Whistleblower

I WON!!! Out of court settlement of $75,000; furthermore, I did not have to sign confidentiality clause to receive this settlement. The Board of Nursing also dismissed all confidentiality charges against me after investigating my case and agreed with my lawyer that I acted in good faith in filing my complaints to the Board. I'm also please to report the The Attorney General told my Lawyer that these oppressive room plans are no longer being used at DMH facilities. All in all it been a pretty good day for my former patients and myself. I wish to thank all of you for your kind remarks and and support. Warmest regards. T. F. RN

And, if I had ever in my life met a schizoprenic who seem to be having a good time, I'd be happy to agree with him...Of course you have! What about the shizophenics who only hears the "good voices" saying nice thing to them and complimenting them. You can tell they are in a happy frame of mind because you see them laughing seemingly at nothing and with no one . The voices they are hearing are pleasant and agreeable to them. Do they seem miserable or are they suffering greatly then? Do you encourage these patients to accept medication in order to stop these good voices in their tract . Will they even take the medication willingly? Is hearing the good voices currently a threat to themselves or others? These are questions you may have ask youself at one time or another. I bet when you saw this happening to one of your patient's you stopped him/her in his/her tract, distracted him/her, and offered youself as a real person he or she could talk to. You may have offered him/her a PRN but you never forced it on him/her. Am I right? I think the point is we should work with one another and celebrate all of our lives. Setting schizophenics apart from the rest of us, fearing them and isolating them in state hospitals or jails does not celebrate their lives and has only hurts humanity at large. I too have enjoyed our conversations. Warmest regards, Tom

I know exactly what your talking about when you speak of 'the golden age of psych nursing' it was then we treated our patients with dignity and respect and viewed our pataints as having a functional illness not organic or medical model as it is called today. Many of us used medication on our patients not so much to treat a disease or control their behavior but to help them alleviate whatever mental anguish they were going through at the time. Some patients saw the medication effective but many others did not. Oddly the antipsychiatry people are largely composed of former psychiatric survivors who have empowered themselves to tell the world of the horror stories they have to endure as psychiatric patients. Many of them speak of the medications they are given as being spiritually deadingning. Many say they have been harmed by ECT. lobotomies and the like. The few dissenting psychiatrists are simply telling us that mental illness does not exist in a disease state inside the brain. Hard as they try the American Psychiatric Association and years of pseudoscience research have yet to demonstate any true genetic marker or any thing else that might prove mental illness is a disease of the brain. The pendulum has swung to the "medical model side of thing" by the drug companies who used the American Psychiatry Association to make phenomenal profits out of the pains and suffering of the mentally anguished Upon observations over the years I have found that people suffer from mental illness not because of some disease process but primarily because they have experienced some kind of real or imagined personal crisis or abuse in their lives and because they suffer from a moral delemma. Take for example the women who drowned her children to prevent them from growing up in this evil world of ours. In her mind she drowned them to save their innocents and to permitt them to go directly to heaven. Consider countless so called Borderlines who may inflict harm on themselves for the guilt they feel for having been raped by their sibling or relative. Counsider countless schizophenics who either God or the Devil is talking to them. Who are they going to listen to? Us nurses who are mere motals or these supreme beings? Ever heard of the Moral Treatment of Care for the mentally ill? It was highly successful years ago and could easily be applied today. Warm regards, Thomas M Fraser RN

