Wednesday, February 22, 2006
That's Just CrazytalkOh wow.
What a weird career I'm having so far! I never planned to jump from specialty to specialty, but the experiences I'm having are amazing.
I started at the psych hospital last Thursday and I thought I'd put off posting until I had a good feel for how things worked. My very first day was like "awwHELLno!" and I thought I'd gotten in over my head, but the second day (Friday) was pretty cool, and Monday and Tuesday went well also. Today I think I can give a good overview of what it's like.
The first day I followed the LPN (a current RN student and very nice young woman) as she did med pass. She set up a mobile med cart sort of backed up into the seclusion hallway so that no one can get behind her. Patients lined up to get their meds, and it went smoothly until a female patient (who had to sit in a chair next to the med cart for 20 minutes for cheeking precautions after taking her meds) went off on her verbally. I mean, this patient was spouting insults, hostility, swearing and calling the LPN every name in the book and insulting her in any way possible - some very personal. It was not only bad, but it went on for 20 minutes! I could tell the LPN was just barely controlling herself, and practically shaking with anger, but she was professional. In retrospect, although that exchange really made me mad and frustrated that nothing could be done about it, it was a great learning experience and a very good example of what I may have to go through myself. There were also 2 shows of force that first day, and maybe the attitude of the whole unit was thrown off by that early-shift hostility-fest. A lot of patients seemed to be screaming about one thing or the other for the rest of the shift.
The second day I was put on an hour's duty of line-of-sight for a female who was on self-harm precautions. We got a chance to talk, and I enjoyed that. Later I did another hour on an underage female who basically had to have a chaperone wherever she went because the rest of the patients are adults. We had a nice conversation also. I'm quite aware that not all of my exchanges are going to be cooperative, many patients are hostile and delusional. I honestly felt much safer at the jail, because there was always an officer right there. That day was much nicer, patients were a lot calmer, and as I walked around on the unit, I was able to meet several of them and introduce myself.
A major difference in psych nursing for me is that sometimes there is just nothing to do but go out into the unit and talk to patients. The charge nurse is very nice, and she's making sure I get a good orientation and learn what I need to know. She said "I know it's weird, and I had a little trouble with it myself at first, but sometimes the job is just going out and interacting with patients. You feel like you should be doing something more to earn your wage, but being out there and connecting is really important also." It makes perfect sense, it's just that I guess I expect to have to chart everything, and I don't. I redirect patients, make sure they're using their coping skills, try to get them involved in groups, reorient them if they're delusional, and sometimes just listen.
One of the nurses precepting me told me to make sure I don't stay in psych nursing too long or I'll lose my other skills, and I believe that. I'm going to work on getting my BSN in the evenings. I'm not anywhere near as exhausted after work as I was at the hospital, and this will be a great time to do it. The program that I'm looking into requires 10 credits of a foreign language as a pre-req and I'll see if I can get that this summer. I've always wanted to learn spanish! :) I've got to do statistics also, but they say that can be done concurrently with the BSN program.
That's all for now. I think I'm going to put up a bunch of new blogs tonight, so stay tuned. I'm sorry I didn't get to NurseBlog of The Month last month, but think about some nominations, because NBOTM is happenin' this month!
Posted by HypnoKitten at 10:56 AM