
Sep 25, 2017, 07:11 PM
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Member Since: Mar 2011
Posts: 506
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Quote:
Originally Posted by Evil Schnoodle
I can understand both points of view, as I worked on inpatient mental health units and in Psychiatric ERs for 7 years and have been a patient in a psychiatric unit twice. Safety in psychiatric settings is the primary need, for both patients and staff. I would not want to be a patient on a unit if I didn't trust that I was safe. Rules about weapons, razor blades, shoe strings etc. exist to help people stay safe from themselves (when they are not able to do it at the moment), allow other patients the opportunity of a healing environment, and decrease the chances that staff or visitors will be injured, killed, or end up with PTSD.
On the other hand, being locked up, having your clothing removed, being taken away from some possible coping tools (cigarettes, freedom to listen to music when you want...), treated like you are not being trusted, and getting into power struggles with staff....all these things can re-traumatize patients. Over 90% of inpatients have histories of significant traumas...that we can very easily trigger by the same policies we use to keep a safe environment.
An answer is practicing in a trauma-informed care model. Staff use "universal precautions" by treating everyone as if they have been traumatized (sexual assualt, poverty, substance use, prostitution, violence, etc.). Safety is set for ALL involved with information about why safety is needed. Staff treat patients as human being first and patient's second. Patients are involved in their treatment planning and can be givien a menu of options. And when someone is dangerous to self or others, safety is managed in the least restrictive manner possible...with open discussions afterward when possible - acknowledging the difficulty of the situation and how staff and the patient can understand each other and learn to avoid the problem in the future. This is not realistic 100% of the time, but it is an ideal to shoot for. We can keep a safe environment, while restricting people's access to harmful things, and also promote healing by how staff interact with patients and each other...and try to create an environment of mutual respect even with safety being prioritized.
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Absolutely agree about the culture of the unit and how people are treated-re RESPECT. I am grateful to say where I work we definitely try to keep this in the forefront when working with our clients. It goes past trauma-informed care. It's about basic human dignity and rights. I'm glad to hear from a fellow worker in the field striving to give the best care possible. Thank you for your work and all you do!!!
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