This very confrontational video by Jenn Ackerman portrays the reality of those who live with mental illness at the Kentucky State Reformatory in the US.
Perhaps you might share your own feelings or experiences around the way we treat people with mental illness in our correctional facilities?

Trapped: Mental Illness in America’s Prisons http://www.jennackerman.com/trapped from Jenn Ackerman on Vimeo.

My intention was to make that made the viewer feel what I felt when I was inside the prison. I took a more personal and emotional approach to this project than I ever have. I listened to the inmates and the doctors and set out to take photos of how I felt when I was there. I wanted to show weakness, despair, hostility and vulnerability that I saw when I was there. I left the prison everyday wanting to help these men that have nowhere else to go. There were days that I was extremely scared and others that I left thinking how much someone on the outside missed them. Some days, I had to remind myself that many of these men had done heinous things. There were also days when I was reminded that some of these men have faded into the system with no hope of getting out.

I saw them cry. I saw them hit themselves so hard in the head that they bled. I saw them throw their feces at the officers. I saw a world most people don’t even know exists in America. There were hard days but mostly rewarding ones. For most of these men, they have been outcasts of society and rarely heard. So they had a chance to share their story and have someone listen that actually cared to listen not just focused on treatment or safety.

My intention is to spark calls for reform for the treatment of the mentally ill and the prison system in the US. Since beginning on the project, I have produced a film about the subject and have spoken at numerous prison conferences throughout the country. My work has been used as an educational resource for prisons and law schools and I continue to speak for mentally ill inmates throughout the country. My hope is that the project exposes the injustice, spreads awareness and encourages a needed policy change about imprisoning the mentally ill in the US.
Jen Ackerman

Every rare once in a way too long while,
fist light is not so bad.
And we can clean, and take stock and prepare our work.
Prepare.

Every once in a while, first light is light.
And quiet is not a dirty word.

It doesn’t happen very often. But when it does,
This is what I see.

On a good day.
  

first light from Ian Miller on Vimeo.

If you cannot see the player above here is the link to the video.

Last weekend on a trip up the coast, we stopped for coffee in the township of Braidwood.
Thomas Braidwood Wilson was a surgeon who worked aboard convict ships journeying from England to New South Wales and Tasmania in the early 1800’s. During one of the voyages he managed to transport a hive, thereby introducing the first english honeybees to Australia.

Braidwood is a small town pressed firmly down like a tack into the billowing roll of surrounding hills pretty much at half-way point between where I live and the ocean. As the car drives.
Some 1100 residents currently live here. Originally it supported the local sheep and cattle farming industry, and I guess it still does. But more recently, it seems to have become a draw for artists and craftspeople. And tourists.

There are art and craft shops dotting the street and some neat coffee and eating spots to be discovered.
Waiting for Kelly to buy some bread from the local bakery, I wandered into an antique store for a look see.

I creaked around the old room for a few minutes, amongst the smells of polish and grandparents.
The usual array of tables and chairs and glass cabinets containing neatly arranged fine bone china Beatrix Potter bowls and 1970’s plastic lamps. I quite liked one of the dining tables, but it was snatched away by the sold sticker on one corner.

Working my way around, I passed a slightly open door at the rear of the store. Snooping back a bit, I could see that it led through to a much larger room. The door was obviously meant to be closed, but a vacuum of far more interestingness in here sucked me on past the jam.

Stepping through the doorway I snapped off a quick picture just as the lady owner emerged from a darkened corridor between two large bookcases.

“Can I help you?”
“Er…sorry, I just saw all the stuff in here and wanted to take a picture”
“This stuff? Oh, this is the junk that we haven’t got around to fixing up yet. I have been meaning to have a good clean-out in here for years…….come on in, and have a look around”

The room was dim. Two long skylights transected the roof at either end. They cast broad shafts of light, igniting tiny embers of dust that winked alight for a moment and then died as they swirled on through.

From the high ceiling were suspended a large number of chairs and picture frames, and bits of tables, and….oh, I don’t know, bits of farm machinery? Hanging like junksicles, all swathed in icy neon cobwebs.

