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kiwipsychnurse

kiwipsychnurse

Mental health
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kiwipsychnurse has 15 years experience and specializes in Mental health.

male

kiwipsychnurse's Latest Activity

  1. kiwipsychnurse

    Self harmers

    Hi, been a few years since I posted but would like some input please. How do you manage pt's that self harm in an inpatient environment? At present we have a very hands on approach which usually results with intensive nursing in a highcare environment. This is not ideal as it removes a number of nurses from the main ward. Sometimes up to 3 nurses with the patient to stop them. Any input would be great.
  2. kiwipsychnurse

    Smoke free psych hospitals

    Thanks for the feedback. I'm in a forensic psych hospital in Auckland, NZ for the nurse that asked.
  3. kiwipsychnurse

    Smoke free psych hospitals

    Hi, we went smoke free about 6 years ago with very few issues. We were expecting violence to increase but that was not the case. Can I just get some feedback if your hospital is smoke free and which state or country you are from. Thanks
  4. kiwipsychnurse

    Staffing on Inpatient Unit

    You will love this. Day shift 8 nurses 15 patients. Afternoons 5 to 15 and nights 3 to 15. I think these are the best ratios in the world. Forensic psych hospital, Auckland, New Zealand.
  5. This has been an ongoing issue for the past few months. I guess this is what happens when management try to drastically reduce seclusion but not provide viable alternatives. This week the staff are stopping work for 2 hours in an attempt to sort this mess out. http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10749310 The above is a link to a recent newspaper story. I don't work in the mentioned hospital but do work in a mental health facility in Auckland.
  6. kiwipsychnurse

    for those of you that dress business casual for work..

    Hi, Work in a psych hospital in New Zealand. Most of us just wear jeans and tee shirts. Today I'm wearing a Canadian Rugby jersey, jeans and trainers. Due to the amount of sport we play with the patients it would be very impracticle to dress up although nothing to stop you wearing a suit although you will have some strange looks and people asking you if your going to court with a patient.
  7. kiwipsychnurse

    Violence in Psychiatric Nursing

    I suspect we will never agree on this issue. Makes me thankful for the country I live, the laws we have around Health and safety in the workplace and the strong union nursing has in New Zealand. Note: you can't sue for personal injury in NZ (that is any personal injury even traffic accident)
  8. kiwipsychnurse

    Violence in Psychiatric Nursing

    I have seen cell take outs of mentally ill inmates in a psych wing of the prison in Ohio. The guards went in with pepper spray, shields and body armour. The patient was extreme pain while they restrained him and carted him off to off to another room/cell. That was filmed in 2009 for all the world to see. I show the doco to a students when I do a teaching session. So not only does the US prison/mental health service intentionally cause physical pain but they film it and make a doco out of it. Why should a person, just because they are mentally ill not be subjected to pain/physical force if they are hurting/killing someone. They are no different to anyone else. Violence is violence. If your daughter, son, mother father was being assaulted by someone with a mental illness would say to the police please dont cause them any pain as they have mental illness. What do you do with a patient that randomly punches nursing staff in the face and doesnt care if you are male of female? You have done all the respect, caring, kindness and humour. Sometimes that just doesnt work and you are dealing with someone that is totally irrational that is totally out of control. Sometimes force is nessessary. If you get sacked,lose your registration, sued and prosecuted for defending yourself then thats a sad state of affairs. On a side note: We use no pepper spray, no tie down beds, no restraint chairs, no sheilds and no body armour. We do use physical restraint to contain the situation and seclusion for the minimum amount of time possible. On the rare occasion we use those leather restraint belts that go round the waist and bring the arms in to the waist.
  9. kiwipsychnurse

    Violence in Psychiatric Nursing

    Could it be that the difference between our psych system and yours is you select which patients are suitable for your hospital and if they are too violent and aggressive then you send them to prison? This ensures your hospital's patients are relatively settled and at low risk of extreme violence. My workplace takes those that are extemely violent that have killed, raped, maimed etc. from prison and the community. What do you suggest we do with an extemely violent gang member that is mentally ill? Sometimes de-esclation and all the nice things in life just don't work. Restraint, seclsuion and medication is the only option. By the way we are quite civilised. In New Zealand, 100% of our citizens have access to comprehensive mental health services.
  10. kiwipsychnurse

    Violence in Psychiatric Nursing

    My work place. 8 staff to 15 Pt ratio; if acuity increases then the staff to pt ratio increases. I think we can handle 99% of violent situations and have only had to call the police once in 18 years.
  11. kiwipsychnurse

    Violence in Psychiatric Nursing

    Thank goodness we have acts of law that prevent this type of issue. If someone is trying kill you and you are sleeper hold and you punch them in the groin you get fired? So basically you need to be a punching bag? And not defend yourself because of fear you may lose your job? Is that the same for police,corrections officers or anyone else that deals with violence? In NZ we are allowed to use resonable force to protect ourselves or others.
  12. kiwipsychnurse

    What do you do in the nursing station in your down time?

