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Meraki

Meraki

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Meraki has 12 years experience.

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  1. Meraki

    Handling the "R" word

    I think language changes too over time. Most of the younger generation now has rarely if ever heard people referred to as having mental retardation as that word is less frequently used. So the slang use of 'retard' to mean ridiculous or foolish or stupid - for many is not actually connected in their mind to someone with an intellectual disability. It is just a slang term. It is the same with how now insane, idiotic and crazy have just become part of slang language. Those are all pejorative words to describe people with mental illness but most people who use them aren't deliberately making fun of people with mental illness, they just use it as slang. In the past idiot or insane was always in reference to someone with mental illness - but we have over time disconnected the two and the same thing is happening in time with saying an object or event is retarded.
  2. Meraki

    Things I wish I could tell my patients

    I find your perspective that you can only help people if you have had the same diagnosis to actually be somewhat shocking. I believe that I and the nurses on my team are able to personalize care, to humanize ourselves, and connect without self disclosure. Many of our patients are very appreciative of the support we have provided towards their recovery, without that support being self-disclosure. I would never assume that my experience is their experience and therefore sharing my experience is what they need to hear. As someone who has sought medical help for both physical and mental health care, I search for health practitioners who are knowledgeable about the illnesses, about current treatment options, and who are empathetic and respectful; and not for others who have had a similar diagnosis and want me to tell their personal story. I want them to hear my story and to provide me with their expertise and the best care possible. I couldn't' care less if they have experienced it themselves. Would you only see an oncologist who had already survived cancer? Or only see a dentist who could tell you about his root canal? Or only an eating disorder nurse who herself had an eating disorder? There is a great deal of expertise that exists outside of personal experience.
  3. Meraki

    Things I wish I could tell my patients

    I think you have to be very, very careful with self-disclosure. You can advocate for mental health and work towards decreasing stigma without self-disclosing to patients. There are lots of pitfalls in disclosing and I have rarely seen it go well in my 15 years of psych nursing. It is quite a skill and a challenge to ensure the disclosure is therapeutic. Some of the possible pitfalls are... - patient feels unheard or invalidated, sees disclosure as you shifting the focus to being about yourself. - patient had an emotional response to your disclosure and it impacts their mental health - for example they are worried about you, upset by what you said - patient feels the need to support you, or wants to support you, or thinks you want their support - patient doesn't want to bother you with more of their problems / emotions because they now see you as someone who already has enough on their plate and they don't want to burden you further. - patient misinterprets your self-disclosure and the reasons for it (why are they telling me this?), impacts the therapeutic relationship and leads to boundary violations. - patient now wants more detail, wants to know more, asks you about personal events in your life now that you 'opened the door'. Feels hurt if you then pull back after some disclosure. - focus of conversation shifts to you or to you trying to get focus off of yourself -patent does not react or respond to your disclosure as expected. Doesn't find it helpful, it doesn't give them hope, they can't relate as you though they might - again shifts dynamic of therapeutic relationship, nurse can feel hurt or rejected -patient under no obligation to maintain confidentiality of what you tell them. They share it with other patients, families, team members and information gets modified as it moves around. You no longer have any control of the information you put out there -the reality that the message sent (intentions) is often not the message received (outcomes) Perhaps in a setting where you have a long term relationship with pretty stable clients, it could be beneficial but in acute care or with clients already emotionally vulnerable, it is a bit of a minefield. I still think you can use personal experience extensively in psych without self disclosure. Use a third party - "a friend", "another patient I worked with", "something I have seen is..." Basically sure your experience and what worked without directly connecting it to you.
  4. Meraki

    Seeking Ontario RN's and RPN's

    I work in nursing management in an Ontario hospital. I have many nurses who struggle with mental health issues and some who have diagnoses of mental illnesses. I am under no obligation to report these nurses to the CNO. Over the last few years, I have reported two nurses to the CNO due to mental health issues because in both cases their mental health issue were interfering with their ability to provide safe, competent patient care. I tried to work with both of them to resolve the issues however they lacked insight into how their illnesses were impacting patient care and they refused to collaboratively work towards a solution. They both felt I had targeted them and was victimizing them and that I was discriminating against them because of their illnesses. Unfortunately cognitive distortions, and a lack of insight and judgement are part of mental illness creating a barrier that is difficult to navigate. Investigations are certainly a massive stressor, however if the end result is that the nurse accepts support that allows him/her to be a safe and competent practitioner, then that is a good result.
  5. Meraki

    Best assignment?

