Aro.
Just the mention of that place is enough to send shivers and shame (mental illness is still a taboo in our society) down the spine of an average Nigerian. Shouts of ‘God forbid!’ will ring out with their two fingers, snapping and going over their heads.
Most people if not all, popularly call the hospital, Aro(the location). The formal name is actually, Federal Neuropsychiatry Hospital, Aro, Abeokuta. A hospital catering for mentally ill patients. It’s one of the biggest psychiatric hospitals in the whole country. It’s a hospital that was established in 1944. The hospital has such a rich, long history, but I’m here to write about my experiences.
You can see its rich history as soon as you enter the large compound of the hospital. Around you are ancient well maintained buildings that show the age of the hospital.
Going to the Neuropsychiatry Hospital (NPH) for mental health clinical posting is a rite of passage for Nursing students, especially those in the Southwest. As well taking pictures in front of the hospital’s round logo close to the gate. I know I took a lot of pictures there.
We planned a month of clinical posting. I was apprehensive because it was the first ‘outside’ posting my coursemates and I would experience. We had to pack a month worth of clothes, food, buckets and other stuff. You should have seen the enormous load my coursemates brought on the day we were to leave for Abeokuta. It was daunting to say the least.
We had to travel in two batches and I feared our load would hinder our drive. Thankfully, we arrived at our private hostel in one piece. The hostel at NPH was full and we couldn’t stay there.
We were then divided into groups of five to a room. The eight boys were given one larger room. The room had a large bed fit for three people and there were mattresses for other occupants. Each room had its own toilet, but you had to fetch water in a reservoir in the compound.
It was fun staying in such proximity with my coursemates. If I needed something or if I was feeling lonely, they were only a couple of steps away. This was one of my favourite experiences ever. Luckily, we didn’t spend a dime on transport because the hospital provided free buses for us and other Nursing students at the hostel and other private hostels.
Now, let me go back to the hospital.
Nobody told me this, but out of the four weeks allocated for posting, the first week is to be spent in a class where we were given a mental health textbook for Nurses and the lecturers at School of Nursing, NPH taught us.
Yes, the hospital also has a school of Nursing for students wishing to specialise in Mental Health.
In the first week, I was already getting antsy, eager to start the clinical posting gangan. But, I withstood the classes. The following week, the long awaited day arrived!
I’ve read a lot about mental health, not school books, fiction and watched a lot of movies too. So, I already had an image in my mind as to what mentally ill patients would look like. I was eager to see if the images in my head were correct. Boy, was I wrong! The first shock was that it was literally not like I expected. I had to form new memories of what these conditions are like.
And I’ve always heard tales of patients attacking healthcare providers. So, I was eager and scared at the same time.
In addition to this, I was expecting the posting to be as stressful and busy as MedSurg Posting and Community Posting. But, was it busy? Well, you’ll have to keep reading to find out.
I and twelve of my coursemates were posted to the Female ward. Unfortunately, the ward was filled with student nurses from another school. We were more than 20 student nurses in one ward of only 8-13 patients.
I entered the ward gingerly, looking around, but it looked like a regular ward, something you would see in OOUTH. We greeted the Nurses in charge and they allocated us to each patient. The ward was quiet, serene, filled with light and air because of the large windows and the patients were seated on their beds minding their businesses.
That was the first shock. Are you saying that the wards here are the same as the ones in OOUTH? Are my eyes deceiving me? They were not.
The ward was already filled, so I sat in the Nurses’ Station reading the drug administration note. Unfortunately, I couldn’t study the patients’ case files because NPH uses EMR (Electronic Medical Records). I was surprised at how advanced they were already. It’s the first time I saw e-recording at a government hospital. The records were not opened to us because we didn’t have the passwords but we could see their diagnosis on the board in the nurses’ corner.
After a few hours, I was bored and already counting down to 2:00pm when we would go back to the hostel. The next two weeks went down in the same vein with barely anything to do due to the number of nursing students in just one ward.
