As a professional I’d basically be required to say the above, but I’m also watching from the inside as my country’s health system decays starting with populations that were underserved to begin with like the mentally ill. In other news I have a hospice interview tomorrow. If nothing else I’ll just get to focus on making people comfortable. That sounds so relaxing. I’m getting tired of having to tell people no all the time.

The nurses and nursing assistants all have to wear trackers that track to see if they go near a hand sanitizer station or sink within 30 seconds after entering and 30 seconds before leaving a room. It’s to check for handwashing compliance but in addition to being a narrow and error-prone window it also doesn’t account for other common situations like poking your head into a room to check on someone while on the way to something else and not touching anything or anyone. It creates a situation where you’re better off just breezing through and ignoring a patient calling to you because if you go over there to acknowledge them but don’t have time to set down whatever you’re in the middle of, it’ll hurt your metrics. They might just need a cup of water you could grab and drop off on your way back in the other direction but fuck 'em, admin says you need to make a whole entry and exit ceremony of asking them what they need to keep your numbers up, so they’ll have to wait until you have time for that.

Yeah like tbh the original comment thread wasn’t worth banning them. Kinda silly but whatever. Literally everything after that was worth a ban though. They picked a molehill and just… fought to the last breath on it.

Yeah when I got that report and responded all I could think was “this thread is basically incomprehensible. Why are these people arguing poetry vs theoretical physics? It’s like arguing whether or not TMNT is enjoyable based on it not being an accurate depiction of turtle biology???” There is a time and a place to get this heated about the fundamental concepts that define the universe we inhabit but a lemmy post about a Tumblr post that’s written like an overly dramatic fanfiction just ain’t it. The last time I got into an argument that dumb (somewhat coincidentally also on tumblr) was literally over half my life ago!

Well said. This is the only person I’ve ever personally banned and it’s because they went out of their way to start multiple fights over silly shit.

I recently listened to “A Wizards Guide to Defensive Baking” recently and I was NOT expecting YA fantasy fiction to go that hard on the subject of “heroism” being a term used to excuse the phenomenon of pushing people into dangerous jobs way too young to cover for the systemic failures and often outright corruption of existing power structures. I had a good few years experience in Healthcare beforehand but I graduated nursing school mid-covid and that book really spoke to me.

Somewhat coincidentally iirc it was actually released mid COVID as well, and I imagine had been worked on for years beforehand. So it’s interesting to me that the author picked up on the already existing manifestations of this phenomenon in a way that would speak so well to the epic clusterfuck that ultimately occurred.

I’m surprised that particular aspect of the side effect profile comes into play with acute usage.

Well obvs. It’s basically,“idk which receptor is making them _____ (punch people, refuse to eat or drink, or whatever other immediate harm to themselves / others), but we need it to stop 3 days ago and can figure out the details or a potential cross-taper to something better later.”

Ah, yes, this happens a lot. No, I don’t work in the medical field at all. I just know things, for reasons.

Color me fascinated, lol. My guesses are personal experience / reading up on your own treatment or that of a loved one, tangential relation to the field such as clinical research, or just plain personal fascination. Given you linked to a drug that appears to be in trials my first guess is actually the second one. Hadn’t heard of it, and I’m hopeful, but after seeing abilify get approved for acute agitation I’m… skeptical.

i.e. the psychosis has done so much cumulative damage at this point that you need to fall back to the typicals. That explains why the third-gens are useless.

Yeah a lot of people don’t realize the damage is additive, both people w/ these disorders and unrelated laypeople who think “talented artist stops taking their meds and continues to be talented but starts creating art with weirder subject matter as their brain boils” is a cool story.

I’m mostly replying to add though that risperdal also has the distinction of being avaliable as a long-acting injectable, and if you’re trialing oral meds before committing to an LAI, your options are somewhat narrowed. Zyprexa does have an LAI available, but I’ve actually never seen it used and while I can’t tell you why for certain, I do have a guess.

If you have a patient sick enough that you’re considering an LAI, you don’t want to take benzos off the table for an entire month, especially if it turns out to be inadequate after discharge and they wind up in an ED agitated and unable to report their own med hx and get B52ed and stop breathing. I’ve had a pharmacist tell me considering that interaction is going out of style but a history of that kind of adverse event is difficult for a med to shake. Accutane still has suicidal ideation in adolescents listed as a side effect but I have a strong suspicion that it’s less causation and more correlation with the impact of pizza face on the self and social esteem of a teenager.

