Why we need to do better with Mental Health. We need to listen to John Oliver.

@LastWeekTonight

Why we need to do better with Mental Health. We need to listen to John Oliver.

I believe this. I believe that every day we wake up and we do the best we can. I don’t think any sane person wakes up and says “Hey I’m going to be a terrible person today.”

People with mental illness do not have a choice. Most of them do not get the care they need. Even when they get care they don’t get the care they need most of the time. They get medications that could be helping or not.

At our local mental health center when you finally get in you get 15 minutes with a person whose only job it is to write you a prescription.

A few years ago for weeks I faxed someone there with no answer. For weeks. Every week I sent this person an FYI fax. The day she was leaving she called me. As it turned out we knew each other and she worked as a psych nurse in the program I ran years ago down in Boca. She said this to me. “Let me give you a little advice! No one will ever call you back. Even if you have releases. The practitioner’s only job is to write prescriptions every fifteen minutes. They are not allowed to call you back.”

So here I am out in field and I can’t communicate with the person who write the prescriptions. There is no continuum of care.

There is no care.

Last June a friend of mine contacted me. She had terrible anxiety and depression. She had tried an antidepressant before and didn’t do well. I suggested to her there are all kinds of antidepressants. To call her PCP and talk to him. She called and could not get an appointment until the next September. She finally got a prescription from another one of her doctors and is doing great.

I have a friend who has a son. A really good kid. As a teen he was experimenting and just like any parents nightmare he took one of those designer drugs. I can’t remember the name. They are all awful.

This stuff fried his brain. He ended up at the local (same one!) community mental health center. He was diagnosed with schizophrenia. Placed on a bunch of antipsychotics.  He was zombie. He couldn’t work really. He went to work with him mom but couldn’t even last the day.

I met them at our local Reiki Circle. This is a really good kid. A bright light under all that mess. A good soul. I spent some time with him and his mom. He loved Reiki. I  asked some questions. Is there a family history of schizophrenia? No Was there any signs of mental illness before he took this drug? No. He was a normal kid.

Now granted it can happen and this kind of event can bring it out.

I just felt like the 15 minute old doctor was wrong and I encouraged her to bring him to the University of Florida. She did. They did a bunch of tests. Like me. They said he’s not schizophrenic. They put him on one antidepressant. He still has anxiety. They put him on another antidepressant. I pray someday he’ll be ok. That his brain will be unfried.

I encouraged the mom to continue to bring him to Reiki which they both enjoyed and if she could afford to take him to our marvelous community acupuncture program that we are so lucky to have.

I see him in our neighborhood. He has dog walking business. He always gives me a hug and says “thank you.” I leave in a puddle of tears.

I always encourage him. He is a great kid.

He has a great mom. She really believed in him. Som

Last week there was another shooting. Another mentally ill person. The same thing. The pro gun people come and drown out the people who want more mental health services and nothing is done.

It will happen again.

I don’t want to have this conversation anymore. About guns. About how the GOP is trying to take my free speech away and tell me I can’t ask a patient if they have gun. Who does that?

I’m not even going off on that rant. You cannot talk to people who apparently having difficulty processing information. These people are destroying us with their BS rhetoric.

You want people to work. You help them get well. Because they want to work. Because no one wakes up in the morning and says “I want to be disabled. I want to collect SSDI. I want to worry about where my next meal is coming from. I want to be alone. I want to isolated. I want to be mentally ill.” No one.

Let’s start here.

Let’s watch this fabulous piece by John Oliver together and talk about that. Because John is saying everything I’ve said to all of you.

“In 2013, an estimated 43.8 million adults in the US had any mental illness.
10 million people suffer from serious mental illness.

John talks about how JFK mandated the state mental Hospitals get shut down and he is right when he says we never followed thru with the funding for community mental health.

Many are being place in nursing homes. They send people on a “greyhound” to someplace else so far away they can be admitted to that facility again.”

