Greetings and welcome to our Class Blog. I look forward to reading your reflections about Psychiatric-Mental Health Nursing. The weekly blog entries should be posted by the due dates listed on Blackboard. I will post the weekly assignment. To post individual responses, students should click on the word, "comments" then write in the comment window to the weekly assignment. Blogging is not Discussion Board. Students are expected to reflect on the weekly posting each week. Students are encouraged to read other students' comments. You do not have to respond by commenting to classmates. These are your thoughts. This is a closed blog thus only students enrolled in NURS 432 will have access to this Blog by email invitation. Our confidentiality rule applies to all class bloggers. Please be mindful that scholarly writing is expected. You may refer to our class Blackboard for more detail about this Clinical Activity under Assignment. NOTE: Instructions on how to proceed are located in the Welcome to the May Graduating Class of 2015 message on the lower right side under Blog Archives October 2014. You will not be able to post a comment here. I initiated this Class Blog in 2011 with (6) discussion questions. You will be instructed to respond to my discussion questions ONLY. DO NOT START YOUR OWN POSTINGS. I look forward to your comments. Happy blogging!
Tuesday, September 6, 2011
Week Four
Its been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
Going into my designated psych unit I had mixed emotions. A part of me was nervous and another part of me was excited and ready to get to work. When I finally got there and began to work my feeling of nervousness went away. The environment was calm in the morning and as the day went on the milieu escalated because of events that had occurred. The environment never did get out of control. It was way smaller than I had imagined. The sleeping space seemed to be cramped with 3 to 4 beds in a room. The day room was also crowded. There seemed to be too many patients with the space provided. The nurses were very nice but seemed absent on the floor. I only saw them doing work in the nurse’s station. The techs didn’t seem compassionate enough. One on them was making fun of the patients and laughing at them and I didn’t like that. I believe that although these patients may have done some sick things, are mentally ill, and some don’t know any better they should still be treated with some type of respected.
Initially, I was afraid prior to going to the facility. I’ve always head stories of “Spring Grove”. You really don’t know what a mental institution is like until you’ve actually visited one. The first day, my colleagues and I were shoulder to shoulder. I guess that was our “defense mechanisms” kicking in. I was afraid of the stares and looks that the patients gave us. I was also uneasy with the idea that we had to unlock one door at a time. On our unit, each student is assigned keys to get in and out of each room/door. I felt as if I was in jail. As time went on, I began to feel more comfortable with the patients, because they are people just like you and I. This rotation has given me a different outlook on that way I feel about the mentally ill. This has been a life changing experience for me. I didn’t realize how many people are in need of mental health care. As we go about our busy daily lives, we complain about this and that, but do not realize that there are people out there who wish they could be out here as busy as we are. Some of the patients are very accepting and are eager to work with students. The facility is small and currently houses 38 patients. They have to leave their rooms early in the morning and are not able to return until 8 p.m. They can sit in the Milieu and watch TV, play cards, or go to sleep which is not a lot of options for a full day’s schedule. The activity room is open during certain hours of the day. This gives the patients opportunities to go outside, listen to music or play games. It’s not a lot to do at Spring Grove and it is very close to jail, but I do understand that the patients need a controlled environment. The staff at Spring Grove are “okay” to get along with. Some of them are excited to have nursing students and some of them aren’t, but we make the BEST of it. We are there for a learning experience and we see to it that we get the information that we need to complete our “Charge Nurse” duties.
My inital feeling about clinical was that I was scared out of my mind. I guess I felt this way becasue I did not know what to expect, also the tour of my clinical site was very traumatizing because our tour lady was saying all the bad things that can happen.I must admit to my surprise my clincal site is very calm except for some incidences. The staff that I work with are very helpful in explaining what they do and why. The secretary on my cottage teaches me somthing new eveyday I see her. I actually feel as if I work there. At RICA I thought I would see actual crazy people pacing around, but it is just the opposite the children are full of life and it is a comfortable enviorment.I come to realize that a lot of these kids need love and are yearning for this. If I decide to stay in psyc nursing I will work with children.
My first thought about Pysch was that i wasnt going to like it. When i first arrived on the Mileu i was very nervous and scared. I had no idea what to expect. Since arriving on the mileu and getting to know some of the patients, i now have a different perspective on the clients. I found that most of them are really smart. I am no longer afraid of the clients on my unit, but i cannot not say that im not afraid of others. It saddens me at times when i see the clients sitting around sleeping all day. It is my hope that Spring Grove would incorporate some more activities for the clients. I would also like to see them have a gym, so that they can be more physically active.
It's been a week since my arrival to the psych unit and so far I've had a wonderful experience. The staff is really nice and they are always willing to help. It's very interesting listening to the stories that the patients tell you, and most ot them are very open about their situations. There are some instances where you approach a patient and ask if you could talk to them and they say no, but as the day goes by and they warm up to you they eventually began to talk to you. On our unit we play board games, we have group discussions, exercise class, and karaoake. The patients really appreciate our prescence on the unit. We also watch movies and spend a lot of time talking to our clients. The environment is very warm and friendly and I enjoy being there on Tuesdays and Wednesdays. This is a different type of clinical experience because we are not taking care of patients with medical problems like diabetes, hypertension, etc, but it is a great learning experience dealing with clients with psychological disorders.
My initial feeling about starting this clinical was scared. I believe I felt this way because I didn’t not know what to expect. Upon our first day at the site my anxiety level increased, especially while we toured the cottages and were introduced to some of the clients that were there. As the weeks progress I am not nervous at all. I anticipate going into the unit and seeing my client. The facility that I am at houses children and these children have a lot of different behavioral, emotional and psychological problems. I believe that some of the staff doesn’t know how to deal with these type of individuals. They do not practice therapeutic communication at all here. I believe that this is triggers some of the episodes/incidence that they have on the units. The environment at the facility is sometimes calm and sometimes rowdy like all units. It seems as if the staff yells as loud as the children and they are trying to be their friend instead of helping them deal with problems. Besides these concerns I think that it is a nice facility to work at. The children look forward to getting higher points so that they are able to do different activates which leads them to behaving, taking their mediations, and doing well in all their other daily assignments.
It has been such an interesting experience for at my Psych rotation. I first at first, I went in with a lot of apprehension and fear of the unknown however, I can honestly say it is noting that I imagined. The clients at my facility are very welcoming and quite engaging, every morning when we open those doors, they are happy to see us and cheer us on as we start our daily interaction with them. The Nursing staff and doctors at my facility are wonderful and very resourceful as well, they have been such a big help in reducing our anxieties. I had lots of misconception (chaos) of a psych unit fortunately for us the milieu has been very well maintained and calmed. I was very impressed with how lectures are congruent with the actual clinical setting, the client attitudes, sign and symptom are TEXTBOOK complete and this really helps in “Putting the Pieces Together”.
Before my first week at VA I thought this site will be emotional because of their military backgrounds. But to my greatest surprise it isn’t. The patients are treated with dignity and respect regardless of their ethnic background. Being at VA is a great experience of a life time for me because I have learned a lot from the patients, nurses and even staffs that I can’t express it in writing. All the patients in this clinical site have a military back ground. Every single week I come home with something new from the patients related to their battle field experienced or off duty experience. Most of the patients that I have been having for the past weeks are those that fought the Crimean and Vietnam wars. These are people that keep us and our country safe from the extremist and I am so happy that I have the opportunity to make a difference in their lives. And I am doing it with all my heart because they deserve it. The patients at VA are nice and intelligent to some degree. So far there haven’t been any crisis yet and that I don’t want it to happen because it is my greatest fear. Some of the nurses initially weren’t polite or nice, and just of a sudden they change and started acting and behaving nicely. Don’t know what happened, may be they realized themselves. They are so nice and caring now, it is only God who knows. The staffs are excellent and helpful to us. I really do like this site.
Initially I was excited to be on psych unit. After three weeks of being on the unit I remember why I needed a break from psych nursing. To me psych is mental draining and if there is no action on the unit it makes for a very long shift. I need a busy environment to help move the time along else I find myself watching the clock (which never seems to move). On the bright side certain patients will tell you the most amazing stories and you can learn so many things from them. A lot of the patients can tell you more about their diagnosis and medication than you can tell them. The environment is different from what I am used to. The patients at my clinical facility are allowed to have several items that would be considered contraband and not usual allowed; however, the safety of the patients is still maintained. The staff on this unit are great, they are very friendly and welcoming. Overall I am enjoying this rotation.
Before my arrival at the Psych units, I thought all psych patients are aggressive and can cause harm to self, another patient, or the staff. With this in mind, I was very scared and I took all precaution to make sure none of the psychiatric patients were behind me on my first day at the clinical location. However, after spending three weeks at this clinical location, couple with the nurse-client relationship I developed with the patients in the course of interacting with them, I now have different conception about the patients. I see them as people who are sick and need medical, psychological, and or emotional attention which the environment in which they are offers. Some of these patients say they feel more safe being in this psych unit than the will if they are in the street. The staff in my clinical location, are very cooperative; they do all they can to make sure we get the best from them during clinical session. I am now more comfortable than my first day of clinical, dealing with the psych patient.
I am pleasantly surprised at the willingness of the patients to speak with us students. They have been very receptive when we have conducted our groups and have readily participated. The patient that I had the privilege of working with was open enough with me to share a book he is working on. I came into this class expecting clinical to be a painful process of convincing the clients that we could be trusted, and it seems as if they are sharing more with the students than with some of the staff. The nursing staff have been extremely friendly and willing to help us with any information that we need. The social workers and administrative staff have also been very friendly. Even the physicians are willing to assist us with what we need. The "techs" on the unit have been helpful by informing us which patients would be more receptive to speaking with us. I overheard one of the staff members remarking how we have such a good rapport with the clients and how our groups are informative as well as engaging. I do not have plans to be a psychiatric mental health nurse, but it is reassuring to know that the staff of the facility I have been assigned to have confidence in us.
I have actually enjoyed my experience on the psych unit thus far. It is interesting to learn the backgrounds of some of the patients and their willigness to give so much information about themselves still amazes me. I have enjoyed our group sessions and am pleased when someone comes to us and say that we made their day. It takes a special type of person to work on that unit.. and I don't think I'm there yet. As much as I do enjoy conversing with the clients, I cannot see myself as a new nurse jumping right into it. I believe that dealing with the psych issues of the "normal" patients will be enough for me.
I am very pleased with the psych unit that I am on. The staff has been very supportive of us since the first day we arrived on the unit. I have not met one staff member that has had a mean demeanor towards us. I really enjoy talking to the patients and hearing the different stories and attitudes. So far the patients loved our group sessions especially karaoke. The best moment for me was when I saw one of my patients from my job on the unit and I actually got to sit down and talk with her.
I can honestly say that my clinical setting was not what I expected. The staff are nice and helpful. They make it easier to navigate the task of reaching the patients. This is important since I am not in the usual hospital setting. The patients are open and not afraid to tell you about themselves. This was not what I was expecting. Some are not very cooperative and very closed in. I am also very proud of myself because this clinical has subsided my fears of working with the mentally ill. Overall, I feel that this experience is more positive than I assumed it woould be.
Well...the place in which we are having our Psych rotation is truly DIFFERENT. The enviornment is dark, dreary and truly uninviting. It has a stench that hits you as soon as you hit the door (Not something you are looking forward to at 8 am). One part of this dilapidated building is for Psych patients who voluntarily check themselves in and the other portion is used for subsidized housing. The patients are INTERESTING to say the least. We have had people who talk to the devil (and on a regular basis) to those who have experienced every traumatic life event know to man, and then on to those who are 150% sure that the Federal Goverment is out to get them (exclusively). Some of the patients are truly like your everday people; however, these individuals find it impossible to deal with the everyday stresses that we all have...they fall in to a funk called depression and they end up in a funky place like this. Sad but true. They are then coupled, tripled and quadrupled with the not so everyday person...they get placed with the dude who says he can see the devil on the wall, or the one who has considered taking his life, or maybe the one who sees dead people walking around or, the one who has homicidal thoughts. But hey, this is psych right? The staff at the facilty is really laid back and truly a good group of people to work with. They have been very open with my group and willing to answer any and all questions. Overall, I have been ok within this facilty. I can't say that I have ever felt threatend in any way. If only they could tidy up the place...
I was originally at the VA. Can I just tell you that it is a shame that these same people who fought for their countries have a facility geared for them and it is so drab! They truly deserve better! Ended up getting relocated to Sinai and what a change. The floor is brightly lit, the staff is very welcoming, the patients are even pretty special to me. I don't mean special in a bad way. Other than the fact I know that some of them are not in there for no reason, they seam to be almost like you and I. I didn't have any expectations of what they would be like because I had decided that I was going to just go in with a positive mind. I am glad that I did because it made my first experience with them seem like any other day in a clinical setting. I was actually more relaxed with this type of illness. Maybe psych has a chance after all. My client and I played UNO, I mostly listened as he talked and the night went so fast. I could have stood to spend more time with him the information was flowing like a breeze.
At first, I was at the VA hospital for clinical. I was very surprised that there were so many younger clients in that facility. I always thought of veterans as being older. I wish that the experiences that they had while simply doing their job weren't so negative and painful. I was also surprised at the number of females at the facility. I am now and the Baltimore Crisis Response Intervention Center. Clients at the facility call a hotline for assistance when they feel that they are in a crisis and they are evaluated and they come to the facility vouluntarily. I think that the center allows a way for people to get the help that they need to get through a crisis without being forced into a hospital setting. The clients are willing to talk to students. Some of them seem like they would rather not be bothered. I saw that the clients there really like having someone to talk with. They may even just enjoy having someone there to listen to their feelings and their story. I appreciate the client's willingness to share information and open up to us about their feelings and their experiences. It shows that it is our privelage to be a part of their treatment.
I too was at VA hospital for clinical in the very beginning but got placed at RICA. My experience at RICA is going pretty good. When I was first placed there, I was soooo nervous because for 1 I felt like I was behind, and 2, I was just nervous about meeting my new patient and I was scared because I just didn't know what to expect when working with a new patient. But when I hit the floor, and starting interacting with the staff and the residents there, I felt welcomed. My first day I was antsy, but my second day, I felt more relaxed and more comfortable with speaking to the staff and interacting with my patient. The more and more I let my guard down, I realized that I fit right in. The environment at RICA is exciting, yet calming, though there are moments when it can be chaotic but hey I can deal. I was so amazed at the various issues that many people faced in their childhood that caused to be in the predicament that they are in and honestly it just broke my heart but we take so much for granted meanwhile a child down the street is living a nightmare in their own homes and everybody is quick to judge and worry about materialistic things such as clothing and shelter was the abused child but nobody think of they lasting emotional damage this child will face growing up and the devastating effects its gonna have on their mental health. (let me get off my soapbox). The staff are just so nice and make you feel like you can come and ask them anything and they are willing to help you. As for myself, I went from a nervous wreck to now I actually look forward to going to clinical at RICA and when we get there, the staff and residents readily say "hey".
Wow, can't believe its three weeks already, well i was a bit nervous on my first day of clinical because i just did not know what to expect. I had lots and lots of questions running through my head, were the patients hay and wild, how wws the staff going to treat us and in all how were we going to survive the unit. But all these doubts and fears were cleared when i got the chance to have a one on one interaction with the patients. It was actually fun and believe it or not, those patients were more than willing to interact with us. The environment though, is not as the regular hospital unit and i felt the sponsors could actually do better for these patients. In my opinion, i thinks much improvements is needed at the center, The environment, nevertheless, is a calm place and the patients are well behaved, also, the staff are wonderful to deal with and most importantly very helpful. I always look forward to going to clinical to help the patients come to an optimum level of health.
Some of your thought and feeling about the environment, the patient, the staff and you? At first I was at VA hospital, the environment is pleasant to work, the patient is young adult, and they don’t look like psychiatric patient. My experience at VA hospital was a short one now I am at BRCI an acute care unit for those experience crisis, addiction and need interventions and treatment, their client are voluntary admitted and a stays for days or weeks. We do not have those type of patient in the movie “one flew over the cuckoo’s nest” the surrounding is not impressive, it needed more renovation, the building need a better location for their client smoking break; the while we are in the conference room the client goes out of the pouch for smoking, and all the smoke come right into the conferences room which put us at the risk of second hand smoking. Although the patients welcome student and they are willing to talk to the students. It was a good experience for me, at first I was nervous and thinking am behind. I was able to gain confident and gather information from my client. The staff gives us their full support.
Three weeks go by fast! The first week we arrived to Spring Grove I was excited but did not like the idea of unlocking and locking the doors. It made me feel nervous. But now I have gotten use to the unlocking and relocking the doors. I was never scared of the patients; I just felt anxious that I didn't know how the patients were like at my facility. Since we hear report, I know what the patients have been acting like in the past 24 hours. I have gotten used to walking around the hallways and conversating with certain patients. Most of the staff are nice and acknowledge us. I appreciate the staff that do. I am really enjoying this clinical and it makes me not cross out psych nursing in the future.
Yes, three weeks have gone by so fast. The environment at RICA reminds me of a recreation center compared to other psych wards I have been. The building looks new, with a court yard that divides the units. I was surprised to see a relaxation room decorated like a calming area that you would see n a vacation setting. They do not use any restraints at the facility due to prior incidences at other hospitals with children. The unit is very clean and inviting, it does not have the appearance of a psych ward. One thing that I noticed is that all of the female clients were Caucasian. The mentioned that this was the first time that they had all Caucasian females and they had to learn how to adjust to this type of environment. The females are typical teenagers with rough life experiences. After reading my clients chart, I started to see how much of a challenge it is for her to stay positive. She explained how hard it is for to have lost her mother at age four to AIDS and have been raped. This is just some of the things that happened in her life. As we continued to talk, she looks forward to me coming to see her each week. The staff is very nice and welcoming. They have been so helpful and nice to us, we feel a part of the team.
My initial thought about psych was “what am I really going to do with these patients “I thought all the patients were aggressive and they were always in seclusion. On the first day, our instructor took us on a tour of the facility and I had the opportunity to meet some of the staff and the patients. They were very helpful and were ready to answers any questions we approached them with. One of the head Nurses gave us the history and the service the facility offers for its citizens. Through these interactions, my anxiety levels decreased, because my assumption about these patients was the opposite of what I encountered. At Baltimore Crisis Center, Most of the patients have situational crisis which with assistance and referral, they are able to go back into the society as independent citizens. This facility has 21 beds for its patients and their patients are voluntary individuals. The patients were very friendly and even made a funny comment about my pregnant belly.
Initially, I was afraid to go onto the psych unit because I didn't know what to expect. I watch alot of movies and I kept thinking that the patients were going to band together and attack the staff. But I had to come to my senses and realize this was not a movie. After three weeks, the unit seemed okay but it was a little boring for me. I mean it's nice to innteract with the clients and talk to them but psych is a completely different world. I'm so used to giving medications, dressing wounds, inserting foleys, and a host of other things, that this feels like I'm missing something. The environment is diffent from a regular hospital unit. It's home like. The milieu is like the living room where the patients hang out and play games, watch tv, and listen to music. The patients come and go out of their room as they please unless of course for some reason they are restrained. Also, Some of the clients are open and come up to us to talk and others just stay to themselves. They are normal people , but just with the mental issues that could have been brought on by the smallest things such as losing a job, house, or divorce. The staff are great with the patients. They love for us to interact with them. They are very helpful and nice. My experience has given me a different look than what happens in the movies. I see that these people just want help to control there inner emotions and feelings that are brought on by the mental illness.
In this last few weeks at my facility I have found the environment to be very drab and boring. I feel like the environment is not one to bring about life and happiness in someone who may just be depressed. The staff is nice I have found them to be quite knowledgeable and helpful. They really seem to love their jobs and they seem to be very good at communicating with the clients. The clients aren't as scary as I thought they were when I first arrived. Some of the clients don't even seem to be as mentally ill as they are suppose to be. as far as me, i feel that I am learning more every week. I am becoming more comfortable with the clients and the disease processes. i also am learning how to communicate with these clients in a therapeutic manner. I see growth in myself.
After being in my psych rotations for a week weeks, I can gladly say I have learned a lot. For starters, I don’t feel lost when I get to the unit anymore. I feel comfortable getting around the unit, finding patients and carrying purposeful conversations with them. Some of my assumptions about the unit have been disproven and I have a new perspective on the patients. I noticed that a lot of the patients come into the unit because of worsening depression and noncompliance to medication therapy. They turn to do better while taking their medications. The staffs on the unit have been very supportive and kind. They are always willing to answer questions and help when asked.
3 WEEKS REALLY?! Time sure flies when you are having fun. Initially I was terrified of this rotation, but I have the best instructor and clinical group. I have learned a lot and I am more comfortable around the clients. The clients love to talk and I love talking to them. Each one may have a different story, but the disease process really affects each one the same. The staff is very friendly and helpful. Anytime you have a question or concern, they are willing to lend a hand. The locking of unlocking doors is still a little unnerving, but it’s not as bad as I thought. If a position or opportunity presented itself in Mental Health, at least I will give it a thought now, instead of running away.
Time has went by so quickly I really cannot believe that we have only 2 more weeks left of psych. When I first came in to this half of the rotation I was honestly terrified. I heard that going to spring grove would be just like the movie we had to see for class which frightened me. As the weeks went by I got more confident and see that it’s really not bad at all. The only thing about the location is locking the doors but I am actually getting use to that too. The staff at Spring grove are very helpful and the patients are very respectful and were even eager to learn when I did my teaching presentation.
Going to Spring Grove I was so scared but as time has gone on its only half as bad as I thought it would be. Its still a little creepy because its old and dark. It makes me still a little nervous because you never know what to expect and everywhere you go the doors a locked. From what I have observed the patients are not really doing much of anything but sleeping in the day room all day and pacing the hallway. It really makes me wonder how theraputic is the facility. Anyway the staff are very nice and very helpful in everyway. Overall its an ok place.
Spring Grove interesting; although the facility lacks some modern day technology, the place itself operates and appears to meet the needs of its clients. The Staff members are all too friendly and are eager to help and share their knowledge with you about patients and their personal experience on the unit.
After being on the unit for three weeks, I can say I actually am enjoying my clinical rotation. I was nervous at first when I walk onto the unit, not knowing what to expect. The clients are very interesting clients. The clients always ask why you are here. I say to them, I am here to listen to anything you would like to talk about. The activities that we have presented to the clients have been rewarding and fun. The clients are in a well controlled environment. The staff really enjoy there job, I haven’t once heard anyone complain about there job. They treat the students with respect and allow us to interact freely. The disorders I have encountered have been similar with each client such as depression and Schizophrenia. I have realized that mental illness has hit the African American community hard, and the young adults are increasing in numbers. I feel a lot more comfortable communicating with the mental ill because of my experiences this far
Blog 4 Though, I work in another building and I am already familiar with the buildings, the clients, and the staffs at Spring Grove, I still at first feel uneasy and thought I would be uncomfortable doing my clinical there. I also thought that the patient might start acting up when they see new faces and codes might be called. I thought about how the patient might respond to us as students, will they be receptive, deviance, aggressive, or unpredictable in behavior, but upon arrival, the patients were so calmed, well behaved, and were happy to see students. The environment was also calmed; the staffs were nice, accommodating, and helpful. By the end of the week, I felt relaxed, at ease, and became comfortable.
After being at my clinical site for three weeks now it is not what everybody made it out to be. Psychiatric patients are also consider humans. They are not freaks and they are not crazy as people made them out to be. They are abnormal in that they have medical diagnoses; however they eat the same food and breath the same air as normal people do. Every time I leave my clinical site to go home it makes me more appreciative of my friends and family because many of them do not have families. The environment was calm and welcoming. We actually interacted with the clients; we played pool, listen to music and even colored. The staff was wonderful in how they interacted with the clients. There was no discrimination each and every client received the same treatment.
