July 2008

I can think of a number of reasons why someone might consider a career as a psychologist over that of a psychiatric nurse.

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This wouldn’t be Mental Nurse without a mention of this news story.

I have to say, I have only read the one article about it and not looked any deeper, but incase anyone missed it it’s here.

A NEW drug capable of halting Alzheimer’s disease in its tracks was hailed yesterday as a “hugely exciting” development in the battle against the devastating condition.

The drug, developed and tested on patients in Scotland, slows down the progression of Alzheimer’s by as much as 81 per cent.

Just lately I seem to be discovering more and more good quality, well-written blogs by CAMHS users. Who says kids these days are illiterate, eh?

Anyway, the latest addition to my RSS feed is Writing in the Margins of My Mind. One post in particular sparked my interest. The author is considering whether to study psychology or mental health nursing.

I’ve met a few people who’ve told me they want to go to university and study psychology, “because I want to work with psychopaths/troubled teenagers/people with psychosis.” To which I usually reply, “Well, why don’t you do mental health nursing?” After all, a hell of a lot of what I do as a CAMHS nurse is psychological. A bit of CBT here, some person-centred counselling there. A sprinkling of family therapy. Running the occasional therapy group. And it’s a lot easier to get a career in mental health with an RMN qualification than with a psychology degree.

Then they look at me blankly, mutter something about, “I hadn’t thought about that”, and change the subject. Why’s that?

In The Margins summarises nicely the reason why:
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With all these intellectual, political and argumentative posts recently,  I have been losing interest in joining in the discussion. I’m finding it a little less a discussion and more like a my dads better than yours situation. I am quite sure that I am not alone, therefore I want to write a post about plain old mental health nursing. (Not that there is anything plain about it). Read the rest of this entry »

(Guest post by Luthien)

Hi, I’ve only ever posted one comment before although I have been a regular reader for a long time.  I know that this is very short notice as I really need to submit it tonight at some point, but I would be very grateful for any tips/advice that anyone has regarding writing a supporting statement for an application for a band 5 community CAMHS nurse job.  I was fortunate enough to spend almost 6 months on placement at the place I am applying to, but I know that they are receiving a very high number of applications (CAMHS jobs in my area are like gold dust and only come up every couple of years!) and so I’d be incredibly grateful if anyone can suggest anything which could make my application stronger.

As I said, I’m aware of the incredibly short notice, but I’m hoping that someone might see this in time (particularly Zarathustra as I know you work in CAMHS).  Thank you in advance!

The Cockroach Catcher has an interesting post on the amount of money drug companies are spending on marketing ADHD drugs like atomoxetine and methylphenidate.

Here’s a little thought from me:

Before I came to CAMHS I worked on a rehab ward with people who had enduring mental health problems, and often a whole slew of physical illnesses too. Not only were we handing out antipsychotics, mood stabilisers, antidepressants, hypnotics, anxiolytics like they were smarties, but we were also giving meds for diabetes, epilepsy, hypertension - you name it. Despite this, we never saw a drug rep. Ever.

Now I work in CAMHS, which probably prescribes less medication than any other form of healthcare. Despite this, the drug reps for the ADHD medications (Strattera, Equisym, Concerta, Medikinet etc) are round here every other week, showering us with pens, post-it notes, staplers, calculators, cordless mouses, buying us lunch, making sure we’re nicely stocked up on behaviour monitoring charts, educational materials, anger management booklets, sticker charts. God, they’re desperate to prove they care about us.

If I were a more cynical being, I’d suggest that this means that the drug companies clearly see ADHD as being something of a cash cow.

Kevin Myers, writing in the Irish Independent [1] [2] [3], has been threatened with prosecution for arguing that aid to Africa is doing more harm than good. He highlights the case of Ethiopia where he was a reporter during the famine of 1984 – 1985:

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I’m afraid I am turning more and more into Sociology Nurse - and I can’t help myself. But when the world turns out stuff like this:

All Crying, Self-Harming Emo Children To Be Banned In Mother Russia

..it makes one stop, notice and ask questions.

But what’s the real story behind the sensational headline of Heckler Spray - whoever they are?

