Wednesday, June 30, 2010

Third Time’s a Charm

I wasn’t too sure what to expect today in clinical. Today was supposed to be a “Community Integration” session; however, it happened to be the third Tuesday of the month a Patient’s Government meeting was held instead. The Pt's are allowed to manage their activities and leisure space as they wish, so once a month they hold parliamentary procedures to discuss what will happen during the next month. Sounds exciting, right? Zzzzzzzzzzzzzzzzz I suppose it was good to see how the patients are able to interact with each other, but I was really hoping to see more today. I had to really work to try and stay alert during this meeting. I have to admit that after today I’ll be glad to move to a more acute setting in the main hospital.

After the government meeting I was able to interact with the patients before lunch…

Patient No. 1: An old man in a wheelchair.
DV: “Hello, my name is DV. I’m a student nurse. Would you mind if I sat down and spoke with you for a few minutes.”
Patient No. 1: “I DON’T WANT TO BE BOTHERED RIGHT NOW!”
DV: Welllllll okay then, maybe later.
Okay, so maybe he wasn’t the best person to approach since he was quite the complainer during the previous meeting. I really thought he would have an interesting story. Strike one for the student nurse.

Patient No. 2: Middle aged African American man.
DV: “Hello, my name is DV. I’m a student nurse. Would it be alright for me to sit and talk with you for a while?”
Patient No. 2: Yes.
DV: Great. (Reaches over to grab a chair)
Patient No. 2: “I gotta go get my gla%$%^&**&^&*^%$#$” (Stands up and runs away, never to be seen again.)
DV: (Perplexed) Um, okay.
DV: (To Student Nurse #2 who saw the whole thing) “Didn’t he just say it was okay if I sat down with him?”
Nurse #2: “Yes.”
DV: “Did…um…did he just run away from me as fast as he could?”
Nurse #2: “Um, yes.”
DV: “WTF?”
Nurse #2: “Well, DV, you are kind of intimidating.” (Laughs)
DV: (Sarcastically) “Oh, right….”
Strike two for the student nurse.

Patient No. 3: Middle Aged African American male (A different guy of course.)
DV: “Hello, my name is DV. I’m a student nurse. Would it be alright for me to sit and talk with you for a while?”
Patient No. 3: “You’re sitting right here next to me. Might as well.”
DV: Don’t run away okay.
Patient No. 3: Um, okay. You alright kid?
CONVERSATION CONTINUES AD LIBITUM.

Okay, so I embellished the third patient a little, but the first two were dead on. FYI, this does not make me want to walk up to crazy people and just start talking to them. Must…keep…trying….

DV

Tuesday, June 29, 2010

Study Hall Today

Today’s clinical session was good and bad in various ways. I was pretty pumped up about going into the outpatient site today and talking to patients. I was just going to go in and do it. After arriving on the unit we found out that today was “Community Integration” day. Hmmm, what’s “Community Integration”? As it turns out, it is basically a field trip for the outpatients. They were going to go see a movie. After finding out that the student nurses would not be accompanying the patients on their outing (quite frankly, I wasn’t too keen on that idea anyway) we decided to find someone and interview them real quick so that we would have information to write a care plan. I went into the community room and found a “patient” that I was able to have a brief conversation with. I felt rushed and the setting was not very good. The coordinator of the outing interrupted a couple of times to make general announcements. I’m not sure how well I really did on my interview of this patient, but I did get some basic information from him. This was the extent of my patient interaction today. Yep, it was a bit of a bummer.

After talking to my patient, my colleagues and I went back to the meeting room and proceeded to work on our care plans. In some ways this was a good thing. I needed to get my first care plan turned in for critique and I wasn’t going to have a lot of time when I got home that evening. By the end of the day I was able to get something turned in. It wasn’t my best work because I wasn’t able to really research everything like I would have had I been at home. Nevertheless, I was able to turn something in.

Before lunch we were able to practice our therapeutic communication skills while role playing. This was a real eye-opener for me. I had gone through some of this in my head on occasion and it always seemed so natural. When I was sitting in the hot seat however, it was if my mind just went blank. I couldn’t help but think of Mavis Beacon’s “Typing Tutor” (just go with me here). On this computer typing software there is a game where you are driving a car and every time you make a typing mistake, a bug hits your windshield. By the time I had finished my “therapeutic communication”, I had bugs all over the place – closed-ended questions flying left and right, giving approval, agreeing, changing the subject – all over the place! By the end I finally started getting the hang of it and was able to present some good communication skills. I was apprehensive about doing this at first, but it was a really good learning experience. Hopefully I’ll get better.

Overall today was just okay, but it was productive (just not quite what I had expected). I really hope tomorrow will be better. I need some excitement in this rotation. It would be awesome if I was able to witness just one major meltdown before the end of this semester.

-DV

Thursday, June 10, 2010

Testing the Waters vs. Jumping In

Today was the second day of clinical. We took a tour of the mental health unit of the hospital and finished going through most of the CID. I’m not too sure if I was just tired today or if things just didn’t go as well as I had hoped - probably a little of both. I woke up early again this morning and went for another run. I really enjoy waking up early before the rest of the family. It gives me some time to be by myself during the day. I loved the train ride this morning. I was able to get quite a bit of studying done without the frivolous talk of deadbeat husbands, girdles and such. :) (Sometimes it really sucks to be the token male.) I arrived at the hosptial nearly an hour early and went on up to the meeting room just in case it was already open. Nope. Next week I’ll hang in the cafeteria or waiting area when I get there. The air was still out so I knew it was going to be another uncomfortable day. Now that I think about it, maybe that [the heat] just started things off on a downward slope.