I want to thank John Oliver from the bottom of my heart. Just yesterday for some reason Dr Phil was on my tv. He was berating this person that was delusional. So now America will think that people can talk themselves out of delusions. I didn’t see the beginning so I have no idea what the background is. I don’t know if this kid is on medications. All I know is this baffoon is standing in my tv giving this kid advice. Maybe it good and maybe it’s not. But what is the take away? The take is people can talk themselves out of their delusions which is not true unless your Dr Phil.

Now lets take this situation and think about this. Your mentally ill loved one ended up in a jail in Florida where he has a broomstick stuck up his butt.  Imagine that is your child.

It’s unimaginable.

Unfortunately its true.

I’m going to go even further and say there are a lot of people out there that are mentally ill that could be a lot better.  With the proper diagnostic care , some creatively, and  community followup they could go beyond the community home they live in (If they are lucky enough to live in a place like this.) and function in the world. Have jobs. Relationships. Like every one.

Because they are like everyone except they have chemistry issues.

They could have a life.

I hope you take the time to read this blog. If you live someplace with cool mental health solutions I would love to hear about it.

Here are some other posts I’ve written on the subject.

https://cyndi-lenz.com/2015/06/04/jail-is-the-new-state-mental-hospital-where-are-the-diversion-programs/

https://cyndi-lenz.com/2015/06/02/june-is-educate-your-legislators-in-mental-illness-month-i-said-so/

https://cyndi-lenz.com/2015/05/11/the-asylum-life-house-on-the-hill/

https://cyndi-lenz.com/2015/05/07/dorothea-dix-psych-nurse-and-social-reformer/

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The Florida Legislature Gags Health Care Workers. How not to save a life.

 The Florida Legislature Gags Health Care Workers. How not to save a life.

Just file this  under “Kick me in the head.”

As well as others, like people who don’t want their houses to float away in Miami, or their drinking water to be all salty, or just us folks here in Stuart/Jensen Beach that don’t want to have to worry about pollution, trains with bombs,  and getting flesh eating bacteria when we go to the beach only to be eaten by horny sharks.

When does this endless intrusion end?

Honestly. I’d rather be some sharks dinner than have to figure out how to deal with this garbage.

The people who couldn’t even pass half the credentialing that’s needed to work in the health care field passed a terrible law again to punish all of us that are trying to do our jobs.

https://cyndi-lenz.com/2015/05/31/do-our-legislators-need-to-be-credentialed/

This whole mess started when a woman took her child to the pediatrician in Ocala. Pediatricians go to meetings with other pediatricians.  and in those meeting  they come up with a list of things to “educate” their clients. Just like us nurses do. Especially now that everything is computerized we can’t upload our admission unless all the questions are answered. Many of our safety questions are mandated.  That’s just for regular medical people. I’m not even talking about psych.

Let me repeat that one more time. WE CAN’T UPLOAD OUR PAPERWORK UNLESS THE ALL THE QUESTIONS ARE ANSWERED.

At any rate, the pediatrician is doing his job and this girl totally goes off on him and she gets in touch with her state rep who lives in Sanford. The Florida NRA gets a hold of all this and they just run with it. I’d have to go back and look it up but I think the pediatrician refused to see the patient not because of the gun. Because she went off. Doctor’s have the right to tell patients they don’t want to come back. It happens all the time.

Guess what. One of those questions is “Do you have a gun?” or “Do you have any weapons?” or “Do you have any fire arms? ” We ask this question, honestly ,with the same tone in our voices as did you poop today? It’s just one more question in a zillion questions when you are doing an assessment of a patient. It’s just one little bit of education. We talk about all kinds of things: scatter rugs, seat belts, steps.  Anything that is about the safety of patient is OUR business.  Because that’s our job. Our first priority is to make sure our patients are safe and if they are not we have a legal/moral/ethical responsibility to make sure we fixed the situation so the patient is safe.

I’ve have never in all my years as a nurse had anyone who was upset about this question. I’ve had some great discussions about safety especially when children are involved.

I’m not antigun. We had Dad’s army guns in the house and we had guns in Maine at our camp. I was a sharpshooter at summer  camp in New Hampshire and I carried a rifle on my back in the field of the kibbutz I lived on in Israel. I was taught to be responsible.

