Message from the Superintendent (May 14, 2007)

"Genius is one percent inspiration and ninety-nine percent perspiration." - Thomas Alva Edison

At a conference I went to in D.C. a couple of weeks ago, I got the chance to talk with several other state hospital superintendents about their experiences trying to reduce the occurrences of seclusion and restraint at their hospitals. I learned a couple of things.

One, I am very proud of the work done here at Riverview. We are far ahead of many of our counterparts throughout America.

Second, there may be some opportunities to reduce the use of seclusion and restraint here at Riverview and make this a safer work and care environment. These include the two strategies I heard repeated by several Superintendents. Client options and maintaining a service relationship. In that vain, I have asked Jamie to seek out some environmental supports that staff on the unit may be able to use to increase client choice. These include blanket warmers, I-pods, and on unit computer access. I have asked the PSDs to develop an inventory of environmental choices available to clients. When this is completed we will get the information to each of you and post on the unit. We should all strive to make this a rich and meaningful milieu full of personal choice for our clients.

In relation to maintaining therapeutic service relationships (even under significant stress) I would ask you to study your language. Focusing on language and phrases may significantly help to maintain a service relationship when a client is in distress. Statements such as, “How can I help you right now”? Is there something I can do right now to help you feel safe”? “I am here to help you, what can I do”? “I know this is hard. What can I do to help”? Remember that most violence and dyscontrol is related to fear or being scared. Reassurance even if not overtly acknowledged can reduce that fear and lead to containment and refocusing of energy. Ultimately trust in the authentic nature of such communication determines the degree of help this strategy provides. Trust is developed over time and typically is learned through several interactions based in others assessment of how we (a) maintain commitments [do what we say when we say], (b) display competency [being good at what we do], (c) and our displayed character [motivated by principles of helping and serving].

I know these ideas above are not new but I wanted to take a moment and let you know that other hospitals, like Riverview, focus on these types of strategies to improve care. Sometimes keeping what we know in play is what being the best is about.

As always, thank you for your good work.

In Service,

David S. Proffitt

"No pessimist ever discovered the secret of the stars, or sailed to an uncharted land, or opened a new doorway for the human spirit." - Helen Keller

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Message from the Superintendent (May 14, 2007)