I've spent a joyful week in orientation for work.
Not particularly informative or interesting to someone who has already worked in this field a bit and could probably teach the orientation class. But my ears perked when I heard the following during my incident reporting training...
The state office of mental retardation and developmental disabilities (OMR/DD) does not require social services agencies to report client on client abuse unless it is of a sexual nature.
Let me give you some background. Most states require mental retardation (MR) social service agencies to report a number of different situations to the state to ensure that social services agencies aren't allowing for/causing the abuse/mistreatment of individuals. These situations include: injuries, hospitalizations, abuse and neglect allegations, criminal victimization. Anything bad.
These regulations are a reaction to the big state hospitals of the past that were a world unto themselves with very little accountability where very horrible, awful things happened to the mentally retarded people who lived in them.
One of the awful things that happened in the institutions is clients would hurt one another. Some clients had severe behaviors and hurt people because they didn't know any other way to express themselves. Some clients were predators and bullies. Some clients severely injured and even killed other clients. Staff to client ratios were sometimes 1 staff to 30 clients so staff had little ability to provide the necessary oversight.
So back to present day. An MR agency does not have to report if one of their clients physically beats the shit out of another client whether because of a behavior or because the client is a mean nasty person who likes to hit people (the resulting injury if severe enough might be reported, but not the abuse). The optimistic part of me wants to believe that an agency with integrity will take steps to reduce and prevent these incidents. But the cynical part of me knows that social service agencies have thin financial margins (I have a whole other rant about how the non-profit social services sector should move into the for-profit sector, but that's for another day) that sometimes influence their thinking, so it bothers me that there is no state oversight in this area. I don't care if it's a slight shove or slap or a beating, an individual has the right to live free from such harm and the state should make sure of it.
Ok, rant finished.
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08/31/2007 15:29 #40862
Not Abuse?! WTF?! Long Rant...Category: work
08/28/2007 21:55 #40793
The sounds of Tuesday nightCategory: house
It makes me smile that one of the evening noises I now associate with living on Lexington is the sound of the grocery store carts being pushed up and down the street by individuals sorting through people's recycling bin. Blends right in with the crickets.
I make my angry face, however, at the college students who stayed up until 4am last night drinking and talking loud on their front porch waking me up several times through out the night. I guess I'm becoming one of those old cranks who likes to be well rested before work.
I make my angry face, however, at the college students who stayed up until 4am last night drinking and talking loud on their front porch waking me up several times through out the night. I guess I'm becoming one of those old cranks who likes to be well rested before work.
janelle - 08/28/07 22:19
I dunno, if you think what you're hearing is a gunshot, I wouldn't be surprised depending on where you live.
I dunno, if you think what you're hearing is a gunshot, I wouldn't be surprised depending on where you live.
tinypliny - 08/28/07 22:18
LOL - so that's what it is -- the metallic grating sounds on Tuesdays! I assumed it was the sound of some special cleaners that the city had hired to scrape the gunk off the streets. It did seem odd to me that they would do it before the garbage day rather than after it. Nevermind that the whole idea was atrocious. My brain doesn't think logically, quite often.
Yeah, I am an old crone already. I wake up to every small thud and creak all through the night. Sometimes, I think I hear gunshots in the middle of the night. Some people told me it might be just backfiring from old cars. Who knows...
LOL - so that's what it is -- the metallic grating sounds on Tuesdays! I assumed it was the sound of some special cleaners that the city had hired to scrape the gunk off the streets. It did seem odd to me that they would do it before the garbage day rather than after it. Nevermind that the whole idea was atrocious. My brain doesn't think logically, quite often.
Yeah, I am an old crone already. I wake up to every small thud and creak all through the night. Sometimes, I think I hear gunshots in the middle of the night. Some people told me it might be just backfiring from old cars. Who knows...
08/27/2007 19:35 #40763
As promised......Category: pets
Bad Cat, Fat Cat and Devious Dog.
Also known as Tatanka, Nealie and Buckley.
Anyone want the bad cat? No really, bad cat is just a nick name, she doesn't really terrorize the house....<shifty eyes>
Also known as Tatanka, Nealie and Buckley.
