Implementation of Change from Mixed-Sex Ward to a Single-Sex Ward - Essay Example

? Implementation of Change from Mixed-sex ward to a single sex ward. Implementation of change from mixed sex ward to a single sex ward. Historically, patients have been cared for in mixed-sex wards. However, over the past twenty years concerns to have mixed-sex wards replaced have been widely reported with most patients preferring single-sex wards to mixed-sex wards. This has triggered the need to have single-sex wards replace the mixed-sex wards. The reason most sited have been that mixed-sex wards as opposed to single-sex wards fails to provide privacy, dignity, and respect as demanded by patients. It was established that many women inpatients had bad histories of interpersonal sexual violence. Women vulnerability with severe mental illness to physical and sexual abuses noted in mixed-sex wards. These increased rates of past sexual assaults and abuses among psychiatric impatient made them vulnerable to exploitation and abuse in mix-sex settings. This implies that re-victimization rates among women with mental illness are high. Increased recognition by the service providers of problems arising from histories of such trauma led to increase in same-sex inpatient units. Given the recognition that, trauma leads to pervasive and long term negative effects on mental health and relational problems, emotional regulation difficulties and mistrust of others, there was a general necessity to evade such menace. This paper is a case study on Implementation of Change from Mixed-sex ward to a single sex ward. It entails in-depth discussion about mixed-sex wards and single-sex wards, why the mixed-sex wards should be faced out in favor of the single-sex wards, demerits and merits of the two systems, as well as, the financial repercussions that come along with introduction of same-sex wards. Additionally, the paper explores the area of acute mental health to shade light on what needs to be done to achieve full transformations from mixed-sex to single-sex wards. A mixed- sex ward is a type of patients’ ward in which both women and men are made to share the same space. It may be uncomfortable for the two sex, since some procedures might take place in the opposite sex view. This ends up compromising dignity and privacy. Same sex ward, on the other hand, means service users and the patients share bathroom facilities, sleeping accommodations, and toilet facilities only with same sex people. However, the same sex ward is interpreted differently according to different hospitals. It could be a whole ward that is occupied by either women alone or men alone. It can also be taken to mean a single room, or a mixed ward, where bays or rooms are used to separate men and women. This applies to virtually all the hospitality areas and the unit of mental health. The whole ward is occupied by either women or men but not both. More often than not, this requirement applies to organizations that provide NHS funded care whether in mental health or acute mental health, as well as, heath disability sectors. Areas mostly considered for single sex ward include estates, systems and processes, patient and staff culture experience (Imprrit, N. 2009). A ward is a place at which a team having appropriate specialist skills help in treating a group of patients. In a mixed ward, there is provision of same-sex accommodation by same sex bays or single rooms, as well as, toilet facilities (Mezey, G. 2005). A bay is an area for sleeping having multiple beds or a single bed with all the three sides of the walls enclosing them. The fourthly sides can be partially enclosed or glazed to allow the staff to monitor clinically their patients. Why mixed-sex should be replaced. In recent times, there have been reports indicating that the makers of the policies and some professionals have not learned anything from the risks that have encompassed same-sex accommodation. Same-sex accommodation wards continue experiencing poor opportunities for both recreational interventions and the therapeutic interventions, as well. These wards are sexual abuses risks and suicide (Mezey, G. 2005). Nurses, on the other hand, do not have opportunities to develop and train in aggression management. They tend to experience high stress levels. Furthermore, the mixed sex ward patients have always complained that time for contacting the nurses is less than 20 minutes per day. The patients tend to find the mixed sex wards depressing, frightening, unsafe, hard to sleep during night time, and that toilets do not provide room for privacy of the patients. Why same-sex accommodation be impressed. The same sex accommodation has its merits. First, patients feel relaxed and comfortable while in hospital. Sharing accommodation with the opposite sex members might have a negative impact on privacy and dignity of people at times when they are already feeling that they are vulnerable (Ipsos, M. 2010). Secondly, some patients have religious or cultural reasons that make them not to wish to share accommodation with the opposite sex members. The policy documents existing that are relevant to separation of gender in mental health care include dignity, safety and privacy in units of mental health (guidance for mixed-sex accommodations for the mental health), policy for mental health, implementing guidance (Adult acute mental health care (2006), which made, a recommendation for the inpatient service providers provide self-contained units for women-only ward), and Women’s and Gender Mental Health mainstreaming, implementing of guidance, Health