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Hukilau

Hukilau

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Hukilau's Latest Activity

  1. Hukilau

    New to psych-need reading materials

    "Inpatient Group Psychotherapy" by Irvin Yalom is not only a resource for groups, but provides insight on fundamentals of interacting with mental health patients. Very readable, this book is 20 years old but the information is still golden.
  2. Hukilau

    Safety Policies

    Most of your reply makes good sense, but I am a little disturbed by your last sentence. It's possible that some pts might be strongly opposed to having their room tossed because they are trying to hold onto some sense of dignity during a difficult time in their lives. To suggest that you should perhaps be MORE suspicious because someone objects to such an over-the-top invasion of privacy suggests a lack of understanding of basic human dynamics.
  3. Hukilau

    Safety Policies

    I have worked in at least a couple of dozen different psych units all over the country during the past 30 years. Every place has a different policy regarding safety checks and searches. i can assure you that you are on the extreme end of the spectrum. Q shift checks are way beyond the norm. Having patients turn out their pockets after being off the unit is way beyond the norm. You are correct that there needs to be a balance between safety, privacy, and what is reasonably possible with the resources you have. I would suggest that you research psych facilities in your area, or similar facilities anywhere, and find out what the norm is. Don't expect your nurse manager to be swayed by the evidence, however. One thing I have learned is that, with a few notable exceptions, once a manager believes that things MUST be done a certain way, no amount of evidence to the contrary will change their mind. Actually, this also applies to staff who have only worked at one facility. Here is a reasonable plan based on the best I have seen... usually worked out by experienced staff during many years of practice: 1)Take all pt. belongings BEFORE they come on the unit. Have the belongings searched by staff and separated into four piles: Stuff they can have back immediately, stuff that needs to be locked up and used under supervision, stuff that will be locked up and returned upon discharge, and illegal stuff that will either be destroyed or turned over to authorities. If your pts all come through ER or from other hospitals, it's best if they're changed into hospital gowns before they come on the unit so their clothes can be searched. 2)Do check everything brought in by family/friends. Allow visiting only in community areas that are monitored by staff. 3)Do check pts on return from pass. (Few places actually allow passes any more.) 4)Have Day and Eve charge nurse do room to room rounds at change of shift, but this just needs to be a quick look at each room. 5)If there is reason to believe that there is dangerous contraband on the unit, call a community meeting and have two staff search room by room, with the pt present if they so desire. This should happen rarely. 6) Finally, teach all staff to be constantly observant. When you need to go in a pts room, look around. If you see something that shouldn't be there, calmly let the pt know that you need to take it. Most of the time, pts will act as they perceive you expect them to. If the environment is one of suspicion and total control by staff, then pts will not feel obligated to show any responsibility for themselves or the community. Enough. I hope this might help generate some thought and discussion at least. I have helped start two different units from Day I and also helped two units in the transition from open, totally voluntary to closed invol., so I've thought about and worked on these issues a lot!
  4. Hukilau

    New Nurse Manager in acute psy

    :chuckle :chuckle :rotfl: Thanks! I needed the smile...
  5. Hukilau

    Diabetes question

    As I understand it, you will always be diabetic. That is, it is possible that with a proper balance of diet and exercise you may be able to maintain your blood suger at safe levels, you will never get back to the point where eating sugar won't spike it way above what a normal person would get eating the same thing. But you need a lot more information than you're going to get here on the forum. You need one to one counseling with someone who does this for a living. Note: you will find some claims that diabetes can be "cured" through various diet and supplement plans. That goes against mainstream theory, but who knows? If you discover something that cures your diebetes please post it here. The catch is, a standard ADA diet is really what everyone should be eating anyway. (Heh... I used to drink 6 to 10 Cokes a day along with a half gallon of orange juice, quart of whole milk and a Cinnebonn here and there. Then one day at a routine physical I had a FBS of 174. You know the rest of the story...)
  6. Hukilau

    PowerPoint Presentations

    When you hit "slideshow" do you get choices like "animation scheme" "custom animation" and "slide transition"?
  7. Hukilau