There are some cases that I do need to know if someone has gun. Because if I don’t ask and the person hurts them self  or someone else its malpractice. It beyond malpractice. It’s immoral. It’s beyond reason. Just the thought that I could after all my hard work be responsible for the death of someone because my legislators are idiots just slays me.

http://thinkprogress.org/justice/2014/07/29/3464945/court-upholds-florida-law-that-punishes-doctors-for-talking-about-guns/

“Several years ago, the American Medical Association advised doctors to ask their patients about firearms and “educate patients to the dangers of firearms to children” in the name of public health. But doctors in Florida may be suppressed from giving this medical advice, now that a federal appeals court upheld a Florida law that became known as the “physician gag rule” because it punishes doctors for talking about guns.”

Except it not just about physicians. It’s about all health care workers. We are all gagged and we are all open to disciplinary action.

http://www.theatlantic.com/health/archive/2014/08/doctors-cant-ask-about-guns/375566/

“The American Academy of Pediatrics likens counseling on gun safety to counseling on lead paint avoidance or seat belt use. Pediatricians, the group’s recent policy statement reads, are “urged to counsel parents about the dangers of allowing children and adolescents to have access to guns inside and outside the home.” Doctors are encouraged to promote trigger locks, lock boxes, and gun safes. Some distribute cable locks. The American College of Physicians is similarly proactive, calling gun violence a public health issue “requiring immediate attention.” The group, of which most practicing internal-medicine doctors are members, declared in its recent position statement: “Physicians must become more active in counseling patients about firearm safety.” The college implores doctors to open that conversation by asking patients (with and without children in their homes) about gun ownership.”

http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String+&URL=0700-0799/0790/Sections/0790.338.html

790.338 Medical privacy concerning firearms; prohibitions; penalties; exceptions.

(1) A health care practitioner licensed under chapter 456 or a health care facility licensed under chapter 395 may not intentionally enter any disclosed information concerning firearm ownership into the patient’s medical record if the practitioner knows that such information is not relevant to the patient’s medical care or safety, or the safety of others.
(2) A health care practitioner licensed under chapter 456 or a health care facility licensed under chapter 395 shall respect a patient’s right to privacy and should refrain from making a written inquiry or asking questions concerning the ownership of a firearm or ammunition by the patient or by a family member of the patient, or the presence of a firearm in a private home or other domicile of the patient or a family member of the patient. Notwithstanding this provision, a health care practitioner or health care facility that in good faith believes that this information is relevant to the patient’s medical care or safety, or the safety of others, may make such a verbal or written inquiry.
(3) Any emergency medical technician or paramedic acting under the supervision of an emergency medical services medical director under chapter 401 may make an inquiry concerning the possession or presence of a firearm if he or she, in good faith, believes that information regarding the possession of a firearm by the patient or the presence of a firearm in the home or domicile of a patient or a patient’s family member is necessary to treat a patient during the course and scope of a medical emergency or that the presence or possession of a firearm would pose an imminent danger or threat to the patient or others.
(Because EMT’s have nothing better to do while they are saving the life of your family member.)
(4) A patient may decline to answer or provide any information regarding ownership of a firearm by the patient or a family member of the patient, or the presence of a firearm in the domicile of the patient or a family member of the patient. A patient’s decision not to answer a question relating to the presence or ownership of a firearm does not alter existing law regarding a physician’s authorization to choose his or her patients.
(5) A health care practitioner licensed under chapter 456 or a health care facility licensed under chapter 395 may not discriminate against a patient based solely upon the patient’s exercise of the constitutional right to own and possess firearms or ammunition.
(Who does this anyway? How do you people come up with this garbage? We’re health care workers. It’s our job NOT to judge anyone. Just because your judgmental doesn’t mean we are. A case of pure projection.)
(6) A health care practitioner licensed under chapter 456 or a health care facility licensed under chapter 395 shall respect a patient’s legal right to own or possess a firearm and should refrain from unnecessarily harassing a patient about firearm ownership during an examination.
(7) An insurer issuing any type of insurance policy pursuant to chapter 627 may not deny coverage, increase any premium, or otherwise discriminate against any insured or applicant for insurance on the basis of or upon reliance upon the lawful ownership or possession of a firearm or ammunition or the lawful use or storage of a firearm or ammunition. Nothing herein shall prevent an insurer from considering the fair market value of firearms or ammunition in the setting of premiums for scheduled personal property coverage.
Another care of guilty until proven innocent.
(8) Violations of the provisions of subsections (1)-(4) constitute grounds for disciplinary action under ss. 456.072(2) and 395.1055.
History.s. 1, ch. 2011-112.
If violated we get to go in front of disciplinary board.
How would you suggest we not ask this question since it required? I’m pretty sure we all similar computer programs which ask basically the same question.

