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What made you happy today?

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stui magpie Gemini

Prepare for the worst, hope for the best.


Joined: 03 May 2005
Location: In flagrante delicto

PostPosted: Sun Mar 10, 2019 3:07 pm
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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/murray-river-rod-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.

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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Sun Mar 10, 2019 6:06 pm
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stui magpie wrote:
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.

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K 



Joined: 09 Sep 2011


PostPosted: Sun Mar 10, 2019 6:14 pm
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watt price tully wrote:
...
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?)
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stui magpie Gemini

Prepare for the worst, hope for the best.


Joined: 03 May 2005
Location: In flagrante delicto

PostPosted: Sun Mar 10, 2019 6:25 pm
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Good stuff, seems like this ketogenic diet has been around for a while.

https://www.businessinsider.com.au/keto-diet-william-banting-discovery-origin-1862-2019-1?r=US&IR=T

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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Sun Mar 10, 2019 10:01 pm
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K wrote:
watt price tully wrote:
...
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

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stui magpie Gemini

Prepare for the worst, hope for the best.


Joined: 03 May 2005
Location: In flagrante delicto

PostPosted: Sun Mar 10, 2019 10:39 pm
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^

You ever bump heads with Garth Daniels?

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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Sun Mar 10, 2019 11:04 pm
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stui magpie wrote:
^

You ever bump heads with Garth Daniels?


Doesnt ring a bell. Should I have?

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stui magpie Gemini

Prepare for the worst, hope for the best.


Joined: 03 May 2005
Location: In flagrante delicto

PostPosted: Mon Mar 11, 2019 9:14 am
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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.
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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Mon Mar 11, 2019 10:31 am
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stui magpie wrote:
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)

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HAL 

Please don't shout at me - I can't help it.


Joined: 17 Mar 2003


PostPosted: Mon Mar 11, 2019 10:33 am
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That is a generalization.
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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Mon Mar 11, 2019 10:37 am
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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 Wink

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K 



Joined: 09 Sep 2011


PostPosted: Tue Mar 12, 2019 1:02 am
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watt price tully wrote:
...
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.
...

Hadn't heard of this gentleman before... but the case sounds very disturbing:

https://www.abc.net.au/7.30/is-it-ever-acceptable-to-apply-shock-treatment/7039058

https://www.theage.com.au/national/victoria/state-examining-treatment-of-man-subjected-to-multiple-cases-of-shock-therapy-20160206-gmnd8l.html

https://www.madinamerica.com/2016/02/the-curious-case-of-over-50-consecutive-ects-in-melbourne/

A Swinburne clinical psychology professor wrote:

Over the past few weeks I have been witness to, and increasingly involved in trying to stop one of the most extreme examples of psychiatric brutality I have encountered in my 40 years in this field. And I have encountered quite a few.
...

I think the main message or motivation for writing these four or five pieces is not to show how fatally flawed and dangerous the profession of psychiatry can be ..., but to remind us how complicit the rest of society can be. Some of the agencies that have behaved the worst in all of this are precisely the ones that are supposed to be protecting the human rights of people who use mental health services.
...

The psychiatrist in charge of this whole sorry mess, Dr Paul Katz, did himself no favours by publicly expressing the view that being strapped to a bed for days on end is not so bad because these days they use velcro, not chains.
...

We believe that the media publicity and the public outcry on social media may have helped the Tribunal get it right this time. At least they know they are being watched.


https://www.madinamerica.com/2016/05/psychiatry_garth_daniels/

A Qld. psychiatrist wrote:
...
Victorians, in general, regard themselves as cultured, sophisticated and genteel, which makes the bizarre treatment meted out to Daniels seem even more outlandish.
...

During 2015, he was shackled for about 110 days in all including one continuous period of 69 days.
...

He has been deemed incapable of giving consent to ECT because he refuses it, but also because he cant remember why he needs it. His treating psychiatrists acknowledge that the reason he cant remember is that he has received ECT.
...

The question of whether he is dangerous is important. He is currently being treated as the single most dangerous person in the history of the State of Victoria, if not in the entire history of this country.

... Believe me; I know aggression. Garth Daniels is not dangerous.
...

A cynic might even suspect that Victorian MHS is hell-bent on giving Daniels so much ECT that he wont be able to testify.
...

It is a measure of the scientific naivete of mainstream psychiatry that they could ever believe this. It is also a measure of their intellectual arrogance that they are unable to acknowledge their error.


It's hard to understand how Paul Katz could get away with that sort of thing in a "cultured, sophisticated and genteel" society, or even an uncultured, unsophisticated but 21st-century first-world one.
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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Tue Mar 12, 2019 8:46 am
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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.

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K 



Joined: 09 Sep 2011


PostPosted: Tue Mar 12, 2019 8:57 am
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The articles linked to claim that Paul Katz (and others) got away with heaps -- and not just ECTs. And there are many more articles than those.

e.g.

https://www.madinamerica.com/2016/03/the-mental-health-tribunal/

The same Swinburne clinical psych professor wrote:
...
The patient was not able to exercise his legal right to attend because he was, yet again, tied to his bed. The members of the Tribunal made no effort to question the legitimacy of this, even though their own record of the meeting confirms that there had been no ‘critical incident’ prior to his being tied up, yet again. ...

The psychiatrist on the Tribunal panel went to the ward and quickly assessed that BD was, yet again, not competent to refuse consent to ECT (even though an independent psychiatrist’s report said he was fully competent), but informed us all that he had nevertheless given consent to some medication that he had previously refused. So it seems he is incompetent when he disagrees with them but competent when he agrees.

One of the treating psychiatrists, Dr SM, admitted that part of the reason that he was incompetent to withhold consent was because his memory was impaired, as a result of the ECT (acknowledged in Statement of Reasons), so they had to keep giving it to him against his will to try to get him better to the point where he might be able to consent to have more of it rather than have to have it against his will. When I tried to point out the various logical flaws in this line of reasoning the supposedly neutral psychiatrist on the Tribunal panel, Dr BM, not only failed to question the curious reasoning (as any unbiased Tribunal member would have done), she actually tried to come to Dr SM’s defence, making several points on her behalf, to try to make her sound more logical (she failed). This constitutes clear bias and suggests ignorance of, or wilful neglect of, her role as a Tribunal member.

Meanwhile the Eastern Health barrister, Mr PH, sat at the back of the room openly (ie he did not stop when I turned round and observed him) controlling the chair of the hearing panel with nods and shakes of his head – about who could speak, who should go to see Mr D on the ward, etc.. I witnessed this on two separate occasions. On one, the chair of the hearing panel paused, looked over to Mr PH, waited for his signal and then proceeded in accordance with that signal. This is clearly unethical conduct on the part of the chair, and is of particularly grave concern because the chair of this particular hearing was the Chair of the Mental Health Tribunal as a whole, Mr MC.
...

etc. etc. etc.


That all sounds totally farcical and illegal.
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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Tue Mar 12, 2019 9:04 am
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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 😀 85 km for total ride

Yesterday rode with friends to Mordialloc and back: 45 km’s. Stayed in my bike clobber, had breakfast at home then rode to work and back (avoiding Moomba). At 10 pm once I was past the CBD I could fly home. Rode a total of 75 km’s yesterday.

Got leg cramps overnight!!

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