PAPRSB College of Nursing Brunei Darussalam: Diploma in Mental Health Nursing

The story so far....

2009-04-08T23:29:00.003+08:00

Foremost, apologies to our followers of the blog, though in minor numbers, thanks for the support within this two years. Since the establishment of the blog, we cater for vital information regarding of mental health. Such as Depression, Anti-Psychotic drugs, to name a few. Adding as well the usual activities of our DMHN07 and DMHN 08 lives in a daily basis. As all of you have known, DMHN07 consist of 9 members, all graduated from PAPRSB College of Nursing back in April 2008. For now, everyone is carrying their duties and responsibilities all over the nation in every district. From hospital settings to community and day care amenities. 7 are in the healthcare service while 2 of our DMHN07 are currently overseas proceeding their undergraduate studies under scholarship. Similarly, DMHN08 consist of 3 members. All of which have completed their studies this year (2009) and now in the healthcare service. Congrats to them as well.

Another important highlight is the merging of IM with PAPRSB College of Nursing back in 23/9/2008 from His Majesty's titah. Indeed, a milestone for the college as well as the DMHN program itself for as, the college has reached into university level and the course will be upgraded to Advanced Diploma (Don't quote on that! Refer back to others for better information, thank you).

Basically, we have gone afar from where we all step in and it was definitely to remember by. Not forgetting, the people who were responsible in providing perspectives on Mental Health Nursing. Our heartwarming coordinator, Mr Derek Hayes who is now working overseas. Others as well, our nursing tutors , Cikgu Agong and Cikgu Siti Nahriah, now reading their Masters in University of Southampton. Cikgu Ahmad Faisal and Cikgu Irmawati teaching the pre-registration students. As well as adding a new member in the DMHN family, Cikgu Anne. To sum it all, we have reach a milestone eversince completing the program. Many memories were made. 2 years passed by and more to come, and keeping viewing. Thanks again!!!

FROM DMHN07
in order
(Rujiah, Midz, Azrina, Firdaus, Amir, Rahman, Eleena, Yoyo, Masriah)

medical lecture from Dr.

2008-05-13T07:08:00.005+08:00

During month of may, post basic student from psychiartric units will be given a lecture from medical Doctor and even staffs in psychiatry as well. On the left picture ( Prof. Dr. diva) and the right picture (Dr. Sahkty) are very friendly while delivering the lecture.

2008-04-23T22:12:00.005+08:00

Sorry the sound effect not really good. well done Masriah and you all Mental Health Diploma. Me (amanisma) and Azrina cant join you all in the graduation. Me having chicken pox and Azrina went for Umrah. Hope we will meet again and keep update this blog.

2008-04-23T22:12:00.001+08:00

2008-04-23T21:36:00.001+08:00

Result coming out on 13/02/2008, Congrats 2 Diploma in Mental Health all pass

2008-02-16T22:26:00.007+08:00

Fairwell after the presentation

2008-02-16T22:01:00.012+08:00

Clinical Placement Abroad Report Presentation (HKL) on 19/01/2008 at PAPRSB, College of Nursing

2008-02-16T21:14:00.011+08:00

Thank You all tutors PAPRSB nursing of college, Brunei

2008-01-21T11:27:00.000+08:00

A sincere and endless thank you to Cg Ahmad Faisal, Cg Irma, Cg Agong and lets us not to forget to the most wonderful and kindness man, Mr Derek Hayes. For giving us the knowledge and teaching about world of Mental Health Nursing,
One year may be have gone, yet, your warmest welcome and acquaintance will never be forgotten. This memories has been made and it will be in all of us and to never forget the day we sat foot to the PAPRSB College of Nursing in joining this profession,
!!!Thank You very much!!!

Teaching blogspot how to post it

2008-01-15T18:16:00.000+08:00

Welcome Abd Manaf, Nurol and Fauzana in World of Post Registration in Mental Health Nursing 2008, time for you all to update this blog and enjoy it

2008-01-15T11:37:00.001+08:00

REPORTING AFTER COURSE ENDED AT MINISTRY OF HEALTH

2008-01-15T09:39:00.000+08:00

WEDDING OF THE YEAR 2008

ONE OF THE POST REGISTRATION DIPLOMA IN MENTAL HEALTH NURSING STUDENT

5th INTAKE, 2007

ELEENA BTE HJ AWG ANUAR

RAYME BIN MAHADI

2008-01-15T09:33:00.000+08:00

PREPARATION FOR PRESENTATION PLACEMENT AT HKL

2008-01-15T09:27:00.000+08:00

NEW RECYCLE BIN AT

PAPRSB NURSING COLLEGE

BRUNEI DARUSSALAM

GROUP PHOTO SESSION

2007-12-30T00:29:00.000+08:00

2007-12-30T00:14:00.000+08:00

Thank You very much to all staff Hospital Kuala Lumpur for giving any knowledge and sharing any experience, hope we can meet again

attachment at Hospital Kuala Lumpur on 24/11/2007 until 23/12/2007

2007-12-03T22:32:00.000+08:00

Assalamualaikum and Salam sejahtera, all the authors are doing their placement in Hospital Kuala Lumpur. The picture you see is the psychiatric setting. Its situated within the hospital perimeter

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Inpatient

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Clopixol Syrup 20mg/ml

Strip to detect drug taken

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P10 for male patient only

(after being admitted from inpatient, patient will sent to P10 for observation before discharge back home)

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Outpatient

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Community

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Paediatric Psychiatric

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Daycare

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Daycare Garden

Daycare Kitchen

Relexation Technique using a machine
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Methadon Clinic

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urine investigation for toxicology

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Celebrate Mental Health Day 2007

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We will get back to you as soon as we get more information, so bear with us. Thank you for supporting Mental Health Nursing!

