HOSPITAL PSYCHIATRIC WARD WILL HAVE HOMELIKE SETTING

THE BALTIMORE SUN

The shopping list Jan S. Watts handed the purchasing department at Carroll County General Hospital might have looked like one to equip the house where she raised her five sons.

But the point of the hospital's new psychiatric ward, set to take its first patient in late July, is to be a homelike setting where people can go to get better, said Watts, who was hired this spring to direct the ward.

In preparing for the first patients, Watts is hiring staff, writing policies, developing treatment programs and buying equipment to carry out the therapy.

That's why she has submitted a request for pots, pans, mixers, a popcorn popper and ice cream maker.

"The preparation of food is a very therapeutic activity," said Watts, who decided to go to nursing school while in her 30s, after five years of owning and operating a seafood and catering business in Tilghman, on the Eastern Shore.

Also therapeutic are other domestic chores and activities suggested by the rest of her shopping list, which includes an ironing board, weight machine, television, VCR and parlor games.

One thing not on her list or in her $1.2 million annual operating budget is extra security. The hospital already has a security staff on duty evenings and overnight, Watts said. She'd like the psychiatric ward to use just those guards, if necessary.

"Basically, people here (psychiatric floor staff) will be well-trained in how to de-escalate situations," Watts said. "We'll try it for a year without additional security staff."

Watts has spent most of her career in private psychiatric hospitals and says that hiring husky guards to stand around watching for trouble invites confrontation from patients instead of preventing it.

"It creates the problem," she said. "It's so much easier to say, 'You wouldn't hit me, would you?' "

She said the staff will maintain an environment of trust and caring to deal with patients who get violent. Her three rules for nurses, therapists and otherstaff members who work for her are to be "fair, firm and consistent."

CCGH spent $3.2 million to construct the psychiatric unit and another floor that will be used for medical care. The money is part of a $9.4 million bond for hospital expansion, to be paid back over 30 years through revenue from the rates patients and insurers pay.

Thedaily rate for patients hasn't been set yet by the state, said KevinKelbly, vice president for finance. However, the hospital will request a rate based on averages for other hospitals, or about $350 a day,he said.

The unit will have 12 beds for adolescents and eight foradults who would stay on a short-term basis -- no more than 30 days.

"Our average length of stay will be 10 to 14 days for adults and 21 to 23 days for adolescents," Watts said.

In most cases, patients will go home after that, she said. If they need longer-term care, they would go to another hospital specializing in that.

About half the adolescent patients who come to the ward will be those who are having symptoms for the first time, she said. Most of the adult patients, however, already will have been diagnosed and treated for a mentalillness, but will need help to get through a crisis.

"Our unit will allow patients to enter the hospital when they need to, just as they would if they were having a gall bladder problem, or their diabetes suddenly became out of control," Watts said. "Their condition will be stabilized or improved, and they will return to their community inbetter health."

She stressed that the hospital's ward is another link in mental health services, somewhere between community programs and longer-term care.

Adolescent treatment will be a little different, she said. That age group can be so tumultuous because of peer pressure and hormones, she said, so the movement in mental health is toavoid labeling teens as mentally ill.

Instead, Watts believes that some teens have an especially tough time dealing with a crisis or aset of problems, then become depressed or act out their frustrationsby getting into trouble.

"Adolescence is a time when you seek independence, you seek autonomy, but you may not be mature enough to handle it," Watts said. Parents also may have a tough time dealing with their teen children, she added. "Often these families need a cooling-off period."

By having a hospital in the community to provide a short-term stay for teens, she said that youths won't have to be isolated from friends and family.

Watts has been talking to school officials and other health-care providers in the area to let them know about the ward and how it will operate.

"My mission and my goal in all of this is somehow to normalize the mental health experience," she said.

Although locked doors will separate the psychiatric ward from the rest of the hospital, adults and adolescents will share some common areas, such as a living room and dining room.

The nurse's station will be in the middle, where staff can see down both halls and into all the common areas. Walls will be decorated in pinks, blues andmauves. Furniture, even the beds, will look more like a dormitory than a hospital, Watts said, and staff will wear street clothes insteadof white uniforms.

By the end of June, Watts will have hired the staff of 10 nurses, two social workers, an occupational therapist, anactivities therapist, four licensed practical nurses, seven nursing technicians and three clerks.

She said many of the staff candidates are Carroll County residents who always have worked in psychiatric hospitals outside the county, because that's where the jobs were. Nowthey are anxious to work in their own community, she pointed out.

Watts has lived in Sykesville for six years. She and her husband, Steve, have five sons between 14 and 29, and two granddaughters.

Sheearned her bachelor of science degree in nursing from Salisbury State University in 1979, and her master's degree from the University of Maryland last year.

Now 48 and a psychiatric clinical specialist, her nursing background also includes shock-trauma, emergency, oncology and regular medical wards.

For nine months before taking the CCGH job, she had been a clinical specialist at the Muncie Center of Springfield Hospital Center, but the rest of her experience has been in private hospitals, including six years at Maryland General Hospital as a clinical manager.

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