The_Wonderkid

Everyone at my workplace knows I am gay however the patient have no reason, need or right to know about my personal life in any way, shape or form. If I am asked Ill say yes to a girlfriend but thats mainly just to keep the peace (some patients, especially male, may find it hard to deal with and I don't wanna mess up a therapeutic relationship (Mental Health Nurse here!) just cos I 'came out' to them). If a patient asked me flat out I would probably say no but it depends on the situation. If it was in a community team possibly but I dont feel comfortable having it talked about on a ward setting! TWK

No in a word! I do see your concerns however I must say that being petite gives you the advantage in that you don't look threatening. I found in the past that its the big guys that get alot of hassle overall because they are big guys whereas the smaller women get alot less hassle. Saying that why should it be a problem? I mean some of the smallest women I know are amazing at not only their jobs but also in a restraint situation.

What I found really funny was that I started nursing training a year and a half ago and I have been labelled as a stud with the women. Funny thing is I am the one that's actually gay in the cohort! I don't hear too much of the male nurses = gay though I must admit that when I tell people what I do they go 'oh well that is about right (gay and nursing)'.

Well I have my hair spiked and shaved down both sides (with the spikes going from from to back). Its not an 'extreme' style at all.. The only thing they ask in my university (and most in the UK) is it be clean, tidy and presentable.

Well in my University we had a whole module on the subject of Diversity, Rights and Equality which featured alot of sociology and the like. We get lectures on minorities and the impact of health and illness has on certain groups and HOW we can do our utmost to ensure these groups get the best adn most effective care according to their requirements. This ensures we have a firm grasp on the reasoning behind and the requirements of groups. It is a good way to avoid people being homophobic, racist and the like in practice. However if this is ingrained in the person its hard to shake this anyway. Note - What I find increasinly frustrated with is how the health services have the idea that if a person is of the LGBT that they MUST have some sort of STD testing. Its an assumption which is increasingly occuring especially in GP surgeries. Yet they seem to be less knowledgable that rates of mental illness (mainly depression/suicide) is more common in these groups amongst other details which can affect practice. good topic! TWK

But isn't this all because of people who always want nursing to be a 'female profession'? I mean the way to change that perception and get it put across that the profession is a neutral gendered profession is to have it be 'ok' to be a nurse and be a male. Dressing men up in light pastel colors just goes on to emphasize that the profession is a female dominated industry and that men will be treated in a way which will make them look less masculine because of the field in which he works in. The way I look at it is this. Would it be fair to say to a female business person in a male dominated environment that she must wear what is essentially a MALE suit and tie? Not a female version but a male suit. I am sure that the female rights/activists would jump all over it due to being sexist. So why is nursing one of the few professions (if not the ONLY profession) which can get away with being so pro-female to the point which is promotes this treatment as a way (in my mind) of, whether intentionally or not, deterring males from entering the field? Nursing does NOTHING to promote males to go into the workplace. Every other working environment (be it business, retail etc) ensures that females are treated equally and given the same rights as males. (well at least in the UK, not sure how it works elsewhere). TWK