Around the walls there were shelves stuffed with old books, and jugs, and boxes of things inside other boxes, and tins with mysterious faded labels. There were plenty of desk lamps, not the plastic kind, but the cool 1960’s architects kind. All metal and spring.

Tables jostled for space, some of their draws opened just enough to see they were jumbled full of mysteries. There were broken wooden toys, and leaning piles of LP records and other things that I cannot remember.

It was an amazing place.
Alas, I did not stay long. I knew Kelly was probably looking for me out in the overexposed main-street I could see through the rippled glass in a high window.

I found her a minute later, looking through the window of another antique store a couple of numbers down the street.
“Kelly, you have got to come check this out.”
We dropped the bread and other stuff off in our car and went back to investigate.
But the door at the back of the shop was closed. Er…..and locked.
Nobody was around except the old dog asleep on an overstuffed couch near the front counter.

So. What has all this to do with anything?
Well, nothing really, its just a story of something that happened to me.

However, it might be a reminder that most of the time we often only see the front room of our patients.
One particular, short experience of them, that we walk around in. Picking up things, evaluating, comparing, labelling, judging. We think we have seen it all.

But there are always more rooms out back.
And sometimes these rooms are far larger and far more full of surprise and discovery and value than we expect.

Maybe you will be invited through the door and maybe you will find it locked.
That is up to the owner.

Just appreciate that they are there.

This year International Nurses and Midwives week runs from May 6–12.
Coincidentally my 50th birthday (hint, hint) falls on May 9.
So this all seems rather a fortuitous moment of auspicious planetary alignment…. to run the third annual Note2Nurse day.

The idea of Note2Nurse came to me during one of our departments regular practice development sessions back in 2010, in which we were looking at ways of improving staff morale during the thick winter months of high workloads and falling morale.

Back then, I wrote:

Its a simple thing, but by giving permission for nurses to take a few moments on one day of the year to write a few heartfelt words to each other, I thought a more genuine attitude of gratitude might be cultivated, and by making it personal, individual nurses who don’t usually get any recognition (the quiet achievers) might be given some much deserved feedback.

And not just from nurses. Doctors and other health-care professionals could take a moment to reflect on their relationships with ‘the nurses’ and let them know how they felt.
From my own experience, to receive a few personal words from a mentor or colleague whom you respect can be far more valuable than any material reward.
These things stick in you.

I admit the first year was perhaps a bit of a fizzer, although I believe some secret cards were exchanged in my own department.
Last year I think a few more people hooked into the spirit and got involved.

I am nothing if not persistent, so I think this year by aligning it with International Nurses and Midwifery week we can really get some momentum going around this.

It may seem like such a small and mooshy thing to get involved in for hardcore nurses such as us.  Mooshy that is, until someone you admire gives you a card. Or you experience the feelings of gratitude generated when you write your own note to a nurse. Believe me.

I will be posting a flyer shortly to promote Note2Nurse day, and ask that you assist me by generating some gossip about it on your social media networks. What do you say?

Today is the 10th anniversary of the Canberra Firestorm.

On Saturday 18th January 2003 a freak and devastating firestorm tore through our city.
4 people died and over 500 homes were destroyed.
It resulted in the 2nd largest single hospital disaster response in Australian history.
I was working that day.
2 days later I wrote this story.

———————————————————————–

the firestorm.

It was bloody horribly awesome. Peeking out of the small window in the resuscitation room, it seemed the world had been dipped in a bucket of hell.
Gale force winds whipped at trees beneath a swirling black sky.
Pressing my face against the glass I could see over towards Weston Creek. Dark shapes lit by a dark crimson glow. Even as I watched the glow became an ominous bright orange, white firefly specks spraying up. My sister’s house was down there somewhere.

Just 2 hours previous it had been a relatively peaceful afternoon at work. I had even snuck down to the helipad to take a few pictures of the Southcare helicopter landing.

It was a hot day and the haze of white smoke from a week of distant bushfires hung in the air and covered our cars with a fine layer of talc.

At lunchtime the wind had picked up and the smoke turned from an annoying grey white smudge to a syrupy purple-brown cancer.
Morning staff had just handed over and left for home when the sun went out.

