By Russell Barton
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Additional info for Institutional Neurosis
Each nurse gives orders to her subordinate who in turn gives orders to the nurse below her. The attitude of staff needs to allow a patient to be 'somebody', not, as often in the past, to prove they are nobody. In order to bring this about the nurse needs to be treated as 'somebody'. Nurses' meetings need to be instituted and the doctors and senior nursing officers need to foster criticism. It helps if senior staff can criticize each other. If they present a unified front and are uncritical of each other the tendency of ward sisters and nurses is to 'keep mum and play safe'.
T h e activity and appearance of patients also affect ward atmosphere. It has been found that participation in a ward programme improves behaviour generally and this improvement is furthered by kindly criticism. T h e appearance of patients on the other hand may remain poor unless a specific drive is made first to improve things with the patient remaining passive. The nurse or hairdresser can shampoo and set the patient's hair. Prescribing a pint of shampoo to do the hair of a whole ward from the hospital dispensary which costs about Is.
Letting a patient choose her own clothes from a hospital shop provides her with a personal event, whereas to have to accept whatever a nurse doles out on a ward is impersonal. It is better still to go to a shop in a town and buy a garment than select one from a hospital shop. At different stages in the progress of rehabilitation each one of these methods may be the most appropriate. In the prevention and treatment of institutional neurosis the difference between what is personal and impersonal first needs to be realized and then accent constantly placed on the personal.