Almost 20,000 people committed suicide in the United States with firearms in 2011. More than 11,000 were killed by firearms that year, and more than 200 were killed in accidents with guns. In 2009, almost 7,400 children were hospitalized because of injuries related to guns.

Doctors who ask about guns aren’t doing so because they’re nosy. They’re doing so because the vast majority of those deaths and injuries are preventable.

It’s entirely possible to keep a gun in your home safely. But studies show that the majority of people who keep guns in their homes do so in an unlocked space. Few have any kind of trigger locks. More than 10 percent report keeping their guns loaded or near ammunition, in an unlocked area.

That’s often how children get hurt. Few people argue that young children should have access to guns or ammunition. But that’s what’s happening in far too many homes in the United States. Research shows that guns kept in the home are more likely to be involved in accidents, crimes, or suicides than in self-defense.

http://www.slate.com/articles/health_and_science/medical_examiner/2014/07/docs_vs_glocks_upheld_florida_pediatricians_forbidden_from_asking_patients.html

ut this kind of stuff does happen in Florida—far more often than you’d think. In 2013 alone, at least 17 children in the state were killed by guns, and myriad more were wounded. These tragedies are part of a spiraling, nationwide epidemic of gun violence toward children, which includes a horrifyingly high number of absolutely preventable accidental shootings.

The gag law, nicknamed the Docs vs. Glocks law by its detractors, was passed by an overwhelmingly Republican Legislature brimming over with money from NRA lobbyists. It would seem to be an obvious First Amendment violation: For asking a patient a question that could save his child’s life, a doctor in Florida could lose her medical license or be fined $10,000. The state has no rational—let alone compelling—interest in censoring doctors from asking this basic question, much less preventing doctors from making evidence-based recommendations about public health and safety. And the law is so broad and vague that even an indirect inquiry could potentially qualify as illegal “harassment of a patient regarding firearm ownership.”

I can’t wait for next year! I bet we won’t be able to ask people if they pooped.
I pooped today

June is educate your legislators in mental illness month. I said so!

@joenegronfl

who said

http://fcir.org/2012/07/26/florida-slips-even-lower-in-mental-health-funding/

“More specifically, state Sen. Joe Negron, R-Palm City, advocated cuts to so-called soft services, which include mental health and drug-addiction programs, because many of these services address what Negon views as “a lack of willpower, a lack of discipline, a lack of character.” Negron was the chair of appropriations for health and human services in the state Senate.”

This attitude has got to change. We cannot have legislators that do not believe in taking  care of our most vulnerable people and do not believe in science.

Mental illness knows no parties. It is a bipartisan disease.

mental-health1-1050x641

Let’s educate our legislators. Let’s make a difference.

Let’s make June “Educate your legislators on mental illness month.”

Society is Judged By How They Treat the Most Vulnerable.

