names and made sure they knew I was writing them all down. She checked their name tags against what they told her.
    • She refused to take the meds without a thorough explanation. And she knew a lot about medication because she had done her homework before having a crisis. I also called in a favor or two and had another psychiatrist call my friend's nurse and have her walk through the prescriptions to make sure they were reasonable. If we couldn't get someone physically there to offer a second opinion, we did it via phone. Her own psychiatrist should have done this for her. I hope she dumps him when she returns home.


    During those kinds of calls/visits your outside lifeline makes, be sure they reinforce the message that we (your outside lifeline and you yourself) will not hesitate to take action if we determine that treatment didn't meet national standards.


    And I'd also suggest to you one more thing that you can do right now:


    Create an advance directive and take it to your lawyer and your doctor. Every state is different in terms of how legally binding an advance directive is, but if your lawyer and family sign them, you can at least have the appearance of a legal document that the staff must follow. Give copies to your doctor; keep a copy in your purse/wallet and your car so they're handy if needed.


    My friend will be fine. She will have to cope with the trauma of her hospitalization, and that will be a long road. Ironic, isn't it, that her hospitalization will make her sicker in the future?


    But what isn't fine is the system. What isn't fine are the nurses who talked to her and to me like we were stupid. What isn't fine is the lack of civil liberties for those of us living with mental illnesses. It all makes me want to send yet another letter to my senators and representatives.


    How can things change if we don't raise our voices? Your thoughts?

Published On: April 02, 2008