After three weeks of clinical I am feeling a little more comfortable but yet guarded. The clients for the most part are friendly and happy we are there. We have talked, colored , played board games, and pool. Sometimes when I am home I often think about the facililty and feel greatful for what I have because I could not imagine having to live in a place like that. I wish the patients had more to do. It is all very depressing to me. The staff are friendly and welcoming.
During these past weeks my thoughts about myself was that I was able to overcome my fear and misconception about mentally ill individuals, I thought my world was falling apart, I had to find my way to clinical, because I do not drive, I had to depend on the cab, which cost me about 40 dollars per week, just to get to clinical, I couldn’t really afford it, so I had to use the money for my bills and food to get to clinical because I came too far to give up. The thoughts that were running through my mind was I can’t wait until this clinical rotation is over because it is causing a financial burden on me and my family. I thought about possibly becoming a psychiatric nurse in the near future. I often felt depressed, when trying to get to the clinical site, but once I arrived at the site I felt happy and looked forward to working with my patient and my group members. . I enjoyed my clinical group, instructor and working with my client. I got the chance to present one of my client’s medication to my group members, did my mini mental, did my group presentation on medication side effects and created brochures. I got the chance to interview my patient, which was interesting because I was about to find out information about her life. I enjoyed doing these activities because I was able to help my client and learn about antiphychotics medications and their side effects. This past week I notice that the patients were excited to attend groups with the students, they pay attention, follow the rules and were interacting and responding accordingly.
I didn’t think I would like psych before starting this class and rotation but now I can see myself as a psych nurse. The patient on the unit all really not bad, a lot of them want to talk. A lot of the patients thank us for coming and most of time didn’t want us to leave. The staff was very welcoming and helpful. If we needed anything the staff was right there ready to assist. The environment was very relaxing and calming it reminds me of a floor in a college doom. Once I got pass initiating of a conversation I was ok, this was my biggest fear. I thought it would be hard for me to just walk up to someone and start a conversation but it actually was not that bad.
I know that I would not like to be a psych nurse. The staff was nice for the most part except the new doctor and the patients kind of scare me. Honestly I'm afraid that they are like ticking time bombs waiting to go off at any second. Also, I don't like how they stare at you all the time and that some of the guys are inappropriate sometimes. Otherwise it is very quiet and seems like it is a relaxed and calm setting. I realize that there is always a male staff member around. No one had to be secluded or put in restraints since we have been here and I hope it stays that way. I guess the patients should have as little stimulants as possible but I just think the environment is very drab and boring, the staff does not seem to interact with the patients as much as I thought they should. Overall it was a nice learning experience, but again I know that nursing psychology in a mental health facility is not for me.
It’s been a little over one week since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
Excitement permeated my soul in anticipation of my first Psyc clinical. I had to Google the address, find the location, and get to the facility to meet the professor that I had never met. We got there late but were relieved to have been at the facility. After we were briefly oriented to the units by the nurse in charge, we had the chance to do the scavenger hunt which really made me more familiar within the facility. The facility was clean and well secured and the cottages were allocated to young women - cottage C, adolescence males - cottage B and cottage A for younger boys. The isolation room was the scariest as it has no furniture and seemed to help the client reflect on his or her behavior while in punishment. The staff was professional and cordial which seemed to make us feel welcomed. They were ready to answer or assist us with whatever questions that we had. Most of the patients in my assigned cottage were young adolescence boys and some were being chastised for bad behavior. A couple of them were arguing with the nursing staff and I could determine that some clients were very difficult to deal with on a daily basis. By then, it was time to get our client and read up on their history. After reading and gaining insight about our client, we wrapped and called it a day. My fears and anxieties were decreased because that pressure that I felt prior to that session helped me to understand that even though it may not be a med-surg clinical, psych wasn’t as bad as I made it to be. I particularly enjoyed seeing the clients out in the open associating and being with each other and after learning that some clients have their own assignments only reassures me that the atmosphere seemed convenient for the clients. I’m looking forward to this clinical rotation and want to absorb the most from it.
.Blog #4 It has been about three weeks since I have been here. Without doubts, I can say that some of my impressions about the patients, the staff, the environments and even myself have changed. Prior to coming on this rotation, my perception was that the patients would be violent, the staff would be unkempt in appearance looking almost like the patients they care for, that the environment would be chaotic, and that I would have to work in fear throughout the experience. However to my surprise, everything turned out the opposite. I met with a group of young residents that look clinically normal without any visible or apparent behavioral or relational problems. Several times I watched them play soccer and lift weights. There was no indication of unnecessary aggression or rudeness. The young men and women got along just fine. They followed rules and showed concern and respect for fellow team members. The staff members are so helpful.
Week 4 It has been such an interesting experience for at my Psych rotation. at first, I went in with a lot of apprehension and fear of the unknown however, I can say it is nothing that I imagined. The clients at my facility are very welcoming and quite engaging, every morning when we get to the unit they are open minded to speak with the students. The Nursing staff and unit clerks at my facility are wonderful and very resourceful as well, they have been such a big help in reducing our anxieties. I had lots of misunderstanding psych unit fortunately for us the environment has been very well maintained and calmed. I was very impressed with how lectures are congruent with the actual clinical setting, the client attitudes, sign and symptom are what the textbook implies them to be.
Blog Four I think my clinical environment is an awful environment of anyone! My building, is old, unwelcoming, constricting and just dismal. I wouldn’t want to recuperate there, let alone live there. The patients seem great. It is interesting seeing them and how they display their individual psychiatric disorders. So far in my encounters with my patient, you would not think he had his diagnosis. One clinical day, my classmates and I played games with patients in the day room. We played Wii, pool, Yahtzee, karaoke and coloring. They seemed to enjoy it. The employees, for the most part are not friendly. My classmates and I were going to do an activity with the patients. Most of them were in the room with the lounging watching television or sleeping. We were trying to tell the nurse that we can wait, but she just burst into the room, demanded the remote, turned off the television, turned on the lights, and got everyone up. I thought some patients would be agitated, but they were not. In the day room, there was patient with a karaoke machine, and another with a stereo. They were both on the whole time. The patient on the radio left and another one came and sat down. The orderly in charge asked the patient to turn it off, because the other patient had on the karaoke machine. I felt that she did not have to do that. I don’t feel like some of the employees are therapeutic to the patients, they are just bossy and rude. I find that I am nervous when asking my patient certain questions, because I am afraid that I will irritate or upset him. I am not afraid of my patient, but what I know he/she can do. I do not know what may trigger her/him, and that worries me. So far, I like my clinical, and feel like I could make this my career after I get experience in the hospital. I also know I can’t say that for certain until I have my first bad experience. That may or may not happen in clinical.
Glad to see that your clinical group are engaging the clients. In a long term care setting, its basically custodial care (institutionalization). The patients are sleeping...hmm? Short half-life of most psychotropic meds cause sedation. By late afternoon, patients are often alert and active. Check out the weekly actively schedule on your unit...there are activities, the nurses provided education, give medications, perform treatments, planning care with the interdisciplinary team and assist the somatic doctors...One of the goals for the unit is more activities for the patients...CSU students give them something to looking forward to...
Reflection on Encounters with Patients and Demonstration of Empathy by Nurses and Psychiatrist
To say that the four weeks I have spent at Spring grove mental health facility have been uneventful would be an understatement. These four weeks have been invaluable and one to revere, at least, for as long as I continue to practice as a nurse. The days I have spent at Spring grove have been informative, enlightening, and an eye opener, particularly about the field of mental health and mentally ill individuals. In earlier blogs, I had said “I was skeptical about going for my clinicals at a mental health facility.” However, these four weeks have completely changed my orientation and I can now say I am gaining more confidence working with mentally challenged individuals.
My third week was a most memorable one because I had the opportunity to interview my patient (the interview was revealing and interesting), see vividly how the principles of “limit setting” and “genuineness, empathy, respect and caring” are employed when dealing with mentally challenged individuals. I also had the rare opportunity of observing some of the individuals in their “light mood.” My group and I actually had the opportunity of engaging them in interesting activities including leisure activities that included pool, video games, and singing. The ability to carry out these activities showed that these individuals can be fun to work with if they are not in their crisis situation. It can even make an uninformed person to think that these individuals are normal.
Talking about limit setting and use of matter of fact approach and respect, I noticed that when one of the mentally challenged individuals wanted to attract attention by causing disturbance at the hallway of the facility, the nurse on duty addressed him clearly that he could talk but he would not be allowed to disturb the peace of other individuals. Another individual who kept asking one of the nurse the same question was never turned away but was given the same right answer every single time he asked the question. These scenarios were a practical display of some of the skills I had learnt in class and they went a long way to reinforce my knowledge about skills that can be used to provide care for mentally challenged individuals.
Nurses and psychiatrists demonstrate empathy by being able to accurately perceive client’s situation, perspective, and feelings. They also demonstrate empathy by communicating their understanding to the client and checking with them for accuracy. Likewise, they endeavor to act on this understanding in a helpful way toward the client. The use of these skills enables nurses and psychiatrist to provide therapeutic care to mentally challenged individuals and avoid violence or display of unacceptable behaviors by mentally ill individuals.
It has been three weeks since I have first arrived on the unit, and I love it. The setting was almost exactly like the movies, it was so crazy to me I thought it would be a little different. I am currently placed at Spring Grove Hospital center. The day room of my cottage I feel was too small. There doesn’t seem to be much for the clients to do. One client said the only thing they had to do was sit in the day room, watch tv, sleep, drink water, on when all else fails walk up and down the halls constantly (A lot of the patients were doing this walking back and forth pacing action). I also talked to several other clients on the unit, and there were some characters! I met one person diagnosed with schizoaffective disorder and mental retardation. His stories seemed very elaborate, and heavily exaggerated. It was hard to get much information from him because it was so hard to tell which stories were true from those that were fabricated. There were also several clients on the unit who seemed extremely normal. Upon assessment of these client’s reason for admission most claimed petty offense crimes such as theft, or public intoxication. I feel like it is a little extreme to keep a person locked in a mental institution for several years for something as minor as a disturbing the peace charge. However, I have not taken into consideration that I have not seen most of these clients charts, and have not been on the unit long enough to establish a relationship deep enough for them to feel comfortable disclosing any seemingly embarrassing or less than acceptable information with me. Oh I almost forgot, I experienced an act of transference for the very first time from one of the clients on my last visit. I didn’t spend any time talking to her individually, she usually spent most of her day talking aloud, to whom I do not know, but I overheard one of her conversations, and it seemed like someone in one of her auditory hallucinations was telling her something terrible about me. She would talk to this hallucination and then looking in my direction with one of her eyes would say things to me like “I am going to get her and others on the unit raped and murdered” she also said several times I was “going to get her and her baby killed”. When talking to my clinical instructor he stated there was not even a record of her having any children and she was not pregnant at this time. I am curious to know what this means and why she feels this way but, am really nervous about talking to her one on one. I will probably end up leaving those thoughts to curiosity but we’ll see. Anyway, I am really looking forward to my next rotation and can’t wait to talk to the patients some more they truly are an interesting bunch.
My encounter with the patients and staff initially was that the staff members were too firm with the patients but I have come to notice that the staff treat the patients individually and their knowledge about the typical behaviors of the patients makes them know how they interact with the patients and when to show empathy.
I have noticed that some of patients tend to take advantage of the “new face” when they interact with us, the nursing students and when the staff is not around, they say inappropriate things and at times certain behaviors, of which the Clinical Instructor does not hesitate to address which is considered “setting the boundaries”.
Due to certain behaviors I have seen, having a group activity like my clinical group did today with the patients initially made me feel more cautious, especially since 16 patients attended. I could notice soon enough that the patients were interactive, respectful and happy that they had the activity and other patients were even looking forward to the activity for next week. We had a good experience especially seeing that some patients expressed gratitude for our efforts and giving them chances to tell us what they did to relieve stress/anger in appropriate and encouraged ways.
The nurse I observed giving out the noon medications also treated the patients with respect and empathy and I feel that it encouraged the patients explain more about their symptoms and feel free as to ask for a small cup of juice without feeling like they harshly turned away. I believe that what I have seen thus far has been different from mental health nursing portrayed in “One Flew over the Cuckoo’s Nest”
I am really warming up to the environment since my initial visit for orientation. In my initial visit I put a game face on hoping I wouldn't show any type of nervousness or let the clients know that some of them looked very intimidating. This week at clinical to get over those emotions I simply started small talking with some of the clients and they were very receptive. Through talking to them they actually helped deescalate my anxiety a little and even though I knew anything could change in their moods at any given time, I felt a lot more comfortable in their presence. There was not a lot of staff there this week because it was Veterans Day, the staff consisted of all female nurses and one male tech in which were all very pleasant. The charge nurse was very nice and helpful in assisting me with all the questions I had for her about the client that I had been assigned to. The clients were extremely excited to know that we were on the unit and a lot of them were very fresh. Our unit consists of 30 males and 6 females, in comparison to my initial visit on the unit, the females were a lot more receptive of us being there. The males looked at us with googley eyes and wanted a lot of conversation out of the students, at one point our professor had to tell them to back off. That was hilarious. The most shocking thing that I saw on the unit this week was an Asian client with a flat affect and tattoos all over his body from head to toe. Another shocking thing was the client who was around my age, for whatever reason I definitely did not expect to see that young man on the unit and we learned that he had been there before. Overall my experience at Spring Grove so far has been a great one, we came in apprehensive and left out laughing and smiling.
It has been a few weeks since I started my clinical. It is very interesting and a learning experience because we see everything that we were taught in class. We see all the signs and symptoms of different mental disorders and the people exhibiting them. It is always good to see the information you learn in the classroom exhibited in a practical setting. We are now getting used to the residents. Unlike our first orientation we were all very scared of the patients, but now we stay with them to chat, play games and perform activities such as bingo. This is one of the many demonstrations of empathy by the psychiatrists and nurses. We were opportune to observe routines in the place such as how they receive their medications and line up. Everything in the facility is timed and organized in a fashion that the patients were kept busy throughout the day.
We had opportunities to study our client charts and see to different codes that were used in the facility. It has been interesting learning all of these different codes; it is always good to see things in a practical setting. My group is very cooperative. We ask each other questions that we don’t know. Our professor is very helpful and he explains anything that you ask. The other day one of us acted as a charge nurse and was able to give a report of every single resident we had. We had a very good learning experience with this. Initially, it was easy finding the venue, but now as I am more experienced I can easily locate my venue. So far I have enjoyed my time here and hope to continue learning much more about mental health nursing.
I must admit in the beginning I was very apprehensive about starting clinical. I was nervous about what it would be like in the unit, if the patients would be receptive to students and if I would ultimately enjoy my rotation. Over these last four weeks I have gained a new found respect for mental health nurses. It takes a very special kind of nurse to care for the mentally ill. I have been enjoying my time at BCRI. I was able to talk with a client and establish a therapeutic relationship. He was very open and engaging and I was very appreciative. I was nervous about whether the clients would be willing to communicate and to my surprise he initiated the conversation. However, last week I was unable to communicate with a client due to lack of interest in wanting to talk with students. The unit a BCRI is very old. It is not what I expected a mental health facility to be. I was pleasantly surprised with the amount of participation we received in group since we've been there. Overall I am satisfied with my experience thus far. I would like a more stable client but since BCRI has a max stay of about 5 days that is not possible. This week I get to lead group and will be discussing conflict management. I'm excited and nervous at the same time. I hope the clients will be receptive to me and participate. We will see how it goes!! To be continued......
Glad the experience is going well...are you learning something about yourself...its so easy to give of yourself...patients can be labile but keep trying...
At first, my thoughts about the environment on Spring Grove Hospital is that it will be very aggressive and rough interacting with the psyche patients but the reality is quite different. After three weeks of being in Red Brick #4, Spring Grove, I feel very comfortable and happy that I have an opportunity like this to interact and be in the same roof with mentally challenged people. I have come to understand that the way people look at them is different from what they really are. Most of them can be friendly and eager to discuss with you. Most of them will start the discussion and give you answers to your questions. My feeling about the environment has totally changed and1 am very confident to have discussion with them. I have a feeling of empathy on the patients that are stigmatized by the society today. The 3 weeks that we have been there, the milieu has been peaceful and cool except for few cases of shouting. Generally, I would say that the patients are co-operative and happy to have us interact with them. The staff members are good and co-operative. But I observed that sometimes some of the staff get stressed up and have to be firm to successfully handle some situation such as sending a patient to seclusion. As for me, I am so happy to have the experience of interacting with mentally ill patients.
It’s been three weeks of exciting learning experience for me. On my first day of clinical experience at Baltimore Crisis Response Center, I literarily had a knot in my stomach. I was nervous, excited, scared, unsure and giddy all at the same time. Three weeks later, I still feel some of these emotions but in a good kind of way without the knot. On the first day of clinical, my uneasiness was heightened when one of the patients during a group session announced that he felt disrespected that they were using them as an “experiment rodent” by inviting students to come “practice” with them and then angrily walked out of the group. This really made me and my classmates very uncomfortable and we felt that the patients did not want us there. Maybe it was ill perceived or actually occurred but I felt some of the other patients took cue from the comment and also started to act like our presence at the unit was an intrusion. Three weeks later, all that has changed. The patients actually look forward to our arrival. They welcome us with warm smiles and are really co-operative. The staff members have been kind and warm from day one. They are really happy to have us there and eager to assist us with any concerns that we have. Through the ups and downs, I must say that this has been one of my favorite clinical experience so far.
I've had a great clinical experience over these last three weeks. When I started the clinical for mental health nursing I did not know what to expect. I had never had an evening clinical and I had never been to a mental health inpatient facility. My patient population is adolescent males. Their cottage is really nice and the seclusion rooms have artwork on the walls that was drawn by a former patient. The environment is clean and does not smell bad. I went into the experience thinking that the facility would have that "schizophrenic smell". It was the complete opposite. One thing that I did experience that I thought was interesting was I had to assess my feelings. After I read my patient's chart I could feel myself being judgmental. Then I had to remind myself what I was there for and that was to learn and to help. The staff hardly interacts with the students, I thought they would be more outgoing and willing to show us stuff or give us information.
I usually have mixed feelings prior to going back to the spring grove every week. Mainly because mental health nursing is not an area of nursing I was particularly excited about but I must say the clients make the clinical experience worth the while. Each week I begin to feel more comfortable with them and them with me. Most of my initial reservations were because the clients were on a forensic unit and I felt the need to be guarded because of their previous history of violence. The clients are always welcoming and excited to see us each week. My classmates and I have engaged them in activities and some of the clients were excited to participate while other just watched. I think the campus is depressing. The environment feels cold and desolate and the presence of the old abandon buildings only contributes to this. I wish it were more inviting and warm considering it’s a long term facility and the patients reside there many years. As for the client and staff relationships, I noticed that the clients interacted more with the nursing aids than with the nurses. I found this to be interesting because I expected to see the nurses engaging the patients and utilizing some of the interventions that we learned in class but this has not been the case. I know this is partly due to the fact that most of the clients have been there for many years to the nurse client relationship have already been established and the nurses only intervene when necessary.
Good observation...you only get a snapshot of the relationship between the patients and nurses...the advocates are actively involve planning care and implementing treatment plans, giving out meds, treatments, intervening with team and keeping everyone safe. The nurses do groups but not on the days that the students are there because you are the nurses...
My clinical for mental health is at RICA which is a facility for minors, male and female, from about 7/8 years old to 18 years old. The environment outside seems to be like a school campus. The buildings don't look too old, and generally look well kept. It doesn't feel like an institution, but some of the furniture does look more institutional. It actually reminds me of some of the Catholic retreat houses that are spread across the country for Youth Groups in the Catholic Church. On the grounds their is also a school, and a gym.
Inside the the cluster of residential areas called cottages, house the residents. They are connect by a courtyard and the central nursing office sits on the outskirts. It is like a command center. The nurse manager is also stationed in this office. Each cottage is staffed with a Charge Nurse and LPNs. They also have a certified assistive personnel.
The personnel vary from some whom seem very therapeutic, to others who don’t seem to be very therapeutic. It is evident in the interactions that the residents have with staff who are the exceptional staff. However, most of the nursing staff seem invested in the residents.
The older adolescent boys are in the cottage where my client resides. This cottage can be loud and also it can be very active. Sometimes the tone of the space feels like it could quickly turn aggressive from a mild confrontational tone. I have witnessed a resident who was very close to being injected with medicine for behavioral management and medication compliance. The staff seems supportive of each other during the crisis. The resident use a considerable amount of profanity and especially at the staff or during causal conversations with the staff. The residents are reminded that the use of profane language will inhibit their ability to move through the level system. However, there weren't any instant consequences. Unfortunately, for residents who aren't compliant, this was another way to demonstrate their inability to comply with the treatment plan.
I actually am very comfortable with the population. I have worked in schools for children with emotional disorders, so this is not very different. I am concerned about the interaction with staff and residents that does not appear to be therapeutic. However we are able to discuss this with the Professor and understand the impact and the consequence.
I am definitely getting used to being on my unit. I am not nearly as anxious as I originally was. I still cant wait for them to move into a newer building. I still don't like the look of the place, it still looks old and worn down. I would love to go in there and give it a fresh coat of paint, but I digress. Most of the staff are very welcoming, most of them. Some of the staff look like they are tired, and dont want to be bothered so I try to avoid them. A good part of the staff are excited when we come in. The clients are starting to grow on me as well, at least the ones that stay for more than a week. It is difficult to build a therapeutic relationship with our clients because we only see them for about an hour then we never see them again. The average length of stay at BCRI is 8.5 days, so our clients are in and out so to speak. The problem with that is that each time we do a group session we meet all new people so we don't know what to expect. Last week I lead a group myself on the topic of nutrition. I was so nervous and didn't know what to expect but I did great and had a good time. Everyone was involved and participating (probably because I brought them fresh fruit and sugar free life savers). Usually half of them sleep or just look mean during our group sessions but this time everyone was up and at 'em so to speak.
Patients initially sleep due to the half-life of their meds...the body must adjust...that is why we as nurses must teach them not to drive or operate heavy machinery...secondly that mean look is one of the affects (remember patients have negative symptoms)...so you are witnessing the symptomatology and side effect of medications. Glad your group went well...
It’s been four weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you, how is empathy demonstrated by staff and psychiatrist? My experience at BCRI so far, has been an interesting one. I was so nervous at the beginning, didn’t know what to expect. But now, I feel more comfortable. The patients have been very cooperative with us in assessing them and getting all the information required to carry out our assigned tasks, and the staff are also very welcoming. The environment is like a residential place which even makes the patients feel more at home rather than in a psych ward. My worst fear on the first day was how I would be able to attain a good therapeutic nurse-client relationship with my patient, but it really wasn’t as bad as I thought. I was able to talk with the patients and even teach in a group with all the patients present at the group session. It was fun, they interacted more with us during the activity, and most of them seem to be very knowledgeable about psych meds. Which was very impressive for me. I think the patients are beginning to get comfortable with us. They do not see us as a threat but as care providers just as they see the other nurses, doctors and other staff members. So far, the nurses and psychiatrist have shown empathy, and seem to be doing a good job judging from what I’ve seen and comments from the patients.
Seems like you are acclimating to the milieu...so you were surprised by the know of the patients about their meds...thank the nurses...they have done their job!