What does this say about us?

http://www2.nami.org/ContentManagement/ContentDisplay.cfm?ContentFileID=93487

Mental Illness Is Common
Of Florida’s approximately 18.3 million residents, close to  660,000 adults live with serious mental illness
and about 181,000 children live with serious mental health conditions.
Untreated Mental Illness has Deadly and Costly Consequences
In 2006, 2,440 Floridians died by suicide.
Suicide is almost always the result of untreated or under-
treated mental illness.
Public Mental Health Services
are Inadequate to Meet Needs
Florida’s public mental health system
m provides services to only 26 percent of adults who live with
serious mental illnesses in the state.
Florida spent just $38 per capita on mental health
agency services in 2006, or $686.6 million
Nationally, an average of 70 percent is spent
on community mental health services and 28 percent on state hospital care.
by the numbers
Criminal Justice Systems Bear a Heavy Burden
In 2006, 7,302 children were incarcerated in Florida’s juvenile justice system.
Nationally,
approximately 70 percent of youth in juvenile justice
systems experience mental health disorders, with
20 percent experiencing a
severe
mental health condition.
In 2008, approximately 24,600 adults with mental
illnesses were incarcerated in prisons in Florida.
Additionally, an estimated 31 percent of female and 14
percent of male jail inmates nationally live with
serious mental illness.
Many Residents Rely on Public Services for Needed Care
Approximately 10.1 percent of Floridians are enrolled in Medicaid.
Housing is Unaffordable for People who rely on SSI or SSDI.
The average rent for a studio apartment in Florida is
119 percent of the average Supplemental Security
Income (SSI) payment, making housing unaffordable
for adults living with serious mental illness who rely on SSI.
Here is an article from Science Daily

Brain circuit problem likely sets stage for the ‘voices’ that are symptom of schizophrenia

Scientists have identified problems in a connection between brain structures that may predispose individuals to hearing the ‘voices’ that are a common symptom of schizophrenia. Researchers linked the problem to a gene deletion. This leads to changes in brain chemistry that reduce the flow of information between two brain structures involved in processing auditory information.

Here is a video by ROCHE that is a simple explanation on schizophrenia.

The biology of schizophrenia.

Mental Disorders as Brain Disorders: Thomas Insel at TEDxCaltech

Paddlefest 2015: Project L.I.F.T.

Paddlefest 2015:  Project Lift

DSC_0008

http://www.projectliftmc.com

How Project L.I.F.T. works

Project L.I.F.T. combines job-training, community service and behavior modification with pioneering community solutions during difficult economic times. “At-risk” youth members of Project L.I.F.T. have the opportunity to literally affect the lives of hundreds of individuals in a positive way through innovative interventions and service learning experiences.

This sense of self-management and community responsibility will equip at-risk youth with problem solving capabilities to provide insight into why they choose certain negative behaviors and how to successfully intervene to avoid those behaviors in the future.

Each day, members of Project L.I.F.T. receive the opportunity to learn hands-on job skills, guided by professionals in designated fields. The projects that members work on and learn from are then made available to families in need. Surrounded by positive mentors, members are also provided with a safe and healthy environment to build valuable and meaningful relationships, which help them grow mentally and develop skills to prevent relapses. During this process, members are given opportunities to work on their “self” through structured behavioral interventions led by state licensed mental health professionals.

The product of the Project L.I.F.T. experience is not only a “Restored Youth,” but a youth who is better prepared to live and work independently.

I met up with Matt Churchey at Paddlefest and he told me about Project Lift.

Thank You PROJECT LIFT!

Missing Paul Wellstone

Missing Paul Wellstone

wellstone3

Yesterday I attended Candidate Training with Kevin Winchell in Palm Beach County. He referred to  Wellstone Training and it for a moment  I was terrified that I had not thought about Paul Wellstone for a very long time. TIme passed and people become a blur because they are not in front of us on 24 hour news cycle.

This is one person we can never ever forget.

wellstone4

http://en.wikipedia.org/wiki/Paul_Wellstone

Paul David Wellstone (July 21, 1944 – October 25, 2002) was an American academic and politician who represented Minnesota in the United States Senate from 1991 until his death in a plane crash in 2002. A member of the Democratic Farmer-Labor Party, Wellstone was a leading spokesman for the progressive wing of the national Democratic Party.

