Commander Vimes

As a nurse manager, i would say, JUMP, get out then sue the buggers for lying, take them to industrial disute, bring in the unions. OOOOhhh i hate clique environments and thats what this is an old boys club.

Not a risk assessment tool but a national policy guidance. very good though. give my love to the roos, and sorry about the thrashing at the weekend. Rugby was never your strong point LOL http://www.dh.gov.uk/PublicationsAndStatistics/LettersAndCirculars/DearColleagueLetters/DearColleagueLettersArticle/fs/en?CONTENT_ID=4087135&chk=1/P3LV

Just come on in the waters fine. # Depends on what nursing you want to do though. Psychiatry is excellent, really makes a difference to peoples lives. General is good but by god you dont seem to take a break. Midwifery, NAH only for the girlies!! I would suggest you look for a Support worker job, or Nursing assistant job (do you have them in the states) as a way to get your hands dirty and decide if you like it, if so go for the plunge.

Cheers for the info Keetahe, i attended expo and found it very useful. It pretty much answered all my questions bar a couple. How much do you kiwis clear after taxes. I know the cost of living is cheap and the houses are lovely for minimal monies, but how much is in your pocket once the government has taken ther little bit? :uhoh21:

It aint easy, sounds like your doing it right though, but maybe need to back off the shop floor a tab. By being seen to always help out etc it becomes seen as the norm, in reality it can disempower the staff. they need to know that you will be there when they need you BUT they have to accept that they can manage without you at times. The long term scenario will be that they will expect you to always dive in and solve the current crisis, and therefore they will become cushioned against solving the crisis themselves, of which im sure they can. There will always be continuos crisis going on, you need to step back and go home and relax. The place will still be there in the morning.

As a registered nurse your licence is your passport. you have a duty to the team and your patient and your professional standards to report side effects, but i am sure you already know this. its sounds like the usual professional power struggle. tell them to swivel.:rotfl:

Sounds like you got a clear case of bullying and harrassment. see the union.

The holistic framework is supposed to encompass the bio-psycho-social-cultural aspects of the individuals current situation. in a nutshell if we are to treat a patient with for example depression, the mental health nurse needs to look at social aspect that have impacted upon the depression i.e family circumstances, recent loss, moving house, changing jobs etc. Biologically there is the medication, and changes in pyhsiology etc. psychological stressors and coping strategies and personality traits play a part. cultural aspects of religon, support structures, attitudes to mental health all play a part. there are many other influences i havent mentioned. I will recomend an excellent book however that covers all these points and t is the ubiqutous PRINCIPLES AND PRACTICE OF PSYCHIATRIC NURSING BY STUART AND SUNDEEN. My bible. :)

There appears to be a wide chasm between practice in the UK and our friends on the other side of the pond. We are recently in the aftremath of a public inquiry into the death of a young man named rocky bennett. He died whilst being restrained within a medium secure environment. Massive implications for the whole of mental health services within the uk. Also within the UK we do not use "security personel" to restrain a patient, but nurses are trained in control and restraint techniques. I would feel uncomfortable having to ask a man in a uniform with no mental health training to restrain a patient. It would then appear to say that if you dont do what we want then ill call the security team! If a patient is extremely paranoid and delusional and beleives, as many do that the state is monitoring them and police are bugging them etc, then what does a security team coming in and holding them down so a nurse can inject a sedative say to the patient.

Very broad statements from a lot of people. the reality tends to be that when we go into management, and there are many different levels, you tend to become involved in a wider context within the organisation, therefore your priorities change. As a rehab manager i am looking after the whole system. As a staff nurse my concentration and focus is purely on my immediate client. The managers position is such that other influences that are external to your control impact upon the care on the shop floor. A good manager will fight for what is ight but also be aware that others are also fighting for their own patch. The impression is then from the shop floor that they are not Shouting and Screaming for the rights of their own immediate staff and patients. A false impression. The higher you go the more aware you become of the external forces that influence the care you deliver. Its a cut throat world we live in. :imbar

i take it, it didnt happen then

:angryfire I should hope that isnt the norm, if you have to perform Control and Restraint it should be documented fully, events leading upto, during and post event. An incident form also needs completing and signed by the manager. A doctor also needsto assess the patient to ensure he/she was not injured during the "takedown" Ohh and can you change the wording takedown sounds like something out of the superbowl or Mike Tyson. Most of all it should be last resort and documented as such. If you dont write it down how are we to know what it was for or wether there were any antecendents etc. And dont forget to update the Risk Assessment. :)

Soory to say it but Schizophrenia is un curable, theres more to it than medication. Some of the anti-psychotics alleviate symptoms for some of the people but the evidence suggests that only 40% of sufferers gain any benefit from the medication. There are some amazing results though so all is not lost, I find Clozapine beneficial (I run a clozaril clinic amongst other things) Stress plays a major part in Schizophrenia and if you reduce that then Bingo! but not always. Short term treatments include Chlorpromazine, Olanzipine, Risperidone, even ECT. More effective however are the "Talking therapies" Voices groups are shown to be beneficial as are alternative coping strategies.

Why not prey tell, we do in UK if we have done the nurse prescribing module! we have found that we are in the best position to know the Patient and to prescribe accordingly, we have been advising the poor doctors for years.

i hate social worker do goody types, get a proper job become a nurse.