Week 4 blog These four weeks at BCRI has been wonderful for me. The first clinical day, I was very nervous and scared. I was actually expecting to see violent clients but to my utmost surprise the patients have been so calm and cooperative with us. Some of the patients were a bit surprise to see us the very first day but by the time the teaching started they were all relaxed and were all answering questions and asking questions too. I was thrilled to see that they know their medications so well and that though they have mental issues that they were smart and human too. BCRI is unique because of the fact that patients do not stay there for long, in fact the average stay in the facility is about 5-8days so we meet different set of patients each week and maybe one or two from previous week. We haven’t experienced any violence at all and even when they do not want to talk they tell you politely. I feel at ease now interacting with them and having new patients each week has given me the opportunity to interact with different patient. I enjoyed every bit of the interactions and I can’t wait for my turn to lead the group. Most of the staff members are very happy to have us around. They willingly offer to answer our questions and happy to tell us their functions and the different kind of services they provide for clients however, a few of them are not really friendly. The nurses and the psychiatrists have shown empathy when approaching or addressing the clients. Overall, so far, it’s been an awesome experience and I can’t believe that I am considering becoming a psych- nurse.
Do I have a convert? Its nice to know that the experience has given you a different perspective about this field of nursing...you are always welcome to come to psych
After watching movies and hearing personal stories about mental health and being on a psychiatric unit, I had very mixed feelings. I was very excited but oh so nervous at the same time. Now that it has been three weeks and I have familiarized myself with my patient, as well as majority of the patients on the unit, I feel very comfortable. It’s funny to think about how my thoughts of being with these patients have gone from “be on alert, these people have psychiatric disorders,” to “Yooo, I could chill and talk with some of yall on the regular.” The only thing that separates me from my patients is the fact that they have a mental disorder, and I don’t (as far as I know). When studying for exam 2 on the topic of bipolar disorder, I read that those with this disorder are some of the most educated people. Boy has that fact really rang true. I was so dumbfounded to sit and just listen to so many of the intelligent things some of my patients have said in a conversation. As far as the environment goes, I was expecting a much larger space (like in the movies), but it is much smaller. It is spacious enough for the needs of the patients, but smaller than I had envisioned. The patients have their own rooms on the upper level; there is the dayroom where they can watch tv and/or sleep, and the activity room where they can play pool or cards. I The nurses and direct care personnel are always very relaxed, but are always observant and present when a patient needs them. They are very accepting of us there and will answer any and every question that we have (LOVE!) I feel very official having they key to the unit, but at the same time to DOORS! Every single door has to be unlocked to get into and locked and/or double locked after you leave; can be a nuisance at times, but I’m starting to get the hang of it. I love going to Spring Grove, it is an excellent learning experience that I will continue to make the most of.
It has been three weeks for Psych clinical rotation, unfortunately I couldn’t able to interact with a mentally ill patient or a staff member because there was no clinical instructor for my clinical group for the past three weeks. We spent the last three weeks at the school campus working on community mental health assignment and presentation with our class instruction Professor Day Black who worked tireless to get us a clinical site. Guess what, finally our group will be going to Spring Groove on Tuesday. I am excited, nervous and optimistic but I that with professor Day Black on my side things will be just great.
I really enjoy working with my patient. I did not think that I would enjoy as much as I do. Spring Grove could do some repairs such as change the color of the pea green paint to something brighter. I believe that it would help lift someone spirit. The carpet should be pulled up because it is holding smells and God only knows what else. I really like this population. I have had to set boundaries with my patient but overall he is very pleasant and nice. They are a lot of young people in there and it just breaks my heart because they should be out enjoying life not just ony them but everyone. The patients make me laugh. I really enjoy them. Some of them are really intelligent. You have to pay attention to what they are saying and they do actually make sense. Just as Pro. Day-Black lectuers there is alot of pacing, pressured speech, auditory hallucinations, and the smells! Some of the staff are not nice to the patients. I find this unacceptable, degrading and humiliating to the patients. I think they treat the patients that way is because they feel as though they can get away with it because the patients are sedated from their meds.Most of the staff treated the patients they way they would want to be treated I see myself working with the mentally ill part-time. The reason I say part time is because I get too empathtic. Overall I have enjoyed my experience at Spring Grove.
Glad to know that the lectures are congruent with your clinical learning experiences. Are you having countertransference? Oh...to paint the walls another color is an act of God...there are only three colors approved for state buildings...RBC #4 painted the dayroom bubble gum pink...the officials had a fit and it was changed back to the pea green in a few hours...
This clinical has been insightful so far. I remember the first week and how apprehensive I was. I have come to realize that there was no need for the apprehension. First and foremost, the patients are overall nice (maybe not nice to each other, I guess that is expected. They are teenagers, after all! :). Initially, my client was reserved, she did make an effort to open up a bit. She is a smart person, really intelligent, and knows what she wants.
One thing I noticed about the staff is that they are all involved. They work together, share and are attentive to the clients. They work in sync and that prevents any behavioral incident from happening. Probably due to their experience, they understand the clients.
The environment is as homely as it can be. Some of the clients do get to spend some time with their family but some do not have anyone. So, the facility is home to them. Safety is a priority; therefore, it is a locked facility. All in all, it serves the purpose; as a treatment facility but a place for these adolescents to call “home”.
Its been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
My thoughts on the arrival to the designted psych unit since the first time had really changed. At first I was scared and didn’t know exactly what to expect and now I don’t think its as bad. My mood turned around. A first I was scared to walk around without my clinical instructor now I can walk around without an issue. The patients not as bad as I expected. The site is still creepy to me but that’s due to the old age of the facility. Overall I’m more comfortable than I was at first.
FORTH BLOG ENTRY It’s been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
My clinical rotation is a Baltimore Crisis Response Inc. (BCRI). Initially my first thought about the environment was…. “Wow this seems like a half-way house”. But I now realize that although the environment is unconventional compared with other mental health institutions, the apartment- like setting actually proves to be very therapeutic for the patients. Being that the average stay at BCRI is only 5- 10 days I have been able to talk with many patients. The only downside to that is that you have a very small timeframe to establish a therapeutic relationship. The first patient I had was very open and willing to talk and had only been on the unit for one night. She had a diagnosis of Bipolar I and substance abuse. I want to talk with her more but as I was gathering more information from her chart I found out that she decided to leave AMA. The second patient I had was diagnosed with depressive disorder. She had been there for three days prior to our meeting and was very difficult to engage. She said that she wanted to talk but then didn’t say much. I tried with broad openings and open ended questions to which she responded defensively. She said “why are you asking me all these questions anyway”. I calmly told her that I’m only here to help and if she wanted to talk it was completely up to her. She said okay and started to open up. She talked about what brought her to BCRI, what her treatment goal was, and one coping strategy that is helpful when she is feeling sad (which was prayer). The next week I saw her again. She was a lot more willing to talk. She even participated in group and laughed and smiled at some of the responses. My third client allowed me to do a mini mental exam. He was diagnosed with depressive disorder. He was very open, participated in group, and was very funny. When doing the step on the mini mental counting backward by 7’s he said each number correctly in seconds and continued all the way down to number 2. I was amazed… I double checked on my phone and each number was correct. The sentence he wrote was also pretty funny. He wrote “I am trying to figure out the purpose of this”. The staff is great. They are all very friendly. I was able to complete my charge nurse experience coordinating group times, client interaction with students, pre and post conference, and getting and receiving report from the charge nurse and CRU lead staff. I have really learned a lot. I am surprised that I do like psych as much as I do however, I am not ready to sign up to be a psych nurse just yet.
Sounds like you are having a well rounded experience...thanks for sharing...glad you were able to interact and get an assessment completed. How did it feel to be in charge...
PATRICE WILLIAMS It’s been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
As clinical has continued. I realized that the environment, patients, and staff are not as bad as I thought they would be. I was originally very anxious because it was a new environment and I had never had to give care to 100% psych patients. I have always given care to those that may have some sort of psych issue as it related to an underlying medical condition. However, after getting into a routine and talking with my patient, I became a little more comfortable and relaxed. I realize that everything takes time and comfort comes with experience. As I get more experience in clinical, my therapeutic communication with the psych patients is improving. Also, the staff is helpful, but honestly don’t do as much work as I thought they would do. The patients, for the most part, are friendly and their behaviors are predictable. I can usually tell when someone is agitated and may get aggressive so I give them their space and come back in a few minutes when they seem calmer. So far, I am enjoying clinical and learning a lot.
What was your expectation of the role of the staff in milieu management...the psych environment requires a different skill set from your other discipline specific clinical rotations...its all about safety and meeting the patient's basic needs.
After returning to my designated Psych unit, my initial thoughts and feelings of being nervous and anxious have drastically changed. After being acquainted with the unit and having the opportunity to introduce myself to my client, I felt more comfortable with the atmosphere and environment. I was not afraid of being surrounded by the clients, but was interested in learning more about each one. In fact, when my time was cut short with my own patient while he was telling me his life story, I was disappointed, as I wanted to learn more about him and his experiences that led him to where he is now. I was not able to interact as much as I would like to have with the other staff on the floor, however they did seem very nice and welcoming to any questions we had. All in all, my clinical instructor helped me open my eyes by doing clinical activities with us, and helping us put the knowledge we have learned in lecture, into practice. I am excited to return to clinical next week and see what else is in store!
Approach the staff, techs, social worker etc to get additional information...they love to show off for students...make sure you ask the nurse questions too...
Mental Health Clinical – Week 3 Today marks my third week of clinical, I am extremely happy and more relaxed, looking back; I came to realize exactly how tense and anxious I was during and immediately after my first clinical day. Now, after completing the “I don’t know what to expect” phase that characterized the first and second clinical days, I can truly piece together how I was actually feeling this past clinical day. So today I know my way around RICA, didn’t have to wait like a stranger in a deserted Island. I got around pretty well with my anxiety level depilated; I was able to focus on meeting with my client and conducting my assessment. Then came another anxiety, the uncertainty associated with not knowing if my client would cooperative or not. If he was going to be in the mood to volunteer as much information as I need to complete my assessment. I have been to clinical before, but It is one thing to walk into the room of a sick, vulnerable stranger with a nurse preceptor directing and guiding you, it is a different ball game when you are face to face with a patient you just met with no idea what to say to him, or even whether to sit or stand, or where to begin. I just wanted to act naturally and pay all my attention to the patient like a caring nurse, but I was aware of how unprepared I was. For one moment everything I learnt in class disappeared. I was unarmed intellectually. At that moment I came to the realization that my success in completing my assessment would be partly dependent on my approach and interaction with the client and this requires professional skills. Now I appreciate why people have to go to school to learn how to work with this population, but believe it or not anxiety sometimes brings out the best in us. Within minutes I was interacting with my client like we had known each other for ages. The staffs in the unit were very helpful and cooperative one can tell they have been doing this for a while. They were very professional too. RICA environment is very appealing and relaxed, I have been to some state run mental health institutions, but I think RICA is the best; it stirs up the temptation of wanting to become a psychiatric nurse.
Week Four: As we can see time has passed by very fast in our clinical experience. Since I have been at Spring Grove I must say I have enjoyed myself. My patient is the sweetest guy, I don’t even notice that he has a mental issues. I try to treat him with respect and I see that he enjoy not being treated like a crazy person. My patient is very open to answering questions and he love to help out as much as possible. Last week my clinical group did a group section with all the patients and it was fun! In our group we exercised, it was nice to see the patients moving and have fun. But one thing I have notice at my clinical site, I don’t see the nurses enacting with the patient as much, I just see them give meds and that it. It sad because sometimes all the patients just want is a little conversation.
The nurses are deferring to the clinical group...remember you are the nurses for the day complete with a student charge nurse...the unit nurses and patients have a long established relationship and engage advocate to patient in their weekly one on one....the nurse is responsible for all 30 + patients and must know and follow the treatment plan of every patient regardless of disorders, interact and plan care with the treatment team, provide structure for the shift, give out assignments, make sure patients get meds, treatments, see doctors, address lawyers and the judge, manage illness, provide psychoeducation, chart emergencies, monitor and chart effectiveness of meds and the list goes on...the techs serve as the eyes and ears and will alert the nurse for the need for additional intervention...the techs are highly trained in aggression management and even therapeutic communication...check out the patient's schedule to see groups the nurses initiate....
The site of my clinical is quite different from what I thought it would be. I didn’t expect a site so close to residential area (other sites I have seen were locate away from residential areas). I also expected it to be locked down. At this site, you cannot come into the facility without being let in, but you can leave. I don’t know why, but this made me a little more comfortable, maybe because it suggest that danger is more likely to come from outside the facility. The clients weren’t exactly what I expected either. I expected them to a little more “crazy”. They are for the most part relatively normal, but hey normal is relative. Anyway, I have found the clients to be mostly approachable and open. Talking to them hasn’t been as scary as a thought. The staff has been friendly and informative when approached. They also been a little more hands off then at other clinical sites I have been to. I would have expected different. All in all, I am learning a lot. Even though I was nervous about conversing with the clients, I have found that for the most part they are not difficult to talk to. Most have been open and some have been excite to have someone to talk to. Because of them I am learning more about the symptomology of the conditions and the people behind the diagnosis.
RICA has been tucked in the Beechfield neighbor seems to me like forever. Residential unit has to be locked for the safety of everyone including the neighbors. The teens can be explosive. They are taught how to control some of their rage. The staff provides external controls to help them using a matter a fact approach which seems harsh to many of your class but necessary.
With three weeks gone by so far I am disappointed with how much the state institution has fallen apart. I do not like the conditions that the patients are in. The actual buildings are falling apart and two small for what I would say are the new standards for living. If the patients are not incarcerated, then I feel like the accommodations should be better. An example of this is the way the locks work. My biggest fear right now is not being attacked but not being able to unlock the door because the lock is not consistent and there is a certain way one must hold the door in-order to get it open. The grounds on the other hand are pretty spectacular. As far as the patients go, I enjoy them. I like the differences between them all and them and watching them interact. My Patient is going through some stuff right now and it is interesting because I am able to watch my patient go through symptom changes and question why these things are happing. Using my knowledge in practice. I have mixed feelings about the staff. The staff to me resembles the movies and show portals, the staff tends to treat the patients like children and I can see the patients responding in discuss. I do feel like I am growing as a healthcare provider, I am not worried about anything happening and feel a sense of protection towards the patients.
Right a letter to your new Governor about the need to spruce up the place...students have made educational posters to go up on the walls....report the lock issue to the charge nurse...now that's a safety issue for staff
After a few weeks at Spring Grove facility I have grown to like the place. The patients welcome us as soon as we get through the double locked doors, they all want to tell us about their days, weeks, year. After playing medication nurse, I've learned how differently patient's react to the person giving the medications. Not so nice. Once the patients take their medications, the interesting side effects like swallowing cups and cups of water still remaining thirsty. All in all this is definitely a fun and interesting clinical rotation. I never know what to expect, and it's always a great experience every week.
Overall, this clinical experience has been wonderful. It did not take me long to become acclimated with the environment and the patients. In addition, my clinical instructor and the hospital staff have been very helpful and informative regarding nursing roles and how tasks are carried out throughout the day. Being in the clinical environment has helped me to get a better grasp on the information we have learned through lecture and textbook readings. It has also helped me better understand the importance of mental health care in its entirety and how important it is for the general public to be aware of various mental disorders and clarify misperceptions of mental health.
The last three weeks working at my clinical site has been interesting. I feel as though I'm finally getting into the groove of things and what to expect during clinical. I will say my clinical site is not exactly what I expected it would be. I expected to find patients that met the ideal idea of a "psych" patient. I haven't yet seen any patient exhibit signs of bipolar or schizophrenia. Most patient at BCRI have substance abuse dependence and an underlying mental health issue such as depression. Most clients I have interviewed the last 3 weeks all were struggling with addiction and were there for help and how to cope and manage their problems. Also since the clients stay at the facility is usually no longer than 5 days we see a different client every week so I am unable to form a therapeutic relationship.
Engaging the client for whatever interactions you have is the therapeutic relationship...its not the amount of time but the quality...the goal is help the client grow
Week Four One word to describe my three week of clinical, since my arrival is “Unbelievable”, when I compare the memories of the night before my first clinical day, it was restless, sleepless, and high level of anxiety. Now I kept anticipating my next clinical day, when I can interact with the patients. This has been and amazing and humbling experience for me, when I look at the patients smiles, and the joy and appreciation they have for us as students, how grateful they are to us for spending time with them and trying to know them. Of course, there are those who are very vocal, and our Professor will set limits immediately, but those few cannot tarnish my joy in knowing these patients. When shadowing the nurse administering medications, I was amazed to see how much they knew about their medications, and what time they preferred to take certain medications. I asked the nurse about new orders for patients, new orders was the same procedure in hospital it is fax to pharmacy and pharmacy deliver it to them, which is on the same property. In addition, lab technician, who comes in morning, draws Labs. Staffing is somewhat laid back, some of the protocols were to have head count on all the patients every thirty minutes and document, there are also finger stick testing for Diabetic patients before meals. Overall, my experience at Spring Grove for past three weeks has been very interesting, and I am hoping to learn a lot more from these special individuals, who has humble me and thought me to, “never judge a book by its cover.”
I am really staring to enjoy my time at RICA... My first day at the facility was quite overwhelming for a few reasons, one being I have never been in a psych facility for teenagers and two after reading up my clients chart brought a lot of emotion both good and bad. week three was a lot better than week one. when I arrived at Rica, the residents where outside in the courtyard playing cards and interacting with each other. my client on the other hand was dancing and asked me to join her. I immediately did with no hesitation even though I was embarrassed because every one was watching us I still went ahead and danced with her to gain her trust and also to let her know I am here for her. After our dance we talked and she was open about her feelings than she was the first week. The staff in C cottage are very welcoming. There's usually one RN, and LPN and three CAMHS supporting staff on duty at all times. The CAMHS staff assist the residents with activities, meals and take them out for weekley shopping. I look forward to week five tomorrow!
Week #4: It’s been four weeks since your arrival to designated mental health hospitals and/or community settings. Reflect upon your encounters in the environment with the patients/families and the staff. How is empathy demonstrated by psychiatrists, by nurses?
I was assigned on the boys unit at RICA. Upon my encounters in the environment with the patients, the staff were very skilled and empathic with their patients. When I first walked in the door I was so scared, after I sat down talking with the staffs my fear went away. They were very professional, they knew empathy is not a word to be taken lightly. It is as serious as it gets. In other words the nurses on the boys unit go into the patients’ mind and get an appreciation of where they are coming from. Throughout the semester prof. Day-Black been teaching us that there is usually more to the patient’s condition than is visibly obvious. I finally understand that concept. The act of being empathetic towards your patients, although felt on both an emotional and spiritual level, also allows for therapeutic detachment which is needed in order to be able to do more for the patient. In as much as the nurse steps into the patient’s shoes, he/she is able to stand back, assess the patient’s situation and see it for what it is whilst maintaining professional objectivity because it also allows for an intellectual discernment.
Week #4 Three weeks at my mental health clinical site went so fast like three days. My initial impression about the facility –Baltimore Crisis Response Incorporation (BCRI) was a first –aid treatment center for mental illness or psychiatric emergency. Also I did not know that it is a residential or inpatient center. However, I was pleasantly surprised when I learnt about the operations and various activities of the center. I was not frightened when I got there because I deal with clients who have mental health issues at my job. The difference is that those at my clinical site do not stay long in the center for treatment or therapy. It was however an informative and educative experience. The clients initially were not receptive thinking that we are just going to bother them. So we were seen as intruders. But after the first week, they changed their attitude to us particularly when my colleague led the first Group meeting on Nutrition and served them free fruits and candies. All of them were treated to good and sweet fruits. The staff were receptive, friendly and pleasant from Day 1. They were very helpful too. The Director of the Center and Charged Nurse gave us talks which were very informative. I hope to learn more and enjoy the remaining weeks of the clinical rotation
How nice of the Director and Charge Nurse to engage students. That's a plus in my book. You will find that patients are suspicious by nature. They have been physically,mentally, sexually and spiritually abused. They are rightfully guarded. Consistency, genuineness, honestly and respect is the key to getting in.
Week 4: It’s been four weeks since your arrival to designated mental health hospitals and/or community settings. Reflect upon your encounters in the environment with the patients/families and the staff. How is empathy demonstrated by psychiatrists, by nurses?
This is my fourth week of experience in psychiatric mental health clinical. For me, this has been a period of gaining new information and having double experience. At first, I was posted to spring grove hospital which on my first clinical day I went there; unfortunately, we were not able to see a patient. On the second day of my clinical, I began community mental health experience which is excited because opportunity was giving to us to research and search for resources used by the homeless and mentally ill client. Another thing I benefited was knowing the correlation between homelessness and mentally ill. However, I have not had an opportunity to encounter a client, family member or his or her environment, but, the good news is, we will be going to spring groove on Thursday morning (20th) to work with patients, thereafter, we will also visit some agencies for homelessness.
Glad you enjoyed the first half of your clinical experience. See you in a few hours at the Grove. Its sleep time ...just finished commenting and grading all the blog postings.
Wow I can not believe three weeks have passed so quick. I really enjoy the mental health environment. It has been a pleasure working with and learning so much about mental illness. Even though the patients have illnesses, they are still human beings. I believe that the patients are lacking support and attention that they long for. In clincal we completed a group with the patients that was titled, "Minimizing and coping with stress." During and after the group the patients expressed some concerns that they had with their environment. Majority of the group expressed that they do not get any attention and that they feel like they are alone. After this group session, I noticed other reasons why the patients feel the way that they do. I initially started off the semester not really like mental health, however, now I can see myself working in this field. As for the staff, I believe that they lack certain skills that should be required to work with the mentally ill, for example, therapuetic communication. I have heard some of the conversations the staff members have with and about these patients and I find it degrading and unappropiate. Everyone situation is different, however nursing care should focus on the client holistically.
Institutionalization much like the prison will breed apathy by employees. Why? This is a long term unit. The chronicity of mental illness and no improvement day in and day out is another factor. Staff are genuinely fearful of the forensic nature of their jobs and feel they have not received appropriate training to address the needs of patients with mental illness and maintain their own safety. How they talk to the patients is often their way of maintaining control. Can't make excuses for the staff but talk with them one on one...start out by saying you don't know how to engage the patients therapeutically in dialogue, what do they suggest? You will find out that they do have the knowledge base...
The weeks have gone by faster than I expected. It doesn’t feel like we’ve been on the unit that long but I think that might be because we went to the Alzheimer’s forum. I will say that I do feel more comfortable than I was on the first day. The patients are warming up to us and talking to us more so that makes our day more interesting. I still don’t really like the environment of being locked in and the smell is horrible but I usually get used to it as the day goes on. I don’t really have much to say about the staff. I don’t really see them do much. I see the techs doing head counts and helping with meals. I also observed the medication nurse give out medications to the patients. As majority of the time the staff is standing or sitting around and I guess they are just observing the patients’ behaviors.
Observing and maintaining safety for all is a major component...please scroll through some of the other postings...I have explained the function and roles of the RN is detail...Feel free to engage the RN or any of the other staff when you are back on the unit especially the SW...they are a hoot.
Initially when thinking of a mental health clinical I was filled with feeling of nervousness and anxiety. I must admit that before being equipped with the proper knowledge and exposure I had many false preconceived notions about doing a clinical at RICA or any other mental instituation. Before, when I thought of a mental institution I thought about all white rooms with padded walls and patients in strait jackets. After visiting RICA I learned that I was sadly mistaken. I am pleased to report that there were no padded rooms or straight jackets (that were visible). The institution is extremely modern and well kept and each patient was treated with the utmost respect by the staff. My patient was also not what I expected. I was expecting an unruly, out of control, loud patient who would be completely disrespectful. However, he was the exact opposite and has never given me or any of the staff a minutes trouble sine I started the clinical. My patient and I have a great time talking, playing cards and other board games. Overall, this has been a great clinical experience because it exposed me to something that I was unfamiliar with and now I feel that as a nurse I will be better prepared to handle all types of patients and give them the best quality care possible.
