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  #1  
Old 10-01-2008, 12:48 PM
Avalik
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Default One of your old patients becoming a nurse?

Hello there... I'm new here. Just thought I'd start out with a post.

The question is more specifically geared toward having a psych patient you treated years later becoming a nurse in your hospital and area. And more into detail, a psych patient that 'visited' your hospital MANY times (like, 500) for OD's, self-harm, psych, whatever (nothing fully-medical based, basically)

-- How would you feel, react, etc?

Feel free to just answer the general question, or the more 'specific' ones.
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  #2  
Old 10-01-2008, 06:06 PM
runningnurse
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Smile

First off welcome
I'd be a little wary at first, but obviously the interactions that this former patient had with the nurses at the hospital has inspired them to become clean, and change their life around. Even though being wary is a good thing, I think that this person needs all the support they can get, as there might be a huge stigma associated with them, being a former patient and all. Maybe tell them something along the lines of-I'm proud of what you've done to change your life and if there are any difficulties/issues let me know and I'll be there to support you through it.
Just my 2 cents
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  #3  
Old 10-01-2008, 08:32 PM
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Hi Avalik. Welcome to Nursing Voices. Thanks for asking such an intriguing question.

This situation sends up all kinds of red flags for me. You mentioned multiple admissions for behavior that indicates pure Axis II (read borderline personality). Those folks can modify their behavior but they can never change their personality. They also have big time boundary issues among other things, therefore, for the sake of everyone, I think the former patient needs to practice nursing somewhere else.

MJ
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Old 10-05-2008, 10:28 AM
Mr Ian
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Oooh... let me bring dissent and discord amongst the pigeons with my big cat. I am disgusted - not at the ex-patient becoming a nurse, but the reactions she is getting.

Firstly, nurses undertake a process to become nurses which includes character testing. If s/he graduated as a nurse and got a job - s/he passed - including the test of character.

Secondly, runningnurse - your sentiments are well meant - but you are so patronising and I'm sorry to shove it in your face; but not that sorry that I won't -
"the interactions that this former patient had with the nurses at the hospital has inspired them to become clean"
Become clean? Was s/he dirty for having a MH issue? (There was no mention of drug use - so if it was a reference to her/him not being a druggie 'now' then you are being highly presumptive).
The interactions s/he may have had may have well inspired them to become a nurse - and perhaps do something to stop people like him/herself being re-admitted 500 times.
"Maybe tell them something along the lines of-I'm proud of what you've done to change your life "
You have absolutely no idea what this person has or hasn't done and even less about what they might appreciate in terms of being 'supportive'. Where was the "I'm so proud of you for what you've done" attitude when s/he was trying to survive 500+ admissions?

Third, Mother Jones! Far be it from me to feel so at odds with you - but presumably 'elsewhere' means somewhere out of nursing - since the post doesn't identify what hospital - or area - or even specialty branch?
Your postulating about her/his character and 'axis II' BPD may well be accurate, or even close - but to presume this makes for a crap nurse or a danger to patients is so stereotyped and does not become you.

Let me add some colour to the picture -
Many people who self-harm, OD and the like are survivors of trauma; most often sexual or other childhood abuse trauma. No-one just 'catches' personality disorder or wakes up one morning thinking "Hey I know - I'll just be an emotional wreck - that'll entertain me". Yes, they may get into all sorts of maladaptive ways of life - like drugs; lots of useless partners; lack of direction or life plan; etc etc etc; since their whole experience of life as a child is based on pain, mistrust, deceit and torment. But they equally may not act in such ways - or any variance on this that they choose to survive by.
The history of this person suggests a time where coping was extremely difficult - just think what you'd have to be going through to "need" to "visit" the hospital 500 times. Yet here they are, some years later having lasted out a degree course and put themselves to productive use in a society that really wasn't of much use to them when they were struggling to survive - with 500 admissions.

So my take would be, if I knew this person, I would stand beside them as a nurse colleague and be pretty humble to remember how easy it was for me to be where I am today.