A 1659 hrs a standby Code Brown (hospital disaster response) was activated.

We began calling in extra staff in anticipation of a serious situation developing. This proved difficult as the both the land-line and mobile networks were either over congested or not working. Many of the staff in the department had family and homes in areas that were threatened, and had to make some very difficult decisions. To stay with the ED team or return home. There were no easy answers.
Meanwhile, all the existing patients in the department were transferred to the wards or discharged home in preparation for incoming victims.
The director of the emergency department juggled phones as he tried to ascertain what was going on ‘out there’. As was to be the case throughout the disaster, communication was a real problem, and the only way we had any idea of the magnitude of what was unfolding, was from the paramedics and public that presented.

It has been well documented that during a disaster the bulk (and often, the most critically injured) of patients will arrive by their own means and not by ambulance, and that is exactly what happened.

Cars began arriving and quickly clogged the ambulance bay. At first it was mostly smoke inhalation, asthma attacks and other respiratory related problems. Then falls from ladders and burns to the hands and feet. (The most serious burn patients all arrived by private car)

Shortly after the Code Brown was activated the shit hit the fan. Things began happening so quickly that time seemed to have unraveled into a syrupy slow motion. The almost surreal nature of the situation was enhanced by the thick smoke that had filled the department and the persistent power surges that would stutter us into darkness and then flicker on as the emergency generators cut in and out.
One of the paramedics walked wide-eyed and pale down the corridor.. as he passed, all he said was “I was shit scared out there.”

Tragically, two females with dreadful burns arrived in the back of a ute. They were rushed into the resuscitation room where the trauma team pounced on them.
Another arrived almost simultaneously. She had been in her stationary car when a tornado generated by the firestorm blew it over she was thrown through the window sustaining serious injuries.
A fire-fighter was dragged in semi-conscious and combative from smoke inhalation and severe airway burns…. all he wanted to do was to get back to help his mates.
He wasn’t going anywhere.

Due to the power failure all the fire doors closed making access to other areas of the hospital difficult. Our computer system crashed and we lost power to the radiology department rendering the CAT scan inoperable, and leaving us with only mobile x-ray equipment for some time.
The main disaster control center for the hospital was having major communication problems.

The department quickly filled with a sea of sick, burned and broken people.
Medical teams were crowded around the 3 beds in resus each occupied by a critically ill patient.
Generally, working in the resuscitation room is nothing like you see portrayed on TV. There is no shouting out streams of orders or rushing around dramatically defibrillating folk. Most of the time we all know what needs to be done, and we all get on with it with a calm surgical professionalism.

But tonight there was a noisy, edgy urgency to the room. It was hot and smoky and difficult to breathe. We had no idea what was going to happen next and we were all dreading the arrival of more seriously burned people.
At one stage the backup generators failed, draining the room of the intensive care specialists as they sprinted up to ICU to help ventilate their patients by hand.

I was designated to a team of medical staff caring for a patient with severe burns. This person was conscious and talking when they arrived. Most of her clothes had been burnt away revealing the leathery yellow-white skin of full thickness burns.
She lay there looking up with terrified eyes. So you touch her and you tell her that everything will be OK (and you know that it will not), and you put her to sleep, and you place her on life support, and you all work your butts off to give her the best chance that you can.

I guess the only positive thing you can say about an incident like this is that it brings out the best in people. And a team of amazing people arrived to support and augment the department. From social workers, chaplains and ex-ED staff who turned up to volunteer their services, to patients and relatives who became caregivers themselves.  All were absorbed into the charcoal faced crowd.

Many of the public who presented with ‘minor’ injuries had just lost everything. Many were almost apologetic not wanting to “waste our time”, and sat in small whispering groups or just sat in stunned confusion.
The waiting room was packed full. Nobody complained.
That day we treated over 270 patients 45 of whom were admitted. The next day we would see 198 with 33 admissions.

Not a single member of the department would be untouched by the tragedy.  Some lost their houses, many had friends and family who lost everything. My sister’s house had burned to the ground. She escaped with only the clothes she was wearing, and her pets.
At last count over five hundred homes have been counted as completely lost.

However…the following days would prove that the most important things in life are surely non-flammable.