More gripping headlines (and my attempt to contend with E and spice up my posts with pics totally and plagiaristically ripped from the NME author-site a la Persuad) reveal:

Emo to be made illegal in Russia?

My Chemical Romance fans protest at the Daily Mail’s London office

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(Guest post by nasogastric)

I  feel sick, and shaky and angry.

What has happened is this.  One of my Section 3 patients is on leave and while at work yesterday I received an upset telephone call from this patient and a family member saying their solictor had called them and told them the section 3 had been renewed.

I checked the notes, nothing to indicate this.  I noted that the Section 3 runs out or needs renewal in a months time.  The patient had seen his consultant on the Thursday and no mention of this.  Their solicitor rang them Friday, then they contacted me for an explanation.
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As if we didn’t have enough to get our biopsychosocial teeth into lately - this latest event gives us opportunity to debate that ever popular yet seldom reconciled issue: Euthanasia.

This week the GMC has determined to suspend Dr Iain Kerr for 6 months following his decision to prescribe to an elderly woman who died from an overdose of prescribed tablets (Temazepam, anti-histamines and painkillers). Dr Kerr had (re)prescribed the Temazepam only three days after a failed overdose suicide attempt. She died 11 days later from a second overdose. The woman was 87.

Dr Kerr said he gave Patient A the sleeping pills as an “insurance policy”.

He told the hearing in Manchester: “She said ‘Give me something that I can take if things get too bad’ and I said yes.” [source]

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Time for our weekly round-up of mental health blogs that are better than ours.

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Last night John Barrowman (Jack Harkness of Torchwood fame) presented a TV programme entitled “The making of Me” in which he went in search of why he is gay. Is it nature or was it Nurture?

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Now I know we’re not a ‘medical blog’, but somethings a-stir lately amongst the medics.

That Neil Bacon fellow (essentially an inadequate doctor who pretends he was a renal specialist but decided to go for the dot.com fortune instead with doctors.net.uk) has started something most annoying to the medical fraternity. I won’t link to any of it (except Shrink’s post on the subject and 360 degree feedback - but only cos he’s an honorary nurse*). You know where the rest of it is.

So what’s up? Well in a nutshell he’s started a ‘rating’ site for doctors (Bacon - not Shrink) - with anonymous submissions from.. well, anyone. It’s a bit crass - actually it’s extremely crass - and I sympathise with the medics - (in the same way they might sympathise over nurses pay).

But wait! Cue the cavalry bounding over the hill - Sir Liam Donaldson, Chief Medical Officer has another idea.

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The Healthcare Commission has produced this report into Acute Mental Health In-patient Care. There’s a HCC press release here.

While the Telegraph highlights:

Thousands of mental health patients go missing from wards

The sectioned patients either escaped from wards, went missing during authorised leave or failed to return to hospital when they should have, a critical report by the Healthcare Commission found.

During six months in 2007, patients detained under the Mental Health Act went missing on 2,745 occasions for a total of 8,870 nights

The Independent writes specifically about how unsafe such wards are.

Despite increased spending of £1.2bn in real terms on adult mental health services since 2002, one in four of England’s 10,000 mental hospital beds is in a trust rated as “weak”, which, says the commission, “does not meet the minimum requirements and reasonable expectations of patients and public”.

There was previous discussion (originally discussing the waste of the ology and iatry in mental health) which developed into suggesting we should be focusing more on the actual wards rather than splitting neurons; but I’m not about to revive it.

So, back to the report. What does it tell us? Apparently it reports that:

Overall, eight trusts were rated as “excellent” (accounting for 843 beds – 9%), 20 as “good” (2,808 beds – 28%), 30 as “fair” (3,985 beds – 40%) and 11 as “weak” (2,249 beds – 23%).

Hmm… so what does this mean?

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Here is something we can all get into a self righteous lather over. I am not sure if Iris Robinson is a British MP or a member of the Northern Ireland assembly her husband, Peter Robinson, is the leader of the DUP and First Minister, but Iris is reported by Hansard as saying;

“There can be no viler act, apart from homosexuality and sodomy, than sexually abusing innocent children.”

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