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Special Observation (special + observation)
Selected AbstractsProblematizing special observation in psychiatry: Foucault, archaeology, genealogy, discourse and power/knowledgeJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2006C. STEVENSON rmn ba(hons) msc phd Special observation by mental health professionals is the recommended approach for those people deemed as at risk or risky. Recent research and academic writing have challenged the benefits of observing people/patients who are defined as ,at risk', and a more human engagement process is being recommended. Despite this assault, practice has not changed substantively, suggesting a need for a thorough exploration and questioning of the practices and process. The paper outlines three Foucaultian approaches to historical analysis. It applies aspects of Foucault's archaeology/genealogy, discourse and power/knowledge to explore the practices of special observation as a means of controlling risk, especially suicide risk. We identify the regulatory function of the ,gaze', professional codes and government policy in relation to restricting professional practices. We argue that observation can be related to moral therapy, wherein the person relinquishes madness for responsibility through a disciplinary process and, in governing risk, a ,professional industry' is created. The regulation of statements about people with mental health issues are exposed and related to what can be said and done by professionals. Finally, we look at productive power in relation to observation, and how it is intimately related to resistance. We conclude with ,soft' recommendations for practice discursively produced through the writing of the paper. [source] On conflict, containment and the relationship between themNURSING INQUIRY, Issue 3 2006Len Bowers A programme of research into conflict (e.g. violence, absconding, medication refusal) and containment (e.g. seclusion, special observation, physical restraint) in inpatient psychiatry has been under way at City University, London, UK, for the past 10 years. Recent research findings, plus the challenges posed by ongoing projects, have made apparent the need for greater clarity about the overarching concepts of ,conflict' and ,containment'. This paper pulls together research findings pertaining to this issue, and conducts a reasoned analysis of what common characteristics might underlie ,conflict' and ,containment'. It is concluded that these are patient threats to safety, and the staff maintenance of safety. Details are presented on the inclusions and exclusions that follow from taking such a position, and potential definitions offered. On the grounds of this conceptual analysis, plus evidence for moderate degrees of statistical association between behaviours and events in each domain, it is concluded that it is legitimate to conduct analyses at the level of total conflict and containment rates, as well as at the level of individual types of behaviours and events (e.g. verbal abuse, sedation). Some of the mathematical difficulties in the analysis of total conflict and containment are addressed, and results of a weighting exercise presented. This exercise challenges our perception of the severity of some containment measures that are becoming more commonly used in acute psychiatry. [source] Constant or special observations of inpatients presenting a risk of aggression or violence: nurses' perceptions of the rules of engagementJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2005I. MACKAY bsc (hons) rmn In acute psychiatric settings the practice of ,observation' is commonly employed. Increased levels of observation, ,constant' or ,special' are used for those perceived as presenting a ,higher' risk. As an intervention it is used most frequently for those at risk of self-harm or suicide, the practice is also however, used for those thought to present a risk of violent behaviour. In this descriptive study the perceptions of 1st level registered mental nurses (RMNs) gave an account of observation for those perceived to be at risk of violence or aggression and insight into what was considered important and desirable in practice. Unstructured qualitative interviews were conducted with a purposive sample of six RMNs from a psychiatric intensive care unit. Three major categories, Procedure, Role, and Skills emerged which revealed a complex practice far removed from its literal description as merely ,watching'. Six subcategories emerged from the Role. (1) intervening; (2) maintaining the safety of the patient and others; (3) prevention de-escalation and the management of aggression and violence; (4) assessing; (5) communication; and (6) therapy. Skills in these and, experience were thought to IMPACT on the success of the practice. The description of this and the skills involved offer a definition of the ,rules of engagement' which give insight to the practice and the training needs of staff advocated for ,observation'. The acronym IMPACT may be useful in this. [source] | ||||||||||