Techs and groups

[alb402]

What kind of groups do "techs" run on your units? I work evening shift on a C&A unit. Over the years are programming has become more lax and the evenings have a lot of free time. Seasoned staff and administration want the kids to have more structure. I was a tech for 4 yrs on the unit before graduating nursing school and now being the charge nurse on evenings. I used to run "therapeutic" groups with the kids all the time (and still do when i have free time) e.g psychoeducation, education on coping skills, anger management, goal-setting, etc. One of our newer "techs" ( we call them behavioral health specialists) stated that she "doesn't get paid enough" to do therapeutic groups and that we simply need therapists on evening shift. Their job description does state that they are to lead groups. The only groups they're currently responsible for on evenings are goals groups where they review goals and coping skills. This lasts approx 10 mins. Am I expecting too much to want them to lead groups again? It seems like the motivation and work ethic of staff has decreased significantly with turn over.

I'm head of our unit council on the unit and my boss has given me a lot of decision making and leadership roles on the unit. I don't want to run to her whining about staff, but how can I make people do their job (Other than wanting to slack off and talk/flirt all night)? Or am I asking too much?

[marshmallowstar, BSN, RN]

No, it's not too much. I was an MHT on a children and preadolescent unit before nursing school and we did groups, and back then we only made $7.80. We did a 4 o'clock group which could be anything from drawing their favorite toys, journaling, coping skills games, "health and stress management" aka playing outside. We did goals review around 7 but ours typically lasted 30 minutes with 6-10 patients (kiddos under 10 were in one group kids 10-13 in another). So maybe a way to expand that? We would ask them if they feel any different than when they first got there? How will tomorrow be different than today? What they rate their mood on a scale of 1-10 or with faces similar to wong-baker. why they were feeling that way? We also did developing an evening routine with them, since most lack this at home. Showers, snack, brush teeth. Then we would do a storytime for the little guys by reading them a couple of story books. The older kids would do relaxation techniques, breathing, imagery or we would ready chapters out of books. For a while we were reading chapters of Harry Potter every other night, the kids loved it.

If the treatment team is asking for increased structure maybe have a treatment team meeting that includes MHWs to develop a new schedule for evening with MHW input. I think getting them to buy into the fact this will actually make their jobs easier, occupied kids are kids that aren't requiring redirection or seclusion/restraint. And take it to your supervisor, she's the boss for a reason.

[suzycap]

Our groups require RN or OT. Last 1 hr. Topics are scheduled. Staff facilitates. Break up into 2 groups each time, depends on function. Hallucinating, etc go to 1 group. Hard to take time to chart on group and assigned pts. Yalom is our guide. Also, started W.RA.P. PROCESS, or can take home and use in iop or ltsr. Wish we could do more, acute into, alas 5-6 days, except pts who need long term 2-3 months!

[suzycap]

Looked into ped psych. Have seen peds in our E R. Tranfer. Hard to see 6 yo want to kill himself or parents that have to be reported for drop off and run. You peds MHRNs are special. 8 yo bipolar?