As a relevant aside - what do you think/feel/do when you see a child being abused? Do we not repulse at it? Do we not think "they are only but a child"?
Why do we do this? Because it makes for a poor childhood. Why is childhood important? Because it moulds who we become.
Why do we bang our fists and spit in the face of those who abuse children - yet when the product of that abused child comes to be an adult - we shun that person? We pass them off and isolate them.

Get off your judgmental horse and walk a shift in their shoes.

And I'm taking my cat with me.
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Old 10-06-2008, 12:34 PM
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Quote:
Originally Posted by Mr Ian View Post
Oooh... let me bring dissent and discord amongst the pigeons with my big cat. I am disgusted - not at the ex-patient becoming a nurse, but the reactions she is getting.

Firstly, nurses undertake a process to become nurses which includes character testing. If s/he graduated as a nurse and got a job - s/he passed - including the test of character.

Secondly, runningnurse - your sentiments are well meant - but you are so patronising and I'm sorry to shove it in your face; but not that sorry that I won't -
"the interactions that this former patient had with the nurses at the hospital has inspired them to become clean"
Become clean? Was s/he dirty for having a MH issue? (There was no mention of drug use - so if it was a reference to her/him not being a druggie 'now' then you are being highly presumptive).
The interactions s/he may have had may have well inspired them to become a nurse - and perhaps do something to stop people like him/herself being re-admitted 500 times.
"Maybe tell them something along the lines of-I'm proud of what you've done to change your life "
You have absolutely no idea what this person has or hasn't done and even less about what they might appreciate in terms of being 'supportive'. Where was the "I'm so proud of you for what you've done" attitude when s/he was trying to survive 500+ admissions?

Third, Mother Jones! Far be it from me to feel so at odds with you - but presumably 'elsewhere' means somewhere out of nursing - since the post doesn't identify what hospital - or area - or even specialty branch?
Your postulating about her/his character and 'axis II' BPD may well be accurate, or even close - but to presume this makes for a crap nurse or a danger to patients is so stereotyped and does not become you.

Let me add some colour to the picture -
Many people who self-harm, OD and the like are survivors of trauma; most often sexual or other childhood abuse trauma. No-one just 'catches' personality disorder or wakes up one morning thinking "Hey I know - I'll just be an emotional wreck - that'll entertain me". Yes, they may get into all sorts of maladaptive ways of life - like drugs; lots of useless partners; lack of direction or life plan; etc etc etc; since their whole experience of life as a child is based on pain, mistrust, deceit and torment. But they equally may not act in such ways - or any variance on this that they choose to survive by.
The history of this person suggests a time where coping was extremely difficult - just think what you'd have to be going through to "need" to "visit" the hospital 500 times. Yet here they are, some years later having lasted out a degree course and put themselves to productive use in a society that really wasn't of much use to them when they were struggling to survive - with 500 admissions.

So my take would be, if I knew this person, I would stand beside them as a nurse colleague and be pretty humble to remember how easy it was for me to be where I am today.

As a relevant aside - what do you think/feel/do when you see a child being abused? Do we not repulse at it? Do we not think "they are only but a child"?
Why do we do this? Because it makes for a poor childhood. Why is childhood important? Because it moulds who we become.
Why do we bang our fists and spit in the face of those who abuse children - yet when the product of that abused child comes to be an adult - we shun that person? We pass them off and isolate them.

Get off your judgmental horse and walk a shift in their shoes.

And I'm taking my cat with me.
I love kitties. Meow!

I thought the nurse was working on a psych unit, and speaking from experience, these situations do not workout. Once upon a time, a long time ago, I worked with a former psych patient that became a psych nurse on the same floor where she had once been a patient. The staff she was working with knew all of her PERSONAL issues. It was more than a case of TMI (too much information). It was a case of information overload. Frankly, there are things that your coworkers don’t need to know you. Also, this nurse’s Axis II personality created a firestorm of malcontent. Borderlines thrive on being the center of the storm, and psych units are chaotic enough without adding that kind of garbage to the mix. I think that the nurse in this case is demonstrating poor boundaries.

I’m not being catty, no pun intended. Former psych patients can be psych nurses or any other kind of nurse, but they really need to find a job where no one knows their personal background. They also need to put their demons to rest before they work as a nurse.


