Psyched for psych

It's been awhile since I've done a nursing post (I've been off for a few weeks - this is my second week back) so bear with me because this is a long one! This week I had my onsite orientations to the units I'll be spending most of my time on for clinicals this semester. As I mentioned before, I decided to do my adults and psych rotations first and on Tuesday I found out a bit more about what my psych rotation will entail (more about adults later - it is less exciting). I'll be spending all my inpatient hours switching between the medical psych and the general psych floors - which was my first choice!

I have always thought mental health was very complicated so I was looking forward to seeing what this clinical would be like and I was not disappointed. The onsite portion of orientation mostly involved an introduction to the types of patients we'll be seeing and a tour of the units. On med psych we will have mostly voluntary admissions that typically transfer in from the emergency department (so they are usually paired with some kind of recent event that landed them there such as overdoses, falls, car accidents, etc.). This is also the unit where they perform ECT and TMS. On general psych we have the more acute and active patients who are primarily involuntary admissions. This is where patients who are suffering from something such as a personality disorder, disorganized thought processes, hallucinations, etc. are admitted. This unit was particularly disorienting because the patients were the ones wearing a combination of scrubs and street clothes and the nurses were all in street clothes! I had a conversation with another student after we left the floor and we both had noticed a young woman and older man having a conversation near the entrance to the unit (one a patient, one a sitter) and we had both had different impressions of which person was the patient and which was the sitter. All staff wears name badges so if you look you can tell - but in passing I suppose it just all comes down to stereotypes. The other helpful indicator is that anyone admitted to the hospital is required to wear no-slip footwear so if you look down at everyone's feet, you can tell who is a patient and who is not.

The offsite orientation involved another very disorienting experience. There was an auditory hallucination simulation (optional - but everyone in my group participated) in which for one hour you had to participate in a variety of tasks such as filling out a job application, word search puzzles, reading comprehension, and a mental status exam (very similar to those that we give patients) all while hearing other things. Apparently this simulation was developed by a woman who had recovered from auditory hallucinations, and it certainly gives me sympathy and hopefully an increased level of patience if I ever have a patient who suffers from hallucinations. I performed pretty poorly on all my tasks.

My outpatient hours will be at a variety of settings including a treatment center for kids, an AA meeting, and a group home and if they are good experiences, maybe you will hear a bit more about those later :) I have to say that I am much more excited for this clinical than I thought I'd be!