Sounds like you have a change of heart about patient care with adolescents at the beginning of a long road of hospitalizations across their lifespan. Those with the best prognosis, stay consistently on their meds and have strong support systems.
Spring grove hospital has been a good experience thus far. The staffs are very welcoming and are quick to advice about patients. Before starting the clinical, I was a bit apprehensive about being in the mental war; I’m more comfortable in being in the unit. I interact with most of the clients. We even engage in playing games and talking about life in general. Although I know I still have to be very vigilant because some of the patients are aggressive and still very delusional, my fear of being in the unit has subsided. I've learned a lot in being on the unit and from the different tasks that have been appointed to me. Being there has made me very self-aware and has shown me how to communicate therapeutically with patients. I do feel a little sad for some of the patients there that are there just because they have no place to go. I feel like there should be another place the patients can live besides being in a locked unit. When my group had a group meeting with the patients, One of the patients stated “I am really happy you all are her with us to talk to us and help us, because most people look at us like we are so different and they put us on the back burner” after that I said to self, I have to be a part of making a change of how the way people think and how mental health patients feel like no one cares.
Time flies; we are already in fourth week of our clinical. I am assigned to Spring Grove hospital center and I did not get chance to interact with the patient yet. But we are working on our group project about community mental health. It was fun to work in this group project and we get to learn about the mentally ill and homeless people in community. We are going to visit some centers that take care of homeless as well as mentally ill patients which will be a new experience. We will be going to Spring Grove hospital center from this week and I am excited as well as nervous for that. Overall, I get to learn about the mentally ill patient at hospital as well as community.
I am excited to hear your presentation on the state of homelessness and mental illness in Baltimore and learn more about the agencies you visited. Prof. Hart's group is also visiting agencies that work with those with mental illness. You will get to compare the hospital experience with community assistance. See you at the Grove in the am....
Since coming to spring grove I had learned a lot about the way that psych patients act. It’s one thing to read the signs of mental illness in the book but it’s a total different experience to see and experience it in person. I have conversed with patients with schizophrenia, bi polar disorder and various others we have learned about this semester and it has been very enlightening. As far as the staff, I have noticed that a lot of the people that work in brick cottage 4 do not talk to the patients like human beings, mostly they talk to them like they are children in a very demeaning manor. I often feel uncomfortable listening to the way the nurses talk to the patients, it’s like they don’t even care that they could be hurting their feelings. I understand that the patients can be very challenging at times and the nurses may be dealing with issues in their personal life but I feel that its not a good enough excuse to not treat the patients like humans. It may not be that during the day but the evening staff seems to always feel annoyed and on edge. I feel much more comfortable conversing with the patients than I did the first week. I am learning their names and who is social and enjoys our company and who doesn’t.
Everyone that employed in nursing at the Grove is not a psych nurse but a nurse who work at a psych facility. There are real challenges to working with a mixed population of forensic and psych patients. The biggest challenge is the fear of being hurt which is real on any given day. Historically, and often times patients are seen not as human. There are some cultures who do not necessary believe psych is a real discipline but believe that the patients are possessed. There will always be good nurses and poor nurses...You get to choose what type of nurse your want to be.
wow! Time goes by fast. I am at spring grove mental institute, first of all the smell of that place drives me crazy, and I am not sure if any of the nurses do any work at all, because they just sit around and do nothing. Secondly they do not interact with the patients at all. However, the few weeks we've been at spring groove I have learned a lot from the patients and our clinical instructor. Being here has helped me understand things better. What I love about clinical is interacting with the patients; we engaged in many activities with the patients, and they seemed to enjoy it.
Psych RN use observational skills and utilize their support staff to be the eyes and ears of the unit. You have to remember that the unit is a long term chronic unit. Some of the patients have been their several years. The nurses are involved in med management, maintaining safety, planning care with the treatment team, they do groups too and as an advocate meet with their patients for one to one therapy session once a week. Before you arrive, vital signs, treatments are done. Talk with the charge nurse and ask her questions about her duties...you will be surprised....
Since beginning clinical rotation for psych I have become more comfortable with talking to patients. I was required to lead a therapeutic group, in which I was extremely nervous in performing. Once I started and began to get participation from the patients I was able to settle my nerves. I am currently doing my clinical rotation at Baltimore Crisis Response Inc. The staff is nice and accepting, which is refreshing because in past clinical settings some staff were not so welcoming. The patients have been welcoming and supportive to us as students. I have found them to be open and willing to talk to us. So far I am enjoying my psych clinical.
Were you surprised by the response of the staff and patients? Hope your first attempt to lead a therapeutic group will not be your last in nursing in general....remember to have clear learning objectives and plan out your group
Since starting the clinical at RICA, my prior misconceptions have changed tremendously. I find myself enjoying going to this particular clinical location because for the most part the kids that are here are awesome and have a lot of character. Also a majority of the time spent at this clinical is interacting with the kids either through them directly talking to us or them just wanting to play a game. Also I like this clinical because the kids seem to really enjoy the time that the clinical group is there and are often disappointed when we leave. The environment of RICA is somewhat clean and the kids have their own individual rooms to give them adequate space. The staff are good with kids and give them boundaries while still attempting to maintain a mutual level of respect. The staff are polite to us, but they are not overly inviting. While Ive been at this clinical site for four weeks, I've only interacted with my patient a few times due to the fact that he either doesn't feel like talking or he's in seclusion/"the quiet room". One of the best aspects about this clinical is getting a clear picture of a disease or condition by seeing it in the patients, it really helps with infusing the descriptions from the textbook.
It has been three weeks since my arrival to Spring Grove, and I’m singing a different tune. I love psych clinical now. I enjoy talking to the patients and watching their behavior. I have not felt as anxious lately…I’m warming up more and more each visit. I love the fact that there are forensic patients on the unit because I would like to be a forensic nurse, and I’m learning that psychiatric nursing plays a major role in forensic nursing. The old look of the building and the smell still bothers me at times, but I’m getting used to it. Me and my patient are building a great therapeutic nurse-client relationship, and I actually think about him during the week, and I look forward to seeing him on Tuesdays…as well as some of the others. I’m starting to think about the termination phase of this…I hope it isn’t too hard.
After getting over the initial shock of the 100+ old building, no computers, poor lighting and cold temperature, its not so bad...glad you are acclimating and building a nurse-client relationship
For me, being enclosed in a psychiatric unit it stressful. I understand that every door being locked is for the safety of the client, but at times I don’t feel safe. The thought that I cannot just runs gives me a heighten level of fright or flight. The staff is all dressed down so it is hard to distinguish nurses from other staff. Some of the staff is not so nice to clients while others are caring and genuine. The clients seem to be moving in a positive direction. One kid drank a bottle of mouth wash and was confined. This incident disturbed the milieu a great deal.
Not having a key can make one feel trapped....uniforms are often a barrier to communication...one of the reasons we came out of white uniforms...most psych units, nurses wear professional attire, its only been in the last few years that nurses started wearing scrubs, usually colorful tops and solid bottoms...being professionally dressed keeps you on even footage with other professionals of the health care team. Nurse will often wear a white short lab jacket to perform tasks. PS the staff has keys (lol)!
Before arriving to Spring Grove I had a picture in my head of how the facility would look. Beige walls, white floors no furniture, and a sad and creepy feeling. to my surprise when approaching the Red Brick Cottage the outside looked like brick homes but the inside was more like the picture I had in my head. The patients were actually walking around in their own world( most of them) while others looked as if they could be part of the staff. The head phones confused me at first but then it was explained that the head phones were used to keep the voices out of their heads (distraction). The staff well what can I say they were all surrounded and sitting near the entrance. I guess that was to keep an eye on every one and to keep them from the door. It was surprising that most of the time you did not see any of the nurses on the floor. I thought to my self that's weird or maybe it's the norm for a psychiatric hospital. For myself I never thought I would be able to actually carry out a conversation with a truly mental patient. Come to find out I was wrong I have enjoyed conversing with the patients an realized that even though some of us may have problems mental or otherwise we are all human.
Surprise...you state that you are enjoying talking with the patients...good...the early stage of the nurse-client relationship...sharing, offering of self...milieu management requires awareness of the location of all patients...so sitting in the hallway gives you a bird's eye view...Go and talk with the nurse and as about all of her duties...the techs serve as the eyes and ears...
Now that I have been in clinical a couple weeks I am beginning to feel a lot more comfortable. I have been able to hold discussions with patients and not be so apprehensive. After leading a group on simple exercises I felt a lot better about being teaching the patients and answering there questions. From being around the patients and getting to know them individually it made it easier not to stigmatize them but rather view them as individuals. Since I have evening clinical we get a lot of time with the patients in the game room and I have just as much fun playing the games as the patients do. With my patient in particular, she has her moments where she is stable and because she is elderly, it’s like you’re talking to your sweet old grandma. This makes it easy to do her interviews because she is so willing to talk and give a lesson. However, it never ceases to amaze me how immediately after she says something sane she then says things that show how extremely delusional she is. Many of the patients seem to have their moments of reality where they seem to be just like me and you and then they do or say something that is completely abnormal. That actually was one of the surprises for me because I incorrectly assumed that once you are titled mentally ill you are always “out of it”. But these patients aren’t having delusions and hallucinations every minute of every hour. The staff seem to be nice. I do disagree with the fact that all the staff go to dinner at one time except for one who is left alone to monitor everyone. During that time we noticed the patients were extra sneaky. As far as the facility I still find it old and creepy.
It’s been several weeks since your arrival at designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
Before I started my clinical rotation at BCRI, I had fear of the unknown. I had already conjured up this image in my mind of clients who exhibited the “market mad man” syndrome. I imagined walking into a chaotic “terror unit” replete with individuals who would scare the life out of me. I imagined some pacing back and forth with no rhyme or reason and muttering unintelligible words to themselves and imaginary people; others spewing forth expletives, some in various stages of undress and yet others with faces contorted with fury, eager to attack anybody in sight. I also pictured an overworked frustrated staff that would probably take it out on a bunch of poor nursing students. But I breathed an audible sigh of relief and even laughed at myself for letting my imagination run so wild. I was pleasantly surprised by the group of clients we encountered on the first day and on subsequent visits. The clients are high-functioning and conversant with their medications and their diagnoses. One told me he was on Zyprexa and Congentin. They actually enjoy the presence of students and most of them actively participate in the group therapy sessions. They are also cooperative in one-on-one conversations. With more visits, I have gained confidence and even begun to look forward to meeting with the clients and practicing my therapeutic communication skills. They are able to verbalize their goals and needs which range from finding a place to stay (many have substance abuse issues and are faced with homelessness), and the need to comply with medication and other forms of treatment. Last week, I had an opportunity to be the charge nurse and enjoyed discussing the plan for the day and activities with the actual nurses on the floor and members of the crisis response unit (CRU). There is a multidisciplinary team at the facility comprising doctors, nurse practitioners, nurses, patient technicians, case managers and members of the CRU. There is an atmosphere of mutual respect for each other’s role and team work. I only took issue with esthetics because the facility is housed in an old high-rise building that has seen better days. The hallway looks a bit drab and the floors could do with a new coat of waxing. The curtains need to be replaced and the general décor improved. But I guess these aspects do not compromise the delivery of quality mental health care to the patients.
You can't judge a book by its cover. Quality is the key. Sounds like clinical is going well...glad you have gained confidence in your nursing abilities.
Since being at my facility for three weeks now I have encountered many strange/abnormal behaviors among the adolescence, particularly the girls. I have seen demonstrations of sexual behaviors or gestures among the girls and most importantly I have witnessed lazy and inadequate staff members. For me, my thoughts and concerns are mainly about the staff’s behavior towards the patients, and less about the patients’ behaviors. Because first off, the staff are supposed to be trained professionals whose duty is to care for the patients effectively; which I believe they have failed to do. The staff members in my opinion are paid to do nothing, which is sad because parents and the state trust them for the care of theses adolescents who need the best care, but sadly they are not receiving it. The adolescents are sent to these facilities for a reason, which is to receive treatment for their mental health disorder therefore its normal for me observe odd behaviors among them; but for the staff to demonstrate poor conduct and inadequate care is unacceptable. But on the bright side I truly enjoy going to my clinical site and observing the adolescent girls interact amongst each other.
Strong opinion...Nurses or Techs or both...when you say lazy what do you mean? How do you quantify poor conduct and inadequate care? Are they providing custodial care? RICA is not a hospital but a residential center? Does that make a difference? Just questions????
Its been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
As a member of the Community Mental Health clinical group, for the past three weeks, I have been working in my “designated psych unit” – the city of Baltimore. My patients have been the mentally ill and homeless population within the community, and the staff have been the various agencies and programs within the city that exist to serve the needs of the client, which is the community. My thoughts and feelings about the environment is that it can at times be harsh and insensitive to the needs of the vulnerable members within the community. This is why there is such a great number of homeless and mentally ill members within the city of Baltimore. On the same note, amazing organizations such as My Sister’s Place and Healthcare for the Homeless causes me to know that there are some patches of warmth and consideration for the needs within the city, as evidenced by the excellent services they provide. Examples of these services are three meals daily, job training, transitional housing, and educational programs. Other services include medical care, dental care, addiction treatment and case management. These are services that “the staff” provide for the community, which is the vulnerable population. These services cause me to realize that the environment is not as cold and heartless as it may appear, but that there is genuine care and consideration that exists. All of these things make me feel encouraged about the types of services that are available in the city to respond to the needs of mentally ill and homeless individuals. As for myself, there is a greater sense of readiness and willingness to join the team of those who serve within the community, both now (perhaps on a voluntary level) and in the future once I am fully licensed as a registered nurse.
Week 4 Blog Before I arrived to Spring Grove, I felt a little nervous. When I first arrived to Spring Grove I thought, “Wow, this place is beautiful”. The landscape and entire campus is just beautiful, but I just felt a little bit of sadness for some reason. I think it was because of the trees and how some people spent their last moments before they ended their own lives. When I got to the Red Brick Cottage, the patients were excited to see us. They all got up to say “hi” and the ones that were too shy to speak were stretching their necks to see us coming through the door. Then as I looked around I thought that this place was not very comfortable for anyone. For the most part the patients were all great. Some of them were not as nice as we would like, but that was expected. I also noticed that the staff wasn’t wearing any uniforms or scrubs that would easily identify them as staff. The only hint someone would get from staff would be the badges. The food was not very appealing which triggered more sadness, because well, the food the patients were eating every day just didn’t look at all too good to eat. I met my patient, and I finally got what Professor Day-Black was saying about how the patients were like little kids. It kind of made me smile because some of the patients really have a sort of innocence to them like kids would. It was still frightening when some of the patients began to argue back and forth to each other because they were easily 4 times my size and all I could imagine were two huge men wrestling toward me. I was somewhat comforted by the security because he was laughing and cracking jokes about the situation so if he wasn’t worried I shouldn’t be right? No I was still nervous. My patient is delightful and makes my experience well worth it. I really enjoy this clinical now because of how fun and enjoyable the whole experience is.
It is interesting how you describe the peacefulness and calmness of the outside setting and its contrast with 100+ old buildings. The food is on a cycle menu...Unless the patient has family or some income, its three hots and cot but I heard its better then the food served in the jail. Traditionally, psych staff do not wear uniforms. Scrubs are optional. Badges and keys sets them apart from the patients.
Its been three weeks since my arrival at red-brick 4 at Spring Grove Health Center. For the most part, I’ve grown in my bearings of how to best deal with those with mental illness. First of, the environment is certainly not to my liking, and certainly not to a lot of the patient’s likings either. There are designated places for recreation, eating, sleeping, and TV watching; all of which are scheduled and the time allotted has to be respected. This certainly deters from the feeling of home, even when a significant number of the patients refer to this place as their long-term home. Second, my attitude towards the patients has evolved into actually developing an understanding of their situation. They are simply patients who intend of having a having a physical ailment as I’m used to seeing, they have a mental illness that affects their behaviors. Even though I’ve heard this sentiment lectured numerous times, I think I have finally gotten an insight into what it entails. Third, I’ve observed that the staff are respectful and courteous to the residents. Not once have I observed any demeaning or degrading behavior portrayed to the residents by the staff. The only negating aspect of the job that I’ve seen(I’m probably biased), is the amount of sitting, observing, and charting that goes on. I personally don't think I could bare to sit that much. I guess one isn't forced to sit down and can very well stand so long as they fulfill their job requirements. Finally and overall, I think I have finally got my wits together on how to be comfortable with myself while dealing with those with mental illness.
Self-awareness is a plus. You have provided a very good overall to your experience thus far. Psych RNs do alot of sitting, observing and charting...but they do other things like keeping 35+ patients and 5 staff safe every shift is an art
It’s been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you? For me the clinical experience has being great so far, since the first day I couldn’t wait to report to clinical. However, clinical at BCRI like any other site has its challenges, the first thing is the parking situation. Because we can’t use their parking space sometimes we have to park four to five blocks away from the building, due to street cleaning you have to be vigilant about what side of the street to park your car on. But once in the building the clinical is very informative. Professor, Hart works at BCRI when she is not teaching, this allows the students to work very closely with nurses at the site. Overall the staff is very helpful in answering any question we may have, they have positive attitudes, and at times they even go out of their way to make sure we feel comfortable with clients. Professor, Hart is very knowledgeable and respected by the people she works with at the clinical site. As an advocate for the patents I truly believe the building really needs to be remodel in order to uplift the sentiment off both the patients and the staff
Heard they have a new building project on the way...Prof. Hart is knowledgeable and well connected...you will find the psych is a small specialty thus real psych nurses all know each others especially the good ones...sorry about the parking situation
it has been three weeks since i started going to Spring Grove and so far i have had an amazing experience. the nurses are very friendly and the environment has help me to learn a lot. my first day at the unit i remember thinking how i was going to interact with my patient and other patients on the unit. and up till now i can actually say it was an amazing experience. my first interaction with my patient was at the medicine station. I had the privilege to work with the nurse who was giving out the clients’ medicine and through this; i got to meet most of the clients and also associated names with faces. It was at that moment i met my patient; he was oriented and appeared stable. I told him i was going to be his student nurse and i will be looking forward working him every Tuesday. He sounded delighted and willing to cooperate. One thing I observed at the medicine station was that most of the patients knew the medications they were on; they quickly questioned a medicine they were not familiar with. i enjoy the environment and its quite easier to interact with the patients. on my second week one of the patients was aggravated and hallucinating. that has been the odd experience and so far i really enjoy my three weeks experience.
Glad you were exposed to the medication administration process...the nurses pride themselves in making sure the patient's know their meds and side effect.
These last couple of weeks at clinical have been very interesting. I love my clinical group we get along so well. I love working with our professor that we have. I am used to working on an actual psych unit in a hospital so these cottages are very new to me. I feel very closed in because the space is so small. I be having thoughts that what if the patients decided to riot and take over the unit how will the staff react to that because it is very little of them and so many patients. When I come on the units it smells so bad because the patients do not take showers and they where the same clothes every day. It is there right though. I like interacting with the patients they have a lot of stories to share. Don't know if they are true but they sure are interesting to hear. My patient is really nice and laid back he is always happy to see me and share how his week has been. I sat in on rounds one morning and they were talking about a patient who was causing conflict between some of the staff. I asked did the patient have borderline personality and they said yes..I immediately knew they were using the splitting mechanism. Can't wait to see what the next couple of weeks will be like in clinical.
It has been 3 weeks since I started going to RICA and so far Ive had a great experience. The nurses there are very welcoming and eager to answer questions and teach you anything you may not know. The clinical aspect is great, its amazing to me how intelligent my client is, I was shocked to learn just how much information he knew about his own illness, reminded me never to judge a book by its cover. Even though we are not allowed to administer any medication however we had to learn about the medications and even gave a presentation of a medication of our choice. The most complicated part of the day is after the clients have had dinner, they get very active and dont want to go down for their quiet time as a result some of the clients get very aggressive and even curse out the staff. Usually once the staff reminds them of the consequences of their actions they usually do what theyre told.
Its so important from the onset of mental illness, that the client learns how to manage symptoms. The nurse is key to education to help with adaptation to their level of wholeness (Levine's model). Psych RNs need to be/stay current in medication actions/side effects and cutting edge (evidence-based) treatments to help the client manage effectively. Its most important that you be able to identify normal adolescent growth and development trends and what is abnormal acting out behaviors. Everyone needs limits and consequences for inappropriate behaviors. This is the premises for societal norms.
When I first walked into the Psych unit, the first thing that came to my mind was how old the building was. Today being my first time on the unit (RBC 4) to meet with the clients, I was comfortable with them to an extent because I have been working in group home facilities for about 6 years. My observation about the patients is that some of them a really friendly while some kept to themselves due to their diagnoses. I felt really bad for some of the patients because they do not have their freedom. About the staff, I would say they are student friendly and were willing to teach and share necessary information with the students.
Glad you had a positive first day at the hospital. Now the challenge is help the patients to prepare for community living. You and your clinical group have assess the prevalence/incident of homelessness/mental illness in the community. The goal in the community is to stop the revolving door syndrome. What are the resources to help those living with mental illness? Where are the gaps/barriers to mental health care in the community. Looking forward to your presentation.
Before the semester started, I dreaded Psych clinical. I remember talking about it in the hallway with my friends. I wish there was a way to get around it. My best friend is a psychiatrist and she has been looking forward to this experience. She is so passionate about psych that I didn't want to hurt her feeling by telling her I truly do not look forward to the experience. I thought she was weird for choosing psych when she can be a family doctor, a surgeon, or something else. Initially, I was not that happy when my group was assigned the community. But after a while, I said to myself, maybe this was an answered prayer. I don’t have to be locked up all day with this patients. What an ignorant way to think right? But Boy! Was I wrong? I LOVE MY PSYCH CLINICAL. I love the environment, the staff and the patients. Everything about psych is interested. I had my first patient experience today and it was interesting to see what I have been reading in the books displayed right in front of my eyes. The milieu was quite for the most part but the hallway was busy. I saw patient pacing back and forth and some talking to themselves. I had an opportunity to offer self by helping one of the patient get her hair done. It was interesting how my conversation with her was seamless. I asked her all this questions and she answered every one of them. I thought it would be difficult to get them to talk, but it was not. The staffs on the unit were exceptional. They were willing to teach. One taught be the importance of locking one door, before opening the other. Another thought be the importance of having a staff in the hallway all the time. I had the opportunity to do a head count with the tech, and I also enjoyed that. In addition, it was also great to see Professor Day-Black demonstrate therapeutic communication with the patient. Every patient she spoke with left smiling. She is really gifted and an asset to Psych mental health. The conclusion of my long essay is that I love this experience so much that I wish 432 was just clinical. But again, how would I learn what to do without going to class first? All am saying is I just might be a psych nurse like my friend predicted. I have learned from this experience never to say never because I just might be a psych nurse at Spring Grove someday. Wow! I can’t believe I just said that, but it is true. The ‘me’ back then, will think the ‘me’ now is crazy for saying that. I love this clinical experience so much, and I am taking up my friend’s offer to shadow her in the psych unit during my Christmas break.
Psych nursing is indeed a calling. Every nurse is not equipped to deal with challenges that chronicity of the disorders and/or unpredictability of the behaviors bring. It is rewarding to see small changes and provide guidance/support to those who live with mental illness daily....Welcome to my world!
