Self Care

Just got back from a weekend long stay at a hermitage. Observed the caged monkey (my mind)jump around a little bit. Took walks, worked out, slept.

This is one form of self care. A kind that works for me, among various other things of course.

Other things work for other people.

General self care approaches are things like adequate sleep, exercise, spending time with family and friends, dancing, spiritual practices like prayer and meditation, healthy eating habits, tolerance towards own imperfections, etc.

We who work in this business have, I feel, a moral duty to take good care of ourselves. After all, we are the tools we work with, and our work will only be as good as our condition allows it to be.

That does not mean, I feel, that we should be perfect. It just means that we owe it to our clients to do our best to keep "fit" both spiritually and mentally. That we try, in our beautiful flawed human way to be sharp and well polished instruments.

Self care is not self-ish. What is selfish is neglecting self-care. It not only precipitates rust-out and burn out, it also hinders us to be of service to those we wish to serve.

What works for you?

Have you done that lately?

If no, why not?

working guy

These are strange days.I have graduated from my program and have started working.

I am not yet certified in my field so I cannot prescribe meds yet.

I can however work as an APRN for six months after I graduate while in this delightful process of being certified. See the Minnesota Board of Nursing website

What that means for what I can do is unclear though. It seems I can legally perform as a P/MH CNS minus the prescribing. But nobody is willing to reimburse my employer until I am certified, and credentialed.

I naively thought this clause was put in the statute so we could practice right after we graduated...

If anyone out there has experience practicing in this strange twilight zone any feedback would be appreciated.

Mental health and scandals

Two scandals regarding mental health related facilities have been revealed in the media recently in Iceland.

One is regarding a Christian based substance abuse facility, where the "minister" and head of the facility was convicted for having sexual relations with a number of his clients. Sexual relations of the sort that would be deemed highly unorthodox by most. This facility was run, in large part, on government contributions which make this horrendous betrayal of trust even more serious, if possible.

The other scandal involves the chief physician at the only long term psychiatric forensic facility in Iceland. He has been issuing scripts for stimulants on names of patients who have never received such medicine, and then had an accomplish retrieve them from various pharmacies. This offense is further exacerbated by the fact that these false scripts were written out for some of the most vulnerable individuals in our society e.g. convicts.

Could this happen in any other field of health care?

Perhaps.

But the fact remains that these things seem to happen more frequently in our field than other fields of health care.

Are the standards for mental health care lower? Is there less regulation for these kinds of facilities? Could it be that there is still stigma in the community, and that is reflected in this lack of oversight?

Mental health services in Iceland

"Kleppsspitali", the biggest long term mental health care facility in Iceland, his role is changing, perhaps too slowly?



We enjoy universal health care coverage in Iceland. We have one of the lowest infant mortality rates and the highest life expectancy rates in the world. But we still have a lot of problems in our health care system, like anywhere else in the world.

This is especially true for our mental health care system. Talk of moving the bulk of the services into the community is common, but practical action is slow to take place. We have started taking some action. Experience from countries like Denmark and the UK help, and user groups make a strong lobby group with increasing numbers of celebrities and politicians stepping up to the plate and talking openly about their struggle with mental illness. This helps reduce stigma in the community and is empoering for other users.

Still we have a long way to go. There is hope. We see how we have built up a powerful substance abuse treatment field and attitudes towards substance abuse in the communiuty are rather healthy, I would think. That is a field were the users of the system took the initiative.

Perhaps that is the key for other areas of psychiatry as well?

No place like home

I am currently back in the "old country". Minnesota has a lot of cool things, but it does not have any mountains and it does not have an ocean near by. Both of which Iceland has in abundance.

I like mountains. They are good for looking at and walking on.
Here is one of my favourites.







I will tell you a little bit about nursing in Iceland later this week.

Graduation

Great things will occur in this building today



Today I graduate from the Graduate school of the University of Minnesota with an advanced practice degree in Psychiatric/Mental health nursing.

This is excillerating and scary at the same time.

My main goal for my first year of practice is not to seriously harm anybody.

I will wait until my second year of practice to start changing the whole treatment paradigm of psychiatry... ;)

Cultural competence

Somalia is a beautiful country in North-Eastern Africa


I have been thinking about this topic alot lately

Been working on a mental health needs assessment of young Somali males here in Minnesota, with a collegue.

We wanted to find out how to better reach out to and serve male Somali clients, ages 18-35 with a psychotic disorder, in Hennepin County.

I was quite humbled after we had done the twelve key informant interviews and literature search on this populations possible community mental health needs.

It is clear to me know how extremely helpful it is to know the fundamental background and history of any population we are serving. Especially those we see frequently.

The things I learned in this process include the importance of cooperation with community resources, again reminded to stop and listen and that families are my clients too, and how many barriers to serving vulnerable populations in this country are due directly or indirectly to economical factors.

I have a lot of learning to do, and a lot of changing too