Will update soon

2007-11-27T01:50:00.000+08:00

Currently, some of us are doing our clinical placement abroad in Hospital Umum Kuala Lumpur (HUKL), Malaysia for a month. Will be back to update the blog as soon as we finish here. Thank you

Happy Birthday Masriah Firdaus and Eleena

2007-11-19T21:13:00.000+08:00

2007-11-16T11:40:00.000+08:00

Mental Health

2007-11-12T22:09:00.000+08:00

Handling Aggressive Patient video

2007-11-11T23:47:00.000+08:00

I was browsing through youtube.com and I found this interesting video of how to handle aggressive patient. I think this video was made by a group of psychatric nurses from USA. Its a three part video.

The main topics discuss in this presentation are

Aggressive behaviours
Stages of escalation
Nurses' reaction in managing client exhibiting aggressive behaviour
Different types of self defense in a case if an aggressive client attack

Hope this presentation is useful for all of us.

Night after examination (10/11/2007)

2007-11-11T14:59:00.000+08:00

Hari Raya Aidilfitri Celebration at Rizqun Songket Mall Gadong

10/11/2007 (Saturday)

7 pm till 10 pm but last a bit late nearly mid night

Congratulation, win luck draw Home Theatre, usefull for next post basic presentation

Examination on 8/11/07 and 10/11/07

2007-11-11T14:38:00.000+08:00

Exam invigilator

Paper 1 - (Thursday 8th November 2007) 8.30am till 10.00am

Proffesional Issues (choose one topic)

Atypical Anti-psychotic medication
Nursing assessment
Day care
Evidence based Mental Health Nursing

Paper 2 - (Saturday 10th November 2007) 8.30am till 10.00am (not enough time)

Clinical practice (choose one topic)

Care of an adult client with serious depression
Care of a young adult client with psychotic reaction to drug use
Care of an adult client with puerperal psychosis
Care of an adult client with bipolar illness

Fairwell party (lunch) at RBC

2007-11-11T13:04:00.000+08:00

Stress up for Extended Project

2007-11-11T12:47:00.000+08:00

Sorry sir disturb your life until at home, this what we say last minute preparation

as a OSCE helper act as Depression

2007-11-11T12:35:00.000+08:00

One of the examiner, Mr Ahmad Faisal

Welcome for the next student post basic

2007-11-11T12:27:00.000+08:00

Abdul Manaf, Fauzana and Nurol

Enjoy your study next year 2008

Depression: A destructive mood disorder

2007-11-09T23:33:00.000+08:00

Depression is categorized under DSM IV (Diagnostic Statistical Manual Edition 4) as a mood disorder having characteristics of persistent or recurrent disturbances in one's life due to physiological stress and behavioural impairment for many years. Having depression is not a joke. Anyone can endure or to have this mental illness of not having coping skills and strategies in dealing with everyday stress. Yet, some individual have the ability to the face the stress while others do not have due to immense and overwhelming effect on one's life physical, social and psychological stressors.

Such stressors can trigger one's capacity in not able to function well in the society. Thus, the stress triggers and disturb those function and this can be categorized into three:

PHYSICAL
Loss/gain of weight, somatic complaints meaning pain does not exist yet the feeling is there, fatigue, lack of sleeping, lack of energy and psychomotor redartation or agitation

SOCIAL
Difficulties in intimacy, sexual, marital relationship, occupational and education

PSYCHOLOGICAL
Decrease of self-esteem, feeling of worthlessness, decrease in concentration and reasoning ability, self-isolation, sadness and excessive worries and anxiety.

These disturbances such as physical, social and psychological can have a huge impact to the individual thus leading to depression. To diagnosed a person who has depression, one must have 5 signs and symptoms that manifest the individual within a period of 2 weeks.

depressed mood most of the day, nearly everyday
marked diminished interest or pleasures in almost all activities

Two of symptoms must be present continuously during the 2 weeks period, adding with 3 other symptoms:

loss/gain of weight
Insomnia
Psychomotor retardation or agitation
fatigue
feelings if worthlessness or excessive guilt
diminished ability to think or concentrate
thinking of death and attempting suicide

Therefore, for mental health nursing profession, we must know of the different angles and dimension surrounding depression especially the causative factors. Ever knowing of the complication of stress may give us an idea what to do and creatively plan a suitable care for the client in making him/her to adapt with the changes in facing the stress. In addition with suitable treatment regimen as well as supportive environment with the client. Hence, making our nursing care worthwhile.

Evidence Based Mental Health Nursing

2007-11-08T22:56:00.000+08:00

The used of evidence based practice has become a popular method in deciding what is best for the management and caring of client's with mental illness. Moreover, this method is derived from using best available research evidence from international counterparts of what is best to be practice. This is however is decided by a Mental health nurse of who has significant background of doing research study and putting it into practice in their clinical area and specialty. Moreover, the intervention identified is of the discretion of the Mental health nurse of whether it can be of good use or vice versa depending on the appropriateness, safetyness, feasibility and effectiveness of the intervention. Combining both, may create an arrays of intervention that might suit for the patients' treatment, adding to it, in respecting the patients rights and value of choosing which intervention posed to be the best for his/her treatment.

