When patients get out of hand/violent and adrenalin!?

[Simmy]

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Edit: Sorry for my crappy english. English is not my first language.

I have been working at a psych. ward this summer as a assistant for my practical summer training. The section I work in deals with the most out-of hand patients that come to the psych.-ER.

Its a locked unit, but with deal with patients that when they first come on they get a "leash" to test them out. If they can't behave they will get stricter follow up and either end in the "protection-part" of the the ward and at time straps...

Today we had a patient that got out of hand:
1) First he punched into a door because he was mad because he had to wait untill the smoking-room was un-occupied (only one pt. at the time) and I had to take his arm and follow him out because he wouldent listen to one of the girls that work there.

2)The the alarm went off when I was outside walking with an other pt. and he had been kicking into a door.

3) Apparently he was stearing at a kitchen knife a little to intensly under lunch and waving it slowly back and forth. (nurse statement)

4) We have an area with a porch outside in a locked in backyard where the pt's. can smoke and get some air. This pt. was not allowed out here because he frequently went into another unit across the yard. So I was outside with two patients that was smoking and the guy comes knocking on the door and gives me a sign to open the door through the window in the door couse he wanted to smoke too. I just looked at him and shook my head as a no and turn back to my patients.

I had told him 2 times earlier he was not allowed out there.

Then 3 seconds later I hear a big BANG! in the door which was 2 feet from me. It was so loud I almost jumped in the air because it caught me by suprise. So the adrenaline started rushing and I got out my key and unlocked the door in a hurry and grabbed the patients arm and yelled out "THATS ENOUGH! You are going to your room NOW!".

The patient throws himself to the side so I lose his arm and just get to stand up when two of the older (BIG) male nurses with alot of experience comes and get between us and take controll over the situation.

I was almost shaking because I was so high on adrenaline/scared/shocked after the loud bang. The patient was standing there saying "you guys are getting in my way. I am trying to go outside with the others. You people have to listen to your boss (meaning him)".

I am so glad the guys came between us, or else it could have ended with him punching me or him getting hurt from me trying to stop him.

The thing is: I feelt so ****ty afterwords because I feel like I acted like such a amature barging in there half screaming to the patient. It was very unprofessional, and if it wasen't stopped by the other staff it could have ended much much worse. I applogized to the nurse in charge later explaining what happend and why I reacted as I did and she told me not to worry about it, but I still feel pretty bad.

What kindeof maked me mad though is that they didn't call the doctor earlier to get a consult on this guy when he was behaving as he was. He even bent the door knob on the door 90 degrees the other day trying to break the door. We have no idea how he did it though. But I think they were going to put him in the security area later tonight after my shift was done.

What would you guys say about this situation. And how would you/do you react to what happend here. I'm only a (soon to be) 2'nd year med-student with 6 weeks experience.

 

[GH253]

If you hold patients against their will, you are the aggressor and they are acting in self-defense. Any complaint on your part is invalid.

 

[Regnvejr]

The moment it is known that he is aggressive and/or pushing limits, then the best option is to get him in a quiet area with limited options. If he can't even get close to, or see the courtyard, then he won't be clamoring for it. Prepare for what he might do two escalation s down the road and limit his access to acing out on those impulses. Yes, to some extend, it is to protect you and staff and other clients, but it is also to protect him from himself.

Clearly, when people come to your unit, they are impulsive and have poor insight and judgment. As such, if you start imagining what they can do wrong eventually, then they don't end up restrained or injected with Haldol.

 

[kugel]

If you hold patients against their will, you are the aggressor and they are acting in self-defense. Any complaint on your part is invalid.

Please explain more fully.

 

[Simmy]

The moment it is known that he is aggressive and/or pushing limits, then the best option is to get him in a quiet area with limited options. If he can't even get close to, or see the courtyard, then he won't be clamoring for it. Prepare for what he might do two escalation s down the road and limit his access to acing out on those impulses. Yes, to some extend, it is to protect you and staff and other clients, but it is also to protect him from himself.

Clearly, when people come to your unit, they are impulsive and have poor insight and judgment. As such, if you start imagining what they can do wrong eventually, then they don't end up restrained or injected with Haldol.

Yes this is what we wish to acchive. And I was trying to get him to his room just for that reason. But he wasen't exactly willing to go there as you read. Our patients are often behaving very manic or are in psychosis when they come to us. They are there because they can't handle beeing in a open (unlocked unit). And this guy in particular has been very quite, but been babeling about God, aliens, UFO's and punishment to the staff since he got there, although never raising his voice at all.

