Nurses for Human Rights

I often wonder how this pill of falsehood about chemical imbalances in the brain causes mental disorders gets swallowed by nurses. We so quickly accept ideas because they show up in medical journals. Not many of us even read the article in full. We’d rather read the summary or abstract and decide from there. We take such things as face value and don’t add our critical thinking skills to the mix. Nurses aren’t taught research methods unless you go on to a Masters and Doctorate program. Even then, the site’s of our critical thinking isn’t turned to substantiate findings from researchers.

From an article in FSU.com, Jill Elish writes that this theory of chemical imbalance is being challenged at least in this one Florida University. She quotes Jeffrey Lacasse, an FSU doctoral candidate and Jonathon Leo, PhD in physiology and professor of neuroanatomy at Lincoln Memorial University in Tennessee. I think the article should be considered by nurses and particularly psychiatric nurses. I give you one quote here and hope you read the article and rethink what we are doing to our mentally ill:

“The media’s presentation of the theory as fact is troublesome because it misrepresents the current status of the theory,” Lacasse said. “For instance, there are few scientists who will rise to its defense, and some prominent psychiatrists publicly acknowledge that the serotonin hypothesis is more metaphor than fact. As the current study documents, when asked for evidence, reporters were unable to cite peer-reviewed primary articles in support of the theory”.

Where is the science behind drugging millions of sufferers from depression and anxiety?

Newsblog Pharmalot reports that New Jersey has passed an informed consent bill that requires any persons under 18 to be given full informed consent before being prescribed or administered psychotropic medications with black box warnings. You can view this bill in pdf here ( New Jersey’s Informed Consent Bill ) and also from the Pharmalot site.

This includes any nurse practitioner who prescribes a medication that has a black box warning and this bill makes them liable in a court of law should they not perform informed consent. This bill should be applauded by nurses everywhere and hopefully this trend will spread nationally. Physicians, psychologists and Nurse Practitioners will all be subject to disciplinary actions by their States Board of Nursing or Medical Board of Examiners.

Sign this petition and lets get this enacted across the US:

http://www.ipetitions.com/petition/NrseCall2Arms/

Nice article from the Wall Stree Journal about massage therapy being used in lieu of antipsychotic medications on the elderly. It seems there is success in using alternatives to drugs on the elderly and it more aligns with what we nurses like to do for our patients. Hands on nursing is the most gratifying aspect of what we do. With a little training, we have license to put our hands on our geriatric patients and ease their pains and discomfort. For all we know, it’s these little nagging pains that exacerbates demenita or mental agitation. I’m just specualting here but what if we find out that human physical contact -massage, hugs, and touching - all contribute to our mental health? What if - we find out that touching and massage can “reset” the neurons and calm mental agitation? Sort of blows the chemical imbalance or brain abnormality theories out of the water, right? But what do I know…I’m just a nurse.

I’m one for statistics and evidence based outcomes. So, here is what I think about this:

“The results are startling. Nationwide, some 30% of nursing-home patients are put on antipsychotics, according to federal data, but Providence Rest has cut its own use down to 2% or 3%. That’s the lowest rate of any nursing home in New York, and among the lowest in the country, according to the New York Association of Homes & Services for the Aging.” WSJ

MSNBC reports that old habits are hard to break in Soviet Russia. Once upon a time Stalinist Russia used mental health facilities to detain, drug, and abuse government dissidents. This report says it’s happening again. What should be noted here by nurses is that after only a few months of treatment with antipsychotics, the victims sustain permanent neurologic damage. If psychiatry is truly a medical profession and follow an oath, why would they agree to do such things to a human being? The fact that psychiatry would agree to be a detaining point and involuntarily commit normal people who otherwise would not need treatment on the orders of a government is a human rights abuse issue. I haven’t heard any American Psychiatrist denounce this treatment or band together to protest. Why? Nurses, we need to protest and let our legislators know that we don’t agree that this is done on human rights issue numbers 3 and 5 of the Universal Declaration of Human Rights. Exercise your political will. Sign this petition:

http://www.ipetitions.com/petition/NrseCall2Arms/

The Financial Times reports that researchers found no evidence that today’s SSRIs had any effect on treating depression. According to their findings after reviewing over 50 clinical trials “we found that new-generation anti-depressants worked no better than a placebo – a dummy pill – for mildly depressed patients”. This is what Dr. Timothy Scott also brought to light in his wonderful book America Fooled. Dr. Scott showed clearly that the clinical trials were skewed toward showing effectiveness when really they were saying that they had no better effect than placebo.

