I’m remembering as I write, a funny example of that. (Confronting a pt with their own behaviour) This patient (given a diagnosis of paranoid psychosis but over the several years I nursed him, I concluded it was paranoid personality disorder) was in seclusion for attacking someone. By then, nurses had to conduct regular reviews and record them on forms. Since then, the intervals and paperwork have been made more onerous, given those horrid nurses’ stubborn refusal to stop secluding violent patients and ruining managements’ stats.
But we could still keep them in until they demonstrated remorse, learning, willingness to change. Now trying to get through to this particular man was like breaking down a brick wall. He was securely protected with layers and layers of armour. There was no way I ever found to get him to question his own behaviour, thinking, self-justification and so on. My take is that there was an unhealthy helping of denial at play. Denial is a mental defence mechanism. It is healthy and protective – until it isn’t. He was a nasty piece of work, with a horrendous index offence and no intention of examining it. Denial enabled that refusal. And it was protective, it was doing its job, in that for him to look in the mirror and see what he really was, would show him a truth that would push most people to suicide.
In the meantime though, we had to manage his violence and threat without the benefit of his insight, reflection and taking responsibility. (*c) Tricky but absolutely possible. One of those ways is to keep him locked up for an uncomfortably long time. NB many patients do reflect on what they should/shouldn’t have done while they are away from any stimulation and distraction and come out better. I’ve seen it. But for this man, the only lesson we could teach – because he was determined not to learn – was ‘this is so miserable I must keep my fists to myself so I don’t have to go through it again.’
So when I went in to review, I’d have a mental list of questions, all designed to challenge – and provoke – him to recognise and address his own responsibility and risk. He was used to this. This one time (at band camp) I wrote the list out and unfolded it before I started. We left after the second ‘F off’.
*c) When genius management order a ward to waste a staff to sit outside the seclusion room (to monitor and record every 15 mins because, as any parent of a baby or a teenager knows, it is indescribably dangerous for anyone to be alone in a room) what they deny the patient is solitude and privacy to – in boomer language – think about what they have done.
But now we can’t challenge their selfish, childish, self-centred, parasitical, violent, acquisitive behaviour. It isn’t even wrong for the patient to have attacked you – or someone else. No, you horrid unreconstructed bigot, they are merely demonstrating ‘behaviour that communicates distress.’ And you, you wicked nurse, probably caused that very distress, through your outdated, patriarchal, moralistic attitude. Under this Satanic, upside down value system, any negative judgement about a patient’s violence is now forbidden. They weren’t doing wrong, they were merely communicating their distress. Parents of children and especially daughters, how dangerous do you think letting that idea loose might be? Recently, we had a hero judge let two sadistic teenage Irish gyppo rapists (and ‘rape’ does NOT adequately describe what these subhumans did) off with a community punishment. Do you suppose that kind of thinking was baked in to the judge’s training and ‘guidelines’.
NB If they can discipline you for breaching it, then it isn’t a guideline, it’s a law.
3. Over-regulation by unguarded guards. BILD (*d) can lie and falsify with impunity in the claims they make in their RRI training courses. As I’ll show, I don’t just make groundless accusations, I’ll evidence them.
*d) other organisations offering toothless and woke restraint training are available.
4. Industry. Restraint Reduction and Least Restrictive have become cottage industries. In the same way as ECHR and Human Rights legislation. Gee thanks Tony and Cherie. (I have a little theory about this – impossible to evidence. For quite a few decades, Law has been pushed as a well-paid, desirable, high status profession. Combine that with the monetisation of Higher Education, where the goal is to squeeze as many bums onto seats as possible and it becomes no surprise to find a glut of qualified solicitors with not enough work. As a direct consequence we’ve seen legal firms pushing the envelope to bring legal challenges to all sorts of areas that never had them before, exploiting and monetising areas like Autism diagnoses, Neurodivergence – if ever there was a word designed to elastically gather in as many subjects as possible under one umbrella – and getting a Special Education statement.
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