What made you happy today?

[stui magpie]

Ah, sorry. Misunderstanding. My take on "bums rush" is basically being turfed out the door.

Good to see you down to 101, you're now my weight. How much is that you've lost?


Anyway, I had a good short weekend up in Toc, back home now.

Beautiful weather up there this time of year, cool nights (16) and warm days (30-32), little humidity, bloody perfect.

Got up there lunchtime Friday, unpacked the car and did a quick grocery shop then whippersnipped the whole yard and mowed the back.

Kicked back with a beer and chiiled out, cooked a T bone steak for dinner with some greek salad and potato salad and watched Meg on DVD.

Yesterday wombled down to the foreshore market in the morning, bacon-egg and cheese burger for breaky, then home to mow the front lawn, do some weeding and water the bits that the sprinkler on a timer don't get, then kicked back with some margaritas while reading "Harry Potter and the Cursed child" for a while.

The Murray River Rod run was on https://glass4classics.com.au/event/mur ... -run-2019/ and the twon was full of classic cars, so about 5:30 I wombled down to the Palms hotel, got a schooner (or 3) and a spot in the beer garden out the front where I could watch all the cars driving up and down the main street. The main street was blocked off to ordinary traffic from 6-9pm and there was hundreds of people out in the street and down on the foreshore kicking back, listening to the music and watching the cars cruise past.

Very tempted to get some tucker at the pub but headed home, cooked some dinner and kicked back in front of the TV.

So many of the small country towns are dying, but Toc is thriving due to a smart focus on tourism and events during the warmer weather.

[watt price tully]

Ah, sorry. Misunderstanding. My take on "bums rush" is basically being turfed out the door.

Good to see you down to 101, you're now my weight. How much is that you've lost?


........

Cheers mate, down about 13kg, much slower rate of loss than the first 10 -12 weeks or so.

[K]

...
people with my experience are valuable commodities: I know how to discharge and I'm thorough. Too many (non nurses) admit everyone and many don't need admission at all. A lot of people know how to feign symptoms and over the years you begin to develop a good bullshit detector. Also when your experienced enough you can be clear and striaght up when others in the ED who under pressure can fluff around and not make a decision ( a lot of young nurses), placing themselves and others at risk.
...

So is the problem too many people wanting to be admitted, rather than e.g. too many people being involuntarily kept there by nurses or police? (Oh, I see the "fluffing around and not making a decision" part, which maybe is part of the latter, is it?)

[stui magpie]

Good stuff, seems like this ketogenic diet has been around for a while.

https://www.businessinsider.com.au/keto ... ?r=US&IR=T

[watt price tully]

...
people with my experience are valuable commodities: I know how to discharge and I'm thorough. Too many (non nurses) admit everyone and many don't need admission at all. A lot of people know how to feign symptoms and over the years you begin to develop a good bullshit detector. Also when your experienced enough you can be clear and striaght up when others in the ED who under pressure can fluff around and not make a decision ( a lot of young nurses), placing themselves and others at risk.
...

So is the problem too many people wanting to be admitted, rather than e.g. too many people being involuntarily kept there by nurses or police? (Oh, I see the "fluffing around and not making a decision" part, which maybe is part of the latter, is it?)

This isn't one flew over the cuckoos nest. Life isn't Hollywood. People who are made a compulsory (the term involuntary went out in 2014) under the act aren't done so lightly.

Overall demand far outmatches supply. Placing a person under an order of the mental health act is the last thing you want unless the person:

Is clearly mentally ill
Is a danger to themeselves or others
Needs immediate treatment
& community based options aren't suitable.

When I have a drug induced agressive paranoid violent male (most days of the week) they don't have to be placed on a mental health order. Under a duty of care people can be injected, restrianed etc if they are going to cause harm to themselves or others,

The fluffing around is related to things like:

* not calling security soon enough or not all,
* allowing a person to be verablly abusive without consequence ( eg I want my needs met now despite others being in front of them or just being rude/ abusive: too many staff put up with agression etc & I don't tolerate it at all ( either D/C or sedate after assessing the situation) sometimes people can be de-escalated: eg. I always commence my interactions with offering a person a drink etc & show care
* not restraining a person (ankles and wrists) by security when it is damn obvious they are presenting as a risk, that you have told staff they are a risk, you have entered that information on the ED data abse so it's easily availabe, etc
* not providing timely medications at times intrtavenously to sedate people when they are so agitated, drug affected or perhaps ill that is say having a manic relapse of BiPolar etc.

etc....

With the lack of accommodation services, drug issues, alcohol issues, pscho-social issues,some people think they can come in for "time out": will not happen. Mental health inpatient units are for acute mental health issues when other options are not able to succeed and when there is a risk.

M<y job is to assess risk, mental state and determine a plan of action: all option are open when I see someone:

1. discharge (D/C) without follow up (phone call follow up will always occur)
2. D/C with GP follow up
3. D/C with their therapist etc
4. Referral to a community team
5. Referral to a crisis team in the community
6. Admit voluntarily
7. Admit against their will (Place a person on an Assessment Order)

Those 7 options covers the bases more or less. I'm not a therapist or a counsellor while having those skills, mine is much more practical and functional

[stui magpie]

^

You ever bump heads with Garth Daniels?

[watt price tully]

[stui magpie]

He was zoned to the eastern region so you likely wouldn't have seen him unless the Police dragged him in there. Semi famous case, lots of supporters about him getting involuntary ECT's. All I know is the staff in the psych were shit frightened of him.

[watt price tully]

He was zoned to the eastern region so you likely wouldn't have seen him unless the Police dragged him in there. Semi famous case, lots of supporters about him getting involuntary ECT's. All I know is the staff in the psych were shit frightened of him.

I've heard about the situaton (only superficially) but didn't recognize the name.

Every region has some issues, some lititigious people, some times things go awry: you're dealing with 1000's of people in a pressured, strained and under-resourced situation.

ECT can be of great benefit to a number of people: I've seen it work on thje severely depressed: that depressed that they are so psych-motor retarded that it will take litterally more than an hour to get a spoon of food from the plate to their mouths, virtually catantonic (although that term if too often misused)

[HAL]

That is a generalization.

[watt price tully]

There can be some tricky situations such as

* the adoloescent who when asking how you can be of assitance says: "well your the expert, you tell me"
* the entiteld shites who say "well you're not even a doctor let me see a doctor now"
* or when you might not have satisfied the person distress the way they wiould like say" "Well I'm going to kill myself and it's your fault"

....alll in a day's work

[K]

[watt price tully]

The Psychiatrist “didn’t get away” with anything. What you missed is that like all “ compulsory” people Daniels case was reviewed by the Mental Health Tribunal: an independent of government statutory authority that reviews all compulsory (involuntary) patients.

The panel is comprised of a lawyer, a psychiatrist and a lay person. The tribunal errs on the side of individual rights as a rule of thumb.

The tribunal can revoke orders to make people “voluntary”

The tribunal is an inbuilt review mechanism: part of the checks and balances of the system.

ECT is not a one off treatment but a series of treatments when used.

[K]

[watt price tully]

Rode to Frankston on Sunday Morning. Tagged onto a group of about 10 riders doing about 35-42 km’s per hour from Seaford to Mordialloc: out of my comfort zone, way out. However you get dragged and drafted along like a train. You still work hard but gee to be riding at 38km’s most of the time was just fantastic