I Am FURIOUS!!!!

Long Term Care Columnist / Guide · May 2, 2005

Leslie........I am so sorry........I can't even imagine the pain of what you're going through right now. :crying2:

I do know that it's a good sign that Tiff told you about what's going on at that facility. I think that means she wants to get better, and she wants and needs you to be part of it. Here's where you've got to maintain your cool, however, even though your instincts are screaming "DO SOMETHING!!" Yes, you should be the one who makes the decision where, and whether, to transfer your daughter, and yes, you have the legal right to question the facility's practices. But you've got to stay calm.......vent to us all you need, but when it comes time to confront staff, you want to be in full control of your emotions, otherwise they may be apt to think that you're the main source of Tiff's problems. We've all done it.......we see a patient with a family member who's angry, loud, obnoxious etc. and we think "No WONDER Mrs. So-and-so's having chest pains!"

I'm glad you got Tiff off the 45/15 restriction.......that just seems dumb to me, what good does that do? But I'm even more glad that she is TALKING to you.....as long as the lines of communication are open, you've got a fighting chance. Don't give up, don't give in........you need to help direct her care, and if you feel she's not getting what she needs, by all means transfer her to another facility....and PM me if you want to really let 'er rip!

leslie :-D · May 2, 2005

thanks marla.

when she was admitted, i let it be known that i wanted to be consulted before any meds were given to her.

so i gave the permission for the lithium and zoloft.

today they called and asked if they could give her vistaril 50 mg po AND benadryl 50 mg po( for thickened secretions).

i told them absolutely not-that the combo would snow her.

i gave permission for the vistaril and told them that vistaril will thicken her secretions and could give the benadryl at hs, as long as it wasn't combined w/anything else.

i don't know when, but i do intend to look at her charts since she's a minor and i'm her legal guardian. should be interesting to read what they documented about today's events.

i've been there qd since admission; i just have to find out my legal rights when they try to transfer her to another in-pt facility.

when she was at children's for a psyche work-up (through the er), i told them i didn't want her committed; they plainly let me know that they could override my decision....so i need to know, once she's medically stablized, if the same holds true.

i'm so burnt marla....but yeah, i'll pm you (lost your email address when i lost my hard drive) if i'm going totally nuts.

xoxo

barefootlady, ADN, RN · May 2, 2005

I am so sorry you have such a heavy burden. When our children are ill, we do everything in our power to protect them. I am glad your daughter is being open with you and discussing the pooling of meds and lack of safety measures on this unit. This most definately needs to be discussed with her therapist, physician, the head nurse of the unit and the facility administrator. They will not want to hear it, they may try and downplay these events, but let your voice be heard.

I do not know how committment works in your area, once medically stable here, with proper outpatient care, not all patients are transferred, but it generally takes the agreement of everyone, including the patient signing a contract for long term outpatient care. If this contract is broken, then committment is swift. Good luck, and remember He is there for you and your daughter. I will pray for you both.

danu3 · May 2, 2005

Have you got a local NAMI chapter where you are? Depending how active the chapter are, you might get lucky and have people in there who knows and have informal connection the mental health system in terms of who is who and can help you. Also if you have the documentation and if you really decide to fight, it is helpful if the local NAMI is right behind you in terms of making telephone calls, going to board meetings to complain, writing letters, ... etc.

-Dan

leslie :-D · May 2, 2005

Have you got a local NAMI chapter where you are? Depending how active the chapter are, you might get lucky and have people in there who knows and have informal connection the mental health system in terms of who is who and can help you. Also if you have the documentation and if you really decide to fight, it is helpful if the local NAMI is right behind you in terms of making telephone calls, going to board meetings to complain, writing letters, ... etc.
-Dan

what does NAMI stand for?

i've already emailed this facility's parent headquarters to ask who the medical director/ceo is, adding that i have some very serious concerns re: dangerous conditions at this facility. i also added that i initially was going to get the state in to investigate but opted to deal with the hospital's ceo first. that should get the ball rolling. and should there be an investigation, i will demand they withhold interviewing my dtr until she is discharged. that way, no one can try and retaliate (i'm talking about the pts)....that was tiffany's fear since she was the newest one there. God only knows how long this has been going on. trust me, even after tiff is out, i plan to ensure this mayhem stops. my dtr looks even worse than when she was admitted. :crying2:

thanks danu.

Home Health Columnist / Guide · May 2, 2005

nami = national alliance for the mentally ill

the mission of the national alliance for the mentally ill is "to eradicate mental illness and improve the quality of life of those affected by these ...

http://www.nami.org

find your state & local nami

http://www.nami.org/template.cfm?section=your_local_nami

danu3 · May 2, 2005

nami = national alliance for the mentally ill
the mission of the national alliance for the mentally ill is "to eradicate mental illness and improve the quality of life of those affected by these ...
http://www.nami.org
find your state & local nami
http://www.nami.org/template.cfm?section=your_local_nami

there is going to be a change in the near future to natiional alliance on mental illness instead. it is a nationaly organzation started a while back by a few very frustrated mothers. now they have alliances with law makers, psychiatrist, psychologist, social workers, you name it... lots of them are struck by a serious mental illness close to home (like having a love one who is affected by it).

