Jane Sanderson RN, and Beth Smith RN, have to keep on their toes, since the drugs and the treatment of Mental Health patients is changing so rapidly. The two women staff the Medication Clinic in Mental Health at The Brantford General Site.
Besides offering medication monitoring services in their office, they are often out in the community, visiting patients who won't or can't come into the hospital. Previously named the "Injection Clinic," the name was changed when the second generation of drugs became available. These new drugs are administered orally and not injected. Often, patients cannot or will not come into the hospital to receive their medications. The medications help the mentally ill manage their symptoms, allowing them in many cases to relieve or alleviate their feelings of distress.
When the Medication Clinic travels into the community to help clients stay on their medication, the symptoms become manageable. "Going out into the community is stopping the revolving door," says Jane describing their outreach service. "When they feel better, they might be able to come into the Hospital on their own," adds Beth.
The results of the long acting medications are often dramatic, with some patients being able to progress from not being able to leave their homes to actually holding down a job. These "second generation" medications leave behind many of the negative symptoms that the previous class of medications was know for, such as lethargy, lack of motivation and low energy. They have also reduced the incidence of Tardive Dyskinesia, which is a term describing the long range side effect of constant movement and twitching that some patients experience. However, the new drugs, such as Clozaril, require regular monitoring of blood work. For this reason, both Beth and Jane have been certified as phlebotomists and do the work either in their offices or in the community. Besides the work of their clinic, they help Recreational Therapist, Debbie Court provide a Thursday afternoon "coffee club," which provides community integration, socialization, entertainment and services to interested clients. Following on a successful Christmas dinner this past year, they recently provided an Easter dinner for their clients. "We do counseling, teach social and living skills, help problem solve, find case managers, housing, and intervene in any other problems the clients might encounter," says Beth. All this extra work goes a long way towards making the clients feel comfortable with them and as a result, there is less hesitancy when it comes to staying on their medication. The nurses point to the numbers as proof that the Medication Clinic is working. Registration at their Clinic has almost doubled in the last six years and Hospital re-admissions for their clients have been reduced by 6 to 9 percent.
These visits facilitate the development of interpersonal skills and activities of daily living, which is the first step to further involvement in community integration. Jane can see the results become obvious on the faces of her clients, "They don't get out much and really look forward to our visits, they just love to sit and chat when they come in for their medications."
PHOTO: Shane Arsenault and Debbie Court, (background) enjoy a day of rafting down the Grand River. Alng with the Medication Clinic, events of the "Coffee Club," help to encourage patients to socialize and be integrated into the community.