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.