He DID get a injection of Zyprexa the other day while beeing held down (using force).

The problem for me is to handle myself totaly profesional with a situation when your adrenaline and instincts are telling you to attack any danger around you. I've been able to do this the whole summer with no problem untill this incident.

 

[Faebinder]

Don't expect a full blown psychotic person to be cooperative. Their insight and judgment is impaired. It takes time to start to control your frustration with their lack of insight and judgment. Especially the lack of insight, that part is frustrating after a while. Trying to explain to the patient that the FBI has no reason to come after him can be frustrating. On the other hand, just because you have schizophrenia, doesn't mean you should be violent. People who aren't mentally ill who do that go to jail. The excuse we use for the patient is that he/she is mentally ill and cannot control themselves, therefore we need to established a controlled environment for them. The patient requires better setup of limits, time in a quiet room to calm down and some medication tweaking likely. If you can tell that to yourself, you can fend off some of the frustration... and this takes time and practice.

On a side note.... Many patients extra smoke to try and alert their minds. Several studies show that patients with schizophrenia are more likely to smoke than the average person and this trend is established BEFORE the onset of the disease. It's a form of self medicating. I am glad we got rid of smoking on our unit. The patients used to be superficially cooperative just to go smoke.... besides the fact that smoking is harmful to everyone in the area of course 🙄.

 

[Faebinder]

If you hold patients against their will, you are the aggressor and they are acting in self-defense. Any complaint on your part is invalid.

Clearly you got great insight... you'd rather they go hurt someone outside and end up in jail.

 

[whopper]

If you hold patients against their will, you are the aggressor and they are acting in self-defense. Any complaint on your part is invalid.

Most states, (probably all of them) have specific laws written detailing that it is a doctor's responsibilty to hold a patient against his/her will if that person is dangerous (danger defined by the specific state's laws) due to a severe psychiatric illness.

If you have a problem with that, then you have to take it up with the state's laws. This is a power that doctors are obligated to enforce by law, just as police officers are obligated to take action against people as defined by the law. Personally I don't have a problem with it, though I also believe that this type of power needs to be transparent, double checked and highly scrutized to prevent abuse and allow protection of patient's rights.

If a patient was psychotic, and told me he wanted to kill someone as a result of his psychosis, and the law told me I could not do anything--then I would not do anything (and I would disagree with the law, but I would follow it, and try to get it changed through legal means). However it currently says I must do something--hospitalize that person against his will.

As for the incident written above, several hospitals have violence reduction training such as telling employees exact protocols to follow if a patient becomes violent. These protocols will protect you, as well as minimize the odds that the patient will be physically harmed.

I will state that several programs I've seen do not include residents in this training which I think it ridiculous. I had to campaing pretty vocally for 2.5 years to get one started in the program where I trained. They offered it to the other psychiatric staff, but left the residents in the dark. Aside from psychiatry, any ER resident IMHO should also get this type of training since things can go violent in an ER.

 

[Simmy]

I had two short classes in how to take controll over patiens who are out of hand by using non-violent force. It works pretty good, but it requires two people to be able to use the technique to "floor" them.

Most states, (probably all of them) have specific laws written detailing that it is a doctor's responsibilty to hold a patient against his/her will if that person is dangerous (danger defined by the specific state's laws) due to a severe psychiatric illness.

If you have a problem with that, then you have to take it up with the state's laws. This is a power that doctors are obligated to enforce by law, just as police officers are obligated to take action against people as defined by the law. Personally I don't have a problem with it, though I also believe that this type of power needs to be transparent, double checked and highly scrutized to prevent abuse and allow protection of patient's rights.

If a patient was psychotic, and told me he wanted to kill someone as a result of his psychosis, and the law told me I could not do anything--then I would not do anything (and I would disagree with the law, but I would follow it, and try to get it changed through legal means). However it currently says I must do something--hospitalize that person against his will.

As for the incident written above, several hospitals have violence reduction training such as telling employees exact protocols to follow if a patient becomes violent. These protocols will protect you, as well as minimize the odds that the patient will be physically harmed.

I will state that several programs I've seen do not include residents in this training which I think it ridiculous. I had to campaing pretty vocally for 2.5 years to get one started in the program where I trained. They offered it to the other psychiatric staff, but left the residents in the dark. Aside from psychiatry, any ER resident IMHO should also get this type of training since things can go violent in an ER.