thought you might want to read a perspective from a mental patient. as a psychiatric nurse for over thirty years i find this piece disturbing and yet i see a lot of truth in what mr unzicker writes. warm regards tom www.antipsychiatry.org to be a mental patient by rae unzicker (1948-2001) to be a mental patient is to be stigmatized, ostracized, socialized, patronized, psychiatrized. to be a mental patient is to have everyone controlling your life but you. you're watched by your shrink, your social worker, your friends, your family. and then you're diagnosed as paranoid. to be a mental patient is to live with the constant threat and possibility of being locked up at any time, for almost any reason. to be a mental patient is to live on $82 a month in food stamps, which won't let you buy kleenex to dry your tears. and to watch your shrink come back to his office from lunch, driving a mercedes benz. to be a mental patient is to take drugs that dull your mind, deaden your senses, make you jitter and drool and then you take more drugs to lessen the "side effects." to be a mental patient is to apply for jobs and lie about the last few months or years, because you've been in the hospital, and then you don't get the job anyway because you're a mental patient. to be a mental patient is not to matter. to be a mental patient is never to be taken seriously. to be a mental patient is to be a resident of a ghetto, surrounded by other mental patients who are as scared and hungry and bored and broke as you are. to be a mental patient is to watch tv and see how violent and dangerous and dumb and incompetent and crazy you are. to be a mental patient is to be a statistic. to be a mental patient is to wear a label, and that label never goes away, a label that says little about what you are and even less about who you are. to be a mental patient is to never to say what you mean, but to sound like you mean what you say. to be a mental patient is to tell your psychiatrist he's helping you, even if he is not. to be a mental patient is to act glad when you're sad and calm when you're mad, and to always be "appropriate." to be a mental patient is to participate in stupid groups that call themselves therapy. music isn't music, its therapy; volleyball isn't sport, it's therapy; sewing is therapy; washing dishes is therapy. even the air you breathe is therapy and that's called "the milieu." to be a mental patient is not to die, even if you want to -- and not cry, and not hurt, and not be scared, and not be angry, and not be vulnerable, and not to laugh too loud -- because, if you do, you only prove that you are a mental patient even if you are not. and so you become a no-thing, in a no-world, and you are not. rae unzicker © 1984 [ main page | next article: "does mental illness exist?" ]

You nailed this one on its head! I have postings elsewhere but I can not resist answering the original survey question. My license is in jeopardy for carrying out my mandated responsibility to report in good faith to my state BON any and all illegal activities that I witnessed in my place of employment. I reported my Director Of Nurses to the BON for aiding and abetting unlawfull activities. The Bon dismissed my complaints against my Director of Nurses citing unsubstantial evidence. The Bon is now siding with my Director of Nurses who claims that because I named patients in my private and confidential report to the Board I somehow violated my patients trust. I swear that none of my former patients have ever brought charges against me for this or any other reason. The Bon continues to prosecute me even though the hearing officer told the lawyer for the Bon to dismiss my case because prosecuting me will have chilling effects on nurses to ever report patient abuse, mistreatment or neglect again. For political reasons I suspect the BON will choose to never resolve their case against me. I expect they will leave me dangling for years to come. Warm regards, Tom

Well done! I especially agree that a sort of perverse pleasure-release of endorphins- take place during the cutting episodes. Surprisingly, when patients are able to label their sick behavior of cutting as an addiction a recovery process can usually take place. Placing patients in restraints and or seclusion for extended periods of time - weeks and months at a time to stop this behavior- does not help these patients and tends to make things worse for all concern. Regards, Tom

J&J don't know the half of it. In my case, "No More Tears" shampoo has helped me a lot. TLC to ALL ! Warm Regards, Tom

You make me feel good inside. Thank you soooooo much! Warm Regards, Tom

It is 8 o'clock in the morning. I'm just returning home from my new place of employment in New Hampshire. Thank you so much for your kind and loving words. Win or loose, I'll keep you posted. Warm regards, TOM

Hi Everyone, I have been a praticing nurse for 29 years.I was personally fired by my Massachussetts State Employer, The Department of Mental Health (DMH), for violating patients Confidentiality. To make a long story short, I admitted to sending a series of private reports, to covered entities, of patients abuse, mistreatment, and neglect related to unlawfull room plans that were being used to treat the mentally ill in the State facility I was employed at. I was fired even though I believe I acted appropriately under Massachusetts Mandated Laws in sending these confidential reports, under the HIPPA Privacy rules,[even before these rules were applicable] to covered entities such as the States Attorney General Office, JCAHO and the BON. Under the recomendation of DMH, the BON is now attempting to prosecute me for violating patient confidentiality in connection to the private reports I sent their particular Health Investigator. I also have filed a Health Care Whistle Blower suit against DMH. My case will be settled in court in a trial by jury. I thought by telling all of you this it might bring the hypothetical to a real life situation. Warm regards, Tom