Dude sometimes we still give thorazine. And tbh ime the 3rd gens don’t do shit for my typical patient. For context also though, I’m essentially providing ICU level care, so when you say the word “symptom control” it’s often referring to like, fists.

We had a Lady maxxed on Haldol BID one time and she managed to cheek for a week and eventually she just hauled off and rapid fire punched a nurse in the head three times. She legit thought a man was entering through her window every night on a beam of light to forcibly impregnate her and deliver the baby. She kept demanding to see the 50 babies she had up on L&D from the past few months. I’ve actually seen quite a few pregnancy delusions and they’re almost always completely wild psychosis. Another was such an angry manic but high insight enough that when she couldn’t take it anymore she would just come scream at me for the thorazine.

I’m unsure if you don’t work inpatient psychiatry or you just work somewhere significantly classier than I do. I do work in an inner city area that’s flush with people stuck in a cycle of drugs / homelessness so I’m also not going to tell you that any of this is the best solution, just that it’s the only one avaliable to any of us right now due to shitty government policies.

To the extent that men can lactate! It’s one of the possible side effects of risperdal, which I have to be aware of because I give it fairly regularly. It’s all the same structures it’s just a matter of the hormone signals they’re getting.

an oldie but goodie

Soap is decreasing friction. The dental floss done correctly should apply compression to the tissue and force fluid out of the area. This is especially helpful if a lot of tugging has resulted in swelling.

If you’d like to edit the thing I wrote for free at 2am to include your edits for clarity and more localized bureaucratic knowledge, I’m happy to link right to you at the beginning. Other than that, you’re welcome.

If you’re as disabled as you say and either you have documentation (such as state benefits) or it’s just obvious I would try APS (adult protective services) over the cops. Things will move faster and more effectively if you do some of the legwork (hypothetically speaking) for them ahead of time.

1. Get in touch with the family that might take you in. Try to find three options who confirm they will take you. Write down or keep in a Google doc or whatever their: full names, phone numbers, email addresses, and physical addresses. The number one thing I see holding up cases like yours is housing, and if you have all those details worked out ahead of time a caseworker can do a lot more for you a lot faster. A lot of the time our psych social workers can get someone a uber / lyft or bus ticket easily enough, the problem is figuring out where they’re going. If you have the contact info of someone they can call right there and then who has already agreed to take you, you are a slam dunk open and shut case. Get three so you have backups.

2. Arrange for a ride locally such as a friend or acquaintance or literally anyone else who has a car and is willing to help you for 24-48 hours. This should not be hard to talk someone into. Many people want to help a person like you but don’t have the resources to house someone for weeks or months. For this acquantaince you are an easy way to help and feel good about themselves. Use that. Tell them to wait for you to contact them. Again, try to get three options set up so you have two failsafes.

3. AFTER you’ve done that, call your local APS (adult protective services) or file a report online. Do whatever you can to keep your family from knowing you called because it might take a few hours up to maybe even a day or two for them to get to you and you don’t want your family tipped off in the meantime. Tell them you’re being held by your family and kept from accessing your legal identifying documents like your birth certificate. If you get state benefits your documentation or papers regularly mailed to you may also have a compliance / abuse reporting hotline number somewhere on it. You could also try a crisis hotline through an organization that does community outreach. Tell them they have abused you in the past and you are in fear for your life. Tell them you HAVE A PLACE TO GO you just need help getting your documents. Again, you are easy to help in this situation, they don’t need to worry about setting you up with benefits or housing or anything, just transport maybe. This is what the numbers and addresses are for, they may want to confirm you have somewhere to go and even have options. Just play up the danger and that they’re keeping you from your documents. If you get an asshole worker wait six hours and try again (change of shift) or try calling a different agency or the next town over. You may also be able to find other places to call or worst case scenario call 911.

4. The SECOND they show up and if they’re able to get you those documents, get the hell out to that person who’s helping you locally and block your family and do not tell or hint or give them any other indication of where you’re going. Don’t even tell the person giving you a ride if you think it will get back to them. If necessary tell them an entirely different final destination and just get them to get you to the airport / bus terminal and get out.