 

[GH253]

Please explain more fully.

Involuntary commitment is an act of violence against the patient which is equivalent to imprisonment. Because the patient has not committed a crime, however, it is the psychiatrist who is the aggressor, and the patient has every right to use violence in self-defense, just as if you had attacked him on the street. You have no right to hold someone against his will just because you are a psychiatrist and you think you know what's best for him. Involuntary commitment is a monstrously evil institution and whoever participates in it fully deserves to be the recipient of retaliatory violence.

 

[GH253]

Clearly you got great insight... you'd rather they go hurt someone outside and end up in jail.

"Insight" is a term used by psychiatrists to invalidate their patients' independent judgment. If a someone disagrees with your expert diagnosis from the DSM-IV, that infalliable authority, just say he lacks "insight" (i.e. that his refusal to accept your beliefs is the result of mental illness) and you get to be his boss. Great!

 

[GH253]

Most states, (probably all of them) have specific laws written detailing that it is a doctor's responsibilty to hold a patient against his/her will if that person is dangerous (danger defined by the specific state's laws) due to a severe psychiatric illness.

If you have a problem with that, then you have to take it up with the state's laws. This is a power that doctors are obligated to enforce by law, just as police officers are obligated to take action against people as defined by the law. Personally I don't have a problem with it, though I also believe that this type of power needs to be transparent, double checked and highly scrutized to prevent abuse and allow protection of patient's rights.

I fully understand what the law says. The law is arbitrary. At one point in history, racial slavery was permitted by law. If you choose to work in a setting where patients are committed involuntarily, you forfeit your right to safety. Also, even though you are under the coersion of law, you should try to avoid following immoral laws whenever you can get away with doing so.

 

[GH253]

Clearly you got great insight... you'd rather they go hurt someone outside and end up in jail.

It is a total perversion of justice to imprison innocent people because of what you THINK they might do. If someone with a mental illness has committed a crime such as threatening someone, he should go to jail like everyone else. If he hasn't committed a crime, you have no right to do anything to him. And even if he has, you still have no right to do anything to him, because you're a psychiatrist and not a corrections officer.

 

[whopper]

I fully understand what the law says. The law is arbitrary. At one point in history, racial slavery was permitted by law. If you choose to work in a setting where patients are committed voluntarily, you forfeit your right to safety. Also, even though you are under the coersion of law, you should try to avoid following immoral laws whenever you can get away with doing so.

Hmm, well I don't know your background, but avoiding following "immoral laws" whenever you can get away with it is tantamount to breaking the law in this case.

I do agree that there are laws that not everyone agrees with, some of the laws we've had in the past such as slavery were unethical, even evil. I would have no problem being a rebel, and breaking the rules in a totalitarian government.

However if you disagree with a law, and you live in a democracy or a representative republic like we do, instead of breaking the law, you have a responsibility to fight it through the system first, not breaking it. That means working within the system to change it, not breaking any rule you do not personally agree with.

For this reason, I would ask that this thread or poster be locked or banned. Its one thing to disagree, its another thing to encourage practice which could get you to lose your medical liscence, break the law, encourage practice which is below the standard of care, and possibly end up with someone going to prison.

If you could cite reasoning as to why you made the above statements, showing insight based on the current medical/legal/ethical standards that we currently base our practice on that supports your argument, then I'd retract what I wrote, otherwise I advise lock and/or ban.

It is a total perversion of justice to imprison an innocent person because of what you THINK they might do.

Hmm, well part of the standards that allow doctors to commit someone involuntarily is based on what the person already did. E.g. If I got a psychotic patient, and the person did nothing violent, that gives me very little reason to believe they will do something violent. Pretty much every patient I've committed that I thought was going to be violent was because that person already was violent, and to a degree where they were breaking a law (e.g. they would've fit the definition of someone commiting assault, domestic violence, disorderly conduct etc).

I'd argue that it'd be a total perversion of justice to put someone in jail or prison that may have done an act that was illegal, and they've met the McNaughton standard. Those people deserve the oppurtunity to be psychiatrically treated and found not guilty by reason of insanity.

 

[chameleonknight]

Ask the family of Nicola Cotton, the NOLA police officer murdered by a homeless schizophrenic, if detaining the mentally ill is a good idea.