Nevertheless, this posed to be a challenge. Since the most research study derived from randomized control trials 'quantitative' are of 'gold standard' aka best available resource in the evidence hierarchy, the literatures from Mental health nursing are mostly of qualitative approach and appeared to be of low evidence. This is similar of using grey literatures such as non-peer reviewed articles, books and so forth.

Positivists looks into quantitative as an objective and measurable method, gaining the result through rigorous mathematical statistical analysis with control subjects, thus looking into numbers or macro samples. While qualitative is of the in-depth perceptions, looking into subjective data that surrounds the individual who have experience of certain issues. This is closely related to cause and effect. Having to see of how nursing practice might produces any positive outcome or vice versa. Once identified, what are the underlining factors and themes?

Having used of grounded theory, phenomenology and ethnography, this does not use of scientific approach but rather identifying underlying themes of an issues that affect the individual or client alike using experiences and perceptions. Since the basis of Mental health nursing practice is on human interaction and behaviour that led to used qualitative approach, this has not been in favour amongst the scientific community as they rather want hard evidence using experimental methodology and design that might induce 'best' practice.

Therefore, to what extent can we Mental health nurses choose which approach might induce best practice. Since the evidence is only derived on scientific approach rather than human experiences, the best way is to use 'clinical judgment' that deals with the mental health nurse with extensive analysis of patterns between the issue and the human subject. Adding critical thinking of how this human experiences might have an impact on the nursing practice should be considerate. This is because some of this issues might be potential of what is the outcome of the treatment and care, similarly the quality and effectiveness of the care given.

With clinical judgment and critical thinking, this will predetermine the use of any approaches whether quantitative or qualitative of which might produce the 'best' practice corresponding to the effectiveness, appropriateness, feasibility and safetyness of the client and the mental health nurse. After all, at the end of the day, the client has the say whether to agree with the evidence based practice treatment as he/she determines the whole outcome of the management and care.

ISSUE ON ECT

2007-10-26T22:37:00.000+08:00

What is ECT?
ECT is basically an electric shock delivered to the brain which produces fits or seizures in the person receiving it. It has been controversial since it was first introduced and remains so today.

How many times is it given?
Usually between 6 and 12 times in a course of treatment.

How is it done?
-The patient is asked to lie down on a bed in the treatment room. Their shoes, dentures, watches and jewellery are then removed.

-Present in the room should be an anaesthetist (a doctor who specialises in putting you to sleep, looking after you while you are asleep, and then waking you up again), a pyschiatrist (a medical doctor specialising in mental illness), and one or more nurses.

-The patient is hooked up to a few monitors via electrodes (or to most people sticky pads), generally placed on their head and fingers. These allow the doctors to monitor the patient during the treatment. The patient is then given injections. This is usually done via a needle that is inserted in the back of the hand, this is only done once and allows more than one drug to be put into the body without the need for a lot of injections.

-The first drug injected puts the patient to sleep. Often at this point the patient will be given an oxygen mask to try and enrich the amount of oxygen in their blood, and thus reaching their brain and vital organs. Once the anaesthetist is satisfied that all the vital signs being monitored are safe, they will inject another drug. This is a muscle relaxant, that is designed to reduce the physical effects of the fit that the treatment will produce. In other words to stop peoples' arms and legs flailing around when they fit as this may injure them or other people.

-The current is then charged up to the right level, this is typically around 80 volts. The psychiatrist then puts two padded electrodes on the patient's temples (or occassionally on the same side of the head), and the person is given a shock. Almost immediately, the patient stiffens as their muscles tighten up, and they will start to twitch. The anaesthetist will pass a tube down the patient's throat to ensure that the person can breathe and doesn't choke. The amount of time the twitching lasts is written down, this is basically how long the fit lasts.

-Once the fit has finished, and the team is certain that there are no medical complications, the patient is ready to be woken up. A nurse will monitor a persons' recovery, and remove all the tubes and leads that were used in the treatment. This is often done in a specialised recovery room. When the person wakes up they are usually given a cup of tea or some such similar drink, and left for a while longer before they are ready to return to a hospital ward.

Discussion for issue:
Is there always a negative outcome from the ect to the patient, health professionals and family?
Does any study done on patient experience after the ect?
Does it negatively perceived by patient or positively or both?
Though ect is perceived as negative practice for some health professional, is the new generation of health professionals still learn or being teach about performing ect to patient in mental health nursing?
Performing ect was influenced by the ward regulartory procedure and to which extent the health professionals come to an agreements of performing ect.

In the local setting, few years back, when clozapine was not yet famous as the first line treatment, only risperidone was used, ect was hardly performed to schizophernia patient or major depression. Nowadays when clozapine was famously used in treating schizophrenia, ect was performed more than before. The issue is why ect was performed more than before when clozapine was widely used as first line treatment. Does it because a more advanced era make the illness more advanced and more difficult to treat? Or maybe before no enough skillful health professionals can performed ect or maybe they dont like to perform ect to patient? Or is it because more depression nowsdays than few years back? However it is a issue because few years back, SSRI is widely used until recent, but why nowsdays SSRI made no diferent to certain patient and required ect to make them well.? This is a difficult to be answered. So does ect that bad? However a study need to be done locally to explore feeling of any patient that has gone on ect.