Anyone want the bad cat? No really, bad cat is just a nick name, she doesn't really terrorize the house....<shifty eyes>
fellyconnelly - 08/27/07 22:48
holy laser eyes batman!
our bad black cat likes to perch on unsuspecting shoulders with every claw of his fuzzy little paws.
holy laser eyes batman!
our bad black cat likes to perch on unsuspecting shoulders with every claw of his fuzzy little paws.
tinypliny - 08/27/07 22:18
...and that is why cats and dogs are a distinctly different species. A case in point is their different responses to the photographic flash. While the members of the feline family generally disinter their demonic ocular powers, the canine lot just close their eyes and take the moment to reflect on their lives.
...and that is why cats and dogs are a distinctly different species. A case in point is their different responses to the photographic flash. While the members of the feline family generally disinter their demonic ocular powers, the canine lot just close their eyes and take the moment to reflect on their lives.
janelle - 08/27/07 21:28
Seriously, (e:Libertad). We're at 265. Feel free to knock or say hello if you see us!
Seriously, (e:Libertad). We're at 265. Feel free to knock or say hello if you see us!
janelle - 08/27/07 21:21
Kewl, so neighbor (e:Libertad) do you want to be neighborly and rescue us from our state of beerlessness?
Kewl, so neighbor (e:Libertad) do you want to be neighborly and rescue us from our state of beerlessness?
libertad - 08/27/07 21:09
I want bad cat! Except he would eat my rabbit and my rabbit eats me out of house and home already, but he is worth it. btw I live on the same street as you.
I want bad cat! Except he would eat my rabbit and my rabbit eats me out of house and home already, but he is worth it. btw I live on the same street as you.
lauren - 08/27/07 20:13
Awww, your bad cat looks like (one of two of) our bad cats, laser eyes and all!
Awww, your bad cat looks like (one of two of) our bad cats, laser eyes and all!
theecarey - 08/27/07 19:42
This is really a great pic with them standing there as if in a line up. Which one is guilty? I say not Bad Cat, as it looks like Bad Cat has laser death-ray-soul eating capabilities.And probably opposable thumbs. *niiiice kitty*
This is really a great pic with them standing there as if in a line up. Which one is guilty? I say not Bad Cat, as it looks like Bad Cat has laser death-ray-soul eating capabilities.And probably opposable thumbs. *niiiice kitty*
08/27/2007 19:32 #40762
My friends from PittsburghCategory: life
The weekend before last I took my Pittsburgh MR/DD friends and their staff into our home and out and about for the weekend.
We went to The Anchor Bar which they loved, because, well, they love eating, and they really love eating fried things.
The next day we took them to the zoo. I hate to poo on my new city, but the Buffalo Zoo...really not so fabulous. But I understand that they have big plans for the future so I'm looking forward to that.
Jim, Marianne, Patty, Nelson, Patrick and Dennis in the Elephant House:
Marianne was the bravest of all and fed a cracker to the Giraffes. By the way, it costs a fricking dollar to feed a cracker to a giraffe, but you gotta charge that when you're building a new elephant house, I suppose.
Nelson, myself and Dennis on the carousel. Nelson's my buddy and wanted to share a horse with me, but I told him that Drew would be jealous so he would need to ride his own horse.
I also took them to the American side of the falls. I thought the American side was really nice, but people are always doggin' it!
I really love this view:
The whole crew at the falls:
Everyone picked out cheapy souveneirs and the ladies got hats that said "Cutie" and "Foxie"!
Patrick loved our dog, but Nelson would screach, "Son of a Bitch" if our dog even looked at him sideways!
All in all good time. Next year, I want everyone to get passports and secure permissions from guardians and then I'll take the whole crew to the Big City in Toronto!
We went to The Anchor Bar which they loved, because, well, they love eating, and they really love eating fried things.
The next day we took them to the zoo. I hate to poo on my new city, but the Buffalo Zoo...really not so fabulous. But I understand that they have big plans for the future so I'm looking forward to that.
Jim, Marianne, Patty, Nelson, Patrick and Dennis in the Elephant House:
Marianne was the bravest of all and fed a cracker to the Giraffes. By the way, it costs a fricking dollar to feed a cracker to a giraffe, but you gotta charge that when you're building a new elephant house, I suppose.
Nelson, myself and Dennis on the carousel. Nelson's my buddy and wanted to share a horse with me, but I told him that Drew would be jealous so he would need to ride his own horse.