Sorry EDIT not relevant

Hey everyone! I am new to the forum. Having worked for 4 years on an Acute Admissions Unit here in the UK I decided to go do my training to become a registered nurse in Mental Health. I am curious to a number of different things relating to Mental Health Nursing considering most of the posters here seem to come from other parts of the world! 1) What training does a nurse have to do to become qualified where you come from? In the UK nursing students have to do a 3 year 'Diploma' course (not a degree like some places) in which the first year is a general (Adult, Child, Mental Health and Learning Disabilities) nursing year in which you have to attend all the different branches or specialities. Years two and three are based in your chosen field (mine being Mental Health obviously!) There is no need for a degree although there are enhanced diploma and degree options that can be taken. 2) What are the opinions on HCAs (Health Care Assistants) from qualified staff? I have had a number of different reactions from nurses varying from the odd one or two that are very very well stuck up to people who are very respectful. I was on a 1:1 observation with a patient at one point and asked the nurse if she could take over as it was her turn on the obs (not in a 'you better come here its your turn' kinda way but in a 'you are more qualified to assess this distressed person' kind of way). anyway she pretty much turned and said 'if you want to do the risk assessments, care plans and the like then you can but until you are able to then don't moan'. This took me back somewhat as I wasn't expecting the hostility. However later in my career when I began to pull people up on it, I gained an awful lot of respect from my peers and was considered a reliable member of the team. Is this something you have encountered? How do YOU view care assistants? 3) Does your country/state have a particular Act or policy with relates to Mental Health? Here in the UK (as many people probably know) we have the Mental Health Act which ensures patients are treated in strict guidelines and have their rights met. Is this the case wherever you work? 4) How is the mental health services set up in your area? Is it set up with Secure, Acute, Community, and then the specialities? 5) How rigid is your Mental Health Services? In the UK (apart from secure units) its more a flexible, less rigid format which is generally more tailored to the needs of the person. There is less emphasis on restraint, seclusion and rules and more focused on individuals, choice and getting people in and out of hospital in the quickest time with the best outcomes. Into services which promote independence and co-operation between support services and patient groups. We have CATT (Crisis) Teams which go into homes of riskier patients 3 or 4 times a day, Assertive Outreach teams, liason services, support groups as well as Acute and Secure services for people that need this and Personality Disorder, Eating Disorder, and other specialist facilities. The reason I am asking this is a member of my cohort at Nursing School recently went to another country (within Europe) and it was found that they were 20 years behind in terms of how their services were run. Thanks for your time... Always keen to learn about how other places run their services and as I read through the forum I get lost when hearing all the different terms (LPD? etc!) Thanks again TWK

I have been reading some of this thread and find some comments very insightful and helpful and others, well, plain hilarious/unimaginable. I have worked with a number of people suffering from Borderline Personality Disorder (if you suffer from Heart Disease are you called 'The Heart Disease'? Borderlines? Hmmm Interesting phrase but anyway!), and I genuinely believe that this is one of the most (if not the most) destructive Mental Illness/Disorders which get the least amount of attention and sympathies from Mental Health Services. I can see the general impression of working with these people is rules rules rules... and control control control... The one thing that strikes me is how BDP patients always seem to want to pass off responsibility to nursing staff, teams and psychiatrists. They use their behaviours as a way to achieve this. So when every bit of control is taken away from them where does that leave the patient? In stalemate. They are kept in set boundaries and rigidity and then when they are going to be discharged their behaviours worsen for fear of all that control coming back. The way it was dealt with at my Unit (which was VERY effective) was the nurses would give the responsibility and control over their actions back to the patient. Along with this teaching about coping strategies and the like were involved as well as CBT. It was shown that if a patient could use these skills to make appropriate choices regarding not only their own care but also their actions, this had a positive effect on the long term prognosis of getting back into community and living a more constructive life. I understand that there is a need for control/rules in a more Secure environment however I do believe that the more you take away from the patient the more of a patient they 'become'. My rule (in the unit) was always consistency. If your staff are consistent you develop a rapport and trust and the rest can be achieved. If you set rules the person will undoubtably fight against them. If you enable the person to choose and make their own decisions on their actions and responsibilities then they are more likely to work with you longer term. Of course do this in a safe environment and assess danger and take action where required however the myth that Personality Disorder Sufferers just want to 'manipulate' and 'split' teams is more to do with ineffective planning and implementation of services rather than a conscious effort to thwart peoples efforts.

No. My patients don't wear name bands, don't have photos taken of them and don't have tags with barcodes on them! We aren't a medical ward so why act like one? lol Generally the best way to find out who someone is is to ask them! TBH I have worked in units where you know who everyone is anyway. Its just the way it works and if you don't you ask a colleague to tell you who they are. I do find it fascinating how other places work and do things. Some of the ways strike me as very erm unique to say the least. My question is why SHOULD a patient wear a name band? Shouldn't the staff know who every patient is on their ward anyway? How can you give an intervention or write notes if you don't know who you are talking to? Doesn't putting name bands on patients ensure that there is a patient/staff divide and cause a possible breakdown in communication as a result? I thought the main purpose of Mental Health Nursing was to build a therapeutic relationship with patients in which you can build on to achieve a set goal (getting the person better and out into the community). In the UK (Acute Assessment/Admissions Mental Health Wards) staff wear plain clothes (smart casual) and name tags (ones which break off if pulled to stop injurious behaviours) and patients don't wear bands of any sort.