Besides limiting staff contact and providing a primary contact staff person for the Borderline; to avoid splitting; Benign Neglect is the Management of Choice for the general staff dealing with the Borderline Personality Disorder. Forget about continuous room plans and indefinite 1:1. These treatments causes severe dependency; simply do not work; and, in some states could be judged as illegal and coercive in nature. In addition such treatments are countertherapeutic in the long run and do remove care from other patients. These people are living a lifestyle of continual crisis and self loathing. If they are to ever change for the better then a certain dignity of risk must be taken collectively by all staff. Once the Borderline goes over the edge of sanity and reasoning and there is an immediate threat of suicide, then and only then, should a temporary 1:1 be ordered and even this must be time limited and well defined for safety reasons only. Most certainly, DBT is, without a doubt, the best treatment for the Borderline when done by those who are trained. One distinct advantage of this treatment over 'room plans' is that it can be ongoing and done outside a hospital setting. While the Borderline is in the hospital, general staff should always be non-judgemental. General staff should encourage the Borderline to employ the Tools provided in this treatment especially whenever she is in crisis with others and/or is contemplating self harm..After a borderline anounces that she averted the crisis, praise is in order by all. Regards, Tom

will this help convince your family?regards, tom what is mental illness? mental illness is a term used for a group of disorders causing severe disturbances in thinking, feeling, and relating. they result insubstantially diminished capacity for coping with the ordinary demands of life. mental illnesses can affect persons of any age-children, adolescents, adults, and the elderly-and they can occur in any family. several million people in the country suffer from a serious long term mental illness. the cost to society is high due to lost productivity and treatment expense. patients with mental illness occupy more hospital beds than do persons with any other illness. those with mental illnesses are usually of normal intelligence although they may have difficulty performing at a normal level due to their illness. schizophrenia schizophrenia is one of the most serious and disabling of the mental illnesses. it affects approximately one person in one hundred. the disease affects men and women about equally. its onset is usually in the late teens or early twenties. people with schizophrenia usually have several of the following symptoms: disconnected and confused language poor reasoning, memory and judgment high levels of anxiety eating and sleeping disorders hallucinations-hearing and seeing things that exist only in the mind of the patient delusions - persistent false beliefs about something, e.g. others are controlling their thoughts deterioration of appearance and personal hygiene loss of motivation and poor concentration tendencies to withdraw from others unfortunately there are many myths about schizophrenia. people with schizophrenia do not have a "split personality" and are not prone to criminal violence. their illness is not caused by bad parenting and it is not evidence of weakness of character. their illness is due to biochemical disturbance of the brain. depressive illnesses depressive illnesses are the most common of psychiatric disorders. they are generally less persistently disabling than schizophrenia. the primary disturbance in these disorders is that of affect or mood. these mood disorders may be manic depression (bipolar) in which the person swings between extreme high and low moods, or they may be unipolar in which the person suffers from persistent severe depression. about six percent of the population suffers from an affective disorder -a major cause of suicide. persons diagnosed as having bipolar illness usually have several of the following characteristics during a period of mania: boundless energy, enthusiasm, and need for activity decreased need for sleep grandiose ideas and poor judgment rapid, loud, disorganized speech short temper and argumentativeness impulsive and erratic behavior possible delusional thinking rapid switch to severe depression persons having depression (or depressive phase of a bipolar disorder) may have four or five of the following characteristics for two weeks or longer: difficulty in sleeping loss of interest in daily activities loss of appetite feelings of worthlessness, guilt and hopelessness feelings of despondence or sadness inability to concentrate possible psychotic symptoms suicidal thoughts and even actions other disabling mental illnesses include severe anxiety and panic disorders, personality disorders, and obsessive compulsive disorder. causes of mental illness the causes of biologically based brain diseases are not well understood, although it is believed that the functioning of the brain's neurotransmitters is involved. many factors may contribute to this disturbed functioning. heredity may be a factor in mental illness as it is in diabetes and cancer. stress may contribute to the onset of mental illness in a vulnerable person. recreational drugs may also contribute to onset but are unlikely to be the single cause. family interaction and early child training were once thought to cause mental illness; however, research does not support that theory any longer. can mental illness be prevented? cured? since the causes of long term mental illnesses are not known, there is no effective prevention at this time. more research is needed to determine causes and strategies of prevention. likewise, there are no cures for mental illnesses. however, treatments can substantially improve the functioning of persons with these disorders. what are the treatments for mental illness? an expanding ranges of medications markedly reduce symptoms for many people. supportive counseling, self-help support groups and community rehabilitation programs promote recovery and build self-confidence. housing and employment services enable some people to develop independent living skills, hold a job, and achieve a fulfilling life. others may need support for most or all of their lives. helping them achieve a sense of dignity with the highest degree of independence, productivity, and satisfaction with life is the goal. the above write-up was provided by nami, the national alliance for the mentally ill, of arlington, va. see our bibliography of brain and neurological diseases