    PowerPoint Presentations

    Yikes! I have 2003... I thought that was about the same as 2000. Hmmm..... Do you see anything that says "slide design"?
  8. Hukilau

    PowerPoint Presentations

    When you open PP, click on "view" and make sure "task pane" is checked. The task pane will be to the right of your slide box. Click on the dropdown that says "getting started" at the top, then click "slide design" and "animation schemes". Play around with that for awhile then try a couple of the other features. There's more, but that should keep you happy for awhile!!
  9. Hukilau

    New Nurse Manager in acute psy

    I am now wondering if this was a bogus post to begin with. Maybe some kind of class project in a nursing management course. No one could be as hopelessly out of touch as the OP portrayed himself to be.
  10. Hukilau

    meds over obj/consent for tx-BIG DIfferece??

    It is really great that you are thinking about these issues! I believe most of what you stated above was, indeed, the intended use of the Mental Health Advance Directive. But the patient should still have the right to refuse medications, even if he previously agreed to it. That's the part that has been abused. In one state where I worked, an advocacy group went to another facility and had patients sign the AD, which then came with the patient to my hospital. During the interview, it became apparent that the patient had no idea what he had signed! And yet some staff were trying to say we could medicate him even if we had to restrain him to do so because he had signed a document that listed that medication as OK! See the potential for abuse? Your basic admission interview should cover what is most and least helpful to the patient when he is out of control.
  11. Hukilau

    PMN,Bestaff,TNA?

    I am about to take an assignment with Bestaff in MA. My recruiter, Matthew, kept working on the assignment even though he knew my first choice was somewhere else with another company. Guess what? The other recruiter was not keeping in touch to tell me what was happening. Matthew kept working and maintaining contact. Made me feel like he was paying attention. I hope to keep working with him for several more assignments!
  12. Hukilau

    Hospitals in Hawaii

    Look at the post. He "heard it through the grapevine." That deserves no credibility at all. I lived in Hawaii for 25 years and worked in several of the hospitals. It's just like any other major city. There are good and bad experiences. Honolulu attracts some of the best and brightest healthcare workers, and some of the worst. Here's the bottom line: You can do anything for 6 months! Go try it!
  13. Hukilau

    meds over obj/consent for tx-BIG DIfferece??

    Do a search for "Protection and Advocacy" in your state. At one time every state was mandated to have such an agency. Things have changed somewhat now but you still might find something. Another thing you can do is search the statutes yourself, although depending on the state it can be difficult to make any sense of the mental health laws. As others have said, it sounds like what you describe is illegal anyplace I've worked. There is a recent push to implement "Advance Directives for Psychiatric Patients" in some states, which some healthcare providers interpret as meaning, "Once you sign it, we can do whatever we want to you!" But that's a whole 'nother can of worms!
  14. Hukilau

    book reccomendations for new psych nurse

    "Inpatient Group Psychotherapy" by Irvin Yalom. You probably won't actually get to do any group therapy, but Yalom's writing style is very enjoyable and informative and will give you a solid foundation in how to THINK about what you are doing with psychiatric patients. (Note: make sure you get the inpatient group therapy book, he also wrote one on standard group therapy which doesn't apply nearly as well.)
  15. Hukilau

    New Nurse Manager in acute psy

    Let me put this as gently as I can: You don't know what you're talking about. (Sigh... I was afraid it would come out like that.) You have no psych experience and you immediately think you know what this unit needs. I am sure change is needed. I am sure there are some terrible practices among the staff. But you simply cannot understand the dynamics of the situation, and apparently neither can your superiors for putting you in such an impossible situation. I don't expect you to accept any of what I say. I can only hope that you get so discouraged you quit. That would be best for you and the unit.
  16. Hukilau

    Max security ward job

    Asking how much you weigh is highly inappropriate and is probably an indication of the head nurse's feelings of fear and ineffectiveness (or sadistic leanings.). If you take that job expect to be in the middle of physical confrontations daily. I would ask what kind of crisis intervention training they use there for the staff. Sounds like they need, but probably don't have, something heavy-duty like MOAB, which stresses de-escalation but teaches you the necessary skills to protect yourself and others when you have to.
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