Other issue of ect is the patient still need to take continue medication after ect. Therefore what ect actually can do?

open house

2007-10-23T20:38:00.000+08:00

Selamat Hari Raya Aidilfitri
Maaf Zahir Dan Batin

my open house for raya akan diadakan pada 26/10/2007 pukul 2ptg hingga 7malam

bertempat di no 7 spg 688 kg bunut jln tutong seberang parking sekolah bunut, tangah2 workshop

datang tau jgn tak datang

Selamat Hari Raya

2007-10-12T04:00:00.000+08:00

To all of our authors and to our loyal readers, Selamat Hari Raya Aidilfitri. Please drive safely on the road when visiting your loved ones.

Have a good festive holiday to all!

2007-10-10T19:55:00.000+08:00

World Mental Health Day has been celebrated annually on 10 October since1992. Every year a different theme is set by the World Federation for WorldMental Health Day. The theme for 2007 is 'Mental health in a changing world: the impact of culture and diversity'

We live in a culturally interconnected world where one person in every 35 is an international migrant. Dramatically different languages, religions and cultures coexist in a single country. This cultural diversity may influence many aspects of mental health, including how individuals from a given culture communicate and manifest their symptoms, their style of coping, their family and community supports, and their willingness to seek treatment.

In the mental health care setting, culture impacts how people:

label and communicate distress;
explain the causes of mental health problems;
perceive mental health providers; and
utilize and respond to mental health treatment.

The 2007 World Mental Health Day campaign, an initiative of the World Federation for Mental Health, will bring attention to trans-cultural mental health services and treatment.

Presentation on Poster

2007-09-23T15:33:00.000+08:00

Although there is agreement on what ‘stigma’ is (a mark of disgrace or discredit that sets a person aside from others), definitions differ in the breadth of experiences they describe. Stigma, by definition, is a mark of disgrace or shame (Anon, 2007). It is the negative effect of a label (Hayward & Bright, 1997). For Corrigan & Penn (1999), stigma is another term for prejudice based on negative stereotyping

Stigma can have a bad impact on clients with long term mental illness and their families that they might feel ashamed, particularly when the illness produces behavior which is out of the ordinary and so obvious for others to see for example, talking to oneself. In view of this, stigma has a fatal effect on all aspects of the clients live as well as their families such they become reluctant to seek help, do not comply with the treatment. In addition it also forms a real barrier to optimal recovery, it causes distress, discrimination in housing, education and employment, economics burdens, increased feelings of hopelessness and low self esteem and confidence that leads to suicidal behavior. Family members may also feel lonely, have less social interactions with others in the community due to being ashamed and total social rejection, distress and violations of humans. In the ends, this leads to social exclusion (Sticley, 2005)

Stigma can be prevent and be reduce by thinking the positive image by:
1. Health promotion – talks workshop, seminars, advertisement, posters, post cards or letters (Herrman, 2001)
2. Laws and Policy of Mental Health Nursing needs to be enforces and improve in order for the clients to have a better access to Mental Health Services (Funk et al, 2004)
3. Involving government and non government organizations – conducting a seminar to convey correct information’s about Mental Health Illness to the public (Sticley, 2005)
4. Changing and improve attitudes of the Health care Professionals – increase the professional self-understanding about mental illness (Sadavoy et al, 2004)
5. Developing a new and appropriate of Mental Health Hospital – provides an excellent opportunity to clients who will use the service provided, valuing them and their carers (Wildgoose et al, 2005)

Seminar at IPA about Cognetive Behaviour Theraphy

2007-09-23T15:11:00.000+08:00

What is CBT?
It is a way of talking about:
How you think about yourself, the world and other people
How what you do affects your thoughts and feelings.

CBT can help you to change how you think ("Cognitive") and what you do ("Behaviour)". These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the "here and now" problems and difficulties. Instead of focussing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

It has been found to be helpful in:
Anxiety
Depression
Panic
Agoraphobia and other phobias
Social phobia
Bulimia
Obsessive compulsive disorder
Post traumatic stress disorder
Schizophrenia

How does it work?
CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:

A Situation - a problem, event or difficult situationFrom this can follow:
Thoughts
Emotions
Physical feelings
Actions

Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It can also alter what you do about it.

What does CBT involve?

The sessions

CBT can be done individually or with a group of people. It can also be done from a self-help book or computer programme. In England and Wales two computer-based programmes have been approved for use by the NHS. Fear Fighter is for people with phobias or panic attacks, Beating the Blues is forpeople with mild to moderate depression.

If you have individual therapy:
-You will usually meet with a therapist for between 5 and 20, weekly, or fortnightly, sessions. Each session will last between 30 and 60 minutes.

-In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and you will check that you feel comfortable with it.

-The therapist will also ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now.

-You decide what you want to deal with in the short, medium and long term.

-You and the therapist will usually start by agreeing on what to discuss that day.

The Work
-With the therapist, you break each problem down into its separate parts, as in the example above. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.

-Together you will look at your thoughts, feelings and behaviours to work out:- if they are unrealistic or unhelpful- how they affect each other, and you.

-The therapist will then help you to work out how to change unhelpful thoughts and behaviours

-It's easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, your therapist will recommend "homework" - you practise these changes in your everyday life. Depending on the situation, you might start to:

-Question a self-critical or upsetting thought and replace it with a positive (and more realistic) one that you have developed in CBT

-recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.

-At each meeting you discuss how you've got on since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don't seem to be helping.

-They will not ask you to do things you don't want to do - you decide the pace of the treatment and what you will and won't try. The strength of CBT is that you can continue to practise and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.