I also took them to the American side of the falls. I thought the American side was really nice, but people are always doggin' it!
I really love this view:
The whole crew at the falls:
Everyone picked out cheapy souveneirs and the ladies got hats that said "Cutie" and "Foxie"!
Patrick loved our dog, but Nelson would screach, "Son of a Bitch" if our dog even looked at him sideways!
All in all good time. Next year, I want everyone to get passports and secure permissions from guardians and then I'll take the whole crew to the Big City in Toronto!
08/26/2007 18:27 #40739
Weekend MusingsCategory: life
Really nice weekend. Totally enjoyed meeting several fellow (e:peeps) at the bars on Friday night. People were a little bit different than I imagined, which made for fun to compare the online persona to the real thing in my head throughout the night.
Saturday me and some menly men helped two people move out of their third floor apartments into a third floor apartment together. It needs a little work, but seeing as she makes a living doing set/props design, I'm pretty sure that her place will be fabulous by the time she's done.
In the afternoon, I went down to the church to assist with the handing out of free lemonade. It was amazing how snotty some people were about saying no to free lemonade. A simple no thanks should suffice, yes? But a highlight was meeting (e:leetee) !
Sunday morning I woke up to the aching of my muscles screaming at me for all the third floor moving on Saturday. I willed myself out of bed and off to church where I played a piece on clarinet for the worship service. It was well received so I had a pleasant stroking of the ego today! The afternoon involved some good loving followed by Gilmore Girls on the couch. Now I gotta go because my husband just brought me a plate of pierogies with peas swimming in a white cheesy sauce.
Saturday me and some menly men helped two people move out of their third floor apartments into a third floor apartment together. It needs a little work, but seeing as she makes a living doing set/props design, I'm pretty sure that her place will be fabulous by the time she's done.
In the afternoon, I went down to the church to assist with the handing out of free lemonade. It was amazing how snotty some people were about saying no to free lemonade. A simple no thanks should suffice, yes? But a highlight was meeting (e:leetee) !
Sunday morning I woke up to the aching of my muscles screaming at me for all the third floor moving on Saturday. I willed myself out of bed and off to church where I played a piece on clarinet for the worship service. It was well received so I had a pleasant stroking of the ego today! The afternoon involved some good loving followed by Gilmore Girls on the couch. Now I gotta go because my husband just brought me a plate of pierogies with peas swimming in a white cheesy sauce.
leetee - 08/27/07 08:47
awe, thanks. Was great meeting you and (e:Drew) too. When we arrived, i saw people in front of the church, and based on outfit, i guessed who was (e:Drew). :)
awe, thanks. Was great meeting you and (e:Drew) too. When we arrived, i saw people in front of the church, and based on outfit, i guessed who was (e:Drew). :)
janelle - 08/26/07 21:53
Quite the opposite, felly. You were pleasant and fun. Can't wait til we meet again =)
Quite the opposite, felly. You were pleasant and fun. Can't wait til we meet again =)
fellyconnelly - 08/26/07 21:17
great meeting you the other night! pardon me if i was drunk and/or obnoxious...
great meeting you the other night! pardon me if i was drunk and/or obnoxious...
tinypliny - 08/26/07 19:24
Damn, I missed your lemonade and the clarinet concert. I am always missing things... I just had to finish some stuff I was dragging on and on from last week and got done only at 4:15. :/
Damn, I missed your lemonade and the clarinet concert. I am always missing things... I just had to finish some stuff I was dragging on and on from last week and got done only at 4:15. :/
My mother is a uh...for lack of knowing the actual title, a secretary for the ARC. Basically, she is employed by the state of NY and handles a good deal of paperwork involving mentally retarded clients or consumers.
i don't know what she is... but no not a nurse.
Oh, right...<blush> Lauren's mom must be a nurse?
BMs as in Bowel Movements. polite way to say 'make a poopie.'
(e:tinypliny). Good analogy and good questions.
Yes, there could be a tendency to underreport instances of client to client abuse to lower the numbers.
What prevents the under reporting of such incidents is that agencies undergo annual surveys where the state comes through and combs through all forms of documentation. If they find an instance of possible abuse that wasn't reported, they cite the agency for failure to report abuse. Failure to report abuse is a significant enough issue to place an agency on "probationary" status which means they'll be surveyed again in 6 months and unless everything is up to snuff they could risk losing their license and the program is shut down.