they also offer a very good 12 down in the trenches class on serious mental illness for family members who has a love one who has mi. sometimes you have nurses in the class too and they say it helps them (very different if the person is someone you love and you care for 24/7).

see if your local chapter has it, it is call family to family and is taught by family members who is going and has gone through the similar hell you are going through. great class to network also as you start to know what doctor is good, who knows what and so on.

also you have something similar for people who is coping with a serious mental illness. it is a 9 to 10 week class and it is call peer to peer and is taught by people who has a mental illness. these instructors serve as model to the rest of the class and give hope. deal with all kinds of issues from learning to set up a personal network so let oneself know if one is relapsing to your legal rights in job interviews to how to work effectively with a pdoc to all kinds of stuff.

you can't force your love one to take the peer to peer, however. they have to want to take it.

anyway, if you are lucky in the sense that your local chapter is very active, definitely join and know the people there so they can back you up. who knows, some of the parents might have their kids in the same facility and had horror stories too. work together and you'll be much much more effective.

-dan

danu3 · May 2, 2005

Oh, forgot one more thing. NAMI is what you call a "mix" group. That is the memberships are consist of family members or friends of people who has a serious MI AND people who are suffering from a MI.

Our annual picnic for example, is nice as you have both families, friends, and people who are coping with MI. The nice part is that nobody really care if you have a mental illness or not in the picnic as people learn to see pass the illness and see the person instead (guess that is what nurses do also). Plus everyone eat together and play together.

-Dan

danu3 · May 2, 2005

I looked at your profile. Here is the state NAMI also to save you some time.

http://www.namimass.org/

MA state level. Look at the education section and also the local affiliate section just to get contacts.

http://www.nami.org

National

-Dan

PMHNP10 · May 2, 2005

today when i went to visit her, i found out she was on 45/15 room lock-up; 45 minutes in her room, 15 minutes out.
today she told me that there are 4-5 of these teens who pocket their meds in their mouth, then later pool them altogether and divide them.
so tiff hasn't gotten 1 dose of lithium because another girl wanted it.
she told me she took 3 seroquels, 1 trazadone, 1 adderall, and 1 librium.
also she gave her self rubber burns on her wrist from an eraser; her wrist has 3 lg-sized scabs.
so instead of getting better, she told me all the things she has learned on this unit. this a.m. she got a prn vistaril for agitation. she told me she pocketed it, then crushed it and snorted it. she had never known about snorting before this.

Are you sure you didn't admit her into a state prison, because this is the behavior of convicted felons? Did you notice any shanks? I don't mean to be flippant about this, but either these kids are masters at cheeking meds (which is possible and regardless of how diligent/cautious the med nurse is, could be impossible to catch btw) or the person handing out meds isn't bothering to watch them take their meds.

have any of you psyche nurses experienced this?

Unfortunately, like I said, this is commonplace within the prisons.

do i have any say in the decision to tranfer her to another in-pt facility? if she starts taking her lithium a/o and she stabilizes, do i have any legal right to refuse this transfer? i would put her in an out-pt program where there is therapy 8 hrs qd then go home at noc.

I'm a little confused here. It sounds like she is in a very non therapeutic environment, so why wouldn't you want her to go elsewhere? As for legal rights: Was she court ordered to attend this treatment facility? If so, then you don't have a lot of say (of course this might vary from state to state). However, if she is a minor and it was your choice to put her in to the program, it should most certainly be your choice to take her out of it; whether or not she would be allowed into a type of day treatment program would again depend on where you live. If you do withdraw her from a program AMA, I can see where it might make it difficult to get her into a day treatment program, but I'm speaking in general terms and can't specify anything for your particular situation. I wish you luck getting your daughter the help she needs.

leslie :-D · May 2, 2005

I'm a little confused here. It sounds like she is in a very non therapeutic environment, so why wouldn't you want her to go elsewhere? As for legal rights: Was she court ordered to attend this treatment facility? If so, then you don't have a lot of say (of course this might vary from state to state). However, if she is a minor and it was your choice to put her in to the program, it should most certainly be your choice to take her out of it; whether or not she would be allowed into a type of day treatment program would again depend on where you live. If you do withdraw her from a program AMA, I can see where it might make it difficult to get her into a day treatment program, but I'm speaking in general terms and can't specify anything for your particular situation. I wish you luck getting your daughter the help she needs.

no, she wasn't court-ordered. when she got worked up by psyche in children's hospital, they said she needed an in-pt facility in the dual dx program. i told them no, and they said they could override my decision if need be. so i reluctantly agreed. they said this facility had a good reputation. but i was just talking to a counselor, trying to set up an outpt program for her, and she said this facility wouldn't be her first choice.

and NO, i do NOT want her going to another in-pt facility. teens with dual dx have problems so this type environment i feel would be pervasive within these types of confinements/units. she's learned more destructive habits than therapeutic ones. now and today, she did take her lithium. everything she told me yesterday was 1. a cry for help and 2. she doesn't feel safe in that environment. i just put a call in to the medical director and left a message on his vm.

hellll hath no fury like a mother scorned, and that's the truth.

thank you for your well wishes.

leslie