Articles by Mo

I recently did a post on my site about a bipolar guy who, while drunk and detained in a psychiatric hospital in the USA, threatened to kill the president. The staff reported this to the secret service and the guy was subsequently sentenced to almost five years in jail.

Timothy Pinkston was detained in a psychiatric hospital at the time and therefore I would presume “clinically insane” or whatever the term is. I can’t understand how they could send him to jail for something he said while he was officially mad and safely locked up in a psychiatric hospital.

I wondered if you guys could enlighten me how things would pan out if there were a similar incident in a UK psychiatric hospital. The case raises lots of issues but there are four main areas that concern me.
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In the news this week comes the shocking revelation… dementia victims “being failed by the NHS”. Perhaps no big shock to you mental nurses but what is interesting is the drug companies launching a legal challenge in the wake of NICE not advocating the prescription of anti-dementia drugs. I’ve always found the notion of prescribing drugs for dementia a bit of an ethical dilemma. Probably because I haven’t worked much with people in the early stages of the illness, I have for the most part seen distressed people in advanced stages of dementia. Why anyone would want to prolong their distress was always a bit of a mystery to me. I’ve heard some religious colleagues argue that life must be preserved at all costs but I’ve always taken some comfort in thinking that their God also created bronchopneumonia.

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I was about to post a further reply to Mental Nurse’s post Diary Of The Demented but my replies get so lengthy I thought I’d be better just creating a new post.

When our old Victorian asylum was starting to wind down, many people were full of optimism, looking forward to waving goodbye to the long, dim, corridors with high ceilings. Farewell to the stains, the smells and the memories of a dubious history. They envisaged a brave new world of shiny purpose built units. These new state of the art environments would benefit and uplift all of us, reducing stress and promoting well being. Oh, everything was going to be so much better.

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After reading Olanzapine’s recent article about how difficult dealing with death and self harm can be, I remembered an incident that occurred when I was a student. A recently qualified nurse had the misfortune of finding a patient hanged in his room. The whole ward was shocked and the nurse who discovered the bloke was quite understandably deeply traumatized by the incident. The following enquiry did little to alleviate the nurse’s distress. However, colleagues were very sensitive and everyone did whatever they could to offer support. The reason I’m mentioning this is because it is the only time I have ever seen psychiatric nurses being supportive towards a colleague’s psychological problem. Since then, without exception, I have found psychiatric nurses attitudes towards their peers’ so called “weaknesses” quite appalling (and I’m really pleased that I didn’t go mad till after I had left the wards).

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Back in 1980 when (due to a clerical error!) I accidentally ended up working in a psychiatric hospital, I was, like most newbies, nervous and very green behind the ears. I landed a job as a nursing assistant in a “rehab” ward. “Rehab” was of course a euphemism for “abandon all hope”. The ward I landed in was the end of the line in a chain of rehab wards. The chain started off with “acute rehab” where your 6 weeks to 6 months revolving door punters were shunted in and out. In the middle link of the rehab chain were the 30-60 year olds who had not been cured and had failed to rejoin society despite “acute rehab” and were now permanent (but accepted) residents in a colourful and fairly lively community where the unexpected often happened and a cigarette could buy you anything. I was however, inducted into the elephant’s graveyard at the very bottom end of this chain, “the departure lounge”. A place for the elderly, institutionalized, functionally ill to sit in a circle and finally get to smoke their cigarettes in peace while awaiting the undertaker. Many of these folks had spent all their adult lives in the bin, seen cultures, modes of treatment and various regimes come and go (both inside and outside the grounds).

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Way back in 1981 I was a guinea pig in the “new modular scheme of training” where all nurses shared a common foundation programme for the first 18 months. So our first year at college consisted of learning things like the anatomy the eye and useful practical skills like making beds and injecting oranges. We then spent several months as slaves on medical and surgical wards. All essential stuff for us budding RMNs. You can imagine how excited we were when in our 2nd year we got our first actual lesson (they weren’t yet called lectures) in psychiatric nursing! We had a great tutor who had spent years nursing on the wards. One of the practical skills he told us about was how to display empathy, how to let someone know you had some idea of what they were feeling. He cited some good examples and also recounted a real incident with a patient where he displayed empathy by saying “That must have been very frightening for you”.

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