Department 2004 pushed for reconfiguring acute mental health care services to every self-contained inpatient single-sex wards or self contained women-only wards. Acute mental health. During the past decade, the admission wards for acute mental health have been under increasing scrutiny. Generally, this does not cast the acute wards positively, but described for the worse as non-therapeutic and giving an impression that they provide singularly little privacy, as well as, minimal contact between patients and staff (Ramsay R. 2000). Additionally, acute wards have experienced continued changes. The gradually reducing the number of beds due to adopting the philosophy of the community, as well as, adopting the asylum closure program implies that psychiatric wards should now care exclusively for patients with enduring and severe mental health problems. The past psychiatric institutions were the origins for the profession psychiatric nursing and the traditional seat of power for the acute mental health. Since their closure, acute wards have increasingly been seen in an unflattering light. In the traditional asylum, these psychiatric institutions were formally seen as prestigious areas to work. This contributed to reduction of the acute mental health admission in ward in terms of recruitment of the staff, the nature of the role of the nurse, as well as, in the retention. The acute mental health operated the 24-hour services. However, poor service esteem and demoralization in teams of acute wards is now a norm (Ramsay, R. 2000). The Constitution of the NHS states that all service users have a legal right to access high-quality care, which is effective, safe, and respect their dignity, as well as, privacy. Same-sex accommodation provision across NHS is a clear affirmation that the health services are committed to respecting the service user’s privacy and dignity (Imprrit, N. 2009). Service users like those in long-stay care unit should live in a normal environment, with separate same sex day area for those users preferring it. Service users’ experience in care refers to the ward culture, physical arrangement for separation of gender, staff attitude, ward culture, as well as, gender sensitivity. The requirement for the same sex accommodation is rooted in making sure service users are provided high-quality care. This improves their experience s in care. For the case of mental health services and learning disability services, delivering same sex accommodation is sharply tied to care planning and assessment, monitoring. Additionally, financial repercussions might arise if not well delivered. Changes made in the physical environment might not be enough to improving the privacy, safety and dignity for the service users’ in the settings of mental health and disability. In the setting of mental health and disability, it is necessary to consider views of service users’. How safe they feel, and whether they were treated with respect and dignity considering their right to privacy. Both female users, as well as, men users (young people and females in particular) might be vulnerable while in the inpatient care. Few of the users could have histories of offending, or sexual abuses. All users should be provided with single bedrooms or allowed to share a bed bay with same sex members. Washing facility and the toilet facilities should be similarly segregated. These users should not share with the opposite sex members. For cases where there bays are shared, the curtains should not be used as partitions between beds. This is to ensure their sense of security is maintained (Imprrit, N. 2009). In the units for the mental health and learning disability, the users of the service are encouraged to be dressed in their own clothes at day time as opposed to being dressed in nightwear and gowns. They are also encouraged to be involved in the other activities, and in the therapeutic programs involving mixing with the opposite sex members. Because of this reason, personal space for the rooms of same-sex should clearly be separated from the daytime mixed space. The women-only lounges for the day should also be given. The older service users should be accommodated in the same sex environment. Research show that people at ages over 65 years, accommodated on same-sex wards tent to score higher (Mries, H. 2009). This shows that older service users prefer being accommodated in same sex as a way of depicting dignity and respect to them. Research shows that 31% of women of ages above 65 say that being in the wards of the same sex will be a factor for them to feel that they were being treated with the required dignity and privacy (Mries, H. 2009). Supportive cultures. Changes in the physical estate alone might not lead to achieving privacy, dignity, and safety in the mental health and the disability setting. Organizations ought to consider promoting a culture of gender sensitivity in providing care (Ipsos, M. 2010). To achieve this, there is the need to develop policies and practice, as well as, leadership that help in promoting and understanding of gender issues that relate to care planning and assessment. The policies and leadership developed need to be equipped with assessment and planning skills appropriate for the training of the staff and analysis of issues related to gender in adverse incidents and in complaints. Financial Repercussions. There should be financial repercussions for providers of same-sex accommodation in cases where they fail to do it. The operation framework for NHS demands that providers should publish a declaration to show that they have