    I am looking for fresh ideas for written assignments for a mental health theory course I am teaching. I have done research papers, ethical dilemmas etc. i am looking for other assignment ideas that you have done that you think have been good learning experiences for students. I want them to think critically but still something that can be objectively marked. Thanks!
  6. Meraki

    Good assignments?

    I am teaching a mental health nursing course next semester to undergraduate students and I am looking for suggestions for good meaningful written assignments to give students. If they are going to put the work in, I want them to really take something from it! Any ideas?
  7. I teach in a nursing program and I am looking to change up the syllabus and assignments next year. I am interested in hearing form nursing students as to any written assignments you did in school that were meaningful to you and that you learned the most from? What kind of assignments would you want to be given. It is a mental health nursing class but examples from any class are welcome to give me an idea of the types of assignments. Thanks!
  8. Meraki

    How to approach this?

    I disagree and I think this is a dangerous position to take. Of course there is as you say frustration about changes in routine or new people. However I think to dismiss all complaints as just being resident complaining is dangerous - especially as in this case my grandmother said the CNA caused her pain and discomfort because she was going to do things her way no matter what my grandmother said - . There are aides that can be rude, disrespectful and actually abusive in some cases. While I don't think what happened was abuse I would never accept that it is okay to hurt a resident in order to get things done in their own ' new' personal way. My grandmother complains all the time about one thing or another but when I find her in a state of extreme agitation as I described and in pain from being twisted in a way she doesn't bend I am not going to tell her that is okay and she needs to give the new CNA more time.
  9. Meraki

    How to approach this?

    I haven't been back on this site for a while! just to respond... The system in this home is that only the night CNA and the admin have keys to the supply room so whatever the night CNA leaves out is ALL that is available for the next 24 hours. It used to be that the nurses also had keys but these were taken away form them as they were getting supplies for residents. the admin here are very much about the budget and don't want a single extra supply going out. I met with the DON three times months ago trying to get them to leave her an extra brief for the days she needed it but was refused (well to my face she said yes but it never happened and when I followed up she had 1000 reasons why) This facility is not family friendly and I agree they are even less staff friendly. I have gotten to know the nurses well over the years and while all the good ones leave I have heard many vents about admin just before they leave. It bothers me that they treat staff so poorly. I know many of the staff are very scared of the admin and have asked me not to say things because it is always put back on them (even if it is a policy thing out of their control). This does happen a bit on evenings - the night CNA leaves a box of a few extra briefs and these get fought over and hidden I have no idea why you are offended - I said very explicitly that the issue was with these two particular people and I was not generalizing to all admin. I have gone to them many times, they do not help, yes it is a problem. That is great you are family friendly - not all admins are. As I have said - these admin will spend time with me but do absolutely nothing in terms of action. Thankfully I just heard that the DON is retiring so maybe there is hope they will get someone decent. Oh and as to the original problem - the new CNA only lasted two weeks then was never seen again. We also buy briefs and these are strategically hidden throughout her room!
  10. Meraki

    Communicating with patients that don't speak English

    seeing as she spoke such minimal english that her son had to interpret it is quite possible she misunderstood you. i have lived in many parts of canada and have never come across 2nd and 3rd generation canadians who don't speak any english or french. they would have had to go through their entire education in english or french which would be impossible to do without learning or speaking the language. many still go to chinese school on weekends and evenings but their education is in english / french. even if they live in chinese communities and shop in chinese shops they would have been educated in english / french. most first generation chinese are pretty adamant that their children will have good educations and i have never met anyone who kept their children home and not in school and kept them from learning french / english. there may be an extreme case where they were homeschooled or not schooled at all but from my experience that is pretty rare in the chinese community.
  11. Meraki

    PTSD after patient attack

    Sounds like you did absolutely everything you could. I am really sorry your co-workers aren't more understanding. They didn't experience it the way you did and really shouldn't be judging you in any way. You can't go back until you are healthy...and I am glad your boss and doctors are enforcing that. You had some pretty significant injuries that need time to heal. Are there friends / family outside of work you can moral support from? Hopefully your co-workers are actually more empathetic than they are coming across....I don't think any of them would want this in their lives. Maybe they just miss you or are short staffed and want you back, but actually do understand why you need to be off? I'm hoping that is it. Definitely call your EAP...staying on top of your mental health is just as important as your physical health. It sounds like you are on top of this too...recognizing symptoms and seeking help before it gets worse. All the best.
  12. Meraki

