The Lunatics Have Taken Over the Asylum

Who put this maniac in charge?

Due to circumstances beyond my control, I now find myself as the manager of an acute psychiatric admissions ward. I fucking hate management, I don’t do rules and we’re in the midst of a global pandemic! What could possibly go wrong? Let’s not forget folks, pandemic or not, people still need a safe space to go absolutely fucking mental.


I’ve never really chased Medium curation. As a hapless wine-loving stoner, convincingly disguised in real-life as a high-functioning, upstanding member of society, I don’t really have the time for such nonsense. I know what you’re thinking —

“This is all very well, but this imbecile appears to be talking absolute codswallop!”

Actually, I’ll have you know that I may well be a burnt-out, cynical Generation Xer, but that doesn’t stop me knowing my PPE from my PVC, my corona from my coroner and my pandemic from my infodemic. Oh, by the way, I forgot to mention that I’ve already caught COVID-19 and having fully recovered, I now find myself in the unenviable position of being one of the most valuable of commodities in the British NHS; a frontline nurse that can tell the difference between a corona cough and a corona lite.

While on the subject of tussication, I heard the guy who came up with the idea for cough drops died last week. Apparently, due to the lockdown, there’ll be no coffin at his funeral.

Like many others, I had a nice little gig going on until this global pandemic came along and caused absolute fucking chaos.

My part-time gig as a senior psych nurse recently presented me with an opportunity to professionally develop, and that didn’t involve climbing the greasy pole of management. At the time, my position in the team was senior enough to get away with the telling of what some may regard as inappropriate jokes and the pushing of boundaries but junior enough to not have to deal with the bullshit politics of the management level above. You see, I like my work-life like I like my 24 letter alphabets, without the BS.

Regarding my clinical practice and professional conduct, I’ve always prided myself on the level of contempt and disdain I have for my managers. Don’t get me wrong, I don’t have anything against them individually, but collectively they couldn’t even get on top of things at a paperweight convention.

Sadly, in an outdated institution such as the NHS, archaic and ineffective top-down management styles continue to reign supreme. In turn, this results in a neverending conveyer belt of clinical cannon fodder being burned out, downtrodden and disempowered by the very institution that is supposed to motivate, nurture and encourage it to become the innovative, and creative leaders of the future.

So I now find myself stepping up from senior psych nurse into the role of Clinical Team Leader. This is the reason I’ve not been online over the last few weeks.

Having now been in post for 2 weeks I’ve had time to reflect and I’ve made some observations:

  • Top-down management is a crock of shit
  • Life is a series of tough decisions that can’t be avoided
  • A management team is only as kind as its biggest arsehole
  • Not all clouds have a silver lining
  • Sometimes all we can do is embrace the chaos
  • Rulebooks and windows, say no more

Back in the day, we coughed to hide our farts, now we fart to hide our coughs.


Originally published in Medium publication The Swipe, 25th April 2020.