alpha omega

As you can see, I'm not a psyche nurse, so I wasn't asking the right questions! This patient population was always a pretty mellow crowd, so I guess I'm wondering why so many, and why in such a short time. Well, we had a couple suicide attempts. We had a couple of our male residents engaged in agressive sexual acting out (constant verbalizing of a sexual nature, frequent and repeated attempts at grabbing staff and female residents, "humping" inanimate objects)--one had to be sent to a psychiatric facility for a day or two because he was also violent and unable to be redirected. The homicide was a woman who decided to kill her husband with a blunt object, he called for help. The situation was very serious--she is big and strong, and if help hadn't arrived we would have had an actual homocide. She was referred to psyche eval, and the husband didn't press charges. I guess the question is that this is all very sudden. The residents here are all rather on the mellow side, not former criminals or anything. I'm only here on a part time basis. We haven't had more than the normal rate of staff turnover, that I'm aware of. Also, these incidents have been scattered among our levels of care. In other words, Skilled care, Personal care and Independent have been pretty much equally affected (it's a retirement community). After the first two serious incidents, we were all inserviced on de-escalation, but the incidents keep coming!

Am working in a LTC facility. In the last two months, we've had a significant new cluster of psychiatric emergencies, up to and including an attempted resident-to-resident homocide. My floor has essentially become a psyche ward. In the past we would get the odd psychotic break, never more than one per year. Any ideas? I'm starting to dread going into work.

There is a difference between professional ethics and moral ethics. Professional ethics are the way a particular profession carries out its mission. Moral ethics are based in natural law. I totally understand recognizing the futility of recussitating an 18weeker or heroic measures to a person with a terminal illness. But there are different levels of wrongness. The heroic measures you mentioned aren’t designed to kill, but to attempt to save life. It may be futile, but it’s still directed at livesaving. On the other hand in the abortifacient devices that would be mandated under hhs are aimed at taking life. According to the National Conference of State Legislatures website (2012), 28 states have contraceptive mandates. 20 of them have appeals processes for faith-based institutions to be exempt from these mandates. 8 states have no apparent appeals process. Again, the HHS mandate is about an attempt to dismantle the First Amendment. Forcing health care providers to participate in actions against their conscience is a major overreach for the Federal Government. It is not a referendum on any particular religion’s teachings. PS. Erm, fear is an emotion (as in “you’re scaring me”). Therefore, that was an emotional appeal. And yes the remark about God tapping somebody on the shoulder is definitely snide.

Oh jeez, here we go with the “you’re scaring me” rhetoric. Too bad people on this site can’t sit down like grown-ups and discuss issues without the name calling and emotional appeals and snide remarks about other peoples religious faith. everwonder_y: There are 8 states that mandate this coverage, without exceptions. It’s still an unjust law. subee: answer this. If people aren’t using contraceptives now, which are free (under title x and other programs) or cheap, as I explained before, what makes you think they’ll use them if the hhs mandate goes through? This is still all about the First Amendment.

And not only for end-of-life, tewdles, but patient-directed care is appropriate for for all stages. Patients need to be very savvy about health, and health care choices. We have a lot of good information in the internet right now, but some of it is bunk, and as nurses we can help direct our patients to good, competent websites, and show them how to evaluate the accuracy of what they're reading (ex: is it a site trying to sell you a supplement, do they have peer reviewed articles to back up their claims).

I work for an agency that sends me out to LTC facilities to cover overnight shifts. Oftentimes I'm the only license on the floor or even in the building. All well and good. But the really scary part, is--more often than not, the offgoing shift rarely greets me with anything more than "are you the nurse from that agency?", without even checking my ID! They don't have any idea who I am or even have me sign in anywhere... The next time someone says "are you that nurse who's on tonight?" , I'm going to reply: "Yeah, let's go with that". And see if they have the gumption to check further.

[color=#2d2d2d]and back to the hhs mandate and the "who will pay for all the unwanted children" argument. birth control is already free (under title x) to very cheap. if people aren't using it now, what makes you think they'll use it just because the mandate goes through? this is a first amendment issue.

[color=#2d2d2d]totally agree. but i think obesity will always be harder to combat than smoking because nobody actually needs to smoke, but eating is a necessary activity. in my experience, doing anything in moderation is harder than quitting outright. doesn’t mean we shouldn’t try, however. also, the shock-style used in antismoking campains with the people who have disfiguring trachs and amputations are not appropriate for the obese population. ads would have to tread very lightly the thin line between “lose weight to be healthy” that health care wants to promote and “lose weight to be acceptable and loved” that madison avenue wants to promote.

[color=#2d2d2d]first of all, contraception is already low cost. oc is about $20 per month, condoms about $1 each. but that's not really the point. [color=#2d2d2d] [color=#2d2d2d]second, if they roll back the hhs mandate, all the contraception won't magically disappear. it will still be there on the shelves for those who choose to buy it(with their own money). [color=#2d2d2d] [color=#2d2d2d]thirdly, this whole "debate" was created out of thin air by this administration to fuel their own agenda. before the hhs mandate, employers had the right to offer contraceptives through their health insurance or not. an employee who didn't like it was free to find another job with an employer who was more in line with their way of thinking. there were still choices and nobody was forced to act against their religious beliefs. then obama decied to stir up the pot, and have us all fighting amongst ourselves. now, people are screaming for something that was never guaranteed in the first place. i wonder how many people realize they are being used and manipulated? how many people have any idea how this violation of the first amendment can very quickly lead to other violations? [color=#2d2d2d] [color=#2d2d2d]fourth, what right does anybody have to reach into my pocket and take my hard earned money to subsidize their sex life? [color=#2d2d2d] [color=#2d2d2d]i take responsibility for my own sexual activity. i'm not asking anybody to do something i'm not willing to do myself. i walk my talk.

I think it's okay to offer to pray, if it's soft-pedaled, like "Some people find comfort in prayer. I can pray with you if you like." If they refuse, then drop it.

If the patient seems very anxious, my standard line is something like: Would you like to talk to somebody about this, like a clergyman or a counsellor? It gives them choices and doesn't impose any one view. I privately pray for all my patients.

If you want birth control, pay for it yourself. If you can’t afford it, then what are you doing having sex? I’m hearing a lot of “stay out of my uterus...but first pay for my contraception”. Here’s a radical idea--take responsibility for your own actions, and don’t go making other people pay for your voluntary medications. Just sayin.

No, you're not forced to directly assist in abortions. However, some nursing schools (at the advance practice level) may teach you to offer abortion as an alternative in certain high-risk pregnancy cases. And then penalize you if you don't. Some schools offer conscience protection, some don't. If you are going into an advanced degree program, find out ahead of time before you invest a lot of money only to have to violate your conscience later on down the road.

You're going on the assumption that nurses agree on every issue. But we don't. Believe it or not, some of us...oppose legalized abortion...don't want to pay for YOUR contraception...support the right of faith based institutions not to cover certain procedures and medications, either for their patients or employees (although we treat every person, regardless)...are very worried about the erosion of our First Amendment rights and aren't about to be fooled into thinking the HHS mandate is about healthcare for women...believe that oral contraception is healthcare...

Why is nobody outraged that the only "cure" that male researchers have come up with for female hormonal imbalance and acne is a drug that shuts down an entire bodily system? This sends the clear message that female fertility is a nuisance, not a life-affirming gift. BTW, I was exposed to this attitude by a very crunchy, organic-loving hippie friend of mine. She makes a lot of sense.