    I learnt that if your busy on nights and I'm excluding admissions then dish out the PRN. Having patients up all night drinking tea and coffee watching TV is not promoting recovery as all they do is sleep the next day. Also avoid talking to them on night shift. Sounds counter productive but 2.00am is not the right time to cover issues of feeling picked on when they were at primary school or how old they were when they were potty trained. Plenty of time for such conversations during day and afternoon shifts. Just finished a month of nights. Must have tools. A laptop or macbook. Wireless internet connection and a Facebook login and a heap of downloaded TV shows to catch up on. Hey at least I'm awake!! Anyone here sleep on nights. Come on be honest!!
  13. kiwipsychnurse

    Violence in Psychiatric Nursing

    Seated holds sounds like you require a great deal of strength for this method to work. I have no idea how this works I'm guessing you have a nurse either side and sit the patient down and prevent them standing up. If we tried to use such techniques in our forensic facility I foresee at great deal of staff injuries. People being put in hospital by patients, massive amounts of sick leave. We use restraint called C & R. It basically bends the patients wrist back and inflicts a great deal of acute pain. Very effective and had been in place for 18 years now. Not one broken wrist in our work place. Our work place is very unionised and when we are confronted with people attempting to change the way restaints are done we can always make it a union issue or health and safety issue. Oh a note about night shift. Kick back watch TV bring in a laptop play some games. Reading polices and patient histories at 3.00am is useless, your brain is all mush. Do the basics but just relax. This is my opinion. When you look back on your career will you say I read polices at 3.00am or watched Dexter on my laptop and got paid for it. :)
  14. kiwipsychnurse

    Sensory Modulation

    Yesterday I attended a sensory modulation forum. This approach was targeting reducing selection and restraint. The speaker was an American OT by the name of Tina Champagne. Some of the concepts were to get in early with an agitated/distressed patient's and introduce them to some form of simulation. What I was shown was pictures of sensory modulation rooms which had bean bags, vibrating chairs, nice pictures on the walls, music etc etc. Weighted blankets and lava lamps were also mentioned. My concern started to elevate when although not sold as a seclusion/restraint replacement but more as a tool mental health staff could use. I paid attention to the make up of the room, most attendees were OT's or psychologists. Looking at the age and gender make up my guess was that less than 10% of the room had ever been involved in restraint or seclusion. Or ever been face to face with a psychotic patient that wants to do serious harm to you. So here's a product being pitched at a room full of health professionals as means of reducing restraint and seclusion. I work in a forensic mental health unit and deal with some of the most dangerous people this country has. If you try alternatives with this patient group you seriously risk your own safety and your colleagues. At the end of the day I walked out of the room shaking my head in disbelief. I'm sure there is a patient group out there that would respond well to sensory modulation (elderly, children, depressed) but using this approach on psychotic forensic patients that cannot be rationalized with!! I just had to get this off my chest as its been eating away at me. If anyone reading this works in a forensic unit and has a sensory modulation room/approach I would love to know how well its reducing restraint/seclusion. I also posted this in psychiatric nursing forum. Just to cover my bases.
  15. kiwipsychnurse

    Sensory modulation

    Yesterday I attended a sensory modulation forum. This approach was targeting reducing selection and restraint. The speaker was an American OT by the name of Tina Champagne. Some of the concepts were to get in early with an agitated/distressed patient's and introduce them to some form of simulation. What I was shown was pictures of sensory modulation rooms which had bean bags, vibrating chairs, nice pictures on the walls, music etc etc. Weighted blankets and lava lamps were also mentioned. My concern started to elevate when although not sold as a seclusion/restraint replacement but more as a tool mental health staff could use. I paid attention to the make up of the room, most attendees were OT's or psychologists. Looking at the age and gender make up my guess was that less than 10% of the room had ever been involved in restraint or seclusion. Or ever been face to face with a psychotic patient that wants to do serious harm to you. So here's a product being pitched at a room full of health professionals as means of reducing restraint and seclusion. I work in a forensic mental health unit and deal with some of the most dangerous people this country has. If you try alternatives with this patient group you seriously risk your own safety and your colleagues. At the end of the day I walked out of the room shaking my head in disbelief. I'm sure there is a patient group out there that would respond well to sensory modulation (elderly, children, depressed) but using this approach on psychotic forensic patients that cannot be rationalized with!! I just had to get this off my chest as its been eating away at me. If anyone reading this works in a forensic unit and has a sensory modulation room/approach I would love to know how well its reducing restraint/seclusion.
  16. kiwipsychnurse

    terminated, am I blacklisted from mental health?

    You didnt hit him, his nose was pushed into your hand as a result of some kind of restraint. Are you guys not union? Sounds like no proper investigation took place. I feel sorry for you.