If an agency did report every instance of abuse, there would be both censure and supportive intervention. The state would fault the agency for the abuse if it appears that the agency is not doing anything to prevent the abuse (i.e. client A keeps abusing client B on a weekly basis). In some instances, agencies can request more money from the state to help alleviate the situation. Worst case scenario is that the agency says we can no longer serve the client without endangering other clients and the client will go to a program better suited to his needs.
And for clarification, I don't work in the mental health world, I work in the mental retardation world. There are some similarities, but there are a lot of differences too.
I'm guessing BM=Behavior Management, but not sure. Lauren will maybe answer.
BMs? Bone Marrow Biopsy? How would those help?!
Confused.
Hmm.. I am not sure I got any behavioural management technique training. It was a psychiatric ward where patients hardly stayed for more than 2 weeks at a maximum, so we didn't have many chronic patients. Many of them were cases of severe depression and suicidal tendencies (non-organic delusional, bipolar, schizophrenic, psychosis episodes), kept under observation. My only contact with them was talking to them to get their case histories. The entire time I spent in the wards was training on how to get reliable histories and get the acute patient to open up enough to talk to you.
Again, I am not sure whether the ward was overpopulated/ understaffed - I didn't think so. However, there were a couple patients that only the senior consultants were allowed access to. I think one of them had attempted to jump out the window and the other had tried to choke the patients on the adjacent beds.
So I guess the ward I was in was, indeed, a very different scenario to what you usually deal with.
That said, (and since I am somewhat curious about how the system you suggest might work) I gather your argument is that if the people managing the wards (or facilities) were required to report instances of inter-inmate violence to the higher authorities, they would be more sensitive to the issue and avoid looking bad by preventing these incidents or actively intervening to reduce these incidents? That could work - but what if, as you mention in your post, the institutions lacked any integrity to begin with? Would they not be then tempted to supress information anyway?
In trying to understand this argument, let me draw a parallel with infectious diseases. If each county was required by law to report every instance of polio symptoms, and if the county were overly conscious about its health infrastructure image, might it not try to under-report possible suspicious (but unconfirmed) cases of polio symptoms (Acute Flaccid Paralysis (AFP), an early symptom of Polio, is not unique to Polio - it can be a result of other viral infections/asthma etc.)?
Even if it did report every instance of AFP, would the state be forced to take measures to better fund the health-infrastructure of that particular county or would the county be blamed for the lacunae in its health infrastructure?
What do you think would be the situation in the mental health world? Would the organizations that report these violations be censored and reprimanded or would it lead to a supportive intervention from the higher authority?
This may be totally off base, but this reminded me of watching one of those "inside our prison system" specials wherein the officers on duty will not attempt to break up fights between inmates, even or perhaps especially of serious injury or death may occur, because their own lives are at stake. In your case however, it seems that the consumers or clients should be the number one priorty and unless your own personal safety is in jeopardy, something should be done to prevent it. I of course also have no idea about the mounds of paperwork that must be sorted through on a daily basis, but according to my mother she has records of every clients BM's, so is abusive behavior less of a priority?
Okay, I'm going to try to be succinct. Also, I've never managed a psych ward, so I'm coming from the perspective of someone who manages group homes which provides a little bit of a different environment, but there are some similar principals of human rights.
An agency realistically cannot guarantee that it will 100% prevent client on client abuse. Agencies do have the responsibility to decrease incidents and they can do it by considering how they place individuals together; using behavioral support plans and training the staff appropriately. I think that the incidents need to be reported to the state on a regular basis or an agency and its staff may begin to regard client on client abuse as a given and let it grow to dangerous levels. Or is that a slippery slope argument, lol?
When you worked in a psych ward with patients were you trained in behavioral management techniques? Just curious. My guess is that you weren't trained in those techniques but the nurses and other staff were.
My other guess is that isolation got used on the psych wards you worked in when the ward was understaffed or over populated.
Also, in the MR field we do consider isolation to be a form of abuse and it's rarely to never used.
Okay - I have never been into social services but I have worked in psychiatric wards with patients before and here's what I don't get. How will you ensure that the clients don't continue to be abused by other inmates (also clients) if they are hurting each other? You could isolate the violent client - but isolation could also be a form of abuse. Where do you start? Where do you draw the line?