How effective is CBT?
It is one of the most effective treatments for conditions where anxiety or depression is the main problem
It is the most effective psychological treatment for moderate and severe depression
It is as effective as antidepressants for many types of depression

What other treatments are there and how do they compare?
CBT is used in many conditions, so it isn't possible to list them all in this leaflet. We will look at alternatives to the most common problems - anxiety and depression.

CBT isn't for everyone and another type of talking treatment may work better for you.
CBT is as effective as antidepressants for many forms of depression. It may be slightly more effective than antidepressants in treating anxiety.

For severe depression, CBT should be used with antidepressant medication. When you are very low you may find it hard to change the way you think until antidepressants have started to make you feel better.
Tranquillisers should not be used as a long term treatment for anxiety. CBT is a better option.

Problems with CBT:
If you are feeling low and are having difficulty concentrating, it can be hard, at first, to get the hang of CBT - or, indeed, any psychotherapy

This may make you feel disappointed or overwhelmed. A good therapist will pace your sessions so you can cope with the work you are trying to do
It can sometimes be difficult to talk about feelings of depression, anxiety, shame or anger

How long will the treatment last?
A course may be from 6 weeks to 6 months. It will depend on the type of problem and how it is working for you. The availability of CBT varies between different areas and there may be a waiting list for treatment.

What if the symptoms come back?
There is always a risk that the anxiety or depression will return.If they do, your CBT skills should make it easier for you to control them. So, it is important to keep practising your CBT skills, even after you are feeling better.There is some research that suggests CBT may be better than antidepressants at preventing depression coming back. If necessary, you can have a "refresher" course.

So what impact would CBT have on my life?
Depression and anxiety are unpleasant. They can seriously affect your ability to work and enjoy life. CBT can help you to control the symptoms. It is unlikely to have a negative effect on your life, apart from the time you need to give up to do it.

Fairwell party for Sir Derek Hayes

2007-09-23T15:03:00.000+08:00

visited to Narcotics Control Bureau

2007-09-01T14:16:00.000+08:00

In 1988 the Narcotics Control Bureau (NCB) was established as a Government department under the Prime Minister's Office. It was aimed specifically at taking over the responsibilities of enforcing relevant drug laws in Brunei Darussalam, as well as activities in preventive drug education, which had until then been overseen by the Ministry of Education.

Mission: To support and promote awareness on the national policy on the abuse of drugs and intoxicating substances. To create a community free from the problems of misuse of drugs.

Function: Being the lead agency in enforcing the relevant laws pertaining to the eradication of abuse of drugs and intoxicating substances; to provide support services in demand reduction through Preventive Drug Education and Aftercare Services and serve as the main agency in coordinating all matters pertaining to the eradication of the abuse of drugs and intoxicating substances.

Current Illicit Drugs Situation

The extent of the drug problem in Brunei Darussalam is reflected only by indicator data, as there are no available national estimates of the number of drug abusers in the country. 64 clients were treated for substance abuse in 2003, while 94 drug seizures and 701 arrests for drug law violations were reported. By 2004, the number of illicit drug seizures had increased to 113, whereas the number of arrests had gone down significantly to 266. In 1990, the primary abuse problems were related to over-the-counter drugs. However, according to recent data, nearly 95% of recent seizures and arrests made relates to methamphetamine.

Based upon 2003 and 2004 law enforcement data, methamphetamine is the dominant illicit drug being abused and seized in Brunei Darussalam, and at present crystal form methamphetamine is reportedly the only type of methamphetamine available in the country. In 2005, the ranking of illicit drugs most often abused, cannabis comes second to methamphetamine followed by nimetazepam and ketamine.

Methamphetamine and cannabis are predominantly administered by smoking, while nimetazepam and ketamine are consumed orally. There have been reports of limited occurrences of methamphetamine injection among some abusers. There are no estimates of the Injecting Drug User (IDU) population or the percent of IDUs estimated to be infected with HIV.

Legislation for Illicit Drugs Control

The main legislation for narcotics control in Brunei Darussalam is the Misuse of Drugs Act (MDA) Chapter 27, which on several occasions has been amended and revised. This legal instrument covers all illicit drug offenses and provides sentencing guidelines. The law specifies the amount and type of drugs that fall under its provisions and includes death as punishment for the trafficking of illegal narcotics. Section 15 of the MDA states that individuals caught in possession of certain amounts of illegal substances are presumed to be trafficking.
The Drug Trafficking Recovery Act of 1996 also provides legislation to recover profits of narcotics trafficking, while the Criminal Conduct Order of 2000 provides law enforcement with greater leeway to recover proceeds of illegal conduct and assist in the implementation of overseas forfeitures.

National Efforts and Activities

The Narcotics Control Bureau (NCB) enforces the drug laws. In addition, NCB is responsible for the Preventive Drug Education activities and the Preventive Drug Education and Aftercare Services. The promotion of public awareness policies to create a community free from drug abuse problems are a central objective of national initiatives.

The Preventive Drug Education Program, along with the Anti Drug Forum, has increased communication between local community leaders and government agencies. Also, the educational community has increased their anti-drug curriculum for greater impact on youth. Additionally, the media has been used across the country to promote drug abuse prevention.

International Cooperation

Brunei Darussalam acceded to the UN 1961 Single Convention on Narcotic Drugs, the UN 1961 Protocol Amending the Single Convention on Narcotic Drugs, and the UN 1971 Convention on Psychotropic Substances in 1987. In 1993, the UN 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances was ratified. Brunei Darussalam is an active ACCORD partner country. NCB also participates in relevant bilateral and regional drug control forums.

