My plain life

trying something different

Coming across as paranoid. — May 31, 2015

Coming across as paranoid.

Jack has just had a phone call  for an emergency shift cover, it is at a hospital for adults with mental health issues and the ward he is working on today is Belvoir Unit. This unit is a ward for  males from 18-65 years of age and the diagnosis ranges from Paranoid schizophrenic to self harmers and alcoholics. This ward is a ten bedded unit with mainly male staff but it also has female staff, as you will find out if you work on a male unit it always helps to have female staff in certain situations. Sometimes when a male patient has a situation that could turn violent a female presence doing the talking , de-escalation has a calming effect of the patient,  Don’t get me wrong it does not always work it could sometimes have the opposite effect. It’s all about knowing your patient and constantly assessing the situation and willing to take the lead in changing it in the last seconds. You will have to realise that even though all patients are there for treatment on one ward/unit they are or should be treated as indaviduals with careplans that are for the patients benafit not to make it easy for staff but easier stay for the patient.

Jack has turned up at 13:00 on a Thursday afternoon for his shift , he has been here a few times and has found it a little bit difficult as one of the patients pays a lot of attention to Jack. This is because the patient has told him he reminds him of a man the abused him as a child, thats why the patient pays a lot of attention to him. Jack has come across this attachment disorder before and it does not bother Jack, as he knows that he is not to alone at any time. So Jack goes in to the office and asks for a handover which took him about ten minutes to start as the nurse in charge is dealing with an incident on the ward. As the nurse in charge finishes and walks in the office she smiles and says to Jack

‘Sorry about the wait, we had an issue with Jon’.
Jon is the patient that has the attachment disorder with Jack. Jon over heard staff talking about Jack and another person coming in to work, which excited Jon and he started getting elaited in behaviour and could not bring himself down again. With Jon’s behaviour getting worse he had to either have oral madication to help him calm down but her refused this and had to be assisted by staff to have an Intramuscular injection to help calm him down. So this meant staff had to physicaly hold Jon by the arms, luckily Jon was willing to accept this I.M injection in the right arm just below his shoulder.
Jack listened to the hand over about the patients and the goings on in the ward and it appeared that it has been a settled day with just Jon playing up a little. After the hand over Jack walks onto the ward and greats the rest of the staff and says hello to the other patients on the ward. While talking to one of the staff after greeting everyone Jack talks to a member of staff called Carl. Carl is a senior health care assistant, who has worked on the ward for about seven years and to be fair he knows his stuff and knows most things about the patients. On the ward Carl is what is commonly known as a fire fighter on the ward, this means he is the first port of call for any incidents that occur on the ward. Carl starts to hand over a few things to Jack while they sit at the dinning tables which are just across from the day area where all the patients are sitting watching a film. Carl tells Jack that Dean who is a patient that has been there for just a week is having a rough time as he is suffering from Paranoia and p[eople should be careful when Dean is about. Dean is having such a bad time even if people look at him to long he starts to get paranoid.
As time goes on by on the ward Jack is sitting in the day area just keeping an eye of everyone, doing the hourly observations. This basicly means for the next few hours Jack has to be able to see all patients every fifteen minutes for the next few hours. Jack went off down the corridor with Carl to check on the patients in their bedrooms, and when they come across Jon’s room he is there standing at his door looking threw his observation window which is in the door. Jack looks in the observation window and gets a fright as he sees Jon just stairing straight back at him with a look of fear on his face. Jack turns to Carl and says
‘ Dam that scared the crap out of me’
and they bothered laughed at this and walked off, not thinking about the affect it will have on Jon who as we know is paranoid. As Carl and Jack walk off down the corridor back to the day area Jon comes out of his room shouting at Jack, as he knows better not to start on Carl. Jon starts to march in an agrressive manor towards Jack and Carl raising his voice but directing it at Jack saying
‘ what did you say about me?, what the hell are you planning?, your going to try and kill me arent you?’

