Motivational things

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Tag: nursing

Another Day working as a Health Care Assistant — May 28, 2016

Another Day working as a Health Care Assistant

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This little article will try and make people see what it is like working as a health care assistant within a mental health hospital. There are many different names a healthcare worker will be known as, such names as Nursing assistant, Health care assistant, Nursing Assistant or Nursing Auxiliary just to name a few. To work as a health care worker there is at the minute but it is looking like the health authority may change that in the future. One of the main things you need is a good understanding of people, a caring side no matter what happens and to be none judgemental attitude towards people no matter why they are there.

People (patients) will   be in hospital for all sorts of reasons; I have come across people that have been admitted due to developing mental health problems due to the stress of being in prison. Patients come in for reasons of being abused by people known to them, Witnessing traumatic events such as war crimes to them or others. Eating disorders, Schizophrenia, self harm due to abuse or trauma. Depression and bipolar are just to name a few. Yes they are or can be big issues for newly diagnosed patients but with the right medication treatment and therapy to deal with problems they can be managed well on the ward and in the community.

Just because some one has this diagnosis it does not mean that you have to cross the street when you see them or that they are dangerous. The best and most supportive thing you can do for someone with a mental health problem is say HELLO or just ask HOW ARE YOU? Then be there for them, listen to them and treat them like a friend or an individual. Don’t judge  them because of an illness. Be an ear for them, a person to talk to or just sit with them and spend time with them. Don’t get me wrong it can be difficult at times and you will hear stories of a horrific nature whether its something they have done or they have had done to them. All you need to do is listen and not show expressions of shock or horror in your face. Listen, give guidance if they need it and be supportive no matter what. Some patients may have urges to hurt themselves at times and all you need to do is be supportive and try and guide them away from wanting to hurt themselves. This can be difficult and mentally stressful on you. So no matter how mentally strong you think you are you will need to unload on your mentor or a colleague just so the stress of the information does not well and build up and stress you out.

With what I have written the job role is extremely rewarding and mentally fulfilling and when you have had input with a patient and you see them doing well and then they move on to a better placement or even back home. You must think that you have had a massive input on that persons life and made it better. Doing this job is definitely not for the money but the emotional rewards is massive. I work in a very stressful job as a health care assistant and have been doing for over 19 years. The place I work is very demanding and can be physically demanding at times due to the nature of the patients and their problems but no matter what happens I can’t see myself working anywhere else. If you decide to become a health care assistant you will come across people (staff) that are good at de-escalation, dealing with confrontation, and one or two staff will be good all round no matter what is going on on the ward.

Myself, without trying to sound big headed, I can deal with most situations such as aggression, confrontation, self harm or just a shoulder to cry on. I always pass over to the nurse in charge what has been disgust and enter everything in the  patients notes whether it be hand written or electronic patient notes. At the end of every week or day depending how stressful it has been I sit in a room with someone I feel I can talk to and unload onto them. What you need to remember is when you speak to the colleague is not to be afraid to show your emotions when chatting, this helps you release the stress.

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Ordinary day for Jack — June 1, 2015

Ordinary day for Jack

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Toaday is an usual day for Jack, this is because he has no work on today and he has not had any messages to come into work. So at this moment intime all Jack is doing is Just laying awake in bed looking at the clock on the wall ticking by second after second, minute after minute. After a while the clock hits eight oclock so Jack decides to get up and gets dressed in his gym gear. Obviously he doesn’t have a shower as he will be twice as smelly and sweaty when he gets back from the gym. So after getting dressed Jack goes down stairs and tries notr to wake his wife who is sleeping in bed. Jack prepares his protient shake (2 scoops) with raspberry flavouring and a 800 ml of squash with a little pinch of salt added to replace the lost salt from his workout. This squash to be fair is just like buying one of those workout drinks but only home made. Jack checks he has got his lock and key for his locker, music while he works out so he can drown out everything around him and concentrate during workout, gloves to reduce the chance of gripping blisters and finaly his sweat towel to mop his brow during workout.

