Animal Cruelty ' Therapy'?

Meerkat · Jun 29, 2006

oh this makes me SO glad I am not a psych nurse. half the time I think psych is so easy, but i don't understand half of it. one time a nurse ( on a locked inpatient unit) said to me. open patient, insert med...that's what we do. the mental health workers are the ones who know about this spych stuff. GREAT! I know a couple great psych nurses but... wow. i'd hate to run into that kid at the grocery store...

Not to get off topic, but the nurse who said that to you must not have been a very good psych nurse. We do far more than 'open patient, insert med'. We run therapy groups, tackle violent patients to protect themselves and others, take punches now and then, evaluate patients constantly for suicidal/homocidal behavior, talk em down from the ledge, provide wound care, provide nursing care to medically compromised psych patients, interact constantly with family members, do safety checks every 15 minutes to look for contraband such as:

razors, food from 'outside'(family member once brought cyanide to a patient in food, helped him commit suicide at the hospital), drawstrings, ropes, mirrors, mouthwash, pencils, ...

some other things we've found on searches: bullets, knives, shanks, sharpened toothbrushes, needles, dope, wire, pins, forks, toilet paper (for making a rope), sharpened keys.

Some things that patients have swallowed or other wise inserted into their bodies the second someone wasn't looking: Pencils, thumbtacks, screws, an electrical cord pushed so far up into the member that it had to be surgically removed, staples, sewing needles in the bladder, antifreeze, rat poison, bleach, liquid plumber (the last few items of course were before the patient got to us, but just an example of how volitile they can be).

However, they don't always need objects to be dangerous to themselves or others. One of our patients gouged his own eyes out with his hands. Don't be kidded, psych nursing is no walk in the park. It is constant vigilance combined with traditional nursing.

Again, not to go off topic, but just a little vignette of psych shift.

beautifulb · Jun 29, 2006

One of my first jobs was working on a geri-psych unit. I found it to be very challenging to say the least. Definitely not a walk in the park.

As for this boy, it sounds as if he is not going to end his torturing ways anytime soon. I hope that something works, for everyone's sake.

Good luck.

hsieh · Jun 29, 2006

sounds like a future serial killer to me.

nursekathi · Jun 29, 2006

Is this boy going home to live with the naive father? That is a scary thought.

It is even more scary to me to think that the treatment team is aware of this behavior and allowing it to continue; very irresponsible. It sounds to me like they are just trying to appease him until they can get him out the door. How is his behavior otherwise, such as is he violent towards other patients & staff?

Mimi2RN, ASN, RN · Jun 29, 2006

The boy needs to be permanently in a secure, locked situation. I once worked in a state locked childrens facility, and knew kids like that. He will get worse on the outside, the only questions are who and when he will kill. No sense of right and wrong, and no remorse.

Meerkat · Jun 30, 2006

Is this boy going home to live with the naive father? That is a scary thought.
It is even more scary to me to think that the treatment team is aware of this behavior and allowing it to continue; very irresponsible. It sounds to me like they are just trying to appease him until they can get him out the door. How is his behavior otherwise, such as is he violent towards other patients & staff?

He was not violent toward staff or other patients. He mostly isolated himself, was quiet and sat off in a corner away from the group. He did not participate.

I say 'was' because he has been released home after a week. In fairness, we are stabilization, not long term. But I think it is irresponsible to release him to anywhere but a long term residential treatment center.

CharlieRN · Jun 30, 2006

We have a pt who tortures animals (I'll spare you the details---it's nauseating)...and some staff members decided to let him have fruit as a substitute for his urges. He is given a spoon or a pencil and stabs, mutilates, smashes, etc the fruit in this hazy-eyed gaze.
Somehow this doesn't seem right to me. Isn't this feeding in to destructive urges? Sure, I'd much rather see an orange violated than an animal...but this doesn't sit well with me. Any opinions?

I'm not sure exactly what the ideal tx plan is for a child who hurts animals. I do have a lot of experience with people who hurt themselves. With them the use of an alternative, less dangerous behavior has been found to be helpful. ie: drawing on your arm with a red marker rather than cutting, crushing a paper cup, tearing up magazines, squeezing an icecube in the hand.

The use of a socially acceptable symbolic alternative to unacceptable habituated acts has a history in human behavior. Even now, in parts of the orient, a pumkin filled with vermillion dye is placed on the ways to be crushed by a new ship as it is launched. It represents the child who was sacrificed to assure good luck for the new ship in the past.

If you want to extinguish a bad habit you identify the stimulus to performing the habituated action and replace the unacceptable action with an acceptable response to the same stimuli. ie: If you bite your nails, you carry around a nail clipper and cut your nails when you have the impulse to bite them.

TitaniaSidhe · Jul 3, 2006

Extreemly irresponsible on the part of the treatment team not to address this behavior prior to discharge. First thought that came to my mind is he an only child or will he be exposed to other younger or smaller children for they will be at serious risk. I wonder if he displays other symptoms such as bed wetting, fire setting, etc.

LoriAlabamaRN · Jul 4, 2006

I do not think this boy is anywhere NEAR being ready to go back to society! I shudder to think what he will be doing, and I doubt that he will just be mutilating fruit.

Hellllllo Nurse, BSN, RN · Jul 4, 2006

Nope, we can't do that. HIPAA plus he's a minor. The first line in the H and P reads something like: "This is the most disturbed child I have ever worked with".

Does he also set fires and/or have enuresis?

CharlieRN · Jul 4, 2006

He was not violent toward staff or other patients. He mostly isolated himself, was quiet and sat off in a corner away from the group. He did not participate.
I say 'was' because he has been released home after a week. In fairness, we are stabilization, not long term. But I think it is irresponsible to release him to anywhere but a long term residential treatment center.

With all dur respect 'cause I know you are a competent professional, but where is the "long term residential treatment center" that could handle this client. I'm assuming from the tenor of your remarks that he would need a locked facility. I just don't know of any.

Hellllllo Nurse, BSN, RN · Jul 4, 2006

Does he also set fires and/or have enuresis?

http://www-socsci.paisley.ac.uk/DM/serial_killers/skill/tsld033.htm

"One of the most dangerous things that can happen to a child is to kill or torture an animal and get away with it". - Margaret Mead

http://www.admiralsantiques.com/animal_abuse_and_future_killers.htm