Visited to Al-Islah Drug Rehabilitation Centre, Muara

2007-08-29T19:21:00.000+08:00

Visited to Maraburung Prison at Tutong District

2007-08-29T19:12:00.000+08:00

This new prison started its operations on August 1, 2001, many rehabilitation programmes such as psychological rehabilitation, counselling, civic rehabilitation and vocational training, have been held. On top of that, inmates are also given spiritual and physical education. The prison has permanent religious teachers. The Maraburong Prison is a new facility built to accommodate male inmates who have committed less-serious offenses and who are given shorter imprisonment sentences

Maraburong Prison, which can accommodate 150 inmates. The prison is mainly for first-time offenders. Second and repeat offenders are placed in Jerudong Prison. This new prison is located within the Bukit Panggal area, built on 81 hectares at a cost of B$18.8 million. It is one the modern building prisons in the country, which is equipped with sophisticated facilities in terms of security systems.

There are classes, surau, workshops (handicraft), with facilities like dinning hall, kitchen, mini library and volleyball and sepak-takraw courts

Visited Lecture from Narcotics Control Bureau, Gadong

2007-08-29T19:04:00.000+08:00

Lecture by Matron Pg Hj Sabtu, 2nd floor, RIPAS Hospital

2007-08-29T18:59:00.000+08:00

Majlis Ilmu at ICC, Berakas

2007-08-29T18:49:00.000+08:00

concentrate on astronomy. apa yang kau tengok tu Ramli?

Orang kuat Brunei, its not a stone but a comet

Visiting Lecture from IPA, Ustaz Adi Dzaki

2007-08-29T18:46:00.000+08:00

Attachment at Hospital Belait

2007-08-29T18:41:00.000+08:00

Not at Dusun Durian but Community visit at one of patient house site, so tired but interesting about 5 - 6 houses in one day

Becoming a Mental Health Nurse

2007-08-10T09:01:00.000+08:00

Cath Melia somewhere in 1982 studied how student nurses feel about becoming nurses. It became a prominent reference in understanding how would be nurses experience the process of becoming a nurse. Studies have also been conducted on would be Mental Health or Psychiatric Nurses by Montgomery sometime in the 1990's (will need to check the reference). However it would be interesting to learn how you feel about becoming one yourself.

Questions for you to ponder when considering the above;

What makes you choose Mental Health Nursing?
What do you learn to become a Mental Health Nurse?
How do you think the programme has prepared you to become a capable / competent Mental Health Nurse?
What experience you get out of working with the experts in mental health?
How do you imagine you career as a Mental Health Nurse would be?

drug-induced weight gain

2007-08-08T09:03:00.000+08:00

Weight gain has become increasingly prominent with the newer atypical antipsychotic agents especially Olanzapine and Clozapine used to treat Schizophrenia.

Obesity is considered a heterogenous metabolic disorder associated with physical inactivity and overeating that emerges essentially because more calories consumed than expended as energy in which it occurs more commonly in individuals with a family history of obesity and is more prevalent in people with mental illnesses. Therefore nursing strategies on helping patient to control weight gain and also help them to reduce the risk of metabolic effects of anti psychotic drugs such as Type 2 Diabetic Mellitus, Hypertension and cardiovascular disease is important. There are many strategies have been identified such as change the prescribed meds, change their dietary habits and more.

so if there any comment or idea regarding this topic, u are welcome.. ;D

Review on Baby Blues Depression: A session with 2nd Intake Midwifery

2007-07-13T13:45:00.000+08:00

Group work on Schizphrenia major problems

2007-07-13T13:29:00.000+08:00

100 years Ministry of Health

2007-07-13T13:20:00.000+08:00

Another birthday and it is Yoyo 23rd birthday

2007-07-13T13:12:00.000+08:00

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Happy birthday to Norariyanti. May Allah bless you with happiness, good fortune and success in life and hereafter. AMIN

P.S: Sorry could not make it during the "cut the cake" ceremony. Don't worry, I had a slice and thanks to the person who sponsor the cake. Thanks to Aman for the pictures

Nursing Seminar conjunction with International Nurses Day

2007-07-13T12:59:00.000+08:00

International Nurses Day is celebrated on 12th May 2007, this year, our college organised a seminar of which the invited speakers were Dr Stephen Tee from University of Southampton and Dr Hj Abdul Hamit from the Ministry of Health.

Close up picture of Amir and Firdaus

Hearing attentively to the seminar

Yoyo and Midz as well as Azrina and Eleena

Visiting lecture from Psychiatric Department RIPAS Hospital

2007-06-16T21:09:00.000+08:00

In order to understand of how the psychiatric nursing healthcare delivery system works here, in terms of protocols, legal, nursing guidelines, the program has been designed to invites Professional healthcare workers in teaching us of the system. All of them are senior psychiatric nurses as well as psychiatric doctors. It was delightful that they came to teach and give information to us.

Evaluation Day and Awardees to the top of the cream

2007-06-16T21:04:00.000+08:00

Before the end of semester 1, Mr Derek conducted an evaluation regarding of the course program in terms of teaching, assignment, clinical placement and test. It partly reflects of whether we have achieve the set objectives of the course and the way to impart our clinical skills has improve. In such a way, constructive criticisms was expected in doing this so as to improve this mental health nursing program.

Another highlight during that day was the awarding the top of the cream in contract learning, practice examination and test. As well as to our class representative for his service for six months. The gifts were given from Mr Derek.