Carl suddenly stands infront of Jack and tells Jon to stop shouting at Jack and he will let Jon know what they was talking about. Jon carried on marching towards Jack and Carl pulled is alarm and takes hold of Jon and Jack jumps in and takes hold of the other arm containing Jon just in case he gets aggressive. Carl raises his voivce a little bit just so Jon can hear him over his own voice, Carl tells Jon that Jack and his self was just saying that Jack got frighterned when he looked threw the observation window aand saw Jon just stairing and watching evrything going on. Jon shouts at Carl and says

‘liar you planning to kill me in my sleep, your working with them liar’.
Carl and Jack start to walk Jon down to the day area and went to sit on the sofa whilst still holding him. As we walk in the lounge the patients all get up and walk out of the lounge as Jon is shouting his mouth off. Jon is sat down on the sofa with Carl and Jack and Carl is left doing the talking as Jon has a little bit of hatred towards Jack as he thinks that Jack is out to kill him. Jon contiues with his raised voice saying that Jack is working for the company and they are sending Jack messages through the TV and he is recieving them by a transmitter in her head.According to Jon, Jack is recieving messages from ‘The Company’ and hearing orders on how to kill off Jon without anyone knowing what has actually happened.
At this point Carl activates his alarm and more staff respond into the lounge where the three of them are sitting. The reason why Carl has activated his alarm is because he knows when Jon starts talking about ‘The Company’ it usualy ends up with Jon getting so paranoid that he could get so aggressive that he may hurt someone. Carl looks at Jack and nods down to the floor as if to relocate Jon to the floor to control his outburst. As Jon was talken to the floor and the other staff came in and took hold of JOn, There was staff holding his left and right arm, legs and head. The qualified walks in and asks Carl what has happened and Carl explains to the qualified what did happen and at this point Jon shouts out
‘ You liar, you are planning to kill me tonight, I saw you whispering while you and Jack was watching me’.

Carl continues to explain what happened and Jon continues to shout.
‘There trying to kill me’

Nurse in charge says to Carl ‘i’ll get an I.M for Jon’

Jon hears this and starts to struggle more during the restraint by staff and shouts out
‘ No don’t inject me, someone help me she is going to kill me with an injection, please help me,

The other patients don’t bother with Jon as this is nothing new to see or hear. Carl starts to talk to Jon explaining what has gone on and what will happen like the injection as the situation has gone to far now. After five minutes the nurse in charge brings the injection and injects Jon in the left butt cheack and during this Jon starts to cry and says
‘I hope you are happy? You have just done what The Company have tried to do. You have just let her kill me’.

After the nurse in charge leaves it takes about ten minutes for the injection to work and now staff can relocate Jon to the seclusion room to calm down for a short amount of time. Staff come off Jon’s legs and ask Jon to bring his knees to his chest and the member of staff holding his head raise it up to hip level while kneeling. Once Jon is in kneeling position the staff guide Jon to standing with the staff but with Jon’s head ramining at hip level to the staff memeber holding his head. The staff and Jon walk to the seclusion room where Jon will spend a little bit of time to chill out. Once in the room they get in position to relocate Jon to the floor and once on the floor Jon starts off shouting
‘Don’t lock me in here the company will gas the room and kill me’
Once again Jon starts to become resisitive as in trying to get out of the room, but luckily the staff have put him on the floor face down and have full control of the situation. Fist thiing to happen is Carl and Jack bring the patients arms to his back to the point of resistance and the nurse controling the heand stands and takes hold of the arms and Jack and Carl leave the seclusion room. As Carl shouts that the door is clear the nurse on the head lets go of the arms and exits backwards from the seclusion room, shutting the door and locking it behind them. Jon gets up suddenly and starts to pound on the door shouting
‘Let me out, they are going to kill me’.
The nurse in charge goes to the observation camera and observes Jon for a while as he continues to pound on the door.

Inn the next few hours Jack has escorted patients to sessions and out round the grounds with no problems but the one thing the rest of the patients ask Jack is if he is ok after what happened. Jack just smiles and nods at the patients asking him this. Jack knows that he really should not be discussing the situations with other patients. Apart from this situation Jack has had a very peaceful day doing things he enjoys and also the patients sat in the day area watching a film. I thhink it was a comandy, rom com.