    PTSD after patient attack

    I am not sure what you see in her post that fits with a diagnosis of PTSD? It sounds like a terrifying, even traumatizing experience and she speaks of high anxiety but that doesn't necessarily mean PTSD. It is quite possible that if the OP seeks out support now and gets professional help to work through the situation that she can recover emotionally as well and hopefully not develop PTSD. I also struggle with calling someone who is autistic and psychotic a criminal and referring to this as a crime. Truly, that is a very stigmatizing attitude. Often when someone is autistic they do not fully understand what is happening and become terrified. Add to that psychosis and possible paranoia or persecutory delusions and you have a petrified teen trying to defend / protect himself from what he may think is people attacking / trying to hurt him. Tying someone in that state down for hours can greatly increase their fear / agitation. Fear and terror gives people superhuman strength. OP, please do seek out help to recover from this emotionally as well as physically. It sounds like a terrifying experience and having anxiety after something like that is a normal response. Also don't make a decision now about returning or not to the ER. Hopefully a therapist can also work through that piece with you, depending on how your anxiety and feelings are at the time of returning to work. One thing that can help as well is to look at what can be done to prevent this in the future and make you feel safer....are there policies or practices that could be put in place to prevent further similar incidents? Can you get psych support in your ER? Kudos to your hard work in recovering thus far and hopefully you will have a full recovery. You will get back to excelling as a nurse...in the ER or in another area.
  13. Meraki

    Nervous about HIPAA

    It is really hard to never talk about any situation with any patient as it is what we do all day and there are funny stories, sad stories and things we just want to share. I agree with the others who say never use any identifying information. What I do if I am vaguely talking about a patient is I change details...man to woman, old to young or young to old, change family members from daughter to sister etc.... This way it kind of becomes a composite story and is definitely not identifiable. I don't think there is anything wrong with saying you once looked after a patient who left the floor - that is pretty vague!
  14. Meraki

    Sleeping on the job.

    How many 12s did she do in a row? you said coming off a week... Being new it is hard to say no and it may be she accepted way to many shifts. The management may realize they kind of took advantage of her and feel partial responsibility hence not firing or suspending her. Staying wide awake while sitting with one pt all night is hard to do even when you are rested - especially when starting out and adjusting to night shift. If she did too many shifts in a row it may have just been more than her body could handle. 3 12s in a row is plenty.
  15. Meraki

    How to get registration in Ontario

    BScN has been entry to practice in Ontario since 2005 so the CNO will not let you write without a BScN. Do you have a degree in another field? If so I know McGill (and maybe other schools?) has a program (2 or 3 yr) that gives you an MSN and makes you eligible to write the CRNE - but you definitely need to already have a degree to apply. I don't think an online MSN will help if you still don't have a BScN. Can you get a MSN without an undergraduate degree? That doesn't seem right. There are as the other poster mentioned bridging programs. Here it is called a Post RN BN - they are becoming fewer as many diploma RNs who wanted a degree have already started or completed the bridging program. I think Athabasca has a distance Post RN BN program, at least they used to. Look into Post RN programs rather than BScNs - although those may only be for nurses already registered as RNs in Ontario, I'm not sure.
  16. Meraki

    How to approach this?

    There is truly no point in this case in going to admin, DNS, DON. They are not family friendly. Their knowing about it will have zero effect. I understand in most cases that would be the right approach but in this particular LTC they will do absolutely nothing. To my face they will tell me all kinds of wonderful things they will do....and they will do absolutely nothing. That is why I can go to them but the sole outcome would be that it had been documented. There is a well established history of this. It isn't about management/admin as a whole it is about these particular 2 people. Therefore my only option is to go above them...either to the company that owns the LTC or through the government complaint line. I have gone through both before however I don't really think they are going to act on this...it isn't significant enough. I wish there was a regular night nurse I could speak to but they haven't replaced the one that left...they are just filling the nights at the moment with whoever they can find so there is no consistency. I will wait and see how it goes this weekend when she is back on. My grandmother can stand up for herself in the moment however it leaves her very agitated, anxious and upset and then she obsesses about it for days/weeks.