Azrina in love with her prize *Practice examination*

Masriah*top of the cream in Contract learning*,

Amir *our class rep, you've done well*

Rujiah top in Psycho-pharmacology test

We all are really proud of you guys!!!!!

Avtivities during school holiday

2007-06-16T20:47:00.000+08:00

Happy Birthday 23 yrs old Azrina

2007-06-16T20:37:00.000+08:00

Birthdays....birthdays....this is courtesy from us to you Azrinna...yes...you...the best impersonator. Anyway, earlier that noon, Aman has this idea of suprising Azrinna for a birthday frenzy. All of course except me because I have no idea what's going on until Mas and Rujiah gave a shout out saying its Azrinna birthday. Bless them because if they didn't tell me, I wouldn't have the chance to eat the cake. And it was a beautiful cake.

So when Azrinna went out to call for Mr Hayes, Aman on the other was so excited and went berserk repeating saying "Laju!!!" in high tone voice like the room was about to explode. Apparently, he getting the cake from his car. He was frantically panic but the same time enthusiastic about the whole thing. Thats was funny. So, we guys got prepare, and Azrinna came in with the room lights off and jumped we say happy birthday.

Azrinna was speechless for a short while and her smile was further to the back of her neck *seriously it was, just joking* but it was nice. This is the best thing our group has ever done and indeed it was something memorable and appreciate.

Our birthday girl Azrinna

Three combinations pictures
(L:Our group, C: Mas and happy birthday girl, R: The beautiful and eatable cake)

All of us get in hand with the cake, Mr Hayes was there as well. An exciting day for Azrinna, may ALLAH blessed you with prosperity and health. AMIN

Nurses Day Walkathon at Tasek Lama

2007-06-14T23:14:00.000+08:00

On 26th May 2007, PAPRSB College of Nursing organised a walkathon at Bukit Tasek Lama at the capital of Bandar Seri Begawan. It was to celebrate the International Nurses' Day. This activities invited all students from PAPRSB College of Nursing as well as Education Officers and staffs from the college.

At the front gate of Tasek Lama

Combination of pictures:

Early morning stretches....with friends and a lot of candid pictures caught by Aman

All and all, we all really had a blast and enjoyed ourselves

A dedication to SMARTER

2007-06-14T00:15:00.000+08:00

This is a sweet video done by aremski. If you would visit the website, its http://anakbrunei.org/

Enjoy your holidays mate

Alas, Holiday

2007-06-13T23:30:00.000+08:00

Whew...Its been six months after we started this course. Came to think of it, half a year, though with many difficulties such as coping with the course, and the end of the day lessons, we still have a say by saying "Well, there's another day for something new to learn". That has been the motto of this group. For certain people, this was not easy to go to this bumpy ride especially when needed to give time to your family especially the in-service. Yet, they still have their smile on the faces and still entertain the class. They are wonderful people with uplift personality and great sense of humour.

I have to admit, neither of us especially the double diploma group have not thought in mind of what we dealing with. Coming to clinical attachment, looking into arrays of psychiatric cases, learning to the adapt the working atmosphere, thats tough. Thank goodness, the in-service are there when we need them dearly.

The specialist subject so far,wow, all of it is so new.

The biological basis of Mental Health Nursing (quite an eye opener)
Improving quality of life of psychiatric patient
Interviewing skills
Communication
Psychopharmacology ( a lot to learn and to remember, it will be okay)

All based on how its work and why it did not work. The fun part comes during brainstorming and discussion on to know how it works, why it did not work and how to improve it. This is an excellent problem based learning which we are still trying to adapt with the study technique. All and all, we succumb to this and we passed the contract learning modules. The top was Masriah Abdullah. Congrats to her.

Clinical experience. 2 months was the best. Its more fun and fascinating when trying to see of what is in the book is actually in reality. Especially when its the part during communicating with a patient. That when we practice to improve our dexterity and mind reasoning skills. Yet, we always follow in the detail and procedure one by one of what theory and protocol said this and that, in reality, we tend to forget of what the patients want. I came to learn that, we utterly do what the book says and sometimes miss of what the patient want. Sure we do know the presenting symptoms all and that, the drugs that works to lay off the symptoms and surely we need them to be in shape before they're discharge. But then we should concentrate on what the patient is capable in doing. Looking into the strengths of the patients and weakness enables us to work properly with them. Achieving their goals (in reality to be precise). It does come in mind that it would be definitely be very, very, very and very difficult. Maybe we should give a try. If it doesn't work, we'll find other way of making sure the person to cope well. As what Robert Frost said

"Do not follow where the path may lead,
Go instead where there is no path
and leave a trail"

Keeping on working to find a better solution. You do the work and people will follow your lead. Specialist subject really broaden our view of psychiatric nursing of the fundamentals and dynamic behind it. Some do realize, yet it's our goal to make people understand that normal people are not as different from the people that we treat.

Now, we're moving on to Semester 2, a lot of work to look forward to and here's a list that needed to improve by the way

Come early to lectures and work
Catch up for the extended project (L.R) to be due on late June (we are far away behind, this will be FUN,)
Get prepare of the next core subjects (regroup with other nursing specialists)
Lastly, be proud to be a psychiatric nurse

I think there's all to that, and finally, a very good holiday to my coursemates Yoyo, Midz, Aman, Rujiah, Mas, Amir, L and Reena and to Mr Derek Hayes. Not forgetting, Ahmad Faisal and the other Mental Health nursing teaching staffs. We'll see you next semester.