The thing you have to realise about people that suffer from paranioa is that if you whisper or constantly look at them you could trigger off their confrontational side. They may thing that you are plotting against them in some way. The government are sending messages through the TV or radio for people to attack certain individuals, plotting to start a revolution. When they are suffering in a bad way no matter what you say to them it may not register what you are saying and you are part of the plan to get them.
Hope you guys like what I have writtien? If you have please follow or leave a comment. I still have plenty more to write.

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Working in Mental Health — May 25, 2015

Working in Mental Health

Don’t get me wrong working in mental health has its good day but the good days out way the bad. If you have experienced this you will understand where I am coming from. You could get a patient admitted on a really low point in their life, something on the lines of committing suicide, self harming, taking a hostage due to hallucinations. What you need to do is remain natural in every situation. it is hard at times but think about the things that are going on in the person’s head like thoughts that are not theirs.

I have come across a patient one time who suffered from violent out bursts, killed little animals and would attack anyone who appeared a threat to them and their ways of living and thought process. This patient had an up bringing of witnessing constant violence , such as men beating on their mum or dad and other family members and have witnessed this from such an early age. When they grow up all they know is to deal with being told no or your wrong is to solve it with aggression. When someone does experience this all they will understand is aggression or violence is the only way forward in solving any situation. This patient had witnessed so much violence towards family members and them self that the only thing they understood was beating someone up was good and anyone showing them care, sympathy and compassion is to push them away in any way possible.The people that should love and care have done nothing but hurt people and them.

When we had this patient come in , it was difficult at first because you could be talking to them one minute and then the next they could be trying to beat the living day lights out of you. This was due to the patient suddenly hearing or seeing things telling them that the staff member is a bad person here to hurt you or that the staff member is not to be trusted. So what they will do is attack first and not let you in. At this point the best thing you can do is not to back away but push yourself forward into their ways as in keep showing you care and do care no matter what they give back. This patient did constantly attack me by punching and kicking me every time I spoke to them, this did not push me away it actually drew me closer as any one could see this patient was hurting emotionally and mentally but it was not under their control. I have ended a shift with this patient with bites, bruises, broken skin and black eyes. This did not push me away, as at the end of the day I could speak to the nurse in charge and unload it of my chest.

After about two weeks the patient sat and spoke to me saying that they understand that some of the staff are here to help them and some of the staff do actually care and not there for the money. Trust me the money is not that great for the work we do and the violence we could face. The patient spoke about the things they had observed and witnessed and then later they had spoken about the violent thoughts they had going on in their thoughts. One day the patient had spoken about violent thoughts they had towards me and another member of staff, which was quite horrific. Like I said before after a time of working in this line of work you will start to become unfazed by these situations. This patient wanted to knock me and this staff member unconscious and tie us up, once we was tied up the patient wanted cut our eyes out and replace them with glass so the patient could see them self doing things in the place where the eyes was. This did kind of worry me a little but I thought if I showed fear the patient could play on this and make things worse, plus I was not going to allow the patient to get the upper hand on me. Don’t get me wrong it was quite worrying to hear this but I loved my job and I wasn’t going to be put off by anyone but it did make me more aware of the patient.

When the patient had been here for a while they had opened up a lot towards certain staff and it got to the point when the violence and aggression decreased and they sat with staff talking about their thoughts and hallucinations they were experiencing, which if you work in this line of work is a vast improvement. Rather than acting on their experiences the patient would talk about it with staff they trusted or write it down on paper and ask for a reply either verbal or in writing. I have spent many an hour sitting talking or writing with a patient about the thoughts they were having, but rather that than having to physically intervening on situations.Any decent HCA will tell you thy would rather sit there talking about things than get physical, any one else that says different should not be in that line of work, it’s all about talking.

The patient ended up talking about their urges thoughts and feelings on a daily basis and when this happens keep them talking record all conversations in their notes and keep staff informed of everything that is said and discussed.