MJ
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  #6  
Old 10-06-2008, 05:20 PM
Mr Ian
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Quote:
Originally Posted by Mother Jones, RN View Post
I love kitties. Meow!

I thought the nurse was working on a psych unit, and speaking from experience, these situations do not workout. Once upon a time, a long time ago, I worked with a former psych patient that became a psych nurse on the same floor where she had once been a patient. The staff she was working with knew all of her PERSONAL issues.
Yes there can be boundary issues but considering 1 in 4 people have a MH issue in their life - it's expected at least a quarter of the staff have been to the GP for antidepressants at least.

Having a BPD - as this woman may have - can go both ways. She can indeed be a firestorm - but having survived 3 yr training (after surviving her MH issues to get there) - I'd be thinking she's probably the most patient-aware nurse in the building and probably has more emotional stamina for the job than some wet-behind-the-ears no-life-experience numpty.

I've had suicidal nurses working on shift with me - whilst actively suicidal - and I've also known patient's who make better nurses whilst they're still receiving treatment. You can't stereotype - and you sure can't suggest there aren't nurses out there with axis II already - just waiting to be diagnosed! Have you not worked at least one shift amongst the High Expressed Emotion crew?!
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Old 10-06-2008, 06:05 PM
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Quote:
Originally Posted by Mr Ian View Post
Yes there can be boundary issues but considering 1 in 4 people have a MH issue in their life - it's expected at least a quarter of the staff have been to the GP for antidepressants at least.

Having a BPD - as this woman may have - can go both ways. She can indeed be a firestorm - but having survived 3 yr training (after surviving her MH issues to get there) - I'd be thinking she's probably the most patient-aware nurse in the building and probably has more emotional stamina for the job than some wet-behind-the-ears no-life-experience numpty.

I've had suicidal nurses working on shift with me - whilst actively suicidal - and I've also known patient's who make better nurses whilst they're still receiving treatment. You can't stereotype - and you sure can't suggest there aren't nurses out there with axis II already - just waiting to be diagnosed! Have you not worked at least one shift amongst the High Expressed Emotion crew?!
Nurses who have been treated for depression and who have their disease under control often make very good psych nurses. They are the only ones who can truly know what it's like to want to commit suicide. However, the issue goes back to boundaries. No former psych patient should work where they were once a patient.
The patient in the original posted wasn't described as being depressed.

Have I worked with borderlines? Oh my God, yes! However they don't last long when they are working with psych nurse. They get unhappy really quick when their coworkers set limits on their behavior.

MJ
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  #8  
Old 10-07-2008, 04:38 AM
Mr Ian
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I disagree. And I'll assume on the person being a she - cos she's a nurse - not cos she's got BPD!

I agree that some may not overcome their personality issues enough but the majority of those who have survived a lifelong trauma issue have learned to cope with far more emotional issues than a couple of hissy fitting backstabbing nurses.
The ones who develop emotional management issues later in life are the ones who haven't the skill or experience - or 'mindfulness' to cope with it.

But this particular person made it thru pre-training selection, 3 yrs(+) study and then became appointed to a position - without being flagged?

If she'd gone to a different hospital then recognition might not be an issue - but that's no reason to say she shouldn't work at this one. To treat her differently from one hospital to another for having previous admissions is discriminatory - especially since no other previous (med/surg) patient would be treated that way.

I'd agree with your reservations only insofar as to consider her (potentially) disabled by the nature of her previous psych history - as emotional regulation is a necessary art of nursing that you rightly say can be compromised with such personality disorders. However, given her licensed status - I'd still assume for the better until proven otherwise - as opposed to simply discard the person to the 'do not employ - ever' register.
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Old 10-07-2008, 06:33 PM
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Shouldn't we be supporting this nurse. She has gone through all the requirements and training, so who are we to say she can't practice? The only thing that can be suggested is that she goes and talks to the unit manager about her past history and what they suggest, but if she hasn't done anything wrong then her practice should not be controlled. However if something does go wrong then something needs to be done straight away about it.

With regards to her history in the unit, she shouldn't be working there if she wants to be treated properly, as like it or not she will be treated as a patient before she is treated as a nurse.
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