virtually done away with mixed-sex accommodation (Stoke, J. 1994). All NHS providers ought to put in place strong plans to show the commitment for continuous service delivery. The primary care trust were on an exceptional basis supposed to submit a report to the health authority, the names of organizations that defiled the order of providing same sex-accommodation. The repercussion following the defilement involved withholding of funds to the organization. Those who are responsible for the provision of inpatient services for mental health and learning disability should come up with plans to ensure no sharing of sleeping areas by men and women and provision of the women-only day areas. The operating framework demanded that, from 2010, the service providers were not to be paid for services, not to the required standards, and to that effect detailed contract guidance were released. Support for the Organizations. The NHS service providers receive support to make them commit themselves to providing of same-sex accommodation. In the past twelve months, mental health and learning disabilities trust NHS; have be getting support from one hundred pound private and Dignity Fund that was set up by Health Department (Adshead, G. 2004). This support was aimed at improving the provision of same-sex accommodation across the NHS. This led to improvement in staff training, facilities for SSA, as well as, user communication programs. In addition to the funds provided. Other than providing funds, the department of health that is responsible for deliverance of same-sex accommodation provides guidance help organizations to achieve the expected standards. The NHS organizations are accessible to peer review sessions through their SHA. A succession plans are being implemented that ensures PCTs Trust and SHAs maintained their activities beyond the life of the program that was due to be completed by march 2010 (Adshead, G. 2004). Service users in many trusts were accommodated according to conditions meeting the Same-sex accommodation criteria. However, in ensuring that everyone experiences this, those who provide mental health and learning disability must take a series of steps. These includes making same-sex accommodation a recurring topic for the agenda of meetings of the board, using a comprehensive SSA review to formulate a timed action plan for elimination of remaining areas of the provisions of mixed-sex, and examining the environment, procedures of bed management and admission to help prevent lapses in all standards. In conclusion, transforming from one system to the other has had its shortcomings and transforming from mix-sex to same-sex has its shortcomings too. In order to initiate the complete change, one has to be psychologically ready to deal with a number of issues that do come along with the process. For instance, for a complete overhaul, reasonable investments in terms of finance have to be invested. Same-sex ward requires new toilet facilities, new bathrooms, accommodation rooms, as well as, other amenities associated and limited to a particular gender group. It also calls for psychological adjustments of the population in which the said transformation has to be effected. In most societies, mixed-sex wards have been impressed, and the whole idea, therefore, has been made part and parcel of society believes. This to small extents gives due advantage for the mixed-sex wards over the same-sex. However, this does not change the fact that changing from same-sex ward to mixed-sex ward is the way to go. It only calls for concerted efforts to achieve a transformed system. Where change is inevitable, it has to be impressed and certainly it shall yield the expected results. . In summary, at least there is one thing that is clear: the involvement of user in same-sex wards and is sensitive theoretically with laudable benefits. Along the direction of national policy initiative, there has been significant progress in the positive direction. However, much more should be done for the world to impress the concept. It is through such practical approach that changes from same-sex ward to mixed-sex wards shall translate from rhetoric into a reality. REFERENCES Adshead, G., 2004. More alike than Different. In Working Therapeutically with Women in Secure Mental Health Settings, London: Jessica Kingsley. Bercus, S., 2001. Experience of a women’s psychiatric ward in London (abstract). Abstracts of the 26th International Congress on Law and Mental Health. Retrieved on 25th April2012 from http://www.ialmh.org/. Kennedy, H., 2001. Does a man need special service? Advances in Psychiatric Treatment, Retrieved on 24th April 2012 from http// www.haronenterprises.com. Mezey, G., 2005. Safety of women in mixed-sexes and single-sex medium secured units: staff and patient perception. British Journal of Psychiatry, 187, 579– 582. Ramsay, R., 2000. Needs of women patients with mental illness. Advances in Psychiatric Treatment. Retrieved on 25 April 2012 from http//www health.vic.gov.au/mentalhealth. Stoke., J., 1994. Institutional chaos and personal stress. In The Unconscious at Work .Retrieved on 24th April 2012 from http//www.pestres.org. Ipsos, M., 2010. Public perception of dignity and privacy in same-sex ward . Retrieved on 24thApril 2012 from priory.com/psychiatry. Imprrit,N., 2009. NHS Operating Framework for the World. Retrieved on 25th April 2012 fromwww.sahf.org.uk/uploads/docs/files/36.pd. Mries, H., 2009.Survay of Adult Inpatient2008 in mixed-sex and single-sex ward. Retrieved on 23rd April 2012 from www.hospitalmanagement.net/features/feature. Read More