We don't detain people against their will for no reason, we do it for their safety and the safety of others. Since GH is advocating violence against mental health workers, I doubt he cares either way.

 

[Faebinder]

I second the ban.👍

 

[Simmy]

Agreed!
If you had ever worked in a acute psychiatric ward you would never have argued the issue of involuntarily admisson.

Also alot of the patients are brought to us by the police because they have been a disorder to the public, used violence to the staff in the different insitutions where they live normaly or cut themself severly.

If you THINK for a SECOND that a girl with arms with deep scars all over her arms and bleeding wounds that she inflicted to herself should be left alone because its bad to take away her freedome to help her stop hurting herself.
Or that its better to put a 50 year old chronic mentaly ill person in jail where the staff has no training or medication to help the patient because he or she broke the law in any way, then ok... But I belive you don't. Because that is more inhuman than detaining them in a hospital where they get 24/7 care.

 

[erg923]

below

 

[erg923]

If you hold patients against their will, you are the aggressor and they are acting in self-defense. Any complaint on your part is invalid.

Go speak to the Tarasoff family.....then come back to us.

 

[erg923]

Agreed!
Or that its better to put a 50 year old chronic mentaly ill person in jail where the staff has no training or medication to help the patient because he or she broke the law in any way, then ok... But I belive you don't. Because that is more inhuman than detaining them in a hospital where they get 24/7 care.

Good point, but these kinda people value freedom over anything else for some reason. Im not sure why it takes presendence over saving lives, but thats how they see it. Im sure they have some twisted logic to justify their rationale.

 

[pseudoknot]

The thing is: I feelt so ****ty afterwords because I feel like I acted like such a amature barging in there half screaming to the patient. It was very unprofessional, and if it wasen't stopped by the other staff it could have ended much much worse. I applogized to the nurse in charge later explaining what happend and why I reacted as I did and she told me not to worry about it, but I still feel pretty bad.

I just wanted to respond to this: whatever the ideal might be, the reality is that feelings like what you describe are perfectly normal in an unexpected violent confrontation. While you can learn to control your reactions with appropriate training, the fact that you reacted this way doesn't make you a bad person, just human.

 

[michaelrack]

Hmm, well part of the standards that allow doctors to commit someone involuntarily .

Agree with most of what you wrote, except that most of the time it is someone other than the doc filling out the petition for the committment (ie, usually a family member). In most states, it is a judge who decides on committment, with a psychiatrist or psychologist often providing an evaluation for the court. But it is not the doctor's decision. It is a judge who commits someone involuntarily, not the doctor.

 

[whopper]

And you are correct, and I apologize, especially since I am a forensic fellow and should know better.

The judge in reality commits a patient. A doctor can only hold the patient for a time until that person's case is reviewed by a judge. When a doctor files a petition for commitment, that in fact is just a petition, just like a police officer arresting someone, and putting them in jail to await trial is not the police officer finding them guilty.

If GH doesn't like this, like I said, he/she has every right to protest the law. I however doubt he/she would gain much sympathy advocating the freeing of people psychotic enough to want to assault other people.

Again, like I said, this warrants a ban, not because of disagreement, but because of the advocation of breaking the law. Not only does this warrant a ban IMHO, GH, if his/her identity is known could actually be starting the process of a crime. If I were for example to get a microphone and tell people to burn down a bar, and people actually did it, I could be held responsible even if I did not take any direct physical action to burn the bar. This person's fulfilling half the criterion needed. If someone actually listens to him/her--then a crime would have been committed.

 

[GH253]

Ask the family of Nicola Cotton, the NOLA police officer murdered by a homeless schizophrenic, if detaining the mentally ill is a good idea.

We don't detain people against their will for no reason, we do it for their safety and the safety of others. Since GH is advocating violence against mental health workers, I doubt he cares either way.

I'm not advocating violence against anyone. I'm just saying you don't have the right to complain if you hit someone and he hits you back.

 

[whopper]

I'm just saying you don't have the right to complain if you hit someone and he hits you back.

Fair enough, but what about advocating breaking the law?

 

[GH253]

I second the ban.👍

You are a coward.

 

[GH253]

Fair enough, but what about advocating breaking the law?

It's not illegal to advocate breaking the law.

If you believe otherwise, go ahead and send an email to the FBI. Tell them there's a guy on the internet who disagrees with psychiatry and advocates not committing people involunarily. I'll paypal you $100 if anything comes of it.