In 1998, Wellstone formed an exploratory committee and a leadership PAC, the Progressive Politics Network, that paid for his travels to Iowa and New Hampshire, two early primary states in the nomination process. He spoke before organized labor and local Democrats, using the slogan, “I represent the democratic wing of the Democratic Party”. Governor Howard Dean later incorporated that phrase into his stump speech in the 2004 US presidential election.[3]

wellstone6

On January 9, 1999, Wellstone called a press conference at the Minnesota State Capitol. Despite expectations that he would announce his candidacy, he stated he could not muster the stamina necessary for a national campaign, citing chronic back problems he ascribed to an old wrestling injury. His pain was later diagnosed as multiple sclerosis.

wellstone5

On October 25, 2002, Wellstone, along with seven others, died in an airplane crash in northern Minnesota, at 10:22 a.m. He was 58 years old. The other victims were his wife, Sheila; one of his three children, Marcia; the two pilots, his driver, and two campaign staffers. The airplane was en route to Eveleth, where Wellstone was to attend the funeral of Martin Rukavina, a steelworker whose son Tom Rukavina served in the Minnesota House of Representatives. Wellstone decided to go to the funeral instead of a rally and fundraiser in Minneapolis attended by Mondale and fellow Senator Ted Kennedy. He was to debate Norm Coleman in Duluth, Minnesota, that same night.

paul wellstone

In 2007, former First Lady Rosalynn Carter joined with David Wellstone to push Congress to pass legislation regarding mental health insurance.[54] Wellstone and Carter worked to pass the “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008” which requires equal coverage of mental and physical illnesses when policies include both types of coverage; both testified before a House subcommittee regarding the bill in July 2007.[54] David said of his father, “Although he was passionate on many issues, there was not another issue that surpassed this in terms of his passion.”[54] Because Paul Wellstone’s brother had suffered from mental illness, Wellstone had fought for changes in mental health and insurance laws when he reached the Senate.[54]

http://en.wikipedia.org/wiki/Public_Law_110-343#Paul_Wellstone_and_Pete_Domenici_Mental_Health_Parity_and_Addiction_Equity_Act_of_2008

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (a part of Division C) mandates that if U.S. health insurance companies provide coverage for mental health and substance abuse, the coverage must be equal for conditions such as psychological disorders, alcoholism, and drug addiction.[4][24][25] This act continues and expands upon the previous Mental Health Parity Act of 1996. It states that financial requirements such as deductibles and copayments and lifetime or dollar limits to mental health benefits and substance abuse disorder benefits should be no more restrictive than those on medical and surgical benefits.[26] MHPAEA applies to employer-sponsored health insurance plans with more than 50 employees, though parity is also extended to small group and individual plans under the Affordable Care Act.

He would have loved Obama Care because people like his brother could get the care he deserved.

http://www.theatlantic.com/politics/archive/2012/10/paul-wellstones-legacy-10-years-later/264086/

Al Franken wrote

“When today’s progressives remember Paul, they tend to focus on his sheer political courage. Paul was the only senator up for re-election in 2002 to vote against the Iraq War — a vote he told people he was convinced would cost him his job.

One of Paul’s most famous quotes is this: “Politics is not about power. Politics is not about money. Politics is not about winning for the sake of winning. Politics is about the improvement of people’s lives.

The big fights — war and peace, justice and liberty — are important. But there aren’t any small fights. And where Paul made the biggest impact — where his work resulted in the greatest improvement of people’s lives — was on issues that don’t usually lead anyone’s stump speech: mental health, domestic violence, homelessness among veterans.

Paul’s brother, Stephen, had struggled with mental illness since he was 19. And Paul knew that many people who suffered from mental health problems were forced to suffer all over again because their insurance companies wouldn’t cover the treatments they needed. Paul’s own parents spent 20 years paying down the bill for Stephen’s treatment.

