Coo-coo’s Nest Revisited

For those of you whose only experience with state hospitals is One Flew Over the Coo-coo’s Nest, in the movies or the book, I’d like to tell you a little bit about the movie that is not like any of the state hospitals I’ve ever been in, and I spent my entire twenties in state hospitals.  Coo-coo’s Nest was a lot of Hollywood, and not too much fact.

For one thing, a patient just does not go and punch out the glass that encases the Nurse’s Station on the ward, to get or do anything.  That’s made of fiberglass, reinforced by wire mesh.  If you try to punch it, the only thing that breaks in your fist, no matter how hard you hit the fiberglass.  The same goes for the ward TV.  That’s encased in a fiberglass container, and cannot be vandalized either.  I don’t know what time frame the movie was supposed to be set in, but my first hospitalization was in 1972, and none of these particulars were anything like the movie.

The other thing is, that for the head nurse of the ward to threaten an unstable patient with informing the young man’s mother about his act of promiscuity, and then proceeds to isolate him, supervised or otherwise, in the Nurse’s Station, of all places, while he’s extremely agitated and upset, is not done; not if the head nurse values her nursing registration she doesn’t.  An unstable patient who needs to be isolated is put in a quiet room, also called a side room, or seclusion room.  What it is is an isolation chamber, which takes away all external sensory input from the patient’s environment, to help them calm down more easily.  There are no beds in seclusion rooms.  The only question is whether to lock the patient in or not.  Sometimes, a quiet room is left unlocked, because the patient is trusted to just rest and calm themselves down.  Billy was upset enough to lock him in, in the scene in the movie.  They would never have put him anywhere near anything sharp that he could use to cut himself with, when he was that agitated.

All the seclusion room’s I’ve ever been in have had an indestructible mattress on the floor, and no door handle on the inside.  Sometimes a patient is locked into a quiet room, and, whether locked in or not, the patient is not let out onto the ward again until they become, and remain, quiet and calmed down.  Usually, these days, they have an observation camera in at least one upper corner of each side room, for observation purposes.  I’ve never seen a padded cell, except for in the movies, and I’ve been in a lot of side rooms.

The thing that makes state hospitals so difficult to live in, is that there is normally not much to do, to occupy an active mind, and generally, many of the patients are very upset, in very unique ways, unique to each individual patient.  One needs to learn how to make themselves easy to get along with, or one is always miserable, with trouble surrounding them.  Sometimes, people play cards, but mostly the card game that is played is Spades, not Poker.  Also, there was not much racketeering with the issue of cigarettes, like there was in the movie.  There was a lot of bumming cigarettes on the wards and on the grounds.

Since Federal laws have been leveled against all smoking on the grounds of all hospitals and restricted where all public buildings are concerned, smoking is no longer permitted in any hospital.  This is a fairly recent development in the laws of the land.  This law is making a lot of hospital patients very uncomfortable, because the smoking was noticed to be a relief to many of the tensions of those living in state and private hospitals, for the patients who used to smoke.  The gum and the patch are the most frequently prescribed alternatives to smoking in hospitals.


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