 

[erg923]

go ahead and send an email to the fbi. Tell them there's a guy who disagrees with psychiatry and advocates not committing people involunarily. Let the authorities deal with it.

well then do it and quit mucking up the board! You have hijacked this thread from the orginal topic at hand.

 

[whopper]

It's not illegal to advocate breaking the law.

Really?
http://en.wikipedia.org/wiki/Conspiracy_(crime)

Why not post your name, and if you're a medstudent or resident and your program?

If you got the balls to put your money where your mouth is.

By the way, I've already put my name on this board in the past.

Tell them there's a guy on the internet who disagrees with psychiatry and advocates not committing people involunarily.

There's nothing wrong with disagreeing, there is something wrong with advocating illegal activity which is what you did above. Quoting you----

Also, even though you are under the coersion of law, you should try to avoid following immoral laws whenever you can get away with doing so.

So maybe I will contact the authorities, after you give me your name and your address, which I dare you to do, and I will contact your medschool, premed office, or residency program since they would definitely want to know of a person in their program who mentioned to avoid following the law whenever "you can get away with doing so."

 

[Regnvejr]

Involuntary commitment is an act of violence against the patient which is equivalent to imprisonment. Because the patient has not committed a crime, however, it is the psychiatrist who is the aggressor, and the patient has every right to use violence in self-defense, just as if you had attacked him on the street.

Quite nonsense, sorry. It is not the psychiatrist who grabs him off the street and force him to the hospital.

You have no right to hold someone against his will just because you are a psychiatrist and you think you know what's best for him.

Indeed. That right comes from the law, not from being a psychiatrist.

Involuntary commitment is a monstrously evil institution and whoever participates in it fully deserves to be the recipient of retaliatory violence.

The law sets parameters, and these parameters are set regarding a patient's ability to keep themselves safe. If the patient is found to engage in what is unsafe behaviors with no insight or judgment as to these dangers, then the law sets the rules for how to protect them from themselves.

To claim this as evil means really only one of two things, that (1) you at one point was on the receiving end of this and now is bitter about it, blaming anyone you can reach, or (2) that you are a Scientology plant.

 

[Regnvejr]

"Insight" is a term used by psychiatrists to invalidate their patients' independent judgment.

No. Why do you need to falsely misrepresent this? Are you so out of reasonable positions that you need to falsify misrepresent things? Trying to make false statements about psychiatry to psychiatrists is about as unsmart and delusional as creationists trying to misrepresent to biologists what Evolution is.

If a someone disagrees with your expert diagnosis from the DSM-IV, that infalliable authority, just say he lacks "insight" (i.e. that his refusal to accept your beliefs is the result of mental illness) and you get to be his boss. Great!

What an inane claim. Please drop the histrionics and provide some real and honest information.

 

[Regnvejr]

I fully understand what the law says. The law is arbitrary. At one point in history, racial slavery was permitted by law. If you choose to work in a setting where patients are committed involuntarily, you forfeit your right to safety.

So you are saying that psychiatrists deserve to be killed? Is that a death threat here? You begin to seem a bit unhinged now.

Also, even though you are under the coersion of law, you should try to avoid following immoral laws whenever you can get away with doing so.

Like keeping manic, suicidal patients alive?

 

[whopper]

We're feeding the troll.

A few months ago, someone came to the board questioning the ethics & legality of forced medication & involuntary commitment. The person did garner some verbal attacks back to him, though IMHO he was truly someone who was looking for the truth, especially since he was given a lot of misinformation on the topic from some anti-psychiatry sources.

This is different. This person obviously shows some histrionics, and is not listening or has knowledge of several of the legal & ethical pillars that have been heavily scrutinized in the past concerning this issue. If you also look at this person's other posts--there's a lot of the same in other threads.

Like I said--close the thread or ban, and let's see if this person has the courage to claim responsibility for his/her comments by giving his/her name & identifying information. That's how you can tell the person isn't a troll.

 

[Regnvejr]

It is a total perversion of justice to imprison innocent people because of what you THINK they might do.

Or what they do and report they are going to do.

If someone with a mental illness has committed a crime such as threatening someone, he should go to jail like everyone else.

Wow, so you advocate imprisoning mentally ill people? That's quite disgusting. Shame on you for your callous disregard for the mentally ill. Clearly, you don't give a rip about the mentally ill, so your crusade therefore must be against Psychiatry. That means that you are a Scientology plant or wannabe.

