I thought I’d just give a quick intro to how things work on the Unit. (and to keep my mind distracted typing!) For the purposes of being public with this, I won’t name the specific one I’m in, even though a lot of people may already be aware. But somewhere in the North!
It’s 19-bedded, which is a lot bigger than Rharian Fields, the Unit back in my home-town that have been dealing with my treatment since they opened in 2012 and where I have spent two previous inpatient admissions. My initial thoughts before coming for the pre-visit here was that it would feel a lot more intense, because I was warned it was much more of a ward-environment. And also the staff all wear their nurse/healthcare uniforms which gives a formal impression. At my previous 5-bedded Unit, staff wore there own clothes which seemed to create a homely/naturalistic setting.
I was surprised though, how actually, since being here I’ve noticed it feels LESS intense if anything. Because it’s larger, it feels a lot less ‘claustrophobic’. It feels more free, and as a new admission you feel less obvious arriving and settling in, due to the larger number. You feel less fixated on.
After you’ve had your admission assessment by the Doctor’s etc. during your first 72 hours – you have a commode in your room to go to the toilet, so they can measure your fluid output. (I’m still on this after 2 and a bit weeks but well used to it) and you are on 15-minute observations. If you have a BMI below 13.5 you are put on ‘bed-rest’ which means you must stay in your room seated/lying down or mobilised using the wheelchair around the ward. If your BMI is above 13.5 you’re allowed supervised showers until the 72 hour period is over or you are off your 15-minute observations. Depending on your risk status and what behaviours you may struggle with, you could be put on eyesight observations (like myself) but you work towards general observations, which means they are every so often. Also, when you are off ‘bed-rest’ and your BMI is above 13.5, and your initial 72 hour period is over, you are allowed to take part in the variety of therapeutic groups during the week. These range from dietetics, thoughts and feelings groups, creative groups and all sorts of other things.
In terms of how meal-plans work, most people are placed in ‘Stage 1’ on the treatment programme and start on half portions of the daily meal-plan. This includes; half a portion of cereals, one slice of toast for mid-morning snack, half of two main meals, half of two desserts (you have to choose one of the ‘larger/hot’ desserts, and a either a full-fat-yoghurt/ice-cream for the other), half a pint of milk to use through the day and half a supper snack option.
You also start by eating your meals in the smaller dining room, with usually two members of staff. This is usually more intense with little conversation apart from staff members trying to fill the gaps with their weekend gossip! When you’re on half portions, you can 5 minutes to complete your main, same for the pudding. For full-portions, it’s 10 each time. As I found out today, it can be really difficult when there is a new admission, particularly when you’ve worked towards completing meals and they are struggling to complete much at all.
They have this room and a main dining room, where you spend most of your admission with the majority of the other patients. The second has a more social environment – there are various round tables, with one or two staff in the whole room. It has more of a canteen feel. You usually move through there once you have started on half-portions in the other room, working through a daily gradual increased plan to full-portions.
I’m yet to move in there, I think mainly because of only just beginning to comply with full portions (currently on day 4) and I feel like my behaviours around the food are quite strong, due to not being in control of the food. These involve mainly eating food groups in a certain order and feeling a bit restless at the table. I was recently told that when I can nip these in the bud, I will be able to move through to the more relaxed dining room. (‘Stage 2’ and ‘Stage 3’) Patients at these two stages, instead of having toast as their morning snack, eat their toast alongside their cereal for breakfast. You also eventually portion your own meals. Then, depending on which treatment program you choose, may or may not have an additional snack in the morning or afternoon.
(To explain the treatment programmes – you choose when you are at a BMI of 15 depending on what you’re ready to achieve in terms of recovery – whether it’s to be medically stable, to part weight-restore to a BMI of 18, or to go for ‘full-recovery’ of a BMI 20 and choose to challenge all types of food for a more varied quality of life if you feel more ready to ‘let go’.)
When you work through the stages of your treatment plan, you work towards the opportunity to self-cater in the therapy kitchen. This is cooking your own meals and preparing your own foods at various times in the week to increase your confidence and independence, ready for the real world.
One of the brilliant things I like about this Unit is that we are allowed CAFFEINE!! (& sweeteners) These were completely banned at my previous Unit – even tea. They also locked the kitchen in-between meal-times and you had to repeatedly ask to go in to make a drink. Here, the kettle is in the communal lounge area, which is so much more relaxed. You can go in whenever you like to make drinks, as well as bring all your own teas, coffees and still drinks. (just no fizzy allowed) I know it sounds daft, but being allowed to enjoy a nice cuppa at any point, really does take the edge off going through treatment. I can’t tell you how many times they’ve saved my day. It also helps for getting through the pint of milk a day we have to drink too. I tend to have a ‘Twinings Chai Latte’ – something I’ve wanted to try for yonks, until Anorexia realised you have to use milk with the tea-bag! So being here has it’s perks. At the moment I am besotted with ‘Butter Mint Tea’ and ‘Cherry and Cinnamon’. A lot of patients are crazy about the ‘Beanies’ flavoured coffees.
When you get to a certain stage, you’re allowed to start eating snacks out/meals out etc. I love the idea of the ‘Takeaway’ and the ‘Eating Out’ group which both help towards the well-balanced idea of eating, and increasing confidence in eating these types of foods.
There’s loads of info I could go into, but I’m yet to discover a lot of it myself. There’s lots of things I’ve missed out so far, like the fact every patient is assigned a Primary Nursing Team – made up of two qualified nurses, two associate workers, an occupational therapist and a dietician. But alongside that, every day we have assigned named workers (anyone who’s on shift) who we can approach at any point during the day.
After meals we have a 40-minute rest period in the lounge area. We can watch TV or use any of our own distraction/entertainment methods. When you get to ‘Stage 3’ though, you’re allowed to have this rest-period in your own room! After snacks and supper, it’s 10 minutes rest. Snacks and supper are eaten in the lounge which is another positive I’ve found at this Unit! Makes it feel much more relaxed and ‘normalised’ in comparison to formally sitting at a table with patients to snack which feels so formal, awkward and unrealistic.
Over and out for now!