I knew that I would be sent out into one of the units today, but I’m not too sure what I expected. Actually, I do know. I expected to be able to test the waters today, and I did. However, we don’t have time for that. As it turns out, in order to get everything done that needs to be done during the next four weeks, I’m going to have to just take a deep breath, jump in and hope that I can swim. I feel like I’m already behind in what I needed to be doing today. My first unit assignment was in the recovery group building. What should have happened is this. I should have gone into a group, identified a patient and followed up with that patient ASAP. I didn’t. Did I think about it? Yep, sure did. Was the opportunity there? Yep, sure was. The thing that comes to mind here is that whole “Self Directed Learner” thing all the faculty have been telling us about. I was too apprehensive after the first meeting to seek out that opportunity to practice my therapeutic communication skills. As it turns out, the patient I had chosen attended both group meetings today. She was there in the building and all I had to do was seek her out. Had I left the first meeting and gone to interact with the patient(s) I could have developed an introductory relationship with at least one of them. During the second meeting I had decided to seek out my “chosen” patient afterword. Wouldn’t you know it; she left the second meeting early. Two things happened when my chosen patient walked out…

1. The outward emotion, “Oh, man, she’s leaving. I didn’t get a chance to talk to her.”
and
2. The inward emotion, “Oh, thank God. Now I don’t have to talk to her.”

I’ve come to the realization that this sort of behavior is fairly typical of me. Maybe that’s normal, maybe not. What I do know is this, if I don’t take the initiative to “practice” my skills, I won’t do well in this class. I have to do things in this particular nursing rotation that are directly contrary to my personality. I am not a social person, but I will have to start pretending pretty soon before I start to sink….. [sigh].

So now, after having spent a couple of hours looking at my patient’s chart, I’ve got all of the necessary, fact finding, theoretical, organizational, research work done. I can tell you what’s wrong with her, what meds she’s taking, her delusional statements, her physical needs, etc. What I don’t have is the necessary information I need to actually help this person. What is that information? It’s her tone of voice.

-DV

Wednesday, June 9, 2010

The Train Ride

It’s going to be a very fast ride with some ups and downs along the way. Today was my first day of mental health clinica. It started last night when I went to bed early. I rode the train from downtown to the hospital early this morning. Surprisingly, I wasn’t really very apprehensive last night about my first day like I was last semester in foundations. I think that is partially because I knew there would not be any patient interaction, just orientation. I woke up early and went for a run this morning and then came home to get cleaned up and make my way to the train station. I felt really good about taking the train because I had scoped out the parking situation earlier this week. I made it in time and met my associates and we were on our way.

It was my idea to take the train to clinical so that I would have nearly three hours of study time each day. However, with a “study group” you have to be careful because they tend to turn into chat groups. Sure enough, not much studying got done today. Fortunately for me, my peers decided that the train took too long and I’ll be making the trip solo from now on.

I cannot begin to say how excited I am about clinical this semester. After last semester (Foundations), I need some structure. Each assignment was given a due date at the beginning of the semester. I know WHEN to get stuff done. Yea! We went through each assignment and talked about what was expected and how to get it done. Yea! Yea! Organization is our friend. I feel confident that I’ll be able to have my assignments done on time and done effectively. Here’s the only problem with the assignments…they roll around pretty fast. There won’t be any rest for the weary during the next four weeks. Between attending theory class (8 hrs/wk), clinical (16 hrs/wk), 2 group sessions and getting stuff done at home it’s going to be tight getting in enough time to complete these aforementioned assignments. Thanks to my handy, super awesome excel schedule I think I’ll be able to stay on top of things.

Our orientation to the hospital was pretty eye-opening today. The educational instructor is really helpful and wants to see us succeed while we are spending time at the hospital. Their computer charting system is very cool. There’s almost not any reason to have to interact with the patients. It’s all there on the computer for us.  It’s almost too much information. I’m sure it will take a couple of days to figure out what where to find the information that I need for my reports. Hopefully, this will actually make my time with the patients even more beneficial. I’ll already know all of the basics. It’ll just be practicing my therapeutic communication on a real life person.

Speaking of real life people, it looks like I’ll have the opportunity to observe all kinds of group sessions while I’m at the hospital. I wasn’t too sure what the clinical experience would be like during the mental health rotation. Looks like I’ll be doing a lot of listening. I can do that. While there will be several group sessions, I’ll have the opportunity to interact one-on-one with some of the patients as well. That’s the scary part.…especially after reading some their charts today (These people are seriously messed up). I just have to remember that it’s not about me; it’s about the patients…How does that make you feel?...Can you tell me more about that?...Do you see someone over there?...Are you hearing voices?...What are they telling you? The voices in my head are sometimes telling me “What the hell have you gotten yourself into?” and other times they say “Cool!”

Regardless, I think that that at the end of this six week rotation I’ll look back and remember this summer session as one of the best semesters I’ve ever had. It will be an exciting ride for sure.

-DV