What’s also interesting about the article is that the recommendation by a mental health charity called MIND that urges General Practitioners “to consider alternative therapies such as exercise – particularly outdoor exercise – which it believes has shown to be very effective in combating depression”. SSRIs are a dangerous drug to be handing out in our society for the very reasons of earlier articles…the creation of violence. Nurses should not be supporting the use of SSRIs for depression when clearly the best practice is diet and exercise. First, do no harm. Healthier lifestyles are the answer to our mental health issues.

People have a fascination with electricity these days. Who hasn’t laughed at the drunk getting tazered for being obnoxious. We are then horrified, at least some people are, with the idea of waterboarding enemy prisoners. Most captives survive physically with the “near drowning” experience of waterboarding, at least that’s the argument that it’s not harmful. This isn’t the case here in our own US Borders under today’s mental health system. This article in Mother Jones details the use of electric-shock as an aversion therapy. While most survive the incidents of these shocks, some live with long-term emotional scars from the abuse. Is this the best that psychaitry can come up with in treating mentally handicapped, autistic, and emotionally troubled kids? Any nurse who would support such therapies should turn in their license. You have violated your Nurses Code of Ethics at it’s core. Read this article and then sign the petition below:

http://www.ipetitions.com/petition/NrseCall2Arms/

A release by the FDA warns practitioners that anti-seizure meds increase the suicidality of patients as compared to placebo. There is no doubt that a practitioner should be including this information on Informed Consent.

“The higher risk of suicidal thoughts and behaviors was observed at one week after starting a drug and continued to at least 24 weeks. The results were generally consistent among all the different drug products studied and were seen in all demographic subgroups. There was no clear pattern of risk across age groups.”

See the letter and list of meds here: http://www.fda.gov/bbs/topics/NEWS/2008/NEW01786.html

In the Indy Star it’s reported that Eli Lilly has settled 900 cases of personal injury regarding their anti-psychotic Zyprexa. It should be important to nurses that giving these patients, now damaged by this drug, the full scope of the possible side-effects would have been considered full informed consent. When a drug company does not disclose these side-effects so that nurses and physicians can then weigh the consequences of this treatment and other alternatives, it puts us professionals in a legal nightmare as much as a moral one. Knowing these antipsychotics can produce these effects, how then can we prescribe them to growing children? Without evidence that there is a physical reason for the mental illness as a causative source, and depending on an interpretation and theory of research data for it’s rationality for giving such powerful drugs, we have an ethical duty to 1) know all we must know about a drug to be given, 2) know what the dangers are regarding a specific drug therapy, 3) know alternatives to that specific drug therapy, and 4) provide the patient with that information, untainted by the informers personal opinion, of the above 3 points so that said patient can make a decision…”do I want to accept this therapy” or “I would rather have the alternative therapy”. This story should alert you to the situation we nurses are being put in…we aren’t being told what the real dangers are, we are giving human beings damaging drugs without evidence based results from long-term trials, and we are not informing these patients of alternatives.

In November 2007, a report surfaced that an LPN and a psych aide used electric shocks, used in an aversion therapy(GED), to punish two resident teenagers in the facility. This story, here provided, is disturbing to the core. Firstly because a nurse is involved. Secondly, because we are still using this archaic, obviously abusive “therapy”. It disturbs me, and should disturb you as well, that we use any “therapy” that involves causing pain to a patient. This is a human rights issue…torture can not be disguised as “therapy”. Having your skin shocked, is painful. Full ECT shock is painful. It’s abuse and should be outlawed since there is no evidence that it actually makes a person better. On the contrary, it only makes them worse. I am calling out all you nurses who are supporting this practice to re-read your Nurses Code of Ethics and point number 5 of the Declaration for Human Rights AGAIN. You have a misunderstood concept and should not be practicing nursing in my opinion. A patient puts their health and lives in your trust. When you use outright abuse as a therapy, no matter what a false “science” has said about it’s usefulness, you are not practicing nursing. We are not sheep, we do not follow MDs blindly. If you don’t have the guts to stand up to any MD, psychiatrist, or manager telling you to do something outright abusive to a patient, GET OUT OF NURSING! We need thinkers, we need moral and ethical practitioners, we need heroes, and we need courageous bedside and community nurses who will say no to any therapy that pretends to be helpful when it clearly is not. Stop using electric shock devices on people. It’s abusive. It violates their human rights. Sign this petition:

http://www.ipetitions.com/petition/NrseCall2Arms/