"Philosophical rhetoric when not grounded in reality is nowt but sophistry of the most facile variety." - DeeDee Ramona
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You may want to join a well known new religious movement. By new religious movement I mean cult. Then you will be told what to think and how to argue very badly. You will also probably become very poor very rapidly.
There you go, you have nothing to lose but your mind itself the one step plan to becoming an antipsychiatrist.
One of the recurring themes in these e-mails is “You know you’re [blank] when…” This got me thinking, what would a list of “You know you’re an RMN when…” look like? Let’s create that list, so that we can then e-mail it to everyone we know, and our friends will curse us for cluttering up their inbox and wish a slow, painful death upon us. Fun, eh?
A few from me to get the ball rolling:
Read the rest of this entry »
I notice in recent comments both Bloo and Zarathustra have foreshadowed what I intended. I intend to totally steal their ideas.
Intervention: Building A Therapeutic Relationship - One
Action: Ignoring Clients With Challenging Behaviour
“Just ignore him nurse, he is only banging his head off the wall to get attention”
All time classic this one. Generally used with ars people with a diagnosis of personality disorder, or just those who decide to be loudly unwell when it is time for a tea break. The theory is that time spent with nursing staff is such a wonderful experience that clients will do anything to repeat it. If they do something loud and messy (slash wrists, kick doors, take a tiny overdose) they will get time from staff. The untaught response to a client in distress, like this, is to ignore them. Otherwise they will just do it again when they want something. Ignoring them reduces the reward leading to a cessation of the disturbing behaviour. Fabulous lack of intervention. Very person centred and never ever leads to increasingly bad behaviour leading to an admission to IPCU or even more fun discharge ! If nothing else makes the nurses look like a bunch of … to the rest of the ward.
A sneak peak at the ICD11 and DSMV.
We will start with something easy. Major and Minor Tranquilisers.
I was recently asked how to set up a blog. In particular an anonymous work blog. I’ve decided to answer by discussing my experiences and attempt a guide, with links, that you will hopefully find useful.
Most of this will be aimed at The Management, sorry Julie, for the porpoises of argument management will be deemed as Charge Nurse / Ward Manager / Matron / Sister and above. Whatever your title is if you are the highest authority on the ward you are probably the bottom end of management. Also when looking up from the bottom you can often appear to be one large homogeneous blob.
So here goes.
1. Banish The Blame Culture
If you work somewhere where the comment;
Mental: I can’t do that because I’ll get into trouble with …
is heard too often there is possible a culture of blame. Too much of that and staff become demotivated and willing to experiment and try new (or old) things which may benefit the lives of clients. Simply for fear of ‘getting into trouble‘. It does not matter whether the nurse actually will get into trouble, the fear is the blocking factor.
It was similar to the event I discussed before (I Mental Nurse Am An Idiot) and again entirely my own fault. The problem is usually I don’t lose the plot quite so badly. My current job seems to be sucking life out of me.
No that is not correct. Not the job. It is the ward and the ward atmosphere. There is a culture of fear on my ward and it is not pleasant.
I feel myself being driven to cross the staff patient divide … though often there is not that much of a divide.
That is why this post may not be quite what I am intending, which is to finish off the Guide to the Mental Health Act sequence of posts.
The following is entirely from the top of my head, I am not in the best of moods, you take your chances if you read any further. It is of course entirely my own opinion and should not be considered to be the opinion of any other person.
Cynics Guide To Mental Health Act : 5 : Why We Are Allowed To Lock You Up
I was chatting on the phone last night discussing this series of posts. I was quite proud of myself. Then it was pointed out that I was doing it very much the wrong way. I’ll summarise the conversation:
Mental: Surely it’s better to be sectioned so it clarifies to the patient exactly what their position is ?
Person On Phone: No it is not you idiot !
Turns out they were right.
Was intending to use this post to deal with the legalities and suchlike of longer term sections and compulsory treatment orders. Now I am not. Here are some links though.
England
Scotland
That will cover all the stuff you might actually need to know.
Right back to the conversation.
I never used this during the best part of two years of busy acute nursing. Everybody I asked to stop … stopped.
The Nurses holding power.
Section 5(4)
Under section 5(4) you can also be detained by some suitably qualified nurses (first level ones) for up to 6 hours. This is to give time for the doctor to see you to consider applying section 5(2). This time limit cannot be extended.
The criteria are -
that it appears to the nurse:
that you are suffering from mental disorder to such a degree that it is necessary for your health or safety or for the protection of others for you to be immediately restrained from leaving the hospital; and that it is not practicable to secure the immediate attendance of a medical practitioner for the purpose of furnishing a report under Section 5(2) [Doctors Holding Power].
A written record of this must be made by the nurse and given to the hospital managers, or someone appointed to act on their behalf, as soon as possible.
Nurses’ holding power
Nurses can detain patients for urgent medical examination for up to two hours under Section 299 of the Act. Once the doctor arrives, a further hour of detention is allowed. It is not good practice to immediately institute a second period of nurses’ holding power once the initial two hours has elapsed.
Here is a very selective look at the ways you can be detained for being very mad.
Hello again. I believe the American equivalent of sectioning is being certified. Or at least that’s what television teaches me. Being sectioned allows for a mixture of the following:
I will only be touching upon the basic sections. I have very limited experience with community orders or criminal sections. The choices between sectioned and not sectioned lead to three types of patient.
Cynics Guide To The Mental Health Act : 1 : Principles and Definitions
Please take all the following with a pinch of salt. There are many strictly informative sites about the UK mental health system, remember mental nurse is not one of them 
Hello. Welcome to the Psychiatric Hotline.
If you are obsessive-compulsive, please press 1 repeatedly.
If you are co-dependent, ask someone to press 2 for you.
If you have multiple personalities, please press 3, 4, 5, and 6.
What they say and what they actually mean.
The examples below were taken from an issue of the Nursing Times (God Bless you magazine for introducing me twice to people desperate enough to employ me).
‘The service is dedicated to providing progressive and developing care.’
The service is attempting to implement a wide range of newly minted contradictory guidelines. You will be expected to understand, justify and implement them.
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