My experience at Baltimore Crisis Response, Inc. or BCRI has been great in providing a better understanding in the field of Mental Health. The clinical has really strengthen my knowledge in the roles and skills of mental health nurses. The opportunity of conducting my own group therapy with clients has helped me to improve in the usage of therapeutic communication. The facility is in an apartment building and convey the feeling of a home with the ability to leave anytime. The staff are very friendly and I enjoy hearing the stories of the staff experience in working in mental health. Nothing was like I expected. BCRI provide mental health and substance abuse services in the least restrictive environment possible.
Misconceptions is not unusual. BCRI has provided excellent services to those who need crisis intervention and short stay hospitalization to stabilize and grow.
Blog #4 – Maedin Kebede Wow!!! It has been 4 weeks Spring Grove has a very beautiful land escape and natural views. I feel fresh going there. I love natural views. I wish Spring Grove – the Red bricks cottage #2 be modified to meet the needs of the pt. It would have been the best therapeutic place for the pt. as well as for the staff. Pt. would benefit if they have an open space where they can garden flowers, vegetables etc. In performing this type of activity will direct them to be calm, enjoy fresh air, be productive, and have open space to pace around…. I do not have the fear that I had in the first day, I know their names, call their names and say hi to them and i watched their smile. I observed that Pt. knew their meds and its purpose too. They have choices to get water or juice at med. Pass time. I also watched certain pt. requesting PRN meds. There is a head count Q 30 Min. We had group activity and 18 pt. attended. After the warm up and stretching exercise, we served them with snacks. They were eager and happy to get the snack. I felt empathy for them. Finally we gave them the chance to share their individual experience in anger management. They were open and we shared our experience too. I strongly like the www.silverado.com/ whose goal is to transform the lives of those touched by dementia ……….etc. Can’t Red Bricks cottage at spring Grove and other mental illness facilities have the same goal?
INITIALLY I WAS AFRAID AS WELL AS NERVOUS WHEN I FIRST WENT OUT FOR CLINICAL. I REALLY DIDNT KNOW HOW I WOULD BE ABLE TO DO IT. ONCE I GOT THERE AND THE STAFF MADE US FEEL COMFORTABLE ALONG WITH OUR CLINICAL INSTRUCTOR, THE ANXIETY STARTED TO DECREASE. ONCE I WAS INTRODUCED WITH MY CLIENT THE RELATIONSHIP STARTED FROM THERE. WE INTERACTED WELL AND WE GOT TO KNOW ONE ANOTHER. I SAT WITH HER DURING HER ACTIVITY AND WE TALKED BRIEFLY. THEN I STAYED WITH HER WHILE SHE ATE DINNER AND I ALLOWED HER TO ASK ME SOME QUESTIONS ABOUT MYSELF. SHE WAS UPSET THAT I HAD TO LEAVE BUT SHE UNDERSTOOD. THE NEXT WEEK SHE WAS SO EXCITED TO SEE ME. NOW WE ARE VERY OPEN WITH ONE ANOTHER AND WE BUILT A THERAPEUTIC CLIENT- NURSE RELATIONSHIP.
I'm really enjoying my experience so far at Spring Grove Hospital. The environment on my unit is actually laid back. The unit is usually pretty quiet when I'm there. Most of the patients are sleep or watching television in the morning when I get there. A few patients like to stay out in the hallway walking back and forth. When the activity room is opened, many patients like to go play pool or get some air outside. As far as patients go, there are a select few who disruptive and start trouble. I was surprised to see how happy the patients were to have us there, but I understand why.
The staff on our unit have been very inviting and are willing to help us during our stay. I like going to the morning report to see how the staff comes together to solve issues. Going to the morning report shows me exactly how important the social worker's role is. It seems like there are more social workers than nurses at times. The individual treatment plan is my favorite part of the morning because I get to see how each patient's case is unique. Mental health nurse's roles are pretty different compared to nurses in the hospital. Many times, it looks like they are just relaxing, but they actually do a lot of monitoring and documenting.
Since arriving at Spring Grove, I have grown to like mental health nursing even more. I find many of the patients very interesting. When interacting with the patients, I find out that many of them are very intelligent. Though, mental health nursing is not my first choice specialty when I graduate, I definitely want to work in that field sometime in my career.
My designated clinical site is SGHC Red Brick #4 and I have a love-hate relationship with the unit. I will first start off with the cons of the unit. I dread the smell and the overall uncleanliness of the unit every Tuesday. It is not an environment I can see myself making a living out of. Also I feel unproductive because I am still so used to a nurse doing more than just sitting and documenting and observing. I do not feel like I am learning as much as I should be. The pros of the unit mainly surrounds the actual patients and my clinical group. Seeing the patients really brings the textbook to life, it makes what we learned in class real. Another thing I have come to appreciate is how the patients show gratitude for our presence. Some of the patients just wants someone to talk to and it's satisfying knowing my peers and I can do that for them. My clinical group makes the experience enjoyable as well, there is never a dull moment with this group. The overall environment of the unit is very unpredictable; we've had slow days and we've had some intense days. I appreciate the experience that this facility has given me.
The clinical site designed to me is RICA, thus far, it has been a faculty in which, I have no contingencies with. The patients there are extremly friendly. As I expected, I personally feel as though these girls in whom I work with arenot mental ill and just want to talk. My client loves to talk and I love to listen to her tell me about her work week. The staff are friendly to me and fellow colleagues and they are extremely helpful in our journey of becoming nursing and theyre very delicate with us. I really enjoy this tight environment.
My clinical site that I was disignated to attend was Spring Grove, Red Brick 4. I am really have a fun time with the clients of Red Brick 4. The staff is wonderful and inviting, as is the clients. I enjoy very much talking to my client. he was able to open up to me and was able to tell me thing that Spring Grove doesn't know about him. Almost all the clients there know me by my first name. There's a lot that goes on behind closed door with respect to the nurses and staffing. I would say that the nurses do a lot with observation and documenting. I have no problem with the way that they handle things there. My initial thoughts was that I would be more scared than anything, but now I actually look forward to my Thursdays now.
What I can say with most certainty regarding my experience in these last few weeks at my allocated clinical location is that my thoughts and feelings surrounding the environment, patients and staff, have changed gradually each time clinical has taken place. The first time I was there, for example, I felt nervous and even a little scared. The clients at the facility were waiting near the door to greet us on the first day, and while some were cheerful and welcoming, others eyed us with quiet suspicion. One man amongst the crowd even made a loud statement that incorporated sexism and racism into one packaged deal. It was interesting to say the least. Having said that, our clinical instructor guided us around and told us about with whom to be careful and even whom to avoid. She encouraged us to open up and get familiar with the area and the people within safe rules and guidelines. By the second time we came to the site, we were already playing cards and watching Wii and pool games while conversing enthusiastically with many clients. The staff were nice to us and could tell that we were excited to be there by day 2, so our time there has become more and more comfortable. I think that the staff can see that we are putting forth effort and really care about the clients, so they treat us as part of their team. Overall the experience has become far more comfortable over time for us, so hopefully we are benefiting the clients through our work there.
I have actually enjoyed my clinical site (BCRI). I can confidently say I have learned a lot from the nurses and clients. The clients are more willing to share their experiences. This week my client told me all his medication side effects. I was amazed when he listed all the side effects of his medications. I have enjoyed our group sessions and am pleased when someone raised their hands to ask questions. Am still in the process of using therapeutic communication to relate with the clients. The staffs are so welcoming, especially Nurse S.S I learned a lot from her when I was sent to the detox unit for observation. So far it has been a wonderful experience but I do not have plans to be a psychiatric mental health nurse.
I am really enjoying my time at Spring Grove. The environment is different from what I have experienced so far during my time at nursing school. The patients are becoming familiar. It’s really interesting to take what we have learned about the different disorders in our lectures and apply it to the patients around us. At first, I was hesitant because I did not know what to expect. As the weeks progressed, I feel more comfortable around the patients. Some of the staff are friendly and a great resource to the workings of Red Brick Cottage #2. They were a great resource in learning about the patients and learning the procedures of a mental health facility. I feel that I have a learned a lot during my clinical period.
My clinical experience has been great! There has been a progressive change from the beginning of my clinical experience to were I am currently. Initially, I was very apprehensive going into clinical. The idea that patients were dangerous with no regard for others is what I stigmatized. Currently, I am more comfortable with the environment. The patients understand their boundaries and are seldom out of control. They enjoy our presence and have warmed up to our visits. The staff are more supportive in our visitation and are willing to share the milieu for clinical maturity. During the last week, I realized my stereotypes of the mental health arena have diminished. The patients do not seem as bad as I envisioned and are teaching me more about mental health then that I thought I could learn.
Florence Amaikwu Week four Blog My experience at Baltimore Crisis Response, Inc. or BCRI has been great in providing a better understanding in the field of Mental Health. My clinical experience at Baltimore Crisis Response Inc. has really improved my knowledge in the roles of a mental health nurse. The group therapy with clients has been of a tremendous help for me to improve on my therapeutic communication techniques. The staff are very friendly and I enjoy hearing the stories of the staff experience in working with mental health patients. The nurses are welcoming and eager to help us learn from their experiences I am learning a lot from my clinical site. I look forward every Tuesday to going down to BCRI because it is a good place to learn how to become a good mental health nurse.
My clinical site was at RICA in Baltimore, my experience so far was very good and the environment is clean. When l first got there, l was anxious and nervous to meet my client at the mental facility. I was scared because I do not know what type of client that l am going to meet, and the kind of nurse that will be there. Surprisingly, when I hit the floor on the very first day, met with my client who was very pleasant, the charge nurse on duty was so nice and other clients were showing off because they saw new faces. The second day continue with no issues on my unit, my client was willing to cooperate, the LPN that was charging that evening was so nice to us, and this made it so easy as well as relaxing for us. It was very empathetic seeing those cute kids with mental challenge disease such OCD, ADHD, Anorexia nervosa, depression, behavior disorder etc. They nurses that work in this facility has so much patience to deal with each individual, because the client curse them out in a minute when they can’t get what they want. As for me, l really like the place, the teamwork spirit in my group, the clinical instructor teaches and guarded us well. I have good experience so far and will like to work as a mental health nurse.
Before my first clinical day I was very nervous. My biggest fear was that the clients might be violent or become agitated while we were on the unit. Now that it has been three weeks many of the clients recognize us when we come in. To my surprise they are welcoming and open to engage with us. It’s a great feeling when client recognize us and tell us about their day. Another concern of mine was that I would not be effective in communicating with the clients. I was worried that I would not be able to see past the clients’ illnesses and may not be comfortable speaking with them. Through conversing with patients in the milieu, I have learned you cannot judge a book by its cover, or a client by their chart. I have observed the nurses on the unit constantly have to be on their toes. Clients wander around the unit as oppose to other units where most clients stay in their private rooms and the nurse does not have to worry about clients interacting with one another. Every clinical day I learn something new, and I am always looking forward to the next day.
Before I started my clinical experience at Spring Grove I have to say I was not sure what to expect. The first day did not go well for me I was afraid. The second and third week have been much better and I feel at ease. I have spoken with my client as well as a lot of the other patients and the experience has gotten better. I am much more relaxed and actually feel pretty comfortable and confident that I can handle this responsibility. The patients are very interesting and for the most part are very easy to talk with. I feel like they enjoy talking with us and I am happy to help them if this makes them feel that someone is interested in them and what they have to say. I have learned a lot about the different disorders as well as the duties of the psychiatric nurse. I really don't think psychiatric nursing is for me but It has been an interesting and informative learning experience.
At first, I didn’t know what to expect from a residential crisis center. Crisis to me had always meant out of control so I had envisioned BCRI having patients that were consistently out of control. However, I have learned that the patients are at BCRI voluntarily and are free to leave at any time. The environment is set up to have a “like home” feel to it since it is in an apartment building. The patients are mostly different every week and it has been interesting getting the opportunity to talk to different kinds of patients with different mental health challenges. The staff has been pretty friendly for the most part and do look to do what’s best for the patients. It is nice to get another view of mental health nursing besides being in a hospital or institution.
So far I have been enjoying my clinical experience at the Baltimore Crisis Response Center. On the first day I wasn't really sure what to expect, but as the weeks go on I have become more comfortable with speaking with the clients. Their participation in group therapy is very impressive because they are really engaged in what is being taught and spoken about. When I did my group about personal hygiene I was a little nervous that no one would participate and that I was going to forget what I wanted to say. Yet, I executed the session very well and the group discussion was great because of the participation from the clients. This is the best experience I've had so far in clinical.
Initially i thought going to Spring Grove Hospital was like going to an untamed jail with out of control mental health patients acting up at all time because of the stories that i heard about the facility; they have the worst psyche patients. But that has not being the case at all, its being very quite and well controlled. I started out very nervous going there but now i feel more relax and comfortable engaging in conversation with the patients. SGH cottage 4 is a small unit that houses about 40 patients, 39 as of yesterdays count. Its double locked at all time and stuffy. I feel like it should be open for fresh air daily but that's not the case. Its interesting to watch the patients weekly, some of them pace the hallway all day, others sleep in the day room, some keep to themselves and still most of them are happy to talk to the students. All these patients have their story and some just want a listening ear.Like my instructor said "the fact that they are sick doesn't mean they are stupid".One thing i noticed is that these patients watch each others back like a team working toward the same goal, to get out of there. The staff in my unit are nice, helpful and patience to answer all our questions. In most part they just watched and redirect the patients. Overall, i think its a good experience in SGH 4 with my fellow students.
Before this class I never had any experience with patients that have mental illness. Thus, I was anxious going to Baltimore Crisis Center and caring for patients. However, once I got there I found out that all of the patients are there voluntarily and they are actually in a stable condition. Because of that I became calm and more comfortable with the patients. Also, I noticed that the nurses are very cooperative in sharing their experiences and knowledge's. For example, yesterday I had an opportunity to go to the substance detox unit to observe the patient care. The nurse that I found in there was very nice and were willing to share her experience and her knowledge about admitting patients and caring for them. Throughout this clinical session I am learning ways to incorporate therapeutic communication skills when caring for patients; but I don't think psychiatric nursing is for me.
Initially i thought going to Spring Grove Hospital was like going to an untamed jail with out of control mental health patients acting up at all time because of the stories that i heard about the facility; they have the worst psyche patients. But that has not being the case at all, its being very quite and well controlled. I started out very nervous going there but now i feel more relax and comfortable engaging in conversation with the patients. SGH cottage 4 is a small unit that houses about 40 patients, 39 as of yesterdays count. Its double locked at all time and stuffy. I feel like it should be open for fresh air daily but that's not the case. Its interesting to watch the patients weekly, some of them pace the hallway all day, others sleep in the day room, some keep to themselves and still most of them are happy to talk to the students. All these patients have their story and some just want a listening ear.Like my instructor said "the fact that they are sick doesn't mean they are stupid".One thing i noticed is that these patients watch each others back like a team working toward the same goal, to get out of there. The staff in my unit are nice, helpful and patience to answer all our questions. In most part they just watched and redirect the patients. Overall, i think its a good experience in SGH 4 with my fellow students.
I already knew that Baltimore Crisis Response Inc. was a different type of psychiatric environment based on the name of the facility. It doesn't have hospital or institution in the name so I didn't know what to expect when I got there. My first time on the unit I was pretty surprised when I got there because it looks nothing like a hospital. It reminds you of a dormitory. There are conference rooms and the "cafeteria" on the first floor. The second floor houses the nurses station, patient rooms and group rooms. The third floor has a detox unit on it. It was nothing that I expected. The staff are in casual attire and they just have badges on their necks. The patients are also in their own clothes. The nurses' station is very very old school lol. The patients are there on a voluntary basis so the atmosphere is very different than a hospital. The patients are admitted based on the type of "crisis" they are having. Most of them appear to calm and collected and the turn over is pretty quick. You don't typically see the same patient each week. The patients are usually receptive to students. Most of the staff are very friendly and they love interacting with us. I used to be nervous but now I'm pretty comfortable when it comes to interacting with the patients. I think I'm finally starting to get the hang of it.
Baltimore crisis center is unlike any other mental health unit. A lot has changed since my first reaction to the mental health center. The patients and every experience I have come upon so far has led me to be more open minded about the place. When I first arrived at the Baltimore crisis center all I noticed were the big dim rooms filled with patients sitting around. Send patients were watching TV while others were having conversations. When you first walk in the room you can’t help but notice the nice and inviting patient. They smile, say a kind hello and are always willing to share their past experience or the chief diagnosis for being checked into a mental health unit. Patients are the best part of Baltimore's crisis center. They are by far the most grateful inspiring people I have met in my two year clinical rotations. The staff and patients relationship is also positive. The nurse appear to be well invested in their patients care. Although I didn't have a great feeling about this mental health center in the beginning, I have now come to appreciate it.
Week 4 So far clinical has been a interesting experiences. The staff is friendly and welcoming and the patients, well let’s say they have their days. I enjoy doing group at clinical because for the most part the patients are very interactive and they do enjoy speaking with the students. I like that my site is not an actual hospital because it’s easier to get to know patients because they are seeking help. I am learning a lot and I see myself starting to take a slight interest and the mental health field. The patients have autonomy and I can get a lot of my assignments done because they don’t mind talking to students. Overall I am having a great experience and I am looking forward to finishing this rotation.
I am working at BCRI, some of the patients seem so hopeless that it is sad they are only there for a short period of time. The amount of resources they are given in such a quick period of time is almost a whirlwind of information and when you are medicated heavily some of this information is hard to process. As for my experience i wish i could get more from it. Fortunately for me i work on a mental health unit already so i get a supplemental education from that. I get to spend 12 hours a day interacting with patients and i see all sorts of mental disabilities. Being that mental health areas aren't a normal hospital setting it can both be more rewarding and more of a challenge. I get to interact with more patients at a time which is nice but i also have to know more about all of the patients on the floor since they are all interacting i need to know how to properly respond to situations to keep everyone and myself safe. I'm glad i got to learn the therapeutic communication more to enable me to do this.
Clinical experience at RICA-BALTIMORE will be with me throughout my nursing career. The facility has children with different emotional, behavioral and psychological problems. I have been on older adult psych unit but not on adolescent. The environment at the facility in the evening time are quiet sometimes and can be rowdy and loud sometimes. Some of the staff do not utilize therapeutic communication, it seems like they get loud like the clients as well. There are more of peer pressure, cursing at the staff and fighting in the adolescent psych unit compare to the adult psych unit that I have been before. Also there are more anger and conflict management that trigger some of the episode in the units. Honestly, I feel remorse about the various issue that some of these children are facing. The childhood trauma, nightmares and predicament that they are facing are just sad. Reading through my client chart and post-conference with my clinical groups with different stories on their client are just overwhelmed for these children to experience such traumatic events and emotional damage that will be with them throughout their life. Besides these concerns, RICA-BATIMORE is a nice environment to work in, staff are very welcoming and supportive of our student teaching and activities. Like my client express that, he tried to stay out of trouble to maintain his point, so that he can attend volleyball and finally go home. Am thinking of applying there for a nursing position after getting my license.
I have been at Spring Grove for about 4 weeks now. I enjoy interacting with the patients and seeing the clinical manifestation of the different mental health illness. I wasn’t fortunate enough to see the patients with their family members. However, the staffs are very friendly and interact with the patients. For example, there is a male staff that plays pool with the patients and a female staff that plays cards with the patient. I had the opportunity to go to rounds with the psychiatrists, social workers, and the nurse and I realize the empathy they demonstrated for the patients. One instance, there was a patient that was left at the hospital from birth and had no family that is at the facility. The doctor was so compassionate and said that it is hard for anyone since is like living in a world alone and they were his family. That was really nice of them. So far, my experience had been a learning experience and a pleasure.
The pass three weeks at my psych unit has been a huge learning experience. When I first arrived at the facility I was very hesitant and nervous about the situation. The environment is not the most ideal place for any person but, that is not something I can control. The facility is very old and ran down. In my opinion, the environment is not very therapeutic for the patients. For example, many of the items in the activity room are broken or not fully functional. Sometimes being in a nice, clean, and refreshing environment can put someone in a better mood and I feel like that could be true for the patients.
Throughout these 3 weeks I have become a lot more comfortable with the patients. I know a good portion of the patients by name and a great majority of them are very friendly. We have many opportunities to interact with the patients in the milieu and it is great getting to know the patients. I find myself really enjoying myself at clinicals, especially since I have worked pass my uncertainties from the first few weeks. I have improves my therapeutic communication skills a great deal and I am excited to finish out the last few weeks on the psych unit.
During this past three weeks my perception of a mental institution has changed a lot. During my first day at the clinical site (Spring Groove) I was very uncomfortable and extremely nervous. I did't know what to expect from the patients, the staff and the environment. Now that I got to know the patients and had the opportunity to work with then alongside with the staff, my nervousness has decrease. The enviroment at Spring Grove is almost as a prison, the patients have no automnomy or sense of freedom, I mention to my clinical instructor that I felt so bad for the client for living in such conditions and in a old building that has not been taken care of. My instructor responded to my comment by saying that, the environment may not be the most ideal place but that at least it offers the patient a warm place to live since some of the clients have previously been homeless. At that moment my perception of the environment totally change. The staff at Spring Groove are for the most part very quiet and do not interact with the student much. In the other hand the patients are friendly and love interacting with us. The patients are my favorite part of clinical. It is very interesting to see the different personalities and how every week they act a little different than the previous week as they become more comfortable with the students.
These last few weeks have helped me to become fully aquainted with my patient. He now knows me by name and seems open to my asking him questions. The other patients on the unit also recognize me and my clinical group. We get a lot of participants. The environment is ok and the staff are cool to work with; they have no problems answering any questions we may have. However, the other week(11/5), we were faced with a bit of a challenge. Once arriving to clinical and speaking to the patients and staff as we walked in, we were asked if we could give them a minute while they(the staff) get settled. So my professor and clinical group went to our conference room to continue pre conference. Later we went to the milieu to converse and interact with the patients, we were told it's too loud and that it's "quiet time." Upon going back to our conference room, the charge nurse was asked about the length and days of "quiet time". We were told that it's from 3-6, when shes's there. This made me feel awkward and uncomfortable the patients were waiting for us to come back out. We did come out to the floor close to six and went to the game room and set up for our group therapy. Group therapy was a success! The patients stated they enjoyed group and told us that they wanted us to give them a holiday party. We told them that we'd look into it. One of the patient's told us that he normally doesn't participate in group, but by coming to ours he's learned new things about himself that he actually enjoys and he's happy that he's been going to our group. Overall, I've enjoyed clinical with my clinical group!
Although before I start visiting my psych unit I had a prior knowledge about inmate with mental health, but I watch the inmate as a correctional officer not as a mental health nurse. But now that I have the opportunity to have a hand on care on the patients with mental health, it feels so strange. Initially when I got there I was scared and not confidence at all to perform my duties. But now I feel more confident and nothing scares me to conduct a mini mental assessment, an IPR, and even to conduct a psychotherapy group to a lot of patients at the same time. I have also developed a good rapport with not just the patients alone but alongside the staff working at the Baltimore Crisis Response Inc. I have had the opportunity to assess a client at the detoxification unit, and also had the opportunity to go out with the response team that actually had to go on the street to pick up patient that calls in requiring help. Right now my feeling is that by the end of this course, I would have gotten all necessary skills and knowledge that I require to be a psych nurse kudos to my professors.