So he found a Republican with a similar first-hand understanding of the problem, New Mexico Senator Pete Domenici, and the two introduced legislation that would require insurance companies to treat mental health the same way they did physical health. Paul didn’t live to see mental health parity become law — but it did (thanks in large part to another Republican colleague, Minnesota’s Jim Ramstad), and that crusade has improved, even saved, millions of lives.

hat’s why Paul’s political career began by organizing college students and low-income women to fight for better anti-poverty measures, and organizing farmers to fight against utility companies planning to install power lines on their land. And that’s why the organization that bears his name and carries forward his legacy, Wellstone Action, isn’t a think tank or a super PAC. Wellstone Action trains organizers — not just to articulate progressive values, but to do the “prosaic, practical work” that makes a difference.”

First campaign “Looking for Rudy”

Opposing the Iraq War

“Fast Paul” awesome campaign ad

I’ll never forget the day that Paul Wellstone died. I can never forget this.

and I went to order his book from Amazon

http://www.amazon.com/The-Conscience-Liberal-Reclaiming-Compassionate/dp/081664179X

Amazon reminded me that I bought this book before. I bought it October 2002.

Let’s not forget this awesome man.

wellstone2

Nursing Ethics: Alcoholism , nurses, IPN, and “ego”

I think its very difficult when your not an alcoholic and you have you have to deal with people who are actively.  It’s impossible to be around their behavoir especially when someone doesn’t go to AA and think they can do this themselves or think just not drinking is the answer. It’s even harder when that person is a fellow nurse or doctor or healthcare worker because in that case you have an ethical responsibility to do something. Actually the responsibility goes beyond ethical. In Florida is required.

We, nurses,  have an ethical responsibility to report. We have an ethical responsibility to help. Don’t let anyone tell you any different.

http://www.nursingworld.org/codeofethics

Moral courage helps us address ethical issues and take action when doing the right thing is not easy. Moral courage involves the willingness to speak out and do what is right in the face of forces that would lead us to act in some other way.

Your a nurse 24 hours a day.

Take a moment to remember the nurse who said she wasn’t working as a nurse and therefore she wasn’t going to perform cpr.

http://www.medscape.com/viewarticle/781098_3

http://scrubsmag.com/emt-faces-criminal-charges-after-reportedly-failing-to-provide-care/

Believe me when we screw up the first thing that is pointed out is that we are nurses.

So I think it’s important to understand our responsibilities.

http://www.nursetogether.com/ethical-issue-in-nursing-when-your-colleag

http://drug.addictionblog.org/nursing-code-of-ethics-should-nurses-report-co-worker-drug-use/

So I found this article and I really loved it.  It deals with one issue. EGO and ego. This is one thing that can drive you crazy while dealing with a patient. client , friend or family member. I hope it will help others understand.

http://www.thejaywalker.com/pages/tiebout/index.html

“Dr Harry M. Tiebout

tiebout

Dr. Harry M. Tiebout, a psychiatrist, was an early pioneer in coupling the principles and philosophy of Alcoholics Anonymous with psychiatric knowledge of alcoholism. A strong supporter of A.A. throughout his life, he consistently worked for acceptance of his views concerning alcoholism the medical and psychiatric professions. He served on the Board of Trustees for A.A. from 1957 to 1966, and was chairman of the National Council on Alcoholism in 1950.”

An incredibly thoughtful man.

 

http://www.silkworth.net/tiebout/tiebout_egofactors.html

some of my favorite parts.

 The first question, what factors in the individual must surrender received passing attention in the article on compliance. There, relative to the difficulty of surrender, I noted that “the presence of an apparently unconquerable ego became evident. It was this ego which had to become humble.” The first part of the present communication will be devoted to an elaboration of the nature of this ego factor.

Let us take the same trait of doing everything in a hurry and apply it to the word “immature.” Few will deny that jumping at conclusions, doing things as speedily as possible, give evidence of immaturity. It is youth that drives fast, thinks fast, feels fast, moves fast, acts hastily in most situations. There can be little question that one of the hallmarks of the immature is the proneness to be under inner pressure for accomplishment. Big plans, big schemes, big hopes abound, unfortunately not matched by an ability to produce. But the effect upon the adult of the persisting infantile quality to do everything in less than sufficient time can now be seen in a clearer light. The adult trait is surely a survival from the original psyche of the infant.”

