Category Archives: Mental Health Nursing

Medication time.

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As many of you know by now, it`s not a secret, the young chap I wrote about in a previous blog is my grandson.

https://anightinwithnelly.wordpress.com/2018/09/02/mental-health-services-in-birmingham-are-woefully-lacking/

Since that time, he has returned to live at home.

From when he was first sectioned nearly four months ago, he has had a whole conglomerate of anti-psychotic drugs and mood enhancers, none of which have really improved his mood very much at all although he does have some better days from time to time. Drugs he has been prescribed and occasionally made to take without his consent include Risperidone, Depakote, Haloperidol which incidentally, he was given too high a dose of and this resulted in him being “wired” and unable to properly relax or sleep for about five days, Procyclidine, Lorazepam, Olanzapine, Propranolol, the list goes on. In spite of his family suggesting he is lucid and wishes to engage in talking therapies, so far our suggestions have not been accepted as a good way to go by the team “supporting” his recovery. They say that he is unable to attend talking therapies while he is being medicated.

Catch 22.

Our dear boy struggles a great deal with his condition. The anti-pyschotic medication sedates him to the point where he feels immobilised and despairing of ever getting better. He is fortunate though and tells us that some of the young people he met in hospital have no-one, no family loving them and helping them as they try to get through it. I can only imagine how lonely and isolating an experience this must be.

Last Wednesday, he was taken off the current anti-psychotic and also Lorazepam, which is a strong sedative, for a period of five days to “see how he would cope.” He has suffered withdrawal from Lorazepam, which is a highly addictive drug as well as whatever his brain is experiencing as it wakes up from the last round of anti-psychotics. He is managing with PRN medication (as and when needed) mostly Depakote which stops him from sleeping and Propranolol which is an anti-anxiety drug. He takes them in a fairly haphazard fashion and his greatest desire is not to take them at all. Unfortunately, he is still ill and becomes very anxious and `pacey` without them.

I fail to see how this treatment resembles anything like a recovery or as one of the women I supported some years ago recently said to me, “I got better IN SPITE OF mental health services, not because of.”  She is in her mid-sixties and has spent several years of her life in hospitals under a Section 3. It doesn’t bode well does it.  I hope one day we will be able to look back as a family on this time and laugh and say, “fuck me that was shit wasn`t it!”

The problem with mental health issues is that they don`t show and people can mask their symptoms sometimes for years living in a kind of hell and with no support or anyone to talk to. The effects and impact that mental health breakdown has on individuals and families is major and the episode my grandson experienced and is trying very hard to recover from, has fractured us as a family. We`ve cried, we`ve sometimes laughed at his idiosyncratic behaviours, we`ve disagreed with one another and argued, we have gradually concluded that heavy drugs do not really help, certainly not in his case. They contain the issue, they do not heal. We are hopeful that natural therapies, diet in particular; talking therapies, patience, innovative distraction ideas and plain old love, will get him through this.

If anyone reading my blog can make any suggestions as to a way forward, then do please feel free to comment. I`ll warmly respond to all comments.

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Nurse training.

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In 2001 I had decided that my true calling in life was to be a nurse, so I began a seconded degree in Mental Health nursing at Birmingham University.  I have to say it was one of the most challenging decisions I have ever undertaken and no matter how many  times I employed tricks to remember the order of things, you know  `the hip bone`s connected to the thigh bone` etc. it remained very difficult for me to achieve the standards I knew must be met.  So I didn`t enjoy it all that much, however I met some very nice students there and some pretty far out tutors as well.  Some of the physiology lectures were so enthralling there would be standing room only, yet occasionally I would meet a student so lacking in social awareness or empathy of any kind, I used to think they would be hopeless next to an inanimate object never mind a human being.  I used to wonder what brought them to nursing when it was so clear, they didn`t like people at all.

Every year all students have to work at a placement and there are a number of tests you must pass during a placement in order to continue the course.  For me, one of these was learning CPR and the other was giving my first injection.  The placement was at a large residential nursing home for older people and as I`ve always enjoyed the company of older people; I was looking forward to it.  The manager was an affable Irish man with ruddy cheeks.   I got on with him from the start and it was only when I was a few days into my stay there that I realised he had a problem with drink.  He would slip up the road to the pub at every possible occasion to top up and was the subject of much, highly unprofessional gossip amongst the staff.   In spite of being mildly pissed most of the time, he was an efficient man who ran a tight ship and the standards of care in the home were maintained at an extremely high level. 

 The residents liked him and so did I.

When it came for me to demonstrate CPR to him, he brought out the plastic torso of half a person affectionately known as Jane and laid her on the floor.  Never mind Vinnie Jones telling us `you only kiss your wife` in those days it was de rigeur to place your mouth over the mouth of the person in trouble.   A plastic shield was strategically put in place as protection in case anyone threw up.  I was ready, my patient was ready, my merry manager observing me as I began the CPR.   Unfortunately I must have blown a bit too enthusiastically into Jane as there was a sudden loud bang and both her lungs quickly deflated.  `My God, you`ve blown her up,` my manager stated the obvious, looking at me incredulously through pink rimmed eyes.  He was right and poor old Jane was a gonner!  I think that must have been the prelude to the new ad`s telling us to press hard and fast to Staying Alive……

On another occasion I had to give my first injection.   It being Mental Health nursing, many of the residents had long term mental health issues and were on all kinds of med`s  some of which can only be administered  into the buttock.  It`s quite tricky injecting into the buttock.  You have to divide it mentally into quarters and then make sure you miss a particular area where there are many nerves which can be damaged, irrevocably so.  You also have to ensure you have the correct dosage of medication in the needle.  Nurses have to learn drug conversions which I always found extremely difficult.   I remember my then husband testing me and saying with a playful smile upon his face as I got it wrong for the umpteenth time,  `Helen you`ve just converted enough lithium into our hypothetical needle to knock out most of Acocks Green…..`    Oh how I laughed.

Anyway the old lady who was kind enough to be my guinea pig flinched,  just a tiny bit as the needle went in and she of a thousand injections commented, very generously I thought, `not bad for a first attempt.

Sadly, the manager was sacked but not before he passed me with flying colours.  I was sorry to see him go.  Drink`s a bugger isn`t it.   I only completed year one of my nursing degree as the  following year I went to live in Darwin.   Ever since that time I have been known as Helen, one third of a nurse.