I feel very comfortable and somewhat attached to the clients on the milieu they are always very excited to see us and look forward to doing group. My patient is kind but withdrawn we established a good relationship. Week three we faced some difficulty... when we arrived at the unit we were told that the patients were on quiet time for 3 hours this made it difficult for us to spend time with the clients. We did pre-conference and discussed our plans for group and stood outside of the dayroom until quiet time was over. Group went really well the clients had a great time and enjoyed the snack and the reflections after group each week the number of participants increased. All of the clients are a pleasure to work with and most of them know us on a first name basis.
I have a to admit I like my psych clinical way more than I thought I would. My patient is not really sociable but I have built a relationship with her and many other individuals in the milieu. I absolutely love group therapy. I have watched individuals over the last couple weeks go from just peeking in through the window to greeting us at the door when we arrive wanting to know what we have in store for them. Week three was a little uncomfortable for me. I think my colleagues also felt the same way. When we arrived we were told that the milieu was having "quiet time" for three hours. I found this weird because this new to me and while my patient was allowed to interact with me, the other patients weren't and they wanted to. The staff was also not very warm and welcoming that day either. However, group therapy changed the mood. As always we had a good time and learned about the patients and from them as well. This clinical has been a pleasure.
I have a to admit I like my psych clinical way more than I thought I would. My patient is not really sociable but I have built a relationship with her and many other individuals in the milieu. I absolutely love group therapy. I have watched individuals over the last couple weeks go from just peeking in through the window to greeting us at the door when we arrive wanting to know what we have in store for them. Week three was a little uncomfortable for me. I think my colleagues also felt the same way. When we arrived we were told that the milieu was having "quiet time" for three hours. I found this weird because this new to me and while my patient was allowed to interact with me, the other patients weren't and they wanted to. The staff was also not very warm and welcoming that day either. However, group therapy changed the mood. As always we had a good time and learned about the patients and from them as well. This clinical has been a pleasure.
My clinical experience so far has been going good. I have become comfortable with being on the unit. I still think that the unit seems a little small but this may be contributed to the fact that I value personal space. The patients have really opened up to us and look forward to us coming every week. Interacting with the patients and hearing their stories has been very rewarding. Most staff members have been very inviting and open to answering any questions we might have. However, as time went on I started to notice that some staff members rarely interacted with the patients and at one point subjected them to prolonged quit time hours. Learning of that really annoyed me because that staff member was being reactive instead of therapeutic. After the first day of clinical I was extremely hesitant over the idea about having to go back but after seeing that our presence breaks the monotony while hopefully making a difference makes it worth it.
Before actually going on the unit I drove to Spring Grove the day before so I would know where I was going. I never knew actually where Spring Grove was and the ride kind of freaked me out especially since it was getting dark when I went. However, when I arrived to Spring Grove and walked on the unit it was not as bad as I thought. What I was shocked about was to see the patients lined up waiting to take their medication. Our clinical instructor was very knowledgeable of the milieu and told us who we could work with and who we needed to stay away from. The staff was helpful...most of them and made us feel welcomed. Overall my first experience was a ice breaker and it wasn't as bad as it looks.
Going into my designated psych unit I had mixed emotions. A part of me was nervous and another part of me was excited and ready to get to work. When I finally got there and began to work my feeling of nervousness went away. The environment was calm in the morning and as the day went on the milieu escalated because of events that had occurred. The environment never did get out of control. It was way smaller than I had imagined. The sleeping space seemed to be cramped with 3 to 4 beds in a room. The day room was also crowded. There seemed to be too many patients with the space provided. The nurses were very nice but seemed absent on the floor. I only saw them doing work in the nurse’s station. The techs didn’t seem compassionate enough. One on them was making fun of the patients and laughing at them and I didn’t like that. I believe that although these patients may have done some sick things, are mentally ill, and some don’t know any better they should still be treated with some type of respected.
ReplyDeleteInitially, I was afraid prior to going to the facility. I’ve always head stories of “Spring Grove”. You really don’t know what a mental institution is like until you’ve actually visited one. The first day, my colleagues and I were shoulder to shoulder. I guess that was our “defense mechanisms” kicking in. I was afraid of the stares and looks that the patients gave us. I was also uneasy with the idea that we had to unlock one door at a time. On our unit, each student is assigned keys to get in and out of each room/door. I felt as if I was in jail.
ReplyDeleteAs time went on, I began to feel more comfortable with the patients, because they are people just like you and I. This rotation has given me a different outlook on that way I feel about the mentally ill. This has been a life changing experience for me. I didn’t realize how many people are in need of mental health care. As we go about our busy daily lives, we complain about this and that, but do not realize that there are people out there who wish they could be out here as busy as we are. Some of the patients are very accepting and are eager to work with students.
The facility is small and currently houses 38 patients. They have to leave their rooms early in the morning and are not able to return until 8 p.m. They can sit in the Milieu and watch TV, play cards, or go to sleep which is not a lot of options for a full day’s schedule. The activity room is open during certain hours of the day. This gives the patients opportunities to go outside, listen to music or play games. It’s not a lot to do at Spring Grove and it is very close to jail, but I do understand that the patients need a controlled environment.
The staff at Spring Grove are “okay” to get along with. Some of them are excited to have nursing students and some of them aren’t, but we make the BEST of it. We are there for a learning experience and we see to it that we get the information that we need to complete our “Charge Nurse” duties.
My inital feeling about clinical was that I was scared out of my mind. I guess I felt this way becasue I did not know what to expect, also the tour of my clinical site was very traumatizing because our tour lady was saying all the bad things that can happen.I must admit to my surprise my clincal site is very calm except for some incidences. The staff that I work with are very helpful in explaining what they do and why. The secretary on my cottage teaches me somthing new eveyday I see her. I actually feel as if I work there. At RICA I thought I would see actual crazy people pacing around, but it is just the opposite the children are full of life and it is a comfortable enviorment.I come to realize that a lot of these kids need love and are yearning for this. If I decide to stay in psyc nursing I will work with children.
ReplyDeleteMy first thought about Pysch was that i wasnt going to like it. When i first arrived on the Mileu i was very nervous and scared. I had no idea what to expect. Since arriving on the mileu and getting to know some of the patients, i now have a different perspective on the clients. I found that most of them are really smart. I am no longer afraid of the clients on my unit, but i cannot not say that im not afraid of others. It saddens me at times when i see the clients sitting around sleeping all day. It is my hope that Spring Grove would incorporate some more activities for the clients. I would also like to see them have a gym, so that they can be more physically active.
ReplyDeleteIt's been a week since my arrival to the psych unit and so far I've had a wonderful experience. The staff is really nice and they are always willing to help. It's very interesting listening to the stories that the patients tell you, and most ot them are very open about their situations. There are some instances where you approach a patient and ask if you could talk to them and they say no, but as the day goes by and they warm up to you they eventually began to talk to you. On our unit we play board games, we have group discussions, exercise class, and karaoake. The patients really appreciate our prescence on the unit. We also watch movies and spend a lot of time talking to our clients. The environment is very warm and friendly and I enjoy being there on Tuesdays and Wednesdays. This is a different type of clinical experience because we are not taking care of patients with medical problems like diabetes, hypertension, etc, but it is a great learning experience dealing with clients with psychological disorders.
ReplyDeleteMy initial feeling about starting this clinical was scared. I believe I felt this way because I didn’t not know what to expect. Upon our first day at the site my anxiety level increased, especially while we toured the cottages and were introduced to some of the clients that were there. As the weeks progress I am not nervous at all. I anticipate going into the unit and seeing my client. The facility that I am at houses children and these children have a lot of different behavioral, emotional and psychological problems. I believe that some of the staff doesn’t know how to deal with these type of individuals. They do not practice therapeutic communication at all here. I believe that this is triggers some of the episodes/incidence that they have on the units. The environment at the facility is sometimes calm and sometimes rowdy like all units. It seems as if the staff yells as loud as the children and they are trying to be their friend instead of helping them deal with problems. Besides these concerns I think that it is a nice facility to work at. The children look forward to getting higher points so that they are able to do different activates which leads them to behaving, taking their mediations, and doing well in all their other daily assignments.
ReplyDeleteIt has been such an interesting experience for at my Psych rotation. I first at first, I went in with a lot of apprehension and fear of the unknown however, I can honestly say it is noting that I imagined. The clients at my facility are very welcoming and quite engaging, every morning when we open those doors, they are happy to see us and cheer us on as we start our daily interaction with them. The Nursing staff and doctors at my facility are wonderful and very resourceful as well, they have been such a big help in reducing our anxieties. I had lots of misconception (chaos) of a psych unit fortunately for us the milieu has been very well maintained and calmed. I was very impressed with how lectures are congruent with the actual clinical setting, the client attitudes, sign and symptom are TEXTBOOK complete and this really helps in “Putting the Pieces Together”.
ReplyDeleteBefore my first week at VA I thought this site will be emotional because of their military backgrounds. But to my greatest surprise it isn’t. The patients are treated with dignity and respect regardless of their ethnic background. Being at VA is a great experience of a life time for me because I have learned a lot from the patients, nurses and even staffs that I can’t express it in writing.
ReplyDeleteAll the patients in this clinical site have a military back ground. Every single week I come home with something new from the patients related to their battle field experienced or off duty experience. Most of the patients that I have been having for the past weeks are those that fought the Crimean and Vietnam wars. These are people that keep us and our country safe from the extremist and I am so happy that I have the opportunity to make a difference in their lives. And I am doing it with all my heart because they deserve it.
The patients at VA are nice and intelligent to some degree. So far there haven’t been any crisis yet and that I don’t want it to happen because it is my greatest fear. Some of the nurses initially weren’t polite or nice, and just of a sudden they change and started acting and behaving nicely. Don’t know what happened, may be they realized themselves. They are so nice and caring now, it is only God who knows.
The staffs are excellent and helpful to us. I really do like this site.
Initially I was excited to be on psych unit. After three weeks of being on the unit I remember why I needed a break from psych nursing. To me psych is mental draining and if there is no action on the unit it makes for a very long shift. I need a busy environment to help move the time along else I find myself watching the clock (which never seems to move). On the bright side certain patients will tell you the most amazing stories and you can learn so many things from them. A lot of the patients can tell you more about their diagnosis and medication than you can tell them. The environment is different from what I am used to. The patients at my clinical facility are allowed to have several items that would be considered contraband and not usual allowed; however, the safety of the patients is still maintained. The staff on this unit are great, they are very friendly and welcoming. Overall I am enjoying this rotation.
ReplyDeleteBefore my arrival at the Psych units, I thought all psych patients are aggressive and can cause harm to self, another patient, or the staff. With this in mind, I was very scared and I took all precaution to make sure none of the psychiatric patients were behind me on my first day at the clinical location. However, after spending three weeks at this clinical location, couple with the nurse-client relationship I developed with the patients in the course of interacting with them, I now have different conception about the patients. I see them as people who are sick and need medical, psychological, and or emotional attention which the environment in which they are offers. Some of these patients say they feel more safe being in this psych unit than the will if they are in the street. The staff in my clinical location, are very cooperative; they do all they can to make sure we get the best from them during clinical session. I am now more comfortable than my first day of clinical, dealing with the psych patient.
ReplyDeleteI am pleasantly surprised at the willingness of the patients to speak with us students. They have been very receptive when we have conducted our groups and have readily participated. The patient that I had the privilege of working with was open enough with me to share a book he is working on. I came into this class expecting clinical to be a painful process of convincing the clients that we could be trusted, and it seems as if they are sharing more with the students than with some of the staff. The nursing staff have been extremely friendly and willing to help us with any information that we need. The social workers and administrative staff have also been very friendly. Even the physicians are willing to assist us with what we need. The "techs" on the unit have been helpful by informing us which patients would be more receptive to speaking with us. I overheard one of the staff members remarking how we have such a good rapport with the clients and how our groups are informative as well as engaging. I do not have plans to be a psychiatric mental health nurse, but it is reassuring to know that the staff of the facility I have been assigned to have confidence in us.
ReplyDeleteI have actually enjoyed my experience on the psych unit thus far. It is interesting to learn the backgrounds of some of the patients and their willigness to give so much information about themselves still amazes me. I have enjoyed our group sessions and am pleased when someone comes to us and say that we made their day.
ReplyDeleteIt takes a special type of person to work on that unit.. and I don't think I'm there yet. As much as I do enjoy conversing with the clients, I cannot see myself as a new nurse jumping right into it. I believe that dealing with the psych issues of the "normal" patients will be enough for me.
I am very pleased with the psych unit that I am on. The staff has been very supportive of us since the first day we arrived on the unit. I have not met one staff member that has had a mean demeanor towards us. I really enjoy talking to the patients and hearing the different stories and attitudes. So far the patients loved our group sessions especially karaoke. The best moment for me was when I saw one of my patients from my job on the unit and I actually got to sit down and talk with her.
ReplyDeleteI can honestly say that my clinical setting was not what I expected. The staff are nice and helpful. They make it easier to navigate the task of reaching the patients. This is important since I am not in the usual hospital setting. The patients are open and not afraid to tell you about themselves. This was not what I was expecting. Some are not very cooperative and very closed in. I am also very proud of myself because this clinical has subsided my fears of working with the mentally ill. Overall, I feel that this experience is more positive than I assumed it woould be.
ReplyDeleteWell...the place in which we are having our Psych rotation is truly DIFFERENT. The enviornment is dark, dreary and truly uninviting. It has a stench that hits you as soon as you hit the door (Not something you are looking forward to at 8 am). One part of this dilapidated building is for Psych patients who voluntarily check themselves in and the other portion is used for subsidized housing. The patients are INTERESTING to say the least. We have had people who talk to the devil (and on a regular basis) to those who have experienced every traumatic life event know to man, and then on to those who are 150% sure that the Federal Goverment is out to get them (exclusively). Some of the patients are truly like your everday people; however, these individuals find it impossible to deal with the everyday stresses that we all have...they fall in to a funk called depression and they end up in a funky place like this. Sad but true. They are then coupled, tripled and quadrupled with the not so everyday person...they get placed with the dude who says he can see the devil on the wall, or the one who has considered taking his life, or maybe the one who sees dead people walking around or, the one who has homicidal thoughts. But hey, this is psych right?
ReplyDeleteThe staff at the facilty is really laid back and truly a good group of people to work with. They have been very open with my group and willing to answer any and all questions. Overall, I have been ok within this facilty. I can't say that I have ever felt threatend in any way. If only they could tidy up the place...
I was originally at the VA. Can I just tell you that it is a shame that these same people who fought for their countries have a facility geared for them and it is so drab! They truly deserve better! Ended up getting relocated to Sinai and what a change. The floor is brightly lit, the staff is very welcoming, the patients are even pretty special to me. I don't mean special in a bad way. Other than the fact I know that some of them are not in there for no reason, they seam to be almost like you and I. I didn't have any expectations of what they would be like because I had decided that I was going to just go in with a positive mind. I am glad that I did because it made my first experience with them seem like any other day in a clinical setting. I was actually more relaxed with this type of illness. Maybe psych has a chance after all. My client and I played UNO, I mostly listened as he talked and the night went so fast. I could have stood to spend more time with him the information was flowing like a breeze.
ReplyDeleteAt first, I was at the VA hospital for clinical. I was very surprised that there were so many younger clients in that facility. I always thought of veterans as being older. I wish that the experiences that they had while simply doing their job weren't so negative and painful. I was also surprised at the number of females at the facility. I am now and the Baltimore Crisis Response Intervention Center. Clients at the facility call a hotline for assistance when they feel that they are in a crisis and they are evaluated and they come to the facility vouluntarily. I think that the center allows a way for people to get the help that they need to get through a crisis without being forced into a hospital setting. The clients are willing to talk to students. Some of them seem like they would rather not be bothered. I saw that the clients there really like having someone to talk with. They may even just enjoy having someone there to listen to their feelings and their story. I appreciate the client's willingness to share information and open up to us about their feelings and their experiences. It shows that it is our privelage to be a part of their treatment.
ReplyDeleteI too was at VA hospital for clinical in the very beginning but got placed at RICA. My experience at RICA is going pretty good. When I was first placed there, I was soooo nervous because for 1 I felt like I was behind, and 2, I was just nervous about meeting my new patient and I was scared because I just didn't know what to expect when working with a new patient. But when I hit the floor, and starting interacting with the staff and the residents there, I felt welcomed. My first day I was antsy, but my second day, I felt more relaxed and more comfortable with speaking to the staff and interacting with my patient. The more and more I let my guard down, I realized that I fit right in. The environment at RICA is exciting, yet calming, though there are moments when it can be chaotic but hey I can deal. I was so amazed at the various issues that many people faced in their childhood that caused to be in the predicament that they are in and honestly it just broke my heart but we take so much for granted meanwhile a child down the street is living a nightmare in their own homes and everybody is quick to judge and worry about materialistic things such as clothing and shelter was the abused child but nobody think of they lasting emotional damage this child will face growing up and the devastating effects its gonna have on their mental health. (let me get off my soapbox). The staff are just so nice and make you feel like you can come and ask them anything and they are willing to help you. As for myself, I went from a nervous wreck to now I actually look forward to going to clinical at RICA and when we get there, the staff and residents readily say "hey".
ReplyDeleteWow, can't believe its three weeks already, well i was a bit nervous on my first day of clinical because i just did not know what to expect. I had lots and lots of questions running through my head, were the patients hay and wild, how wws the staff going to treat us and in all how were we going to survive the unit. But all these doubts and fears were cleared when i got the chance to have a one on one interaction with the patients. It was actually fun and believe it or not, those patients were more than willing to interact with us. The environment though, is not as the regular hospital unit and i felt the sponsors could actually do better for these patients. In my opinion, i thinks much improvements is needed at the center, The environment, nevertheless, is a calm place and the patients are well behaved, also, the staff are wonderful to deal with and most importantly very helpful. I always look forward to going to clinical to help the patients come to an optimum level of health.
ReplyDeleteSome of your thought and feeling about the environment, the patient, the staff and you?
ReplyDeleteAt first I was at VA hospital, the environment is pleasant to work, the patient is young adult, and they don’t look like psychiatric patient. My experience at VA hospital was a short one now I am at BRCI an acute care unit for those experience crisis, addiction and need interventions and treatment, their client are voluntary admitted and a stays for days or weeks. We do not have those type of patient in the movie “one flew over the cuckoo’s nest” the surrounding is not impressive, it needed more renovation, the building need a better location for their client smoking break; the while we are in the conference room the client goes out of the pouch for smoking, and all the smoke come right into the conferences room which put us at the risk of second hand smoking. Although the patients welcome student and they are willing to talk to the students. It was a good experience for me, at first I was nervous and thinking am behind. I was able to gain confident and gather information from my client. The staff gives us their full support.
Three weeks go by fast! The first week we arrived to Spring Grove I was excited but did not like the idea of unlocking and locking the doors. It made me feel nervous. But now I have gotten use to the unlocking and relocking the doors. I was never scared of the patients; I just felt anxious that I didn't know how the patients were like at my facility. Since we hear report, I know what the patients have been acting like in the past 24 hours. I have gotten used to walking around the hallways and conversating with certain patients. Most of the staff are nice and acknowledge us. I appreciate the staff that do. I am really enjoying this clinical and it makes me not cross out psych nursing in the future.
ReplyDeleteYes, three weeks have gone by so fast. The environment at RICA reminds me of a recreation center compared to other psych wards I have been. The building looks new, with a court yard that divides the units. I was surprised to see a relaxation room decorated like a calming area that you would see n a vacation setting. They do not use any restraints at the facility due to prior incidences at other hospitals with children. The unit is very clean and inviting, it does not have the appearance of a psych ward. One thing that I noticed is that all of the female clients were Caucasian. The mentioned that this was the first time that they had all Caucasian females and they had to learn how to adjust to this type of environment. The females are typical teenagers with rough life experiences. After reading my clients chart, I started to see how much of a challenge it is for her to stay positive. She explained how hard it is for to have lost her mother at age four to AIDS and have been raped. This is just some of the things that happened in her life. As we continued to talk, she looks forward to me coming to see her each week. The staff is very nice and welcoming. They have been so helpful and nice to us, we feel a part of the team.
ReplyDeleteMy initial thought about psych was “what am I really going to do with these patients “I thought all the patients were aggressive and they were always in seclusion. On the first day, our instructor took us on a tour of the facility and I had the opportunity to meet some of the staff and the patients. They were very helpful and were ready to answers any questions we approached them with. One of the head Nurses gave us the history and the service the facility offers for its citizens. Through these interactions, my anxiety levels decreased, because my assumption about these patients was the opposite of what I encountered. At Baltimore Crisis Center, Most of the patients have situational crisis which with assistance and referral, they are able to go back into the society as independent citizens. This facility has 21 beds for its patients and their patients are voluntary individuals. The patients were very friendly and even made a funny comment about my pregnant belly.
ReplyDeleteInitially, I was afraid to go onto the psych unit because I didn't know what to expect. I watch alot of movies and I kept thinking that the patients were going to band together and attack the staff. But I had to come to my senses and realize this was not a movie. After three weeks, the unit seemed okay but it was a little boring for me. I mean it's nice to innteract with the clients and talk to them but psych is a completely different world. I'm so used to giving medications, dressing wounds, inserting foleys, and a host of other things, that this feels like I'm missing something. The environment is diffent from a regular hospital unit. It's home like. The milieu is like the living room where the patients hang out and play games, watch tv, and listen to music. The patients come and go out of their room as they please unless of course for some reason they are restrained. Also, Some of the clients are open and come up to us to talk and others just stay to themselves. They are normal people , but just with the mental issues that could have been brought on by the smallest things such as losing a job, house, or divorce. The staff are great with the patients. They love for us to interact with them. They are very helpful and nice. My experience has given me a different look than what happens in the movies. I see that these people just want help to control there inner emotions and feelings that are brought on by the mental illness.
ReplyDeleteIn this last few weeks at my facility I have found the environment to be very drab and boring. I feel like the environment is not one to bring about life and happiness in someone who may just be depressed. The staff is nice I have found them to be quite knowledgeable and helpful. They really seem to love their jobs and they seem to be very good at communicating with the clients. The clients aren't as scary as I thought they were when I first arrived. Some of the clients don't even seem to be as mentally ill as they are suppose to be. as far as me, i feel that I am learning more every week. I am becoming more comfortable with the clients and the disease processes. i also am learning how to communicate with these clients in a therapeutic manner. I see growth in myself.
ReplyDeleteAfter being in my psych rotations for a week weeks, I can gladly say I have learned a lot. For starters, I don’t feel lost when I get to the unit anymore. I feel comfortable getting around the unit, finding patients and carrying purposeful conversations with them. Some of my assumptions about the unit have been disproven and I have a new perspective on the patients. I noticed that a lot of the patients come into the unit because of worsening depression and noncompliance to medication therapy. They turn to do better while taking their medications.
ReplyDeleteThe staffs on the unit have been very supportive and kind. They are always willing to answer questions and help when asked.
3 WEEKS REALLY?! Time sure flies when you are having fun. Initially I was terrified of this rotation, but I have the best instructor and clinical group. I have learned a lot and I am more comfortable around the clients. The clients love to talk and I love talking to them. Each one may have a different story, but the disease process really affects each one the same. The staff is very friendly and helpful. Anytime you have a question or concern, they are willing to lend a hand. The locking of unlocking doors is still a little unnerving, but it’s not as bad as I thought. If a position or opportunity presented itself in Mental Health, at least I will give it a thought now, instead of running away.
ReplyDeleteTime has went by so quickly I really cannot believe that we have only 2 more weeks left of psych. When I first came in to this half of the rotation I was honestly terrified. I heard that going to spring grove would be just like the movie we had to see for class which frightened me. As the weeks went by I got more confident and see that it’s really not bad at all. The only thing about the location is locking the doors but I am actually getting use to that too. The staff at Spring grove are very helpful and the patients are very respectful and were even eager to learn when I did my teaching presentation.