“Inability to Accept Frustration

The last trait carried over from infancy is the inability to accept frustration. In an obvious sense, this inability is another aspect of the king within, since one of the prerogatives of royalty is to proceed without interruption. For the king to wait is an affront to the royal rank, a slap at his majesty. The ramifications of this inability to endure frustration are so widespread, and the significance of much that occurs in the behavior of the alcoholic is so far-reaching, that it seems advisable to discuss this trait under a separate heading.”

There are plenty of incredible articles written by Dr Tiebout and how I wish I just knew one psychiatrist who put the amount of thought and compassion into his work as opposed to being there to write a prescription every fifteen minutes. Drugs have taken over our beloved practice of psychiatry. Sometimes good. Sometimes not so good.

Florida has an awesome impaired practitioner program. Here is the one for nurses. There is also one for doctors and for pharmacists.

http://www.ipnfl.org/

Florida is one of the first programs and the program is an alternative to discipline. It’s approach is non punitive.  Here is a link to some great videos. It’s actually grounds for disciplinary action not to report. So it even goes beyond ethics to being a part of the Florida Nurse Practice Act.

http://www.ipnfl.org/ipneducational.html

here is the video on you tube

So as usual, not the blog I wanted to write but the blog that evolved.

What’s the best way to deal with an active alcoholic in your midst? What do you think?

Dorothea Dix Psych Nurse and Social Reformer

There are wonderful nurses throughout history that have made changes that have benefited us all.  Dorothea Dix is one of my favorite historical nurses.

http://www.biography.com/people/dorothea-dix-9275710

Dorothea Dix was an educator and social reformer whose devotion to the welfare of the mentally ill led to widespread international reforms.

Synopsis

Born in Hampden, Maine, in 1802, Dorothea Dix was a social reformer whose devotion to the welfare of the mentally ill led to widespread international reforms. After seeing horrific conditions in a Massachusetts prison, she spent the next 40 years lobbying U.S. and Canadian legislators to establish state hospitals for the mentally ill. Her efforts directly affected the building of 32 institutions in the United States.

Here are two I worked in as a mental health tech.

My first job as a Mental Health Tech.

metstate

http://en.wikipedia.org/wiki/Metropolitan_State_Hospital_%28Massachusetts%29

Danvers-State-Insane-Asylum23

http://en.wikipedia.org/wiki/Danvers_State_Hospital

It was a good idea to let the Mentally ill be separate from those who are in jail. Unfortunately, what happened next is not a pretty story leading up to the emptying of state hospital and now we are back to where she is now where people cannot get good mental health care and many people end up in jail instead of treatment where they belong.

http://womenshistory.about.com/od/civilwarnursing/a/nurses_circular.htm

The following is a document written by Dorothea Dix to lay out the requirements for women who would work in the nursing service for the Union Army during the American Civil War.

  • Circular No. 8., by Dorothea Dix

    Washington, D. C., July 14, 1862,

    No candidate for service in the Women’s Department for nursing in the Military Hospitals of the United States, will be received below the age of thirty-five years, nor above fifty.

    Only women of strong health, not subjects of chronic disease, nor liable to sudden illnesses, need apply. The duties of the station make large and continued demands on strength.

    Matronly persons of experience, good conduct, or superior education and serious disposition, will always have preference; habits of neatness, order, sobriety, and industry, are prerequisites.

    All applicants must present certificates of qualification and good character from at least two persons of trust, testifying to morality, integrity, seriousness, and capacity for care of the sick.

    Obedience to rules of the service, and conformity to special regulations, will be required and enforced.

    Compensation, as regulated by act of Congress, forty cents a day and subsistence. Transportation furnished to and from the place of service.

    Amount of luggage limited within small compass.

    Dress plain, (colors brown, grey, or black,) and while connected with the service without ornaments of any sort.

    No applicants accepted for less than three months service; those for longer periods always have preference.

    Approved,
    William A. Hammond,
    Surgeon General.

History of Social Reform in Nursing