I was able to provide care for patients diagnosed with depression, schizophrenia, bipolar disorder, mental and behavioural disorder. The care was unlike most medsurg procedures. I just had to measure vital signs, observe my patients, talk with them and play games with them. I didn’t enjoy this posting because it was very boring and it was not hands-on. I was bored.
Was I assaulted? No!
Was I insulted? Yes, yes, yes
But, what I noticed was that mental illnesses present differently. I know that mental illnesses can happen to anybody, but it’s something to know in the abstract and another to actually experience it.
So, don’t ever think you’re free from mental illnesses regardless of your wealth, age, sex, levels of education, religion and gender.
One of my favourite parts of Neuropsychiatry Hospital, Aro, was the large, neat, airy compound filled with trees. It was beautiful, really. I could walk through the compound without getting tired.
But, I feel like the compound is not being utilised. I feel like the patients are cooped up in their rooms for too long and they are not allowed to have any electronic devices. It would be nice if the wards were prettier, if there were books of different genres, television, new, neat board games. And even, a supervised walk through the compound once in a week or something like that.
Imagine being a patient and your life revolves around your bed, the bathroom, gazebo and the kitchen? It would be very boring indeed.
Another shock is that you rarely see the patients’ family members in the hospital. Unlike OOUTH where family members are everywhere. The patients don’t need their family members like patients with medical conditions do.
My last week there, we were posted to the clinics, the Outpatient Clinic, Assessment(Emergency), Children’s Clinic(cerebral palsy, epilepsy, speech disability etc), and the Elderly’s(dementia, Alzheimer’s disease)
It was during my last week there that I understood the ‘Neuro’Psychiatry in the name of the hospital. The ‘neuro’ was because neurological disorders often exhibit psychiatry symptoms, hence the same doctors manage them.
I had an ‘oooh’ moment when I heard this, I had been wondering about this since the day posting started.
My favourite ward there was the Outpatient Clinic, my alabere skills came out in full force. Most of the patients’ drugs were administered through IM. And Assessment(Emergency), because of the extensive history taking. You’ve never seen history taking until you’re in a mental health hospital, both the patient and the family members answer lots of questions.
But, the hospital needs to do better in treating the emergency patients. For example, patients are unable to see the Doctor’s every Wednesday because they have seminars on that day. Unfortunately, the patients are unaware of this, most of them make the journeys of hours to reach the hospital only for them to come another day. There should be a way to inform the patients prior to that.
During the one month posting, some male patients rebelled and assaulted two Doctors. And I love the response the Doctors’ association gave, they immediately went on strike after making requests of the management to put measures in place to ensure there is no repeat of that assault. It’s unfortunate that Nursing Associations will be unable to carry out the same thing if it were Nurses that were assaulted, but that’s a discussion for another day.
On Thursday of the last week, we went to Lantoro. It’s in a different location as it’s a branch of NPH. It’s the opposite of Aro. It was congested and the buildings were too close. Apparently, patients that can’t be handled at Aro are transferred to Lantoro. My experience there was similar to that in Aro.
Our last day at Aro, Abeokuta, we didn’t go for posting, but we had a test at the School of Neuropsychiatry Hospital, Aro, Abeokuta. It was a short one and we were done in thirty minutes.
Then, Ile ya!
Or you would think so, but our stuff, oh God! It was a lot and it took hours before everything was loafing into the car. Much thanks to the male students in my class, well some of them.
The End.
It’s not
I enjoyed the mental health posting, but it was not my favorite. I would not be specialising in MH.
For the upcoming Aro ‘posters’, you just need to start your clinical posting with an open mind. It’s nothing like you’ve ever seen. As usual in Nursing, you need money, calmness because you might be staying with your coursemates, and please pack lightly.
P.S: Admission in Aro costs 400K+, and half of the conditions are caused by substance abuse.
P.P.S: Take care of your mental health!