If you don’t like something I have written please don’t be hostile towards this, just let me know and I will try and alter things. Im not saying everything I write id fact but it is not lies either. Please let me know what you think. Thanks for reading.

What I have experienced working within Mental Health —

What I have experienced working within Mental Health

I have said it before, I have experienced quite a few things while working in mental health some are good things and some of them are a little unnerving. The thing is after a time you could become a little unfazed by certain situations. What I do find frustrating is when you are in the public with a patient/s the amount of looks the patients get from the public if they look a little different or they have scares on visible body parts like arms, neck, face or legs. I think the public need a little more understanding in mental health whether it is with adult or adolescent mental health. People staring at the patients can and sometimes does have an emotional effect on the patient. Working in this line of work takes a special caring sort of person, someone that will take the shouting in your face and the aggression towards you and the threats at times and then keep your cool in these situations. Then you sit down with the patient/ client and talk to them what is getting them into this state and helping them out to bring the anxiety or aggression down to an acceptable level. Don’t get me wrong it can be hard to do this and not every one can keep cool all the time, this is why it is ok to take time out off the ward to bring yourself back.

One situation I have come across while working in different in mental health was the time I met a young patient in an admissions unit. She was a young adult around her twenties, She had come from a good home so it appeared at the time, she appeared to suffer from Schizophrenia and was a big self harmer. With this patient she would hear a voice in her head and see a demon as she put it which told her she was worthless, a whore and needed to kill herself. This would set her off to cutting her arms with anything that could cut her skin on her arms and legs, not just to scratch the skin but at times she would cut right down to the bone. To most people this would make them feel sick or horrify them. As for myself I have come across these  situations a lot so it did not faze me to much. When the patient had been admitted and she was settled in and we was about to sort her belongings out to what she could and could not have the alarms were activated. We stopped with the belongings and ran down to were the alarms are going off, it was the new patients room. She had smuggled in a piece of metal, we found out that she had hidden the metal in her underwear. What we found was that she had cut her fore arm open down to the bone and her blood was all over the place. Her arm was covered in blood and it had covered her torso and legs, Staff gloved up and took hold of her and relocated her to the treatment room. By the time we had moved her with her being resistive with us moving her staff got covered in blood, but this was a regular thing on the ward I was on at the time. The patient was distressed and crying as we had stopped her trying to hurt herself due to the voices demanding that she did this. What you have to understand in these cases is that these voices are there only and best friends and so  convincing to them and this is the only person they will listen too.

Whilst in the treatment room the patient was sat in holds with her cut arm out in front of her and the nurse in charge was cleaning up her arm. We had cleaned her up and found out that she had cut to deep for a basic clean up and she had cut through the muscle and down to the bone. I left the treatment room and called for an ambulance and explained to them the situation and they sent a paramedic to the ward to take the patient to A&E at the local hospital. I can say when she came back with her escorting staff she was in a better frame of mind and her night was a lot better.

With what I blog I don’t mean to offend anyone , but it is what I experience and what happens but names and some experiences have been changed a little.

Just another day in Mental Health. — May 17, 2015

Just another day in Mental Health.

As you will find out if you are just starting in mental health or thinking of starting in this line of work, no two days are the same, they may appear the same but if you sit back and think about it you will see that nothing is the same way. In some small detail there are always differences no matter how big or small, plus you will find out that this line of work can be as exciting as you want or as stressful or boring as you would like it to be. So no matter how the job is it is what you make it and no matter what happens it is not always your fault ok, you need to remember this.

