SIGHTS
General Ward: (hospital-like hallways with plain walls and flooring, double doors between wards with security pads for exiting, rooms with nameplates (laundry room, medication room, therapy room, cafeteria, etc.), a common “day” room (magazine and books on a shelf, tables and chairs, games), wheelchairs, orderlies checking on patients and monitoring them, nurses and doctors making the rounds and distributing medications, security personnel walking the ward or working out of security stations, bubble mirrors at hallway intersections so personnel can see down each hallway, trays with paper medication cups holding pills, locked doors, secured drawers and cupboards, paintings and artwork that is caulked into place or otherwise firmly fixed, a crisis stabilization unit for emergencies, patients wearing color-coded wrist bands that indicate possible risk factors (a history of assault, an eating disorder, a flight risk) with a scannable code containing information about medication, meals served with plastic utensils, animals brought in for supervised pet therapy sessions, a basic fitness room and outside recreational area that can be utilized, personal counseling sessions, patients (wandering the halls, humming, talking to themselves, staring out windows, writing in journals or drawing, shouting at other residents, growing violent and being restrained by orderlies)
Patient Rooms: Doors with a small window insert, covered lights (with a dim setting for overnight monitoring purposes), a hospital bed (with a plastic mattress cover, white sheets, blanket, and padded restraints if necessary), a basic set of drawers and a desk, journal books with no spiral bindings, extra thick pencils that cannot be broken and used to harm oneself, heavy curtains pulled across a secured window, a bathroom (shower, tiled floors, a sink and mirror, a toilet, some may also have bubble mirrors for monitoring high risk patients), orderlies searching drawers for contraband or dangerous materials, patients being checked on the first few nights with a flashlight or woken up by a nurse with a needle as she takes blood for testing
SOUNDS
Doors opening and closing, fists banging on doors, echoing footsteps, a squeaky laundry cart being pushed down the hall, the beeps of monitoring equipment, the exhale of a blood pressure cuff, a plastic mattress cover crinkling as one shifts at bedtime, buzzing florescent lights, people (talking to themselves, humming, singing, muttering, crying or screaming), arguments between patients, music used to calm patients during certain sessions (like art therapy), the whisper of cloth (if shoes are not allowed on a ward), air conditioning or heaters that click and rattle, the spray of water against the tile floor from a shower, a faucet spewing water, toilets flushing, coughing, codes being called over a speaker system, the calming voice of a nurse, orderly or therapist, patients making repetitive noises (throat clearing, clicking, or swearing) associated with certain disorders, secure doors opening with a click as a nurse swipes an access card over a reader
SMELLS
Food smells around mealtimes (gravies, oils, bread, spices, meats), disinfectants, sweat, deodorant, bleach-scented sheets and towels, astringent hand sanitizer foam, urine, vomit, alcohol swabs, musty air conditioning
TASTES
Bland hospital food (meals that meet nutritional values but lack flavor), juice, water, vending machine pop or chocolate (if one has obtained special privileges for progress and good behavior), chalky or plastic-tasting pills
TEXTURES AND SENSATIONS
Soft towels, a scratchy paper towel from a bathroom dispenser, the rub of a hospital bracelet against one’s wrist, a cool glass window, gripping a plastic fork at mealtimes, the pain of self-inflicted pinches or scratches, thick cotton socks, footwear without shoelaces that slide loose during monitored exercise sessions, scratching at surfaces (a desktop, scraping paint off a pencil) out of boredom, gagging on a pill, the cool swab of alcohol and a pinch of a needle, gloved hands probing at skin during examinations to look for signs of self-harm, the clammy feel of wet hair that must air dry after a shower, the sense of release that comes from cutting oneself, running a finger along a hemline for comforting repetition, soft clay or cold paint during art therapy
POSSIBLE SOURCES OF CONFLICT
Receiving a medication in error
Arguments over favoritism (real or imagined)
Medication side effects (zoning out, food tasting bland, difficulty sleeping, hallucinations)
Refusing medications or needing to be restrained or isolated
Being on suicide watch and losing all independence
Needing to use the bathroom but finding it locked due to special precautions (like guarding against purging)
PEOPLE COMMONLY FOUND HERE
Chaplains, doctors, janitorial staff, mentally ill patients, nurses, orderlies, psychologists, therapists, visitors (state-appointed guardians, family, and close friends)
RELATED SETTINGS THAT MAY TIE IN WITH THIS ONE
Ambulance, emergency room, hospital room, police car
SETTING NOTES AND TIPS
Some psychiatric facilities exist within a regular hospital (a ward), while others are independent institutions. Patients may admit themselves, or if they’re believed to be in immediate danger of harming themselves or others, they can be admitted by a psychiatrist or legal caregiver. Some mental hospitals may also have outpatient programs for low-risk patients. As with many settings, the rules and procedures will vary, as will the conditions of the facility. Low funded hospitals or wards may have a lot more dirt and grime, not to mention dents in doors and holes in walls from objects thrown. Some hospitals may not allow shoes or shoelaces, and others will; some may completely segregate males and females, while others do not. Visitors may be allowed at certain facilities and yet not at others. If your novel is tied to a specific geographic area, research the local hospitals to make sure yours complies with regional standards.
SETTING DESCRIPTION EXAMPLE
A foul stench coated the hallway, and Cam was not the least bit surprised to smell it the strongest outside room 34. William Rand was a long-term schizophrenic who was known for regurgitating his meds and tossing them away. He was also known for his habit of smearing feces across the safety glass in his door. Sure enough, William had decorated his window, this time adding a smiley face flourish. Cam’s gag reflex kicked in and he rushed to the custodial room’s sink. He’d had it with this place. Time to get a new job.
Techniques and Devices Used: Multisensory descriptions
Resulting Effects: Establishing mood, foreshadowing