Forensic Psykaitry

TitaniaSidhe · Mar 3, 2006

I have had forensic psych patients over the years on my unit(murder, arson, sex offenders), currently have a violent sex offender. Also had a patient who had been inpatient at our facillity numerous times convicted in NJ for serial murders of young run aways & prostitutes, he killed I am thinking 7 young women, had sex with several of them after death & burried them in his back yard. Some he dumped from his boat into the ocean. Now he is in prision but he was a patient of mine off & on for years. Dx. PTSD (VietNam ) & Polysubstance Abuse. If however you are looking for SANE stuff you may try posting the forensic nursing section rather than here.

extrakul · Mar 3, 2006

No I´m looking fore persons that have experiens in forensic psykaitry. I work att a forensic psykaitry ward in sweden and I´m just curius about how things are in the rest of the wourld......

TxPsychNx · Mar 13, 2006

I work in forensic psychiatry. Our patients are treated much better at our facility than they would be in the prison system. What in general were you curious about?

docpsychrn · Mar 14, 2006

i worked in forensic psych at a maximum security hospital for almost 7 years. as one nurse put it, the patients were treated so much better than the prison population. i now work in a prison as their mental health nurse so i have now been on both sides of the spectrum. personally i feel that the department of mental health has literally gone amuck and has lost control as to how the patients are taken care of in this one particular forensic hospital. there have been so many injuries to staff and some patients because of their guidelines of care. for instance, if a patient comes up and punches you in the nose and breaks your nose or your arm etc and they go and sit down in a chair perfectly calm.....you cannot do anything to them! you can't make them go to time out nor into seclusion for their assault on you. if you take a patient to time out you cannot touch them without a doctor's order first. if they don't want to go to time out, you cannot force them. on certain wards of this particular hospital, you have to prompt them first before they can get into trouble for some sort of action they are doing, if you don't they don't get any consequences. i worked on the personality disorders wards (the men for a year or so and the women's ward for over 5 years!!!). a lot of my patients would brag that they were only there because they had copped a plea to keep from going to prison. i always had the pleasure of telling them that they just bought about 10 years straight up with the dept of mental health because of that plea they made! if they would have went to prison like they were suppose to, they would have done maybe a few years and been out....so anyways, my experience with forensic nursing has been very dangerous and yet an eye opener for me in my field of nursing. the offenders in the prison are like angels compared to the patients i had in the forensic hospital! not that any of them are angels in any way...they are just more disciplined and respectful because of the way department of corrections allows their staff to utilize punishment for offender's wrong actions. thanks for letting me share.

docpsychrn · Mar 14, 2006

oh, one more thing....the treatment that forensic patients receive is outrageous!!!!!!! at least at the hospital i worked at. they would get clothing allowances twice a year in the amount of $600 or more to buy name brand clothes, shoes, bras, coats etc!!! my aides couldn't afford to buy themselves new shoes much less clothes for themselves or family and yet they had to escort a patient to a clothing fair to allow them to buy anything they wanted for "free" from state funds. some of the female patients had so many pairs of name brand tennis shoes that they were kept in a closet on the ward because they couldn't keep them in their rooms. it made me sick to see these murderers, rapists, child molesters, arsonists, cutters, etc dress better than the staff that had to take care of them day after day. how twisted is that??? it really angered me that the dept of mental health couldn't see the damage they were doing by allowing this patients to get what they wanted when they wanted it and not have to pay a dime for any of it. they also got the name brand drugs and a lot of them! they got ativan anytime they wanted it for agitation because we were told that we couldn't make the determination if that patient was truly agitated or not. (had a girl playing cards one day and she snapped her fingers and told me to get her an ativan because she was agitated....that was the last straw for me....i told her no that she was doing just fine and that i had it documented that she was in no way agitated as she was playing cards and laughing when the request was made). the wards have montly birthday parties, parties all the time for various reasons, receive a canteen allowance allowing them to eat their weight in junk food (the women put on 100# or more when i worked with them), allowed to watch movies all weekend, sleep when they wanted to, we had to bring trays to them if they didn't feel like getting up for meal time etc etc etc. catered to is what these patients were getting. i got out before i lost my cool. i had already had 5 concussions, disability in both knees from hitting the concrete day after day for 7 years, broken fingernails, ripped clothing and a human bite on my calf that will show the rest of my life and i have to be tested for hiv every year. i also busted my back after a huge altercation with a psychotic woman that took 10 of us to get her to the floor. i have suffered chronic back pain since that time and it will never go away. not worth it to me and hopefully i will never go back there again to work. talk about ptsd!! i would say that anyone that has pulled a stint in a max forensic hospital has got to have some sort of ptsd from it.:angryfire

extrakul · Mar 15, 2006

Hello. in our war and the forensic klinic in malmö we dont take threats lightly. Any threts and violens are dealt with. the ideal situation is to "talk" it down, but if a patient dosent calm down ore atacks a staf the imedial respons i isolation, restaraints and/ore medication. As the hiearky goes regarding waht I as a nurse can do it depends. During day time ther are doktors around and the formal responsability is thers, but if the situation diktates the ward supevisor can determin about isolation, restraints and if the patient in quastion has what we cal "in case medication" what to do. If I formaly diktat one of the above then I must cal the atending doctor as soone as posibile to tell him what I have just done......... regardin demands on medication I dont have to give them just becous the patient demands them. I think 70% of the patients have some druge adicktivity problems and it´s always difukult to tell if the angsisty is fore "real" ore just som way of getting high....ore both..

extrakul · Mar 16, 2006

So how are things in the rest of the world? (sorry about my dislexsia it´s a bit hard writing in ones third languge and having dislexia). hoe do you rehabilitat your patients? wahts the avrigde time spent in the ward and so on..

beochicken · Mar 21, 2006

I work in a norwegian security ward, most of the patients have a history of violence or other serious offences, and the rules are similar to the ones you have in malmô. We dont use restraints very much though, we most usually manage to cope without them.

Rehabilitation is done through psychotherapy, environment therapy, medication and activities. Big emphasis on planning the activities.

extrakul · Mar 21, 2006

Hello beochicken..... I have a qustion regarding a transfer of a person from norweig curently in custidy here in sweden. Troug wish chanels should that go?

grannynurse FNP student · Mar 21, 2006

I don't know which state the U.S. poster works in but forensic psychiatric facilities are not all the same here in the U.S. I have worked in both New York State and Florida. Forensic units are closely regulated and patient to patient, patient to staff, staff to patient abuse is not tolerated and action is taken immediately. Patients do not have access to unlimited funds to purchase designer clothing. The treatment available varies greatly from state to state. And from treatment program to treatment program. Many of our mentally ill end up in regular prisons where their only access to treatment is pharmaceutical in nature. Their conditions worsen. And many of our mentally ill end up in prison because of our cut backs to our mental health systems and the failure of our court system to address this problem by refusing to sentence them to prison. And for their failure to force our state legislaturers to address the problem. And the failure of advocates for the mentally to address the problems reasonably.

Grannynurse:balloons:

beochicken · Mar 24, 2006

Extrakul: you have pm :)