Hey! Your Nervous thats great! I have always said to people who are new on the ward that use being nervous as a good thing. There is a valid reason why you get nervous in these situations and I believe that even the best nurses with years of experience still get a little jittery when someone comes running at them swearing. Its a natural reaction. Personally if I feel nervous it makes me more alert. I am aware of what is happening and I become super sensitive to the things around me, including the person being threatening. This ensures you pick up ques (which may be subtle) which if you were calm you wouldn't. Use it to your advantage. One day it will click and you will ease into the situations you are facing. However I always say that the minute you become too relaxed and get complacent thats when you have problems. Its not always a bad thing to be nervous, sometimes you do your job better when the pressure is on... Don't be worrying about it. It'll come and you will chill out! One last bit of advice. Listen... Listen to everyone around you but most importantly listen to your patient. You shouldn't run into any trouble if you listen to your colleagues but especially if you are listening to the patient (DON'T assume anything!) I found the one thing that caused problems for nurses was they jumped to a conclusion or just plain didn't listen to the patient. If you listen, acknowledge and act on what a patient says to you, you will feel more confident that you are safe and you will begin to build a great relationship with your patients which will make you feel at ease.

I have heard several times of 'lost privilages', needs for patient to be put in 'restraint' and 'seclusion' and I must say it concerns me greatly. Is the way Mental Health (I hate the term psychiatric) patients treated different in the U.S than it is in the UK? Restraint should be used ONLY in a situation in which the person is an immediate danger to themselves or others. Therefore a 'calm' patient should under no circumstances be restrained AFTER an incident. This (as some have stated in the thread) would be using restraint as a form of punishment which of course isn't upholding patient rights (this is the same with seclusion). If the person however was deemed as still volitial then restraint should be used to the minimum until the situation is calmed. If the patient is offered medication and accepts (Via PO) then there is also no valid reason to restrain on those grounds either. As for withdrawal of privilages. It sounds like patient's should feel grateful to be able to have 'privilages' in Mental Health Units, and that for 'bad behaviour' or actions which aren't acceptable these 'privilages' should be withdrawn as a punishment. For whatever reason this patient lashed out. The focus should be more on how to manage the patient in a way which neither puts a person at risk nor places unreasonable restriction on the patient. What I find most concerning is a number of members are calling for 'immediate seclusion'. Isn't it the case that to provide an intervention you first need to assess the person and what would be most beneficial for the person involved (and everyone around them)? If the person is deemed to be 'calm' then wouldn't it go against that theory? Wouldn't a good Mental Health team (not Nurse, as that is too individual) be able to assess a person and place them in a situation which is appropriate? Within the UK system alone there are a number of practices, policies and the like put into place to protect both patient and staff during and after situations such as this. There are protocols for debriefing, constant restraint updates (including de-escalation) as well as support systems and the like in place. Incident forms are a big part of UK health services as a way of ensuring the risks of aggressive behaviours are reduced to a minimum.

Why did I get into nursing? By accident really... I was working for a supermarket and hated it. I didn't feel that my talents were being best used stacking shelves (not knocking people that stack shelves, we need them!) I then had an issue with a manager that just wasn't resolving itself. So i looked in the paper, saw a ad for a care assistant position in the NHS local Mental Health Unit and applied. There was one reason which got me that post (I think)... Growing up my mother was diagnosed with a Personality Disorder. Having grown up practically in Mental Health Units (visiting!) I had first hand (family) experience on Mental Illness and I was passionate about it! (and still am) I saw both amazing and not so amazing things (nothing terrible just little things I wanted to change) and decided 'HELL I CAN DO THIS JOB!'. It took about 6 months. I was one of those late starters in terms of getting comfortable with the job but one day it clicked. Two years ago I was getting told that I really needed to do my training. I put it off and put it off thinking that I would wait til the 'time is right' but I don't think the time will ever be 'right' for most people. I applied, got my position, am in my second year of my training and still love the job like I did 3 years ago!!!!