Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

When is an adult an adult?

  • Comments (12)

I recently had an interesting chat with a young man who had just spent a week in hospital. He’s nearly 18 and was admitted to an adult medical ward. It was both a challenging and at points frightening experience for him.

He was in a four-bedded bay with three other patients, one of whom was at times, especially at night, confused and agitated. He felt lonely at night and not sure how to deal with the distress of the man opposite. During the day it was easier but some staff dealt with the issue of his age better than others.

The only people who were near his age were the student nurses, and he found his exchanges with them really helpful. The nursing staff seemed to appreciate that he would find his situation difficult and were supportive, but sometimes the doctors treated him like an adult and expected him to be able to make decisions about his care. He felt awkward having to say that he would like to consult his parents.

I asked him if he would have preferred to be on a children’s ward. After some thought he said that, if I had asked him that question before he was admitted, he would have said no. However after his experiences, he said, actually of the two choices, he would now opt for the children/adolescent ward.

The problem is, as my question revealed, that neither setting is appropriate and nor can any hard and fast rules to be set. Some young adults are very mature whereas others are still teenagers. But it sounds like the nurses got it right – appreciating the difficulties of offering transitional care and being supportive to help the patient experience.

 

What do you think?

Join us on twitter at 1pm on Wednesday 21 August where we will be discussing the transition from child to adult services.
To join the discussion, search for #NTtwitchat and use this hashtag in your tweets so they appear in the search.

  • Comments (12)

Readers' comments (12)

  • Interesting and valid observation. My experiences of this wavy line between adolescent and adult services is in community (mainly substance misuse and mental health) where it seems that some services have strict criteria - reach 18 and you are an adult and go to another service even if you have been with the young persons service for years - whereas others seem to have a more flexible (but not consistant) approach with 'young persons services' including peeople up to age 24 in some cases.

    Surely there is scope here for services to apply a commonsense approach based on a persons emotional needs and capacity to understand / consent rather and an arbitrary chronological age?

    I have had drug / alcohol using clients who at 20 + lack capacity and the emotional stability to engage with the adult services and in contrast have had 15 yo injecting drug users who are fully aware of what they are doing and the risks involved and who would be a potential disruptive and counter productive influence in the young persons service.

    Unsuitable or offensive? Report this comment

  • Anonymous

    Is it appropriate for a child of 16/17, for that is what they are according to the Children Act, to be placed on a ward with adults? Equally is it appropriate that they be placed on a ward with pre-school children? There is a case for there to be more stratification in pre-adult services. Perhaps 0-5, 6-11, 12-17, along the lines of the different school ages.

    Unsuitable or offensive? Report this comment

  • Anonymous

    Having just turned 17 I was a patient on an adult surgical ward, this was 30 years ago and there was no allowances made for my age. Yet I did not find that an issue as the care was excellent. It is concerning that we are not allowing young people to grow up and be adults, instead looking at treating them as children for longer. Previous comment about client's who at 20+ lack capacity and emotional stability to engage with adult services I believe this is a completely different issue as to whether someone who is nearly 18 is treated on an adult ward.

    Unsuitable or offensive? Report this comment

  • George Kuchanny

    What about an adult with a bipolar disorder? Certainly an adult but incapable of making decisions in his own best interest. Should a parent be closely involved in decision making with medical staff and the adult?

    Unsuitable or offensive? Report this comment

  • Anonymous

    in scotland you are classed an adult at 16.when i was a teenager i classed myself as an adult.so it is entirely appropiate to have patients who are in this age group to be on adult wards.i know a lot of young adults who wouldnt like to be treated in childrens wards.maybe we should have wards specifcally to treat 16 to 19 year olds.even though they are young adults.

    Unsuitable or offensive? Report this comment

  • Anonymous

    at 18 I was on a ward with what I thought at the time were very elderly (well they did have white hair). It was very depressing and I was convinced my outcome would be similar to theirs. not very uplifting or conducive to making a good recovery.

    Unsuitable or offensive? Report this comment

  • As someone about to embark on a nursing degree, thank you for this observation. It is certainly something that I will bear in mind if/when I come across this situation. I will make the extra effort to make sure that such patients get as much support as possible from me. And indeed this has me considering what "extra" support other patients may need to make their hospital stay as stress free as possible. This is why I love reading the NT.

    Unsuitable or offensive? Report this comment

  • Marc Evans

    Its interesting but I think you need to assess on an individual level. I think capacity level plays a major role here, you could have a very independent and mature person at 16 yet (and especially with mental health) have a 30 year old who has capacity issues. Im not saying that you should be treating the 30 year old like a child, what Im saying is that age can sometimes be irrelevant and as Nurses we need to assess understanding and capacity on an individual basis.

    Unsuitable or offensive? Report this comment

  • Anonymous

    Marc Evans | 22-Aug-2013 6:08 pm

    plenty of patients with mental health issues at any age have full capacity!!!!!!

    Unsuitable or offensive? Report this comment

  • George Kuchanny

    Sorry Anonymous | 22-Aug-2013 7:04 pm

    I did not understand your comment. Let us say, take a 30 year old Downs Syndrome person as an extreme example. How much capacity would you say they have? Or do you mean 'capacity' should be interpreted in some unclear (to me) manner within the context of your comment?

    Unsuitable or offensive? Report this comment

Show 1020results per page

Have your say

You must sign in to make a comment.

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.