5. while you’re waiting, get all your medications, medical equipment / supplies, any valuables or sentimental items, and 3-5 changes of clothes all in the same area of the house. Make sure to pack sentimental clothing but especially pack accessible clothing that’s easy for you to dress yourself with. Get them into a bag if you think you can do so discreetly, but a box or even just a pile in an out of the way corner is fine. If you have any special skin safe shampoo or other non-medicine but important toiletries stash them too or just make sure they’re all in the same place in the bathroom. Get everything into 1-3 discreet / hidden piles so you just need to throw them in a trash bag and go. If there’s any valuables you think your family will try to dispute ownership of, try to get any receipts or photos of you wearing or using them or texts from someone who bought them for you or whatever else you can find and put them in a Google drive folder or email to yourself. Worst case scenario though, be willing to leave some things behind if you have to.

Good luck and godspeed. :)

You know this is the recommended stance when deescalating violent psych patient because it keeps your hands visible (as in, not hiding something) and in front of your body / face in case they start swinging. I’ve never really felt comfortable doing it though and this kind of explains a possible reason why. I actually had a guy the other night who asked why everyone else was scared of him and I didn’t seem to be. There were probably a couple other reasons though (I’ve dealt with waaay wilder men, and also he mostly struck me as young, dumb, and loud, and dumb in the young sense not in the cognitively not there sense). But as far as this pose idk it just always seemed really patronizing to me. I usually stand more like One of these where at least one hand is on the neck or side of the head. Usually with my hands overlapping but my fingers not intertwined so they’re easy to separate and throw up in front of my face but not overtly defensive.

It probably doesn’t help that I’m incredibly irreverent of pretty much everything. I got really into western esoteric spirituality this past year (its really been helping me with introspection and integrating my personality in ways that neither secular therapy or my fundie upbringing ever quite fully did on their own) but at the same time I refuse to take any religion seriously, especially not my own.

Anyway someone in a related community got upset at me for having my irreverent attitude because I was “culturally appropriating” tarot cards from PoC and like dude. Look up where that shit is from its Northern Italy where my family is from just two generations ago they were fresh off the boat when the War was starting. You’re appropriating tarot from me. And if you want to get into the specific spiritual / divinatory usage that’s even fucking whiter. The closest you’re gonna get to claiming cultural appropriation is if you go all the way back before the tarot to the mummy dust the hermetic order of the golden dawn were probably mixing into the coke they were snorting while making that shit the fuck up based on their judeo-christian / classical mythology crossover fanfiction.

People just wanna be mad about shit and at this point I really don’t have the energy to spend appeasing people who have already decided to be mad at me. Imma just be over here using these cards to let my subconscious tell me which level of Maslow’s hierarchy of needs I fucked up this week.

Removal of gendered aspects without any additions.

I’m pretty apathetic to gender in general but I’ve had gender confirming surgery to be NB which I guess technically makes me trans and to be prefectly honest I’ve never felt more judged for it than by the lemmy LGBTQ+ community. The 50y/o southern man that was my nursing supervisor back when I was a new graduate was more respectful of my gender and lived experiences than these people. Honestly the thing they seem to hate most is specifically me expressing apathy for gender; I’ve mentioned that my transness expresses itself by not caring about the whole pronoun thing or needing to have any specific pronouns for myself personally, but that I understand it’s a matter of respect for others and I’ve literally gotten banned for saying that. Like almost exactly that. They’re absolutely hateful bastards for no reason other than that they’re upset and need everybody else to be upset too. I’m lucky I have a handful of supportive people irl because I sure asf wasn’t gonna find it here!

Its like gentle passive parenting with 0 proffesional assistance when your kid has conduct disorder (pediatric precursor to antisocial personality, the newer, updated version of psychopathy). “Can you please put the knife down sweetie? Knives make people sad!”

Honestly my biggest issue is getting randomly banned from trans spaces for expressing my own lived experience with surgery and how I view my own body and gender. They’re so “inclusive” that they start excluding people that don’t use their very specific language or share their beliefs exactly. They keep kicking people out then wondering where all the people went!

I wonder if this is due to gobal climate change or local efforts towards sustainable farming and forestry to reclaim areas the Sahara has encroached on in recent years. Could be both.