Fall Semester: Week 2!

I just had a fabulous day in the ER. Sounds kind of strange, doesn't it?

Thursday marked my first real day of my mental health clinical rotation. My instructor has arranged for us to do something a little different each week. My schedule looks a little something like this:

-two days in the chemical dependency unit
-one day in the emergency room crisis center
-one day shadowing the charge nurse for the inpatient unit
-one day shadowing the group nurse for the inpatient unit
-one day administering medicine to patients in the inpatient unit
-one day assisting the mental health technician
-one day with the social worker on the inpatient unit
-one day leading an occupational therapy group
-one day in the outpatient program
-one day doing home health visits with a mental health nurse practitioner.

I spent my first day in the voluntary inpatient psychiatric unit. My main task was to shadow the social worker, observe his support group, and observe the treatment team meetings. Treatment team meetings are a time for the whole team of care providers (psychiatrist, nurses, occupational therapists, social worker) to discuss a patient's history, treatment plans or options, their progress and plans for discharge. It was truly fascinating!

The first half of my day was quite uncomfortable, though. Since the social worker didn't get to the unit until 0900, I spent the first couple of hours floating around the unit. I helped take vital signs before breakfast, spent some time looking over charts, and participated in the morning exercise group, but my main task was to observe and try to talk with the patients.

Who knew just sitting back and watching could be so difficult? Having 10 new people on the unit caused anxiety for many of the patients -- and I think most of the students (myself included) felt a bit of anxiety of their own. Things improved as we all became more comfortable around each other; by the afternoon most students were able to approach patients and strike up a conversation.

On Friday, I spent the first part of my morning shadowing an ER nurse. I got to help clean rooms, observe wound care (although I left before seeing the doctor actually staple the laceration shut), help move a patient up in bed, and talk with the nurses. The rest of my day was spent in the crisis center, which was positively overflowing with people in crisis.

The crisis services center has three patient rooms, a small office, and a quiet room. When I got there, all three of the patient rooms were occupied, the quiet room had been turned into a makeshift patient room, and three additional beds in the ER were filled by crisis patients. Much of my time was spent talking with the crisis center nurse, and observing as the crisis counselor struggled to get patients placed with appropriate resources. Some major shuffling had to go down when a homicidal patient showed up in the ER lobby.

I can't decide what was the best part about my time in the crisis center -- talking with the crisis services team, interacting with patients when possible, or how I was able to advocate for myself so I didn't just sit around. Perhaps that was the best part of all!