ReplyDeleteGoing to Spring Grove I was so scared but as time has gone on its only half as bad as I thought it would be. Its still a little creepy because its old and dark. It makes me still a little nervous because you never know what to expect and everywhere you go the doors a locked. From what I have observed the patients are not really doing much of anything but sleeping in the day room all day and pacing the hallway. It really makes me wonder how theraputic is the facility. Anyway the staff are very nice and very helpful in everyway. Overall its an ok place.
ReplyDeleteSpring Grove interesting; although the facility lacks some modern day technology, the place itself operates and appears to meet the needs of its clients. The Staff members are all too friendly and are eager to help and share their knowledge with you about patients and their personal experience on the unit.
ReplyDeleteAfter being on the unit for three weeks, I can say I actually am enjoying my clinical rotation. I was nervous at first when I walk onto the unit, not knowing what to expect. The clients are very interesting clients. The clients always ask why you are here. I say
ReplyDeleteto them, I am here to listen to anything you would like to talk about. The activities that we have presented to the clients have been rewarding and fun. The clients are in a well controlled environment. The staff really enjoy there job, I haven’t once heard anyone complain about there job. They treat the students with respect and allow us to interact freely. The disorders I have encountered have been similar with each client such as depression and Schizophrenia. I have realized that mental illness has hit the African American community hard, and the young adults are increasing in numbers. I feel a lot more comfortable communicating with the mental ill because of my experiences this far
Blog 4
ReplyDeleteThough, I work in another building and I am already familiar with the buildings, the clients, and the staffs at Spring Grove, I still at first feel uneasy and thought I would be uncomfortable doing my clinical there. I also thought that the patient might start acting up when they see new faces and codes might be called. I thought about how the patient might respond to us as students, will they be receptive, deviance, aggressive, or unpredictable in behavior, but upon arrival, the patients were so calmed, well behaved, and were happy to see students. The environment was also calmed; the staffs were nice, accommodating, and helpful. By the end of the week, I felt relaxed, at ease, and became comfortable.
After being at my clinical site for three weeks now it is not what everybody made it out to be. Psychiatric patients are also consider humans. They are not freaks and they are not crazy as people made them out to be. They are abnormal in that they have medical diagnoses; however they eat the same food and breath the same air as normal people do. Every time I leave my clinical site to go home it makes me more appreciative of my friends and family because many of them do not have families. The environment was calm and welcoming. We actually interacted with the clients; we played pool, listen to music and even colored. The staff was wonderful in how they interacted with the clients. There was no discrimination each and every client received the same treatment.
ReplyDeleteAfter three weeks of clinical I am feeling a little more comfortable but yet guarded. The clients for the most part are friendly and happy we are there. We have talked, colored , played board games, and pool. Sometimes when I am home I often think about the facililty and feel greatful for what I have because I could not imagine having to live in a place like that. I wish the patients had more to do. It is all very depressing to me. The staff are friendly and welcoming.
ReplyDeleteDuring these past weeks my thoughts about myself was that I was able to overcome my fear and misconception about mentally ill individuals, I thought my world was falling apart, I had to find my way to clinical, because I do not drive, I had to depend on the cab, which cost me about 40 dollars per week, just to get to clinical, I couldn’t really afford it, so I had to use the money for my bills and food to get to clinical because I came too far to give up. The thoughts that were running through my mind was I can’t wait until this clinical rotation is over because it is causing a financial burden on me and my family. I thought about possibly becoming a psychiatric nurse in the near future. I often felt depressed, when trying to get to the clinical site, but once I arrived at the site I felt happy and looked forward to working with my patient and my group members. . I enjoyed my clinical group, instructor and working with my client. I got the chance to present one of my client’s medication to my group members, did my mini mental, did my group presentation on medication side effects and created brochures. I got the chance to interview my patient, which was interesting because I was about to find out information about her life. I enjoyed doing these activities because I was able to help my client and learn about antiphychotics medications and their side effects. This past week I notice that the patients were excited to attend groups with the students, they pay attention, follow the rules and were interacting and responding accordingly.
ReplyDeleteI didn’t think I would like psych before starting this class and rotation but now I can see myself as a psych nurse. The patient on the unit all really not bad, a lot of them want to talk. A lot of the patients thank us for coming and most of time didn’t want us to leave. The staff was very welcoming and helpful. If we needed anything the staff was right there ready to assist. The environment was very relaxing and calming it reminds me of a floor in a college doom. Once I got pass initiating of a conversation I was ok, this was my biggest fear. I thought it would be hard for me to just walk up to someone and start a conversation but it actually was not that bad.
ReplyDeleteI know that I would not like to be a psych nurse. The staff was nice for the most part except the new doctor and the patients kind of scare me. Honestly I'm afraid that they are like ticking time bombs waiting to go off at any second. Also, I don't like how they stare at you all the time and that some of the guys are inappropriate sometimes. Otherwise it is very quiet and seems like it is a relaxed and calm setting. I realize that there is always a male staff member around. No one had to be secluded or put in restraints since we have been here and I hope it stays that way. I guess the patients should have as little stimulants as possible but I just think the environment is very drab and boring, the staff does not seem to interact with the patients as much as I thought they should. Overall it was a nice learning experience, but again I know that nursing psychology in a mental health facility is not for me.
ReplyDeletePhillip Williams Assignment # 4
ReplyDeleteIt’s been a little over one week since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
Excitement permeated my soul in anticipation of my first Psyc clinical. I had to Google the address, find the location, and get to the facility to meet the professor that I had never met. We got there late but were relieved to have been at the facility. After we were briefly oriented to the units by the nurse in charge, we had the chance to do the scavenger hunt which really made me more familiar within the facility. The facility was clean and well secured and the cottages were allocated to young women - cottage C, adolescence males - cottage B and cottage A for younger boys. The isolation room was the scariest as it has no furniture and seemed to help the client reflect on his or her behavior while in punishment. The staff was professional and cordial which seemed to make us feel welcomed. They were ready to answer or assist us with whatever questions that we had. Most of the patients in my assigned cottage were young adolescence boys and some were being chastised for bad behavior. A couple of them were arguing with the nursing staff and I could determine that some clients were very difficult to deal with on a daily basis. By then, it was time to get our client and read up on their history. After reading and gaining insight about our client, we wrapped and called it a day. My fears and anxieties were decreased because that pressure that I felt prior to that session helped me to understand that even though it may not be a med-surg clinical, psych wasn’t as bad as I made it to be. I particularly enjoyed seeing the clients out in the open associating and being with each other and after learning that some clients have their own assignments only reassures me that the atmosphere seemed convenient for the clients. I’m looking forward to this clinical rotation and want to absorb the most from it.
.Blog #4
ReplyDeleteIt has been about three weeks since I have been here. Without doubts, I can say that some of my impressions about the patients, the staff, the environments and even myself have changed. Prior to coming on this rotation, my perception was that the patients would be violent, the staff would be unkempt in appearance looking almost like the patients they care for, that the environment would be chaotic, and that I would have to work in fear throughout the experience. However to my surprise, everything turned out the opposite. I met with a group of young residents that look clinically normal without any visible or apparent behavioral or relational problems. Several times I watched them play soccer and lift weights. There was no indication of unnecessary aggression or rudeness. The young men and women got along just fine. They followed rules and showed concern and respect for fellow team members. The staff members are so helpful.
Week 4
ReplyDeleteIt has been such an interesting experience for at my Psych rotation. at first, I went in with a lot of apprehension and fear of the unknown however, I can say it is nothing that I imagined. The clients at my facility are very welcoming and quite engaging, every morning when we get to the unit they are open minded to speak with the students. The Nursing staff and unit clerks at my facility are wonderful and very resourceful as well, they have been such a big help in reducing our anxieties. I had lots of misunderstanding psych unit fortunately for us the environment has been very well maintained and calmed. I was very impressed with how lectures are congruent with the actual clinical setting, the client attitudes, sign and symptom are what the textbook implies them to be.
Blog Four
ReplyDeleteI think my clinical environment is an awful environment of anyone! My building, is old, unwelcoming, constricting and just dismal. I wouldn’t want to recuperate there, let alone live there. The patients seem great. It is interesting seeing them and how they display their individual psychiatric disorders. So far in my encounters with my patient, you would not think he had his diagnosis. One clinical day, my classmates and I played games with patients in the day room. We played Wii, pool, Yahtzee, karaoke and coloring. They seemed to enjoy it. The employees, for the most part are not friendly. My classmates and I were going to do an activity with the patients. Most of them were in the room with the lounging watching television or sleeping. We were trying to tell the nurse that we can wait, but she just burst into the room, demanded the remote, turned off the television, turned on the lights, and got everyone up. I thought some patients would be agitated, but they were not. In the day room, there was patient with a karaoke machine, and another with a stereo. They were both on the whole time. The patient on the radio left and another one came and sat down. The orderly in charge asked the patient to turn it off, because the other patient had on the karaoke machine. I felt that she did not have to do that. I don’t feel like some of the employees are therapeutic to the patients, they are just bossy and rude. I find that I am nervous when asking my patient certain questions, because I am afraid that I will irritate or upset him. I am not afraid of my patient, but what I know he/she can do. I do not know what may trigger her/him, and that worries me. So far, I like my clinical, and feel like I could make this my career after I get experience in the hospital. I also know I can’t say that for certain until I have my first bad experience. That may or may not happen in clinical.
Glad to see that your clinical group are engaging the clients. In a long term care setting, its basically custodial care (institutionalization). The patients are sleeping...hmm? Short half-life of most psychotropic meds cause sedation. By late afternoon, patients are often alert and active. Check out the weekly actively schedule on your unit...there are activities, the nurses provided education, give medications, perform treatments, planning care with the interdisciplinary team and assist the somatic doctors...One of the goals for the unit is more activities for the patients...CSU students give them something to looking forward to...
DeleteReflection on Encounters with Patients and Demonstration of Empathy by Nurses and Psychiatrist
ReplyDeleteTo say that the four weeks I have spent at Spring grove mental health facility have been uneventful would be an understatement. These four weeks have been invaluable and one to revere, at least, for as long as I continue to practice as a nurse. The days I have spent at Spring grove have been informative, enlightening, and an eye opener, particularly about the field of mental health and mentally ill individuals. In earlier blogs, I had said “I was skeptical about going for my clinicals at a mental health facility.” However, these four weeks have completely changed my orientation and I can now say I am gaining more confidence working with mentally challenged individuals.
My third week was a most memorable one because I had the opportunity to interview my patient (the interview was revealing and interesting), see vividly how the principles of “limit setting” and “genuineness, empathy, respect and caring” are employed when dealing with mentally challenged individuals. I also had the rare opportunity of observing some of the individuals in their “light mood.” My group and I actually had the opportunity of engaging them in interesting activities including leisure activities that included pool, video games, and singing. The ability to carry out these activities showed that these individuals can be fun to work with if they are not in their crisis situation. It can even make an uninformed person to think that these individuals are normal.
Talking about limit setting and use of matter of fact approach and respect, I noticed that when one of the mentally challenged individuals wanted to attract attention by causing disturbance at the hallway of the facility, the nurse on duty addressed him clearly that he could talk but he would not be allowed to disturb the peace of other individuals. Another individual who kept asking one of the nurse the same question was never turned away but was given the same right answer every single time he asked the question. These scenarios were a practical display of some of the skills I had learnt in class and they went a long way to reinforce my knowledge about skills that can be used to provide care for mentally challenged individuals.
Nurses and psychiatrists demonstrate empathy by being able to accurately perceive client’s situation, perspective, and feelings. They also demonstrate empathy by communicating their understanding to the client and checking with them for accuracy. Likewise, they endeavor to act on this understanding in a helpful way toward the client. The use of these skills enables nurses and psychiatrist to provide therapeutic care to mentally challenged individuals and avoid violence or display of unacceptable behaviors by mentally ill individuals.
This is good news....I would love to share your observations with the Head Nurse...
DeleteWeek 4:
ReplyDeleteIt has been three weeks since I have first arrived on the unit, and I love it. The setting was almost exactly like the movies, it was so crazy to me I thought it would be a little different. I am currently placed at Spring Grove Hospital center. The day room of my cottage I feel was too small. There doesn’t seem to be much for the clients to do. One client said the only thing they had to do was sit in the day room, watch tv, sleep, drink water, on when all else fails walk up and down the halls constantly (A lot of the patients were doing this walking back and forth pacing action). I also talked to several other clients on the unit, and there were some characters! I met one person diagnosed with schizoaffective disorder and mental retardation. His stories seemed very elaborate, and heavily exaggerated. It was hard to get much information from him because it was so hard to tell which stories were true from those that were fabricated. There were also several clients on the unit who seemed extremely normal. Upon assessment of these client’s reason for admission most claimed petty offense crimes such as theft, or public intoxication. I feel like it is a little extreme to keep a person locked in a mental institution for several years for something as minor as a disturbing the peace charge. However, I have not taken into consideration that I have not seen most of these clients charts, and have not been on the unit long enough to establish a relationship deep enough for them to feel comfortable disclosing any seemingly embarrassing or less than acceptable information with me. Oh I almost forgot, I experienced an act of transference for the very first time from one of the clients on my last visit. I didn’t spend any time talking to her individually, she usually spent most of her day talking aloud, to whom I do not know, but I overheard one of her conversations, and it seemed like someone in one of her auditory hallucinations was telling her something terrible about me. She would talk to this hallucination and then looking in my direction with one of her eyes would say things to me like “I am going to get her and others on the unit raped and murdered” she also said several times I was “going to get her and her baby killed”. When talking to my clinical instructor he stated there was not even a record of her having any children and she was not pregnant at this time. I am curious to know what this means and why she feels this way but, am really nervous about talking to her one on one. I will probably end up leaving those thoughts to curiosity but we’ll see. Anyway, I am really looking forward to my next rotation and can’t wait to talk to the patients some more they truly are an interesting bunch.
You can verify with the staff too...Interesting...
DeleteWEEK 4
ReplyDeleteMy encounter with the patients and staff initially was that the staff members were too firm with the patients but I have come to notice that the staff treat the patients individually and their knowledge about the typical behaviors of the patients makes them know how they interact with the patients and when to show empathy.
I have noticed that some of patients tend to take advantage of the “new face” when they interact with us, the nursing students and when the staff is not around, they say inappropriate things and at times certain behaviors, of which the Clinical Instructor does not hesitate to address which is considered “setting the boundaries”.
Due to certain behaviors I have seen, having a group activity like my clinical group did today with the patients initially made me feel more cautious, especially since 16 patients attended. I could notice soon enough that the patients were interactive, respectful and happy that they had the activity and other patients were even looking forward to the activity for next week. We had a good experience especially seeing that some patients expressed gratitude for our efforts and giving them chances to tell us what they did to relieve stress/anger in appropriate and encouraged ways.
The nurse I observed giving out the noon medications also treated the patients with respect and empathy and I feel that it encouraged the patients explain more about their symptoms and feel free as to ask for a small cup of juice without feeling like they harshly turned away. I believe that what I have seen thus far has been different from mental health nursing portrayed in “One Flew over the Cuckoo’s Nest”
The patients are so happy to have CSU on the unit for groups and snacks...they miss Coppin students at the end of the rotation...
DeleteI am really warming up to the environment since my initial visit for orientation. In my initial visit I put a game face on hoping I wouldn't show any type of nervousness or let the clients know that some of them looked very intimidating. This week at clinical to get over those emotions I simply started small talking with some of the clients and they were very receptive. Through talking to them they actually helped deescalate my anxiety a little and even though I knew anything could change in their moods at any given time, I felt a lot more comfortable in their presence. There was not a lot of staff there this week because it was Veterans Day, the staff consisted of all female nurses and one male tech in which were all very pleasant. The charge nurse was very nice and helpful in assisting me with all the questions I had for her about the client that I had been assigned to. The clients were extremely excited to know that we were on the unit and a lot of them were very fresh. Our unit consists of 30 males and 6 females, in comparison to my initial visit on the unit, the females were a lot more receptive of us being there. The males looked at us with googley eyes and wanted a lot of conversation out of the students, at one point our professor had to tell them to back off. That was hilarious. The most shocking thing that I saw on the unit this week was an Asian client with a flat affect and tattoos all over his body from head to toe. Another shocking thing was the client who was around my age, for whatever reason I definitely did not expect to see that young man on the unit and we learned that he had been there before. Overall my experience at Spring Grove so far has been a great one, we came in apprehensive and left out laughing and smiling.
ReplyDeleteIt was hilarious...men can look but they can't touch or comment....
DeleteIt has been a few weeks since I started my clinical. It is very interesting and a learning experience because we see everything that we were taught in class. We see all the signs and symptoms of different mental disorders and the people exhibiting them. It is always good to see the information you learn in the classroom exhibited in a practical setting. We are now getting used to the residents. Unlike our first orientation we were all very scared of the patients, but now we stay with them to chat, play games and perform activities such as bingo. This is one of the many demonstrations of empathy by the psychiatrists and nurses. We were opportune to observe routines in the place such as how they receive their medications and line up. Everything in the facility is timed and organized in a fashion that the patients were kept busy throughout the day.
ReplyDeleteWe had opportunities to study our client charts and see to different codes that were used in the facility. It has been interesting learning all of these different codes; it is always good to see things in a practical setting. My group is very cooperative. We ask each other questions that we don’t know. Our professor is very helpful and he explains anything that you ask. The other day one of us acted as a charge nurse and was able to give a report of every single resident we had. We had a very good learning experience with this. Initially, it was easy finding the venue, but now as I am more experienced I can easily locate my venue. So far I have enjoyed my time here and hope to continue learning much more about mental health nursing.
Glad your evening shift experience is going well
DeleteI must admit in the beginning I was very apprehensive about starting clinical. I was nervous about what it would be like in the unit, if the patients would be receptive to students and if I would ultimately enjoy my rotation. Over these last four weeks I have gained a new found respect for mental health nurses. It takes a very special kind of nurse to care for the mentally ill. I have been enjoying my time at BCRI. I was able to talk with a client and establish a therapeutic relationship. He was very open and engaging and I was very appreciative. I was nervous about whether the clients would be willing to communicate and to my surprise he initiated the conversation. However, last week I was unable to communicate with a client due to lack of interest in wanting to talk with students.
ReplyDeleteThe unit a BCRI is very old. It is not what I expected a mental health facility to be. I was pleasantly surprised with the amount of participation we received in group since we've been there. Overall I am satisfied with my experience thus far. I would like a more stable client but since BCRI has a max stay of about 5 days that is not possible. This week I get to lead group and will be discussing conflict management. I'm excited and nervous at the same time. I hope the clients will be receptive to me and participate. We will see how it goes!! To be continued......
Glad the experience is going well...are you learning something about yourself...its so easy to give of yourself...patients can be labile but keep trying...
DeleteAt first, my thoughts about the environment on Spring Grove Hospital is that it will be very aggressive and rough interacting with the psyche patients but the reality is quite different. After three weeks of being in Red Brick #4, Spring Grove, I feel very comfortable and happy that I have an opportunity like this to interact and be in the same roof with mentally challenged people. I have come to understand that the way people look at them is different from what they really are. Most of them can be friendly and eager to discuss with you. Most of them will start the discussion and give you answers to your questions. My feeling about the environment has totally changed and1 am very confident to have discussion with them. I have a feeling of empathy on the patients that are stigmatized by the society today. The 3 weeks that we have been there, the milieu has been peaceful and cool except for few cases of shouting. Generally, I would say that the patients are co-operative and happy to have us interact with them. The staff members are good and co-operative. But I observed that sometimes some of the staff get stressed up and have to be firm to successfully handle some situation such as sending a patient to seclusion. As for me, I am so happy to have the experience of interacting with mentally ill patients.
ReplyDeleteMaybe you will consider psych as your specialty
DeleteWeek four blog
ReplyDeleteIt’s been three weeks of exciting learning experience for me. On my first day of clinical experience at Baltimore Crisis Response Center, I literarily had a knot in my stomach. I was nervous, excited, scared, unsure and giddy all at the same time. Three weeks later, I still feel some of these emotions but in a good kind of way without the knot. On the first day of clinical, my uneasiness was heightened when one of the patients during a group session announced that he felt disrespected that they were using them as an “experiment rodent” by inviting students to come “practice” with them and then angrily walked out of the group. This really made me and my classmates very uncomfortable and we felt that the patients did not want us there. Maybe it was ill perceived or actually occurred but I felt some of the other patients took cue from the comment and also started to act like our presence at the unit was an intrusion. Three weeks later, all that has changed. The patients actually look forward to our arrival. They welcome us with warm smiles and are really co-operative. The staff members have been kind and warm from day one. They are really happy to have us there and eager to assist us with any concerns that we have. Through the ups and downs, I must say that this has been one of my favorite clinical experience so far.
You will learn not to take the patient's behavior personal. Clear example of paranoid behavior but you knew that (lol).
DeleteI've had a great clinical experience over these last three weeks. When I started the clinical for mental health nursing I did not know what to expect. I had never had an evening clinical and I had never been to a mental health inpatient facility. My patient population is adolescent males. Their cottage is really nice and the seclusion rooms have artwork on the walls that was drawn by a former patient. The environment is clean and does not smell bad. I went into the experience thinking that the facility would have that "schizophrenic smell". It was the complete opposite. One thing that I did experience that I thought was interesting was I had to assess my feelings. After I read my patient's chart I could feel myself being judgmental. Then I had to remind myself what I was there for and that was to learn and to help. The staff hardly interacts with the students, I thought they would be more outgoing and willing to show us stuff or give us information.
ReplyDeleteApproach the staff, introduce yourself and ask questions...same principles for engaging patients apply to staff
DeleteI usually have mixed feelings prior to going back to the spring grove every week. Mainly because mental health nursing is not an area of nursing I was particularly excited about but I must say the clients make the clinical experience worth the while. Each week I begin to feel more comfortable with them and them with me. Most of my initial reservations were because the clients were on a forensic unit and I felt the need to be guarded because of their previous history of violence. The clients are always welcoming and excited to see us each week. My classmates and I have engaged them in activities and some of the clients were excited to participate while other just watched. I think the campus is depressing. The environment feels cold and desolate and the presence of the old abandon buildings only contributes to this. I wish it were more inviting and warm considering it’s a long term facility and the patients reside there many years. As for the client and staff relationships, I noticed that the clients interacted more with the nursing aids than with the nurses. I found this to be interesting because I expected to see the nurses engaging the patients and utilizing some of the interventions that we learned in class but this has not been the case. I know this is partly due to the fact that most of the clients have been there for many years to the nurse client relationship have already been established and the nurses only intervene when necessary.
ReplyDeleteGood observation...you only get a snapshot of the relationship between the patients and nurses...the advocates are actively involve planning care and implementing treatment plans, giving out meds, treatments, intervening with team and keeping everyone safe. The nurses do groups but not on the days that the students are there because you are the nurses...
DeleteMy clinical for mental health is at RICA which is a facility for minors, male and female, from about 7/8 years old to 18 years old. The environment outside seems to be like a school campus. The buildings don't look too old, and generally look well kept. It doesn't feel like an institution, but some of the furniture does look more institutional. It actually reminds me of some of the Catholic retreat houses that are spread across the country for Youth Groups in the Catholic Church. On the grounds their is also a school, and a gym.
ReplyDeleteInside the the cluster of residential areas called cottages, house the residents. They are connect by a courtyard and the central nursing office sits on the outskirts. It is like a command center. The nurse manager is also stationed in this office. Each cottage is staffed with a Charge Nurse and LPNs. They also have a certified assistive personnel.
