Friday, 27 June 2014

The Discharge Discussion - When Is It The Right Time To Leave Hospital?

So, a hell of a lot has gone on over the past couple of months and it has ultimately led to me asking myself, am I ready to leave hospital?
I guess that ideally, and in a perfect world, the answer is 'you're ready when the Doctor says so' but the reality is, that isn't always the case. The Doctors and staff don't always know when is the best time to discharge a patient. I've been in this hospital now for almost two years and I've seen a lot of girls be discharged and they haven't stayed in the community long. I've also watched others be very settled but they lose hope because the staff are still hesitant to discharge them.
For a few weeks now I've been toying with the idea that I've come as far as I can at this hospital. They have made me better and there is still work to be done but I don't think it's necessary for me to be sectioned and an inpatient for those changes to be made. I have been able to guarantee my safety for a long time now and have had no instances of self-harm since October! I think it would be near-on impossible to have absolutely everyone involved in my care 100% happy with my discharge and since I'm at the centre of it all, I think it's most important that I'm happy and feel ready to leave.

And now, I am.
This is part of what I've wrote for those involved in my care who will have some influence on me leaving:

I have some amazing skills now and at first, I worried that the skills could only be applied to average day to day things, e.g. the voices getting louder, someone triggering me or a difficult 1:1. But they don’t. There’s no limit to what you can use them for, there have been so many times I’ve wanted someone to tell me what to do but I now know that you have to do what feels right, you need to do whatever it takes to get you through things whilst also keeping yourself safe.
I know that I’ve lost staff's trust. I understand this; I don’t blame any of them for that because I know what a wonderful liar I used to be. I could lie to absolutely anyone if it gave me the opportunity to run or self-harm and I wouldn’t give a second thought to the person I was lying to and letting down. My point is; I used to be a good liar. It’s so frustrating that I tell staff when I struggle, I openly cry, I ask for PRN or a 1:1 when I need it, yet when I say I feel ‘fine’ I’m told that I’m blocking my feelings and that I ‘can’t be fine.’  As I have been told many times, by staff, everyone deals with things differently. I’m often told that not everyone who experiences the 'trauma' that I have, reacts by wanting to die. So what right does staff have, to tell me that I can’t be ok because they wouldn’t be ok if it were them? I’ve also been honest about my risk; for so long I couldn’t guarantee my safety and staff kept using the ‘positive risk’ phrase and giving me leave which gave me the opportunity to run and overdose. Since October, I have guaranteed my safety and there have been no incidents of self-harm regardless of the amount of opportunities I have had.
Last Ward Round I pointed out that I’d like more acknowledgement for all of my achievements and how well I am now and I was told that I should be doing it for myself. I am. I’m proud of myself and I’m finally content with the person I am and yes, this is the most important thing but I’ve achieved it. And you don’t stop setting goals just because you achieved one.
For a while now, I have felt that the time has come for me to leave here but I’ve constantly batted this away. After being told the staff had made a decision without speaking to me and without the rationale for it, I realised that I’ve been right all this time; I genuinely believe this hospital has gotten me as well as it can. I know there are still changes to be made and things to be talked about but I don’t see why I need to be sectioned and an inpatient to do this when I can guarantee my safety. It’s not that I worry the upsets I’m receiving from staff will set me back; it’s that I don’t deserve them and I don’t need them. I want to leave because I actually think it will make me happier. I’m so unhappy here now and it’s not about voices, thoughts, or anything like that. It’s literally that I’m not being trusted, the staff are doubting me, and my achievements aren’t being acknowledged. I cannot continue to wake up each morning and try to figure out how I can go about my day while having the least interactions with staff so as to ensure I’m as happy as possible. I’ve always felt I was part of a team here and that we were all working together to save my life and make me better. In all honesty, I feel alone in that now. As long as staff continues to have these attitudes, and treat me in this way then I don’t want to be at this hospital. I will not work this hard only to have the final part of my recovery made even harder than necessary by those who should be helping me.