Some experiences are just too awful to gloss over or rationalise, even years later.
I was working as a sessional nursing assistant in psychiatric wards in central Scotland (see also my previous piece for the Scots Perspective). Slipping in at the start of my shift, I would introduce myself to the other nursing staff, perhaps then get a quick tour of the ward and a quick handover, before starting work for the day.
Almost all inpatient nursing shifts begin with a handover: whoever was in charge of the previous shift reads out a list of all the patients who are in the ward, followed by a summary of each patient’s medical history and current treatment, so that the incoming team can hopefully provide the correct treatment and look out for any improvement or deterioration in a patient’s condition.
One night in summer 2009, I arrived for a nightshift at the intensive psychiatric care unit of a large NHS hospital, to be met by a barrage of fairly raw racist testimony from the nurse in charge of the dayshift. While providing a handover discussing the psychiatric needs of the other patients in the ward, the nurse imparted a nakedly racist summary of events that had led to two men from a nearby detention centre for asylum seekers being admitted to the ward.
“In bed seven we’ve got tweedle dum; I’m just going to call him tweedle dum cos I can’t pronounce his name and in bed nine we’ve got tweedle dee. They’re basically playing the system. They’re both from somewhere in Africa. Tweedle dum was being deported and he was admitted here because they say he’s cut his wrists but I think he’s just at it for sympathy. He speaks English but sometimes he’ll just be silent cos he doesn’t want you to know you’ve understood him. The doctor that admitted him was really taken in by him and said that we need to monitor him for suicide, that’s why you’re here [she gestured to me], but he’s at it. He’s playing the system to stay in the country and he’s taking up a bed here. The other one is basically the same, he’s supposed to have had panic attacks but they were laughing and joking together earlier on.”
That was a professional nurse’s summary of the psychiatric needs of two of her patients. No one in the room bothered to challenge her remarks, and some of my fellow night shift workers chuckled while hearing this description of the two African men in their care.
I was horrified, but what, really, would I have achieved by speaking up? I was afraid that I would be ostracised, in one way or another, if I pointed out that the men in question might very well be experiencing a crisis of mental health, and that even if they were in control of their actions, their distress was likely to be very real. Most likely, I would have been quietly sent to work in another ward that night. I said nothing and carried on.
That night, my work was essentially to accompany the man who was considered to be at risk of suicide, to support him to get through the night without further distress. I found him sitting in the ward’s TV lounge and I introduced myself. This was the first time I had watched a Brian Cox programme, a BBC TV show about the solar system. The two African patients seemed genuinely to be enjoying watching the programme, and so was I. After about half an hour, a colleague came in holding her cup of tea and, without asking, changed the channel to some other programme that she wanted to watch. My colleague turned to me and said “he wasn’t watching that”, referencing the one African man who hadn’t got up and left in the seconds preceding her remark. I hadn’t worked with any of my colleagues that night before, so I felt fairly powerless to do anything to help. I wanted to say: “he was watching it, he was quite content and now you’ve insulted him, the staff here seem undecided whether to treat this patient as a man who speaks English and has communication skills or as one who doesn’t, and for that matter, your own choice in telly is lowest-common-denominator crap.” But, again, I would probably have been hastily moved to work elsewhere if I had complained, or worse, my colleague would perhaps have filled in an “incident form” to record my verbal barrage as an incidence of aggression from one employee to another. The patient got up and left the room; I dutifully followed.
I have no idea what happened to the man in question. I don’t know if he is still alive or if he is still in the UK. But I tried to help. When no one else was looking, I passed to the patient details of the Unity organisation, which helps refugees, migrants and asylum seekers, and I recommended a good legal aid immigration lawyer who might fight his case for him (Latta in Glasgow). He smiled gratefully and he retired to his bed soon afterwards.
I have no idea to what extent the man in question was experiencing a mental illness – I had no qualifications to judge that – but I was horrified that day by the casually racist treatment he and his fellow African psychiatric patient received. These incidents were carried out so casually and confidently by the nursing staff that I doubt they were a one-off. Why should a psychiatric care facility pass judgement on the political and moral status of refugees and immigrants, to an extent that implies they do not deserve psychiatric treatment?
I was in the fortunate position of being able to walk away the following morning without looking back; patients rarely have that choice.