The personnel vary from some whom seem very therapeutic, to others who don’t seem to be very therapeutic. It is evident in the interactions that the residents have with staff who are the exceptional staff. However, most of the nursing staff seem invested in the residents.
The older adolescent boys are in the cottage where my client resides. This cottage can be loud and also it can be very active. Sometimes the tone of the space feels like it could quickly turn aggressive from a mild confrontational tone. I have witnessed a resident who was very close to being injected with medicine for behavioral management and medication compliance. The staff seems supportive of each other during the crisis. The resident use a considerable amount of profanity and especially at the staff or during causal conversations with the staff. The residents are reminded that the use of profane language will inhibit their ability to move through the level system. However, there weren't any instant consequences. Unfortunately, for residents who aren't compliant, this was another way to demonstrate their inability to comply with the treatment plan.
I actually am very comfortable with the population. I have worked in schools for children with emotional disorders, so this is not very different. I am concerned about the interaction with staff and residents that does not appear to be therapeutic. However we are able to discuss this with the Professor and understand the impact and the consequence.
Glad you have open discussions with your clinical faculty. She will serve as you sounding board
DeleteI am definitely getting used to being on my unit. I am not nearly as anxious as I originally was. I still cant wait for them to move into a newer building. I still don't like the look of the place, it still looks old and worn down. I would love to go in there and give it a fresh coat of paint, but I digress. Most of the staff are very welcoming, most of them. Some of the staff look like they are tired, and dont want to be bothered so I try to avoid them. A good part of the staff are excited when we come in. The clients are starting to grow on me as well, at least the ones that stay for more than a week. It is difficult to build a therapeutic relationship with our clients because we only see them for about an hour then we never see them again. The average length of stay at BCRI is 8.5 days, so our clients are in and out so to speak. The problem with that is that each time we do a group session we meet all new people so we don't know what to expect. Last week I lead a group myself on the topic of nutrition. I was so nervous and didn't know what to expect but I did great and had a good time. Everyone was involved and participating (probably because I brought them fresh fruit and sugar free life savers). Usually half of them sleep or just look mean during our group sessions but this time everyone was up and at 'em so to speak.
ReplyDeletePatients initially sleep due to the half-life of their meds...the body must adjust...that is why we as nurses must teach them not to drive or operate heavy machinery...secondly that mean look is one of the affects (remember patients have negative symptoms)...so you are witnessing the symptomatology and side effect of medications. Glad your group went well...
DeleteBlog 4
ReplyDeleteIt’s been four weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you, how is empathy demonstrated by staff and psychiatrist?
My experience at BCRI so far, has been an interesting one. I was so nervous at the beginning, didn’t know what to expect. But now, I feel more comfortable. The patients have been very cooperative with us in assessing them and getting all the information required to carry out our assigned tasks, and the staff are also very welcoming. The environment is like a residential place which even makes the patients feel more at home rather than in a psych ward. My worst fear on the first day was how I would be able to attain a good therapeutic nurse-client relationship with my patient, but it really wasn’t as bad as I thought. I was able to talk with the patients and even teach in a group with all the patients present at the group session. It was fun, they interacted more with us during the activity, and most of them seem to be very knowledgeable about psych meds. Which was very impressive for me. I think the patients are beginning to get comfortable with us. They do not see us as a threat but as care providers just as they see the other nurses, doctors and other staff members. So far, the nurses and psychiatrist have shown empathy, and seem to be doing a good job judging from what I’ve seen and comments from the patients.
Seems like you are acclimating to the milieu...so you were surprised by the know of the patients about their meds...thank the nurses...they have done their job!
DeleteWeek 4 blog
ReplyDeleteThese four weeks at BCRI has been wonderful for me. The first clinical day, I was very nervous and scared. I was actually expecting to see violent clients but to my utmost surprise the patients have been so calm and cooperative with us. Some of the patients were a bit surprise to see us the very first day but by the time the teaching started they were all relaxed and were all answering questions and asking questions too. I was thrilled to see that they know their medications so well and that though they have mental issues that they were smart and human too. BCRI is unique because of the fact that patients do not stay there for long, in fact the average stay in the facility is about 5-8days so we meet different set of patients each week and maybe one or two from previous week. We haven’t experienced any violence at all and even when they do not want to talk they tell you politely. I feel at ease now interacting with them and having new patients each week has given me the opportunity to interact with different patient. I enjoyed every bit of the interactions and I can’t wait for my turn to lead the group. Most of the staff members are very happy to have us around. They willingly offer to answer our questions and happy to tell us their functions and the different kind of services they provide for clients however, a few of them are not really friendly. The nurses and the psychiatrists have shown empathy when approaching or addressing the clients. Overall, so far, it’s been an awesome experience and I can’t believe that I am considering becoming a psych- nurse.
Do I have a convert? Its nice to know that the experience has given you a different perspective about this field of nursing...you are always welcome to come to psych
DeleteAfter watching movies and hearing personal stories about mental health and being on a psychiatric unit, I had very mixed feelings. I was very excited but oh so nervous at the same time. Now that it has been three weeks and I have familiarized myself with my patient, as well as majority of the patients on the unit, I feel very comfortable. It’s funny to think about how my thoughts of being with these patients have gone from “be on alert, these people have psychiatric disorders,” to “Yooo, I could chill and talk with some of yall on the regular.” The only thing that separates me from my patients is the fact that they have a mental disorder, and I don’t (as far as I know). When studying for exam 2 on the topic of bipolar disorder, I read that those with this disorder are some of the most educated people. Boy has that fact really rang true. I was so dumbfounded to sit and just listen to so many of the intelligent things some of my patients have said in a conversation.
ReplyDeleteAs far as the environment goes, I was expecting a much larger space (like in the movies), but it is much smaller. It is spacious enough for the needs of the patients, but smaller than I had envisioned. The patients have their own rooms on the upper level; there is the dayroom where they can watch tv and/or sleep, and the activity room where they can play pool or cards. I The nurses and direct care personnel are always very relaxed, but are always observant and present when a patient needs them. They are very accepting of us there and will answer any and every question that we have (LOVE!) I feel very official having they key to the unit, but at the same time to DOORS! Every single door has to be unlocked to get into and locked and/or double locked after you leave; can be a nuisance at times, but I’m starting to get the hang of it. I love going to Spring Grove, it is an excellent learning experience that I will continue to make the most of.
Glad to hear your experience is going well....I hope the classroom experience is now making sense and you are able to see the big picture...
DeleteIt has been three weeks for Psych clinical rotation, unfortunately I couldn’t able to interact with a mentally ill patient or a staff member because there was no clinical instructor for my clinical group for the past three weeks. We spent the last three weeks at the school campus working on community mental health assignment and presentation with our class instruction Professor Day Black who worked tireless to get us a clinical site. Guess what, finally our group will be going to Spring Groove on Tuesday. I am excited, nervous and optimistic but I that with professor Day Black on my side things will be just great.
ReplyDeleteMe too....yeah....can't wait to hear your presentation on mental health in the community
DeleteI really enjoy working with my patient. I did not think that I would enjoy as much as I do. Spring Grove could do some repairs such as change the color of the pea green paint to something brighter. I believe that it would help lift someone spirit. The carpet should be pulled up because it is holding smells and God only knows what else. I really like this population. I have had to set boundaries with my patient but overall he is very pleasant and nice. They are a lot of young people in there and it just breaks my heart because they should be out enjoying life not just ony them but everyone. The patients make me laugh. I really enjoy them. Some of them are really intelligent. You have to pay attention to what they are saying and they do actually make sense. Just as Pro. Day-Black lectuers there is alot of pacing, pressured speech, auditory hallucinations, and the smells! Some of the staff are not nice to the patients. I find this unacceptable, degrading and humiliating to the patients. I think they treat the patients that way is because they feel as though they can get away with it because the patients are sedated from their meds.Most of the staff treated the patients they way they would want to be treated I see myself working with the mentally ill part-time. The reason I say part time is because I get too empathtic. Overall I have enjoyed my experience at Spring Grove.
ReplyDeleteGlad to know that the lectures are congruent with your clinical learning experiences. Are you having countertransference? Oh...to paint the walls another color is an act of God...there are only three colors approved for state buildings...RBC #4 painted the dayroom bubble gum pink...the officials had a fit and it was changed back to the pea green in a few hours...
DeleteWeek 4 blog
ReplyDeleteThis clinical has been insightful so far. I remember the first week and how apprehensive I was. I have come to realize that there was no need for the apprehension. First and foremost, the patients are overall nice (maybe not nice to each other, I guess that is expected. They are teenagers, after all! :). Initially, my client was reserved, she did make an effort to open up a bit. She is a smart person, really intelligent, and knows what she wants.
One thing I noticed about the staff is that they are all involved. They work together, share and are attentive to the clients. They work in sync and that prevents any behavioral incident from happening. Probably due to their experience, they understand the clients.
The environment is as homely as it can be. Some of the clients do get to spend some time with their family but some do not have anyone. So, the facility is home to them. Safety is a priority; therefore, it is a locked facility. All in all, it serves the purpose; as a treatment facility but a place for these adolescents to call “home”.
Team work is the key to a safe environment and it avoids patient's staff splitting
DeleteBlog 4
ReplyDeleteIts been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
My thoughts on the arrival to the designted psych unit since the first time had really changed. At first I was scared and didn’t know exactly what to expect and now I don’t think its as bad. My mood turned around. A first I was scared to walk around without my clinical instructor now I can walk around without an issue. The patients not as bad as I expected. The site is still creepy to me but that’s due to the old age of the facility. Overall I’m more comfortable than I was at first.
Glad you are getting more comfortable with the surroundings...
DeleteFORTH BLOG ENTRY
ReplyDeleteIt’s been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
My clinical rotation is a Baltimore Crisis Response Inc. (BCRI). Initially my first thought about the environment was…. “Wow this seems like a half-way house”. But I now realize that although the environment is unconventional compared with other mental health institutions, the apartment- like setting actually proves to be very therapeutic for the patients.
Being that the average stay at BCRI is only 5- 10 days I have been able to talk with many patients. The only downside to that is that you have a very small timeframe to establish a therapeutic relationship. The first patient I had was very open and willing to talk and had only been on the unit for one night. She had a diagnosis of Bipolar I and substance abuse. I want to talk with her more but as I was gathering more information from her chart I found out that she decided to leave AMA.
The second patient I had was diagnosed with depressive disorder. She had been there for three days prior to our meeting and was very difficult to engage. She said that she wanted to talk but then didn’t say much. I tried with broad openings and open ended questions to which she responded defensively. She said “why are you asking me all these questions anyway”. I calmly told her that I’m only here to help and if she wanted to talk it was completely up to her. She said okay and started to open up. She talked about what brought her to BCRI, what her treatment goal was, and one coping strategy that is helpful when she is feeling sad (which was prayer).
The next week I saw her again. She was a lot more willing to talk. She even participated in group and laughed and smiled at some of the responses. My third client allowed me to do a mini mental exam. He was diagnosed with depressive disorder. He was very open, participated in group, and was very funny. When doing the step on the mini mental counting backward by 7’s he said each number correctly in seconds and continued all the way down to number 2. I was amazed… I double checked on my phone and each number was correct. The sentence he wrote was also pretty funny. He wrote “I am trying to figure out the purpose of this”.
The staff is great. They are all very friendly. I was able to complete my charge nurse experience coordinating group times, client interaction with students, pre and post conference, and getting and receiving report from the charge nurse and CRU lead staff. I have really learned a lot. I am surprised that I do like psych as much as I do however, I am not ready to sign up to be a psych nurse just yet.
Sounds like you are having a well rounded experience...thanks for sharing...glad you were able to interact and get an assessment completed. How did it feel to be in charge...
DeletePATRICE WILLIAMS
ReplyDeleteIt’s been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
As clinical has continued. I realized that the environment, patients, and staff are not as bad as I thought they would be. I was originally very anxious because it was a new environment and I had never had to give care to 100% psych patients. I have always given care to those that may have some sort of psych issue as it related to an underlying medical condition. However, after getting into a routine and talking with my patient, I became a little more comfortable and relaxed. I realize that everything takes time and comfort comes with experience. As I get more experience in clinical, my therapeutic communication with the psych patients is improving. Also, the staff is helpful, but honestly don’t do as much work as I thought they would do. The patients, for the most part, are friendly and their behaviors are predictable. I can usually tell when someone is agitated and may get aggressive so I give them their space and come back in a few minutes when they seem calmer. So far, I am enjoying clinical and learning a lot.
What was your expectation of the role of the staff in milieu management...the psych environment requires a different skill set from your other discipline specific clinical rotations...its all about safety and meeting the patient's basic needs.
DeleteAfter returning to my designated Psych unit, my initial thoughts and feelings of being nervous and anxious have drastically changed. After being acquainted with the unit and having the opportunity to introduce myself to my client, I felt more comfortable with the atmosphere and environment. I was not afraid of being surrounded by the clients, but was interested in learning more about each one. In fact, when my time was cut short with my own patient while he was telling me his life story, I was disappointed, as I wanted to learn more about him and his experiences that led him to where he is now. I was not able to interact as much as I would like to have with the other staff on the floor, however they did seem very nice and welcoming to any questions we had. All in all, my clinical instructor helped me open my eyes by doing clinical activities with us, and helping us put the knowledge we have learned in lecture, into practice. I am excited to return to clinical next week and see what else is in store!
ReplyDeleteApproach the staff, techs, social worker etc to get additional information...they love to show off for students...make sure you ask the nurse questions too...
DeleteThis comment has been removed by the author.
ReplyDelete
ReplyDeleteMental Health Clinical – Week 3
Today marks my third week of clinical, I am extremely happy and more relaxed, looking back; I came to realize exactly how tense and anxious I was during and immediately after my first clinical day. Now, after completing the “I don’t know what to expect” phase that characterized the first and second clinical days, I can truly piece together how I was actually feeling this past clinical day.
So today I know my way around RICA, didn’t have to wait like a stranger in a deserted Island. I got around pretty well with my anxiety level depilated; I was able to focus on meeting with my client and conducting my assessment. Then came another anxiety, the uncertainty associated with not knowing if my client would cooperative or not. If he was going to be in the mood to volunteer as much information as I need to complete my assessment.
I have been to clinical before, but It is one thing to walk into the room of a sick, vulnerable stranger with a nurse preceptor directing and guiding you, it is a different ball game when you are face to face with a patient you just met with no idea what to say to him, or even whether to sit or stand, or where to begin. I just wanted to act naturally and pay all my attention to the patient like a caring nurse, but I was aware of how unprepared I was. For one moment everything I learnt in class disappeared. I was unarmed intellectually. At that moment I came to the realization that my success in completing my assessment would be partly dependent on my approach and interaction with the client and this requires professional skills. Now I appreciate why people have to go to school to learn how to work with this population, but believe it or not anxiety sometimes brings out the best in us. Within minutes I was interacting with my client like we had known each other for ages.
The staffs in the unit were very helpful and cooperative one can tell they have been doing this for a while. They were very professional too. RICA environment is very appealing and relaxed, I have been to some state run mental health institutions, but I think RICA is the best; it stirs up the temptation of wanting to become a psychiatric nurse.
Yeah...only way to learn therapeutic communication, the art of engagement and complete an assessment is to be like NIKE and just do it...
DeleteWeek Four:
ReplyDeleteAs we can see time has passed by very fast in our clinical experience. Since I have been at Spring Grove I must say I have enjoyed myself. My patient is the sweetest guy, I don’t even notice that he has a mental issues. I try to treat him with respect and I see that he enjoy not being treated like a crazy person. My patient is very open to answering questions and he love to help out as much as possible. Last week my clinical group did a group section with all the patients and it was fun! In our group we exercised, it was nice to see the patients moving and have fun. But one thing I have notice at my clinical site, I don’t see the nurses enacting with the patient as much, I just see them give meds and that it. It sad because sometimes all the patients just want is a little conversation.
The nurses are deferring to the clinical group...remember you are the nurses for the day complete with a student charge nurse...the unit nurses and patients have a long established relationship and engage advocate to patient in their weekly one on one....the nurse is responsible for all 30 + patients and must know and follow the treatment plan of every patient regardless of disorders, interact and plan care with the treatment team, provide structure for the shift, give out assignments, make sure patients get meds, treatments, see doctors, address lawyers and the judge, manage illness, provide psychoeducation, chart emergencies, monitor and chart effectiveness of meds and the list goes on...the techs serve as the eyes and ears and will alert the nurse for the need for additional intervention...the techs are highly trained in aggression management and even therapeutic communication...check out the patient's schedule to see groups the nurses initiate....
DeleteThe site of my clinical is quite different from what I thought it would be. I didn’t expect a site so close to residential area (other sites I have seen were locate away from residential areas). I also expected it to be locked down. At this site, you cannot come into the facility without being let in, but you can leave. I don’t know why, but this made me a little more comfortable, maybe because it suggest that danger is more likely to come from outside the facility.
ReplyDeleteThe clients weren’t exactly what I expected either. I expected them to a little more “crazy”. They are for the most part relatively normal, but hey normal is relative. Anyway, I have found the clients to be mostly approachable and open. Talking to them hasn’t been as scary as a thought.
The staff has been friendly and informative when approached. They also been a little more hands off then at other clinical sites I have been to. I would have expected different.
All in all, I am learning a lot. Even though I was nervous about conversing with the clients, I have found that for the most part they are not difficult to talk to. Most have been open and some have been excite to have someone to talk to. Because of them I am learning more about the symptomology of the conditions and the people behind the diagnosis.
RICA has been tucked in the Beechfield neighbor seems to me like forever. Residential unit has to be locked for the safety of everyone including the neighbors. The teens can be explosive. They are taught how to control some of their rage. The staff provides external controls to help them using a matter a fact approach which seems harsh to many of your class but necessary.
DeleteWith three weeks gone by so far I am disappointed with how much the state institution has fallen apart. I do not like the conditions that the patients are in. The actual buildings are falling apart and two small for what I would say are the new standards for living. If the patients are not incarcerated, then I feel like the accommodations should be better. An example of this is the way the locks work. My biggest fear right now is not being attacked but not being able to unlock the door because the lock is not consistent and there is a certain way one must hold the door in-order to get it open. The grounds on the other hand are pretty spectacular.
ReplyDeleteAs far as the patients go, I enjoy them. I like the differences between them all and them and watching them interact. My Patient is going through some stuff right now and it is interesting because I am able to watch my patient go through symptom changes and question why these things are happing. Using my knowledge in practice.
I have mixed feelings about the staff. The staff to me resembles the movies and show portals, the staff tends to treat the patients like children and I can see the patients responding in discuss.
I do feel like I am growing as a healthcare provider, I am not worried about anything happening and feel a sense of protection towards the patients.
Right a letter to your new Governor about the need to spruce up the place...students have made educational posters to go up on the walls....report the lock issue to the charge nurse...now that's a safety issue for staff
DeleteAfter a few weeks at Spring Grove facility I have grown to like the place. The patients welcome us as soon as we get through the double locked doors, they all want to tell us about their days, weeks, year. After playing medication nurse, I've learned how differently patient's react to the person giving the medications. Not so nice. Once the patients take their medications, the interesting side effects like swallowing cups and cups of water still remaining thirsty. All in all this is definitely a fun and interesting clinical rotation. I never know what to expect, and it's always a great experience every week.
ReplyDeleteBe so ever ready...you never know what will happen next ...the goal is to keep it calm and quiet...
DeleteOverall, this clinical experience has been wonderful. It did not take me long to become acclimated with the environment and the patients. In addition, my clinical instructor and the hospital staff have been very helpful and informative regarding nursing roles and how tasks are carried out throughout the day. Being in the clinical environment has helped me to get a better grasp on the information we have learned through lecture and textbook readings. It has also helped me better understand the importance of mental health care in its entirety and how important it is for the general public to be aware of various mental disorders and clarify misperceptions of mental health.
ReplyDeleteThe last three weeks working at my clinical site has been interesting. I feel as though I'm finally getting into the groove of things and what to expect during clinical. I will say my clinical site is not exactly what I expected it would be. I expected to find patients that met the ideal idea of a "psych" patient. I haven't yet seen any patient exhibit signs of bipolar or schizophrenia. Most patient at BCRI have substance abuse dependence and an underlying mental health issue such as depression. Most clients I have interviewed the last 3 weeks all were struggling with addiction and were there for help and how to cope and manage their problems. Also since the clients stay at the facility is usually no longer than 5 days we see a different client every week so I am unable to form a therapeutic relationship.
DeleteEngaging the client for whatever interactions you have is the therapeutic relationship...its not the amount of time but the quality...the goal is help the client grow
DeleteWeek Four
ReplyDeleteOne word to describe my three week of clinical, since my arrival is “Unbelievable”, when I compare the memories of the night before my first clinical day, it was restless, sleepless, and high level of anxiety. Now I kept anticipating my next clinical day, when I can interact with the patients. This has been and amazing and humbling experience for me, when I look at the patients smiles, and the joy and appreciation they have for us as students, how grateful they are to us for spending time with them and trying to know them. Of course, there are those who are very vocal, and our Professor will set limits immediately, but those few cannot tarnish my joy in knowing these patients.
When shadowing the nurse administering medications, I was amazed to see how much they knew about their medications, and what time they preferred to take certain medications. I asked the nurse about new orders for patients, new orders was the same procedure in hospital it is fax to pharmacy and pharmacy deliver it to them, which is on the same property. In addition, lab technician, who comes in morning, draws Labs. Staffing is somewhat laid back, some of the protocols were to have head count on all the patients every thirty minutes and document, there are also finger stick testing for Diabetic patients before meals.
Overall, my experience at Spring Grove for past three weeks has been very interesting, and I am hoping to learn a lot more from these special individuals, who has humble me and thought me to, “never judge a book by its cover.”
Seems like you have developed a healthy appreciation for psych nursing.
DeleteWEEK 4
ReplyDeleteI am really staring to enjoy my time at RICA... My first day at the facility was quite overwhelming for a few reasons, one being I have never been in a psych facility for teenagers and two after reading up my clients chart brought a lot of emotion both good and bad. week three was a lot better than week one. when I arrived at Rica, the residents where outside in the courtyard playing cards and interacting with each other. my client on the other hand was dancing and asked me to join her. I immediately did with no hesitation even though I was embarrassed because every one was watching us I still went ahead and danced with her to gain her trust and also to let her know I am here for her. After our dance we talked and she was open about her feelings than she was the first week. The staff in C cottage are very welcoming. There's usually one RN, and LPN and three CAMHS supporting staff on duty at all times. The CAMHS staff assist the residents with activities, meals and take them out for weekley shopping. I look forward to week five tomorrow!
I love to dance with patients...you extended yourself...great intervention
DeleteWeek #4: It’s been four weeks since your arrival to designated mental health hospitals and/or community settings. Reflect upon your encounters in the environment with the patients/families and the staff. How is empathy demonstrated by psychiatrists, by nurses?
ReplyDeleteI was assigned on the boys unit at RICA. Upon my encounters in the environment with the patients, the staff were very skilled and empathic with their patients. When I first walked in the door I was so scared, after I sat down talking with the staffs my fear went away. They were very professional, they knew empathy is not a word to be taken lightly. It is as serious as it gets. In other words the nurses on the boys unit go into the patients’ mind and get an appreciation of where they are coming from. Throughout the semester prof. Day-Black been teaching us that there is usually more to the patient’s condition than is visibly obvious. I finally understand that concept. The act of being empathetic towards your patients, although felt on both an emