My plain life

trying something different

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.

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.