The patients wehter they are men, women, children or adolescents and in a setting of learning disabilities, mental health, rest bite, sectioned or day centre, they are there for a reason and what ever happens so be it. You have to look at the bigger picture with a patient, what I mean is if they swing for another person, you have to look at why they have. Are they hearing voices?, Do they see something evil or scary in the other person? or are they paranoid?. There could be a number of reasons for the outburst and you as a career should not think of locking them out the way (seclusion), yes you may have to use physical intervention to what level is down to the level of aggression at the time of the event. Once you control the situation then try and find out what is going on. You may only need to sit with the patient and de-esculate them (TALK), and you could find that after ten to twenty minutes of chatting that the situation may not of been under their control. So you need to show understanding and a lot of empathy in times of situations no matter what has arisen. Don’t get me wrong it can be hard not to feel anger when you get someone in your face either verbalising you with all sorts of threats and offending matter or aggression. You will come across a few idiots that do work in this line of work and enjoy a good restraint, if you can and you find yourself in a restraint with someone like this, try and get them taken over by another person. A person like this is likely to hurt you or hurt the patient and it will happen, I have come across people like this, not good.
You may at times find that a patient may fixate on you through no fault of your own, they just obsess about you, get excited or silly when you turn up for work. They may start to start a situation just so it drags you in to them and they will somehow get that contact with you. It could be starting a fight, self harming, destroying property or tying a ligature and when you do intervene they enjoy the contact. This contact could be anything from you just standing there observing a situation, restraining them, talking to them or telling them the error of their ways. If you find this happening then you need to try and not get involved with this patient on your own or stay out of any potential situation no matter how it turns out or if they request you, let OTHERS deal with it. Every nurse whether they be a qualified or a health care assistant you will come across a patient that will develop attachment problems with you no mater if you are male or female, in a relationship or single.
One of my biggest bug bears is that new staff wether they be young or older come into this line of work and after a few weeks they seem to think that they are there to be the patients best friend, NO, NO,No this is not to happen on any level. You are a Nurse and they are a Patient end of, they are there for their own issues and no matter what you are there to look after them and you DO NOT cross that line. Unfortunately it happens and this makes me sick. Wether they are adults man or woman they are classed a vulnerable adult and need protecting. So please no matter what the patient says to you or promises you remember you are staff, you are not their best friend. Along side this is staff thinking it is ok to tell the patient all their own personal details. This is a big NO as in later days it could present as a huge problem.
I remember an incident when a member of staff got on well with a patient and this member of staff told the patient the area they lived in and described things in the area and once the patient was discharged from hospital the patient went to the area the staff member lived and over a number of days looked about until they saw this staff member and followed them home. One night the patient knocked on this staffs door and lucky for the staff member they checked who was at their door through a window. The staff member called the police and police found that the ex patient was carrying a knife, who knows what would of happened? The patient was later sent back under section but to another hospital as this patient was proven to be a danger to the public. It was later found out that the patient had also been taken drugs which had an adverse affect on their mental state. So let this be a lesson to you that no matter how they appear at first their intentions may not be of sound mind. Not to scare you but things like this are rare and people learn quick from this.
One thing that always fills me with joy is when you first get a patient in and appears to be Psychotic and delusional then after building up a relationship with staff end up either going back home or to a lower secure setting. Even though you may not get a thank you from the patient you know at the back of your mind you have had a huge impact on this patients life. You have helped them get to were they are no matter how big or small the input. What a lot of people tend to forget is that we are all a team and no matter if you are the ward clerk, kitchen staff, cleaners, Health care assistant or qualified nurse we are all equal. Well we are supposed to be equal, but you will come across certain staff that will see HCA’s as a lower form of staff. Don’t let this put you off, if the wards did not have health care assistants the place would not run at all, no potential dangerous situations would never get found out and if there was no HCA’s was on the ward who would be the first people to deal with situations on the ward. The HCA’s well some not all are the firer fighters of the mental health world and I think this is needed to be more recognised in this industry.
There are a few HCA’s in mental health hospitals that will be the first into a situation to protect the patient or others with no regard for their own safety just so that the vulnerable one is safe. In mental health the HCA’s and other staff will come across situations that will involve weapons which could be made from all sorts of things. Things like toothbrush, pens, ligatures, pieces of broken wood or plastic. The problem is that the staff do not have the opportunity of protective clothing or training to deal with situations like this. Usually you will find that it is the policy to call the police. You will find that in the hospital settings that there will be more than enough staff willing to do training to deal with these dangerous patients and situations. I’m not the only one that thinks that the police should not be the first port of call for these situations, there should be a group in most hospitals that deal with dangerous situations just like in the prison or detention centres.