Wow, I am so impressed by the Uk philosophy of care. Unfortunately mechanical external controlls such as restraints and seclusion and sometimes chemicals are still unnecessarily being frequently used to treat the mentally ill in psychiatric hospital in this Country even though many of our laws will dictate otherwise. Have you read about the Pa. success story; Leading The Way Towards a Seclusion and Restraint-Free Environment? You are right, positive leadership is required if we are to change the insensitive culture of care that has existed far too long in this country when it comes to treating the mentally ill with the dignity and respect they deserve. Yes, I would love to hear more information from your side of the pond. Warm regards, Tom

First off, if you were personally involved with placing a patient in restraints or seclusion you should not be the only one initially required to ask any direct questions to the patient with regards to this. It is little wonder that this debriefing practice would agitate any patient and frustrate you. Although I never worked or lived in Pa., I think the Commonwealth of Pennsylvania has the best debriefing policy in the country that psychiatric hospitals anywhere could use to derive a more meaningful debriefing policy of their own: After each incident of seclusion restraints or exclusion ,[ within 24 hrs] a mental health professional and members of the treatment team [ two staff members] shall meet with the patient for the purpose of: 1. assisting the patient to develop an understanding of the precipitants which may evoke the behaviors necessitating the use of the restrictive technique. 2. assisting the patient to develop appropriate coping mechanism or alternative behavior that could be effectively utilized should similar situations/emotions/thoughts present themselves again; 3.developing and documenting a specific plan of intervention for inclusion in the Comprehensive Individualized Treatment Plan, with the intent to avert future need for restrictive techniques; and, 4.[ not for the purpose of blaming someone:uhoh21: ] evaluating whether alternate staff responses and intervention could be more effectively used in the future. " Seclusion and Restraints are not treatment; they reflect treatment failure." -Charles G. Curie, January 1997, Deputy Secretary Office of Mental Health and Substance Abuse Services. Pa. If you doubt the validity of the above statement please feel free to check all of my personal postings of what can go wrong when staff and administration do not work effectively in the care and treatment of the mentally ill. Hope this helps. Regards, Tom

If you can mentally and emotionally take it, keep doing what you are doing and above all else make sure the reprimands and disciplinary actions received by your supervisor is written specifically in answer to your complaints of unsafe staffing. One manipulative trick supervisors play on staff nurses who express concern with unsafe staffing is to devalue the staff nurse. Words like: "I'f you can't handle your assignment here, go elsewhere" or "I'f you don't like it here, just leave" are the typical responses that unscrupulous supervisors play on their staff nurses. Keep a running account of these words against your professional integrity and start a diary as to the date and cirumstances that you are assaulted by such words. In your personal response to your supervisor casually reaffirm that you are only advocating for your patients and ask her not to take further attacks against you. If your supervisor is not receptive to this then check to see if your state has a Health Care Whistle Blower Protection Law and invoke protection under this law immediately before you take any further action against your supervisor or employer. If you are going to complain on behalf of your patients always be a strait shooter and up front or don't even bother. Blowing the whistle halfway is worse then not blowing it at all.. One word of caution. Assuming you have had good past evaluations get a hold of copies of them now because the next step your supervisor will take is to discredit you in some way in future evaluations and possibly before the BON. Best of luck in your role as a true patient advocate. Regards, Thomas M Fraser RN