nickfitz1969

Yes, there's always a negative to come from a positive isn't there? Very sad!

Haha. You really must lighten up! You'll end up with all sorts of stress-related problems! However, it does surprise me that you are talking about another person. That's unlike you. Perhaps you need to get a life. As you seem to be into The Lord of the Rings, I can recommend a tour of the film set down here in little New Zealand. It's not far from where I live. My family and I really enjoyed the tour and you can have your picture taken outside many of the doors in The Shire. My kids had their picture taken outside the door of Bilbo Baggins (green round door) and you can visit the Green Dragon Inn for a drink. It's really good and I really recommend it for kids! See we can play nice!!

Hmmmmmmmmmmmmmmmmmmmmmmm.

I'm really grateful that you allow me to do that Davey Do! Much appreciated.

Thanks!

Very good!

No, Google!

Normal human behaviour. Who would have thought it?

Great post! However, I only post on forum's that I have expertise in, rather than just posting for the fun of it!! As I have mentioned in a previous, I am only an expert in one field of nursing rather than a master of none! Back-handed complements are my forte.

I rest my case your honour!

Sarcasm (noun) "The brain's natural defence against the less intelligent" OR "Sarcasm: the ability to insult idiots without them actually realising it" OR "If you don't want a sarcastic answer, don't ask a stupid question" You choose!

Exactly, its good not be avoidant! Enjoy the shiltz!!!

Saiderap, Patients are not our opponents are they? I agree, a good understanding of personal safety interventions are useful in avoiding risks and maintaining the skills required to manage or avoid dangerous situations is the way to go!

Mental health nursing can be challenging and "dangerous" if the clinician doesn't continually consider the inherent risks in supporting mentally unwell individuals through their crisis. It is often the case that clinicians do not put risk-reducing interventions in place and subsequently get assaulted, but then go onto blame management. If management are unable or unwilling to protect its clinicians, then what can the clinicians do to reduce their risk of harm?

LPC2RN. The difference is that a restraint can actually be therapeutic, rather than sticking someone in a chair and restraining them and then watching them on 1:1 and doing a bit of admin at the same time. I would suggest that this type of intervention would actually wind the patient up, rather than settling them. In the USA this may be acceptable practice and standard practice. However, in other westernized countries with excellent healthcare this type of practice would not be acceptable, especially in regards to patient advocacy groups. Why does it take a specially trained nurse to check physical obs??

It seems that clinicians are getting assaulted and being given little support from their management. So, what as a collective group of professionals can you do about it? Will you stay and get on with it and accept that being assaulted is okay, or can you do something about it? Has anyone ever received a positive resolution to this type of issue, where workplace safety has improved?

So, what as a nursing group can you do about it? If you do nothing, nothing changes.

Does anyone use Invega Trinza (Paliperidone Palmitate) their practice? I note that it is a 3-monthly injection. It is not prescribed in New Zealand, so I just wondered if it is a useful medication to use? Cheers, Nick.

I'm honoured!

In terms of change management, you might wish to consider a transformational leadership approach to engage staff and involve them in the change management process. If you are looking at introducing quality improvement initiatives, maybe look at setting up some small working groups around each improvement, research the evidence and best practice processes that are easily implementable and cost little. Win-win all round. It's always worth thinking about who in the team has a high level of knowledge and would relish these types of opportunities and would get some personal kudos and motivation from it. In terms of structured clinical management for patients with BPD, its often flexibility that is key to engaging this patient group, rather than have too much structure. Do a bit of research on the evidence other than just considering a rigid structured approach. Its about the patient and how the service can engage them in the change process, and not the other way round. Again, you need buy-in from the patient group, otherwise you just go around in circles. Hope this helps!

If a patient attempts to self-harm whilst in seclusion, then at least 3 staff go in and either offer medication or restrain the patient if that is required. Only patients who are under the mental health act can be secluded, so they are unable to refuse treatment if offered. We would offer some brief counselling-type intervention to support the patient to reduce their self-harming behavior, although I note from other posts that RN's don't ordinarily provided counselling for patients as part of their scope of practice.

We provide 1:1 visual observations for patients that harm themselves. No, the seclusion rooms are not padded, but only have a mattress on the floor with a blanket or two. Patients are observed every 10 minutes whilst in seclusion. A minimum of 3 restraint trained staff enter the seclusion room. Also, patients can only be secluded if they are under the mental health act. However, nurses have the legal right to place a patient under the mental health act for up to 6 hours if required, in an emergency.

Thank you for your positive feedback. Much appreciated. I am an expert in my specialist field and I make no bones about that. I don't pretend to be an expert in other fields, as I do not have the specialist knowledge to claim that. Mental health care is a specialist field and unfortunately in countries such as the USA, Australia and New Zealand, have decimated mental health care and the skills and knowledge required by specialist practitioners to support individuals with mental health problems. Anyone can fill a disruptive patient with medication, which undoubtedly does very little to actually produce any significant improvements in functional gain in those individuals. In regard to my comments about being accepted onto a PhD program, I was doing that merely in jest and the irony has obviously been lost on a lot of people! I don't claim to have any superior knowledge. I am an RN. I'm not anything else. If you believe that I have superior knowledge, then thank you for your insight. I have not made that claim! It's also great that you have been reading my other posts; I appreciate that.

Jensmom7, You are right and I accept your comments. I am extremely sorry for my comments and wish to withdraw all of my comments if I have offended anyone. I look forward to real discussions with informed clinician's in the future!

The pleasure was all yours and thanks for wasting your time! Love my new name and your originality!!