As a follow up to this post I asked what questions were been asked at this interview.
what would you do if you were asked to take a patient on close observations to the shop and was told they had a history of self harm ?
for this job:
The job entailed working on a rehab ward- for those who had been hospitalised for a number of years and were planning to live independently. it looked professional- I asked for a tour- a bit like halls of residence actually.
What would you do ?
I think if a patient is on any obs over and above general observation, then there are clearly risk issues that would mean going to the shop would not be an option.
I suppose it comes down to the individual patient. As you know, I used to self harm but when I was an inpatient I would never have dreamed of taking advantage of the situation if I was taken to the shop. Then again, I supose there are rules for this…? Maybe, if it were possible, there should be 2 members of staff with the patient if there was a higher risk.
By the way, hello again! I am back properly now. I am teaching full time again and have moved back into my own flat. Hope you are well. I can read old entries now I have internet access properly again.
Nice to see you back
*Mental Nurse Dances The Happy Elf Dance*
Time to try and answer the above question.
I m presuming close observations mean continuous line of sight contact. Generally someone would only be on close obs if there was considered to be a fairly high risk of something unpleasant happening to them (attempted suicide?) or to those around them (violence ?). As it is such a gross invasion of personal space it tends to be avoided.
The other point is a ‘history of self harm’. Which I would not automatically link with close obs. As elliecat points out most people who self harm would not be very likely to do it on a shopping trip.
If the person is at risk of spontaneously self harming / attempting suicide with little or no warning I wouldn’t be happy with them going out until the risk was reduced.
But, presuming a full risk assessment has been carried out, I would simply accompany the client on the shopping trip and look as little like a psychiatric nursing escort as possible.
A hospital I trained at was in a posh part of the city. The natives used to be quited good at identifying when clients were out on escorted leave. A little gap always used to form around people who looked like they were out on leave. Particularly if he or she had a Chlorpromazine Tan.
Anyway what would I do. Try and set a few basic ground rulesbefore going out, if you buy anything dangerous or liable to be used for self harm we may have to put it into safe keeping on your way back to the ward 
Mostly I think I would just enjoy a trip off the ward.
My experience of interviews is that often the questions don’t actually have ‘correct’ answers. Normally the interviewers want to see the candidate can think and use basic common sense. Therefore they pose questions with very limited info and see how the interviewee fills in the gaps.
Anyway must go and buy some Easter Eggs.
That all sounds quite sensible. I think the most important thing is not to treat a patient as a child or they will probably end up acting like one. Yes… I have been doing some TA!
I was asked at an interview for an HCA post once “Mrs Jones hasn’t had a wash, Mr Smith has just died and you haven’t had a break yet – what do you do?” I said I was going for a cup of tea. I got the job and was seemingly rushed through the induction course, as I started work two weeks later with others who had been waiting for months.
I did qualify my comment by saying that if I was tired I probably wouldn’t be in the best position physically and mentally to help, but that just makes the comment sound dull and sensible.
Of course, once I had started the job I found I wasn’t taking breaks when there was work to do, and cut breaks short if I heard the buzzers going off for a long time. I have only once said I have to go for a break now and that is because the canteen was about to close and I was so hungry I was going to cry.