If he hasn't committed a crime, you have no right to do anything to him.

Go check out the law before making absolutist and false claims.

And even if he has, you still have no right to do anything to him, because you're a psychiatrist and not a corrections officer.

So you are STILL all hip on the mentally ill deserving to be treated like criminals. Very disgusting of you.

 

[GH253]

Good point, but these kinda people value freedom over anything else for some reason. Im not sure why it takes presendence over saving lives, but thats how they see it. Im sure they have some twisted logic to justify their rationale.

For two reasons. First the power to commit patients against their will, or override their autonomy in any way, is the same power that enables every other type of corruption that is very rapidly driving all of human civilzation into the ground- the power to use the force of government to accomplish your social agenda. Second, even in isolation, the authority to commit patients against their will is a power that is prone to abuse. There is a conflict of interest when psychiatric facilities stand to benefit from establishing clients. The facility becomes the judge, jury and jailer and the patient has literally no slightest possibility of defending himself. Some mental health professionals are prone to see EVERYTHING in terms of mental illness and will exaggerate, embellish, and distort facts in order to get people committed. How many people have suffered the devastation and indignation of being locked up in a nuthouse when the circumstances didn't warrant it? It's more than you think.

 

[whopper]

Show some responsibility.

Your name?

Which medschool, residency or premed program?

If you'd like to maintain your anonymity for fear of trolling attacks, then give it to the moderators on the board--and let then decide what to do. Personally, IMHO, someone doing what you did above warrants the moderators report you to certain higher authorities given what you've done above.

 

[Regnvejr]

I'm not advocating violence against anyone. I'm just saying you don't have the right to complain if you hit someone and he hits you back.

Now, you are dishonest. You specifically advocated that just by being part of the process that lands somebody on a psychiatric inpatinet unit, makes it ok to hurt that person. At least don't lie.

 

[GH253]

Or what they do and report they are going to do.
Wow, so you advocate imprisoning mentally ill people? That's quite disgusting. Shame on you for your callous disregard for the mentally ill. Clearly, you don't give a rip about the mentally ill, so your crusade therefore must be against Psychiatry. That means that you are a Scientology plant or wannabe.
Go check out the law before making absolutist and false claims.
So you are STILL all hip on the mentally ill deserving to be treated like criminals. Very disgusting of you.

By far the most distorted post yet in this thread. Your error is that you fail to separate criminality from mental illness at all; you simply use the concepts interchangably. A mentally ill person does not deserve to be treated like a criminal. A criminal deserves to be treated like a criminal totally apart from whether he suffers from a mental illness. If the mental illness can be shown to be the cause of the criminal act, then the person is not really a criminal and I have no problem with him recieving treatment rather than being imprisoned.

 

[erg923]

For two reasons. First the power to commit patients against their will is the same power that enables every other type of corruption that is very rapidly driving all of human civilzation into the ground- the power to use the force of government to accomplish your social agenda. Second, even in isolation, the authority to commit patients against their will is a power that is prone to abuse. There is a conflict of interest when psychiatric facilities stand to benefit from establishing clients. The facility becomes the judge, jury and jailer and the patient has literally no slightest possibility of defending himself. Some mental health professionals are prone to see EVERYTHING in terms of mental illness and will exaggerate, embellish, and distort facts in order to get people committed. How many people have suffered the devastation and indignation of being locked up in a nuthouse when the circumstances didn't warrant it? It's more than you think.

ARE YOU EVEN VAGULEY FAMILIAR WITH HOW CIVIL COMMITMENT WORKS...OBVIOUSLY NOT

COME ON PAL...GET REAL....

By the way, your social skills could use some improvment (I have seen your posts before). If you dont wise up, your're gonna be on a one man crusade, old and all alone, with no family of your own. Go out, have a beer, and meet a nice lady who can tolerate ya......🙂 Then at least you''ll be a happier complainer about subjects which it is clear you have no professional knowledge of. 🙄

 

[whopper]

You've mentioned in other threads that you are applying into the medical profression.

Do you have the courage to put your name to your opinions?

 

[Regnvejr]

By far the most distorted post yet in this thread. Your error is that you fail to separate criminality from mental illness at all; you use the concepts interchangably. A mentally ill person does not deserve to be treated like a criminal.

you just SAID that they did. That if you are mentally ill and are breaking the law per your mental illness, then you deserve to be locked up rather than receive intensive psychiatric care. That IS disgusting.

