This Week in Mentalists (41)

So, what’s been happening in the mental health blogosphere this week? Are you sitting comfortably? Then we’ll begin.

Not Another Nursing Student has a long post on the perils of having a workplace relationship if you work in a mental health unit.

I met Mr Door at work. This isn’t particularly unusual; it’s a small unit, but nearly every member of staff is related to/living with/dating/sleeping with/trying to sleep with another. You have to be very, very sure who you are talking to before you start slagging someone off, as chances are they are their sister/mother/secret lover, and you will make an enemy for life with your indiscretion. Before you know if, half the unit are shooting you the evil’s, and these people can seriously bear a grudge. It’s not the patients you need to worry about, it’s the woman whose cousin’s daughter’s boyfriend you once called a spotty nob-head

The Shrink points to some nurses failing to ensure a patient with dementia gets adequate nutritional intake.

She, “didn’t want breakfast,” so this was the first food she’d had all day. Food was brought and placed at the end of her bed, yet she was in an adjacent room. She was told where it was by the same nurse who told me she can’t walk. My nursing colleague, in a fit of fury, bollocked the nurse and got a small table from the far end of the ward, brought it for the lady and put the food on it. She enouraged her to eat, which she did. Slowly. Too slowly, since staff came to whisk her food off her just 3 or 4 minutes after she started it. No exaggeration, we were making ‘phone calls and documenting it all over 6 pages of notes in the end so we had the times written down. 4 minutes. Hmmm. The food removed, she’s nothing further to eat ’til tea time when, again, food will be offered (invariably out of reach) then left then removed.

No wonder she’s lost weight.

Crazy Nurse has been playing some scenes in her mind.

There is one I call THE PHONE IN SICK SCENE, in which I have to call work to tell the nurse in charge that I won’t be coming in for my shift, because I am back on one of the psych wards. There are one, maybe two, senior sisters/charge nurses who I feel I would be able to reveal this information to if it were the case. Sometimes I am in luck and it is one of them who answers the phone, so I just have to tell them. Othertimes they are not there; and so I call the modern matron [this is the women who had a meeting with my old modern matron before I started this job; whom I have had very little conversation/interaction with, but whom I am convinced knows my history] I call her and inform her of the situation, explaining that I am not capable of informing the nurse in charge because I do not know them very well and I don’t want them to know I have a mental illness. She says she will let them know I will not be in, and not to worry.

There is another I call the CONFESSION SCENE; in which end up telling either lovely nurse practitioner at the GP’s or lovely diabetes nurse specialist about my somewhat off the wall thoughts. Regardless of whom it is I am telling, I end up going to speak to the psych liason nurses in cas. This scene ends there, most likely because on the two occasions I have had the good fortune to experience this firsthand, it has been not had the outcome I was hoping for.

The most frequent scenario I watch over and over is the MOMENT OF ACTION SCENE; in which I jump off the bridge I keep having the urge to jump off (see previous posts)
I end up with some kind of orthopedic injury and wind up with various body parts in plaster of paris. This scene is changeable though: my actual ‘action’ does change, but basically always involves me making the decision to act on my thoughts to shut them up.

The Wife of a Schizophrenic has been attending counselling. It’s not going well.

My counsellor said that it is because I have had to be in control for so long and take responsibility for everything in our home, that it has finally become too much. She offered to help by drawing up a “to do” list, which only increased my anxiety further. I know how to draw up a flamin’ “to do” list, but it doesn’t ease the pressure I feel surrounding doing these things.

I got very upset with her that day. It was shortly after brother B decided to kick brother C’s head in (literally), and I was experiencing anxiety relating to this as well. Not only was my counsellor excusing brother B by insisting that he must be mentally ill (?) but she also insisted that brother C was at fault for not defending himself (??). Needless to say, I haven’t seen her since.

Schizophrenia – A Carer’s Journal is concerned about polypharmacy.

We were pleased when we heard they were discontinuing the haliperidol. The less good news is that they have replaced it with clopixol – another older drug. But as he still has the haliperidol available when needed he could be administered three anti-psychotics each day as well as a benzodiazapine and a mood stabiliser. There is no research evidence for the effects of such combinations. It is all trial and error.

On a positive note he does seem more “subdued”. For “subdued” though read “doped up”!! At least he hasn’t hit anyone recently as far as we are aware.

Writing in the Margins of My Mind has been going through occupational health screenings.

They didn’t rubber stamp “SANE” on my head, but then they didn’t stamp “CRAZY” either, so it’s all good! I also managed to get through it without having a panic attack, which was pretty damn good I thought, seeing as I’m much more likely to have them in situations where it would be really bad to have one. And a situation where I’m supposed to be proving my sanity would pretty much be the worst possible time to start hyperventiliating in a corner. The doctor did, however, say that if I had visible scars on my forearms then it “wouldn’t be appropriate to show them”. I don’t. But still… why? Because it might make a colleague uncomfortable, or because if I accidentally encounter a patient in the filing room then they might think the NHS condones self harm? Who knows.

Coloured Mind and Scattered Thoughts compares attending CAMHS to going shopping.

When you go clothes shopping if you want to be successful you generally try to make yourself look ok. Well good enough so you can walk past one of the many mirrors without wanting to cry. The best look is to try merge in as best as you can so instead of seeing yourself in the mirror you look like one of the many shop mannequins, and never ever experiment with make up as in the bright lights of changing rooms you will realise you look like a clown. When you go to a CAMHS session you can’t wear anything too bright or “out there”, for fear that you will be labelled hypo-manic. Nor do you want to wear the clothes that you have been living in for the last week for fear that they will tell you that you are worse and you need a medication review. The best you can try to do is look the same every week without turning up in the same outfits, and never ever experiment with make-up as that usually gets them running at you with olanzapine.

Teenage Misanthropy clearly disagrees, given the picture he’s posted of his own attire for CAMHS sessions.

Experimental Chimp talks about depression and dental hygiene.

The thing about depression is: Taking care of your teeth isn’t a priority. I’ve been mostly depressed for years, so my teeth are, by this point, in pretty bad shape. I’m like the cliché about English teeth. I’ve had two of them extracted in the last four years (though both were probably damaged when my wisdom teeth came through so it’s not entirely my fault). I hate going to the dentist because my teeth are in such bad shape and my teeth are in such bad shape because I never go the dentist.

I always kind of figured I’d be dead before I needed to deal with this. Why bother going through painful dental treatment when you’re just going to kill yourself sometime later?

Seaneen is hitting the airwaves.

I thought I’d let you know that BBC Radio 4 are making a (short) play based upon my scribblings in this blog.

That’s pretty much all I know at the moment!

I love Radio 4, so hurrah!

The Cockroach Catcher looks at a court case in Alaska that has exposed Eli Lilly’s shocking attempts to downplay the links between Zyprexa and diabetes.

Documents show that in 2002, the Zyprexa sales force was advised:

“We will NOT proactively address the diabetes concern.”

An in true Olympian spirit, they proclaimed:

“The competition wins if we are distracted into talking about diabetes.”

Let us wait and see what the judges in other States think. The earthquake in Alaska happened a while ago but this one may rumble on a bit longer.

We doctors must continue to resist being badgered, coerced and manipulated by pharmaceutical sales reps.

Hear hear. There’s two words to describe Eli Lilly. It rhymes with “clucking punts”.

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