Once hitting the gym Jack starts of with a cardio workout of twenty five minutes at a steady run, during his run Jack ups the pace a little more then after a few minutes reduces the pace, so his heart rate goes up and then goes down to make his body work harder. This will hopefully help Jack build up his endurance and help Jack burn some of his body fat as well at the same time. In Jacks line of work it does help for him to stay and keep fit as sometimes being inrestraint can have a toll on your body aand fitness will reduce the toll on this. After Jack finishes his run he decides to go to the seated row to work out on his back, some machines will be different in weight but Jack decides to set it at 70kg and does about 13 reps and repeats this at least four times. This works out those little wings on the side of you body lol. After this Jack strolls over to the free weights area and sees that are a lot of big lads around this area and most of them appear to be zoned out and concentrating on just them selfs. This is why Jack likes this gym he goes to as most people don’t stand in front of the mirror admiring themselves, People just get on with their own stuff. Once in the free weight area Jack decides to work on his biceps and does it standing with a barbell. On the barbell Jack sets the weight at about 25kg and does 15 reps and repeats this at least four times and after this Jack can feel his arms about to burst as he does his reps at a quick pace just to push his body that little bit harder. Once this is done Jack gets a dumbbell at the weight of 27.5kg and decides to do a one arm row, which means Jack kneels on a bench with one knee and braces himself with one arm and pulls the hanging weight upp to his chest at least 13 times and repeats this four times each arm. This will work out his back muscles at the top of his back/shoulders. Jack walks over to the lateral Pull down and sets the weight at about 65 kg and works out his back again with his biceps secondly. This for Jack after working parts of his back out is starting to be a little bit harder now. He does this though just to push himself that little bit harder and does 65kgs 13 reps at four sets and after Jack is now feeling it. Jack thhinks to himself why do I put myself threw this every other day. Walking over to the free weights again Jack picks up two dumbbells of 10 kgs and starts lateral arm raises to work his shoulders and the back of his neck, working the with reps of 15 and repeats these reps four times dropping the weights on the floor in pain but a good pain of accomplishment. Finally Jack decides to finish off with some more cardio and decides to set the running machine on a setting 5 which is hill running working up to 6% incline then after five minutes it straightens out again then repeats the angle of 6% again. Jack tries this for at least 15 minutes and does quite well at this. Jack knows if her had done this first he might of been able to do this a little better and faster, the only thing is now Jack is starting to feel the burn from working out. If any of the readers work out you will understand what Jack is feeling.

When Jack arrives home he strips off his gym clothes that are full of sweat and jumps in the shower, the reason Jack waits to get home and shower is because at the gym the showers are usually full and this will safe time and Jack can relax in the shower. After washing in the shower Jack dries himself off and hangs up his gym clothes to dry by an open window. Jacks wife is still alseep so Jack starts to walk down stairs and and goes to the kitchen. In the kitchen Jack makes himself a coffee and collapses on the sofa and puts on a film but turns down the volume so not to wake his wife up. Jack looks across at the time and it is already 12:00 midday but Jack decides to finish watching his film before making himself something to eat as he doesn’t feel hungry yet. Just because it is midday why should he eat if he is not hungry?.

Once the film has finished Jack wonders into the kitchen and makes himself a little snak to eat, he decides on some wheat bread crackers and mackerel in a sweet chilli sauce. Jack scoffs this down like there is no tomorrow and follows this with a green tea and mango drink. After washing his stuff up Jack wonders up to his room and jumps into bed where is wife is still sleeping. Did I not say, sorry but Jacks wife is still alseep as she worked a night shift and got home at five am that morning and she will work tonight as well. Whilst Jack is laying in bed he hears his phone ringing down stairs and jumps out of bed and rushes to his phone, answering it just in time. It is the agency asking if Jack can work a night shift in a hospital which is about 15 miles away from where he lives, this place is for the worst of the worst violent offenders with mental health problems. The agency say that because this place is such a high risk of situations the money will be about £35-45 an hour for a ten hour shift. Jack thinks that this is not to bad and agrees to take the work. This place Jack is going to is called Daniels Ward in a high secure unit where patients could be locked in the rooms for up to 2 hours off and on depending on their behaviour whilst mixing with other patients. If there is any risk or signs of a patient becoming unsettled they are escorted to their rooms and lock in there for a minimum of two hours. If a situation has started  due to a patient becoming unsettled then they will be secluded in a padded room for anything up to five hours depending on their behaviour during seclusion. On Daniels ward it is rare for a patient to be secluded long but it does happen.

Coming across as paranoid. — May 31, 2015

Coming across as paranoid.

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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.

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

Just another day in Mental Health.

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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.