A criminal deserves to be treated like a criminal totally apart from whether he suffers from a mental illness. If the mental illness can be shown to be the cause of the criminal act, then the person is not really a criminal and I have no problem with him recieving treatment rather than being imprisoned.

Except that you said otherwise. Shame on you for now lying.

 

[GH253]

Show some responsibility.

Your name?

Which medschool, residency or premed program?

If you'd like to maintain your anonymity for fear of trolling attacks, then give it to the moderators on the board--and let then decide what to do. Personally, IMHO, someone doing what you did above warrants the moderators report you to certain higher authorities given what you've done above.

You are being ridiculous. It's seriously disturbing to me that a medical fellow would be capable of forming such an immature thought as the one you expressed here. Like I said, go ahead and report me to the authorities, tell them you're upset because someone on the internet disagrees with psychiatry and thinks patients have the right to defend themselves against aggression form mental health professionals. See what they say

 

[Regnvejr]

You are being ridiculous. It's pretty disturbing to me that a medical fellowwould be capable of forming such an immature thought. Like I said, go ahead and report me to the authorities, tell them you're upset because someone on the internet disagrees with psychiatry and thinks patients have the right to defend themselves against aggression form mental health professionals.

The greater problem is that you present yourself as being in or entering the field of health care professionals, and then you misrepresent, lie and distort things for the sake of sophist claims. That raises serious questions about your character and therefore about your ethics in being any form of provider in the medical fields.

 

[whopper]

No point in informing the authorities unless you give me your name-and you know it which shows your insincerity.

The fact that you aren't, and that in other posts, you've asked for advice on whether or not to reveal your true opinions during interviews shows you don't have the courage to attach your name to your opinions.

Troller--though I'm suspecting you're someone who truly is applying into the medical field and has these opinions to some degree. Several trollers I can tell are just disgruntled & unhappy people, and them trying to ruin a forum is just their waste of time for kicks. In your case, I'm suspecting you're actually someone that may be in a medical school program, and may actually believe in some of what you're writing.

I would report you to the authorities, or medschool, premed college or residency if you gave me your name--but you won't, so there's no point, and you know this. So that's the best you can come up with.

In the pubilc forum you've pretty much already lost. Now you're just being the kid who's crying, and we should all just ignore you (unless you give me your name--then I'll act on that).

as being in or entering the field of health care profession

Reg, if you view his other posts, he has asked about whether or not he should reveal his true opinions during an interview. I suspect this guy may be at the very least a pre-med considering medschool.

And guess what? If he's like several I've seen--as long as his grades are kick ass--they won't give a damn about his other aspects so long as there's no criminal record, or LORs mentioning his personality--which is an easy thing to accomplish.

 

[GH253]

You've mentioned in other threads that you are applying into the medical profression.

Do you have the courage to put your name to your opinions?

I have the courage to tell you that my name is irrelevant and that your obsession with my identity is equivalent to an ad hominem attack. The mods have my IP address and can send this thread to the FBI if they believe a crime has been committed. I'm confident that there hasn't been.

 

[whopper]

Reg--take a looksie

http://forums.studentdoctor.net/showthread.php?t=654617

GH253
Senior Member


Join Date: Mar 2009
Posts: 154


Should I tell them what I really think?

--------------------------------------------------------------------------------

My opinion of the medical community is not generally favorable. There are some aspects of medicine that I strongly believe in, but there are also certain things going on that I have major, major problems with. The single thing that I deplore most is widely accepted as the standard of care, and although the practice is limited to a particular speciality, the rest of the medical community's tolerance of it really brings down my opinion of the whole establishment, and I believe it is a symptom of greater ideological problems in medicine. If I become a physician, it's given that I will be the type who tends to go against the grain, and will probably be outspoken about my opinions.

My question is: will I sabotage myself if I admit to these beliefs during the application process, i.e. on my statement and during the interview?

Anyways, last comment-nope won't report with just an IP address. Not good enough. You could be on a public computer. Your name & identifying on the other hand would be helpful. Like I said, you don't have the courage to put your name on your opinions--as evidenced by the post above among other things.

Reg-don't feed the troll.

 

[GH253]

The greater problem is that you present yourself as being in or entering the field of health care professionals, and then you misrepresent, lie and distort things for the sake of sophist claims. That raises serious questions about your character and therefore about your ethics in being any form of provider in the medical fields.