Manic depression (Bipolar Disorder)

2007-05-04T18:58:00.000+08:00

I found this in the net, youtube.com server. Its about an interview with a manic depressive patient. Quite interestingly, she know about her illness very well

This is a nice animation done by a nursing class. About bipolar as well.

Our curriculum: what have we learn

2007-04-08T23:16:00.000+08:00

Since this blog was not active for nearly a month, might as well I present of what is going from the past week since March.

So far we have cover the curriculum as listed below:

Psychopharmocology (Status: Complete with test)
This topic covers of the medication of how it works in the receiver (the client). Nurses' role were discussed in this topic such as how to identify the 'EPS' or Extra Pyramidal Symptom, how each drug works of the pharmocodynamic, pharmocobiomechanism and pharmacokinetics. To test our understanding of this, a 60 item multiple choice was examining on our understanding towards this topic. So far, a lot of this is new or have known of this topic. Nevertheless, we are still learning towards the administration of the drugs being given to the client.

Anatomy and Physiology in Mental Health Nursing approach (Status: Follow up)
This topic covers of how the brain function. From a minor understandable terms to the complex terms. Some topics will be cover here such as the neurotransmitter that is responsible for our brain function for example: Serotonin, Acetycholine, Dopamine and others

Research Critique (Status: Complete with assignment passed on 4th April 2007)
This topic covers of the nursing research process of how it works. Basically based on identifying, searching for literatures, assessment, mode of research style and evaluation. The highlights of this topic was that it is very useful for our Extended project which is part of our nursing curriculum. Nevertheless, using this topic of getting our literatures in presenting our cases and issues that need to be understand or to be resolve.

Melayu Islam Beraja (Status: Complete with assignment need to be submit on 16th April 2007)
This topic is very important based on understanding of how Government works based on using Malay and Islamic principles. Not only that, issue of nursing also revolves around MIB such as the use of non-halal medication, communication between male and female, personal space, culture and in our Mental Health profession, suicide issues, how to deal with this. Nevertheless, this topic has provide a grounding level of the whole understanding of Brunei Darussalam healthcare delivery.

From the topics that we've covered, it hope we too can benefit from all the knowledge we obtain. In providing an excellent service to the people of Brunei Darussalam in improving their health status coinciding with the health services and resources.

The 2nd Annual Academic Sessions

2007-03-11T23:18:00.000+08:00

From 20th to 21st of March, the College of Nursing attended the the Annual Academic Session 2007 that bears the theme "Cultivating Research Talents through Interdisciplinary Collaborations".

The main aim are

To bring together health professionals as well as biomedical and lifescience researchers
To provide a platform for them to share and highlight their inter-disciplinary collaborations
To create awareness of the importance of research and sharing information within the medical, health and basic science communities in Brunei Darussalam and the region.

Highlights of the sessions was the introduction of the Brunei Darussalam Journal of Health published by the Institute of Medicine. Now a research centre has been establish!

In this sessions, from the nursing parts, some interesting topics were presented by our Staff Nurses from RIPAS, SSB and PIHM Hospital. It was the highlight for these nurses to present their findings about pertaining to nursing issues or others that might affect the nursing management of a client in improving the healthcare delivery system.

Critical evaluation of international guidelines in hospital emergency management of care for the trauma victim in Brunei by Salleh Kamal Badaruddin

The Importance of psychoeducational approach in improving medication compliance in schizophrenia by Hajjijah Harris (*VERY RELATED TO OUR PROFESSION*)

Effects of on-call work to healthcare workers' health by Hjh Milazita Leman

All of the papers presented were good based on it applicability to Brunei healthcare system and it is hope the nursing services would look upon to their work in order to improve the current situation.

Our college nursing educators also presented their topic regarding of improving the nursing education in Brunei Darussalam which was very interesting and significant findings (I will upload this soon)

Nurses' and midwives perceptions of the relevance of human anatomy and physiology in their profession by Julaini Latip, Khadizah Mumin and Maimunah Othman

Small scale explorative study on nurses and midwives knowledge in the Islamic perspectives of the ethical frameworks by Khadizah Mumin

An analysis of health promotion models utilized in the community health practice in Brunei Darussalam by Hjh Salmah Hj Mohd Noor and Khadizah Mumin

It is hope in the future this annual academic sessions should continue in order to know the current evidenced based practice that can be applicable to all health care profession especially mental health nursing as this needs to be investigate further.

Thank you Rahman for uploading the pictures.

2nd Annual Academic Sessions of the Institude of Medicine 2007 (10/03/2007 till 11/03/2007)

2007-03-11T20:14:00.000+08:00

At CA Mohammad, Sir "lanja" after campaign. TQ V.MUCH

2007-03-11T19:22:00.000+08:00

CLEANING CAMPAIGN ( 08/03/2007)

2007-03-11T18:38:00.000+08:00

2007-03-11T18:28:00.000+08:00

Unofficial website for Mental Health Nursing Brunei Darussalam

2007-03-10T19:11:00.000+08:00

Welcome to Mental Health Nursing post registration program unofficial blog.

Our main aim in this program is to reach the community in providing education through effective health teaching about the awareness of mental health illness and other counterparts. With this blog, it is hope that the public or anywhere in the world would provide their views of the Mental Health profession. Also, our team members will provide up-to-date nursing and community issues as well as our college activities, clinical placement experience and other matters.

Support the Mental health nursing profession!!!!