Strict Behavior Mod versus Abuse?????

[Shell5]

Hey all! I work child/adolescent psych. I have worked psych with adults and adolescents before, however, I am relatively new at this place. The program is a strict behavior modification program. Everyone seems to have their own ideas of what the limit is, what strict is, how much work to give the patient for level freeze and discipline. Some of the work that Mental Health Techs give is abstract and even seems difficult when I try to do it ie; narcissistic traits, spiritual versus emotional and physical bounderies. I have mentioned a few of these issues before but it is obvious they were not well received. It is very frustrating to me.

I love what I do. I love the patients. I love psych and working with this age group. I think some of the staff are too hard on some of the patients ie; "I'm gonna knock that cup out of your hand." One of them cussed in front of the patient the other day. I mentioned it to supervisor and it is like it's no big deal at all because this person has worked there for 12 or so years. The staff that have been there a long time seem to run the place and the supervisors seem almost scared of them.

It seems as if it is left up to me to do all the discipliary or "dirty work." Everyone else is afraid.

I must admit I have to watch my tendency to be too lenient. This is probably due to the fact I was in several such places when I was young and I had mean staff over me and I know how it feels. I am working on this. In may be my imagination, but I feel pressured to sucumb to the ways of the other staff. This is just not me although I have noticed myself being more stern with a more stern voice lately and I'm not sure if that is a good thing or not. Can someone please let me know what you think please. If you have any advice for me. Thank you in advance.

PS: I did let the MHT know we cannot speak to the patient like that "knock the cup out of the hand." It is just really bothering me the way this person talks to the patients. I am frustrated.

[Whispera, MSN, RN]

They're kids, not prisoners....keep on keeping on, Shell5...you're being a patient advocate and that's what we should do!

[Jules A, MSN]

How long have you worked there? I remember some of my perceptions changing after I had been working at my job for a while. At first I also thought there were many things that were too punitive and there absolutely are techs that aren't therapeutic but for the most part I became stricter myself. When I was new I learned a lot from my techs both what works and what doesn't work so don't discount their experience and relationships with your patients. While I'm still a bit easier on my kiddos than some staff would like I have a better feel for why some things are done the way they are on my unit. You will find that different members of staff have different strengths and sadly there are a few that I'd rather do without but bottom line, imo, is that I am the nurse and when I'm on duty its up to my judgement. Hang in there child/adolescent psych is the bestest!