I hate to break it to you, but I already am a healthcare professional. I have seen what goes on in psychiatry and I am not impressed.

 

[kugel]

I'm not advocating violence against anyone. I'm just saying you don't have the right to complain if you hit someone and he hits you back.

Nope. That's not what you were writing about earlier. You were earlier writing about lawful detention in a medical facility as an act of violence (in and of itself) to which violence is an acceptable response.

But let's talk about your current point for a moment. When you wrote, "if you hit someone and he hits you back," you were absolutely correct that it is an expected and "normal" response (illness or no illness). And it IS important for those in the health professions to understand that. Sometimes, psychiatric patients interpret non-violent interactions as violent and will defend themselves - we need to be aware of that, avoid giving that impression whenever possible, and be prepared for violent defensive actions (even when they didn't seem "reasonable"). My own opinion is that physicians don't get enough training in verbal de-escalation and not near enough training in physical defense (NOT counter attack) and non-violent control techniques.

As others have pointed out, in LESS enlightened times, people who had threatened or perpetrated violence, or who simply could not find food/shelter due to an obvious mental disability would be summarily locked up in a cell or in chains. No legal boundaries, no judge, no patients' rights advocates, NOTHING.

And not that long ago. Most of our current laws were written in the middle to late 20th century in order to stop the practice of arbitrary and unlimited psychiatric detentions. The main administration building of the Austin State Hospital (Austin, Texas) has basement offices with wallboard over the original stone walls that still have holes where the manacles were bolted into the mortar. (I saw them in 1982-83 before they were covered up.)

Now, in this country, most every state has strict restrictions on the ability of physicians to detain patients against their will, requiring documentation of imminent harm to self/others or inability to find/use (not just a choice to avoid) food/clothing/shelter. There are penalties proscribed for misusing these statutes, and patients may not be held beyond a few days without judicial review. And I can testify that judges do NOT simply rubber stamp the doctor's opinion.

If hospital detention were not available, such pt's would, indeed, be locked up in jails/prisons. And, in fact, that still happens WAY too often. At least in this country, there are many more seriously mentally ill patients in jail/prison than in hospitals at any given time.

GH253,
You might not find this forum the most inviting (since most of us have accepted the current terms to some degree), but that doesn't mean you shouldn't continue to question individual detention decisions. We do need to be questioned persistently on this in order to be sure we haven't gotten lax or lazy about trying to find ways to treat patients without involuntary detention. If you are in the U.S., there are many ways to do this effectively on the local level.

 

[erg923]

No point in informing the authorities unless you give me your name-and you know it which shows your insincerity.

The fact that you aren't, and that in other posts, you've asked for advice on whether or not to reveal your true opinions during interviews shows you don't have the courage to attach your name to your opinions.

Troller--though I'm suspecting you're someone who truly is applying into the medical field and has these opinions to some degree. Several trollers I can tell are just disgruntled & unhappy people, and them trying to ruin a forum is just their waste of time for kicks. In your case, I'm suspecting you're actually someone that may be in a medical school program, and may actually believe in some of what you're writing.

I would report you to the authorities, or medschool, premed college or residency if you gave me your name--but you won't, so there's no point, and you know this. So that's the best you can come up with.

In the pubilc forum you've pretty much already lost. Now you're just being the kid who's crying, and we should all just ignore you (unless you give me your name--then I'll act on that).


Reg, if you view his other posts, he has asked about whether or not he should reveal his true opinions during an interview. I suspect this guy may be at the very least a pre-med considering medschool.

And guess what? If he's like several I've seen--as long as his grades are kick ass--they won't give a damn about his other aspects so long as there's no criminal record, or LORs mentioning his personality--which is an easy thing to accomplish.

I really dont think someone with such poor people skills combined with such outragous opionioned positions could make it through med school. There is no way he could keep his mouth shut. Either he wont get the LORs for residencey, or he would quit before he got there, because "the system is so messed up" in his mind.

There is a certain amount of ass-kissing, social navigations, and social niceities that allow people to progress from student to master. (much less actually be liked by any pts he sees). Trust me, there is nothing professors and supervisors hate worse than the guy who always wants his opnion to be known because he thinks it sooooo valuable. Alot of med school is just shutting up and doing what you're told (at least in the beggining), and I dont think this guy could do that. My opinion anyway.

 

[Regnvejr]

Reg--take a looksie...

Yeah.