If you could tell an a&e/ER nurse about self-harm

What would you say?

I have been given the opportunity to participate in a session my support worker is running.  The session is for A&E staff to raise awareness about the issues that self-harm raises and ultimately to help them to understand people who self-harm and hopefully help them improve their practice.  I have been asked to talk about my experiences in A&E after self-harming and what was helpful and unhelpful with regards to the way I was treated.

I can’t help but feel underqualified for this role.  I have never been to A&E for cutting and only four times for overdoses.  I don’t really know what it is like and only have my experiences to go on when I am sure someone elses experiences will be of far more use to them.  Anyway I said I will do it even though I am not sure I will do the topic justice and because I am a horrible public speaker.  I guess if even one nurse goes away with a better understanding of what it is like in the run up to a suicide attempt, the act itself and then the impact of landing up disappointed and scared in an A&E ward then I guess I will have had some small part in educating the world.  So far I have not done a great job in promoting the awareness of mental health problems or self harm in my lifetime.  It has always been something I have wanted to do but being a health professional in training I have always felt an element of fear about being judged.  Hell, even this blog is anonymous and sometimes I really wish it wasn’t.

It is also fate that I have been asked to do this talk.  It is on the 16th December 2008 from 2-3pm.  On 16th December 2004 at 2pm exactly I lay down and closed my eyes thinking it would be the last time I would.  Unfortunately (well I thought so at the time) I woke up at 2.05pm the next day ill and disappointed.  I ended up spending 5 days in their ward the first couple of days in a to use their words “touch and go” state.  There will be a post about this but I have yet to peice my thoughts together on this.

I know of a few things I want to say but I can only think of a couple right at this moment (oh yeah and I forgot to mention I am not allowed to just slate the quality of their care- albeit very tempting as there were few positives).

I would like to tell them that:

• Taking an overdose(for me) has never been a spur of the moment decision, it has always been on my mind for at least a week beforehand and usually constantly.  Several months on one occassion.
• It takes a lot of emotional upset to get to the point where you take an overdose.  It takes a lot of balls to take an overdose, ok not just to swallow the pills but the act is potentially final and it takes a lot of courage to stare death in the face.
• Although suicide seems illogical it always feels logical at the time.  It feels like the only option and usually everything else has been tried previously such as coping strategies, calling support networks.
• Most times I have been ambivalent about whether I wanted to live or die after taking the pills.  I didn’t care what happened to me and someone always managed to persuade me to go to A&E by putting the fear of god in me.
• There is one exception to this -  the first time I really wanted to die- there was no “people will miss me” and no reasoning with me (mainly because I told no-one I was planning it).  I thought I had taken enough to do the job and it should have.  I was really disappointed that it hadn’t succeeded.  When I got to A&E I was terrified of what was going to happen and what people would think of me,  No-one told me what was going on- although I probably wasn’t really conscious enough to understand anyway.
• A & E is a scary place to be.
• The has always been a huge fear that staff will think I am just “attention seeking”.
• I have always felt really guilty about creating a workload for them and taking up time and resources- I have never apologised quite as much as I have whilst admitted to the ward.  I have never felt worthy of their attention and care as of course I brought this on  myself and there are plenty of sick people who don’t choose it.
• The best thing that has ever happened on the ward was when one auxiliary found five minutes to talk to me and ask how I was feeling (I have only on the first visit told people I was there.)  It is incredibly lonely with no-one to talk to.
• The feelings that lead up to taking an overdose do not miraculously disappear on entering a hospital (even if you do find ways of covering them up or are too busy worrying about other things.)
• There is then an added problem of having taken an overdose and the physical and medical consequences to add to all your other problems.
• Being asked if you’ve done it before and answering “yes, once” should never get the response “oh well you know the drill then” and no further explanation of treatment.  I couldn’t remember the first time as I was so ill.
• Privacy issues are one thing but not being told anything about anything is incredibly unhelpful
• Being told “It’s a dangerous game you are playing” is equally unhelpful.
• Being sent home to an empty flat is the most dangerous feeling in the world.  It would be so easy to just try again.
• Just be polite and don’t judge.  If you can’t not judge then at least don’t let it show or bitch about us at the nurses station that is within earshot.
• It is NOT a fashion statement/social norm/ emo thing (even though I look like an emo doesn’t mean that’s why I self harm.)

That is my experiences and as you can see it is mainly negative, ooops.  It would be really helpful to get the opinions/thoughts of other people as I don’t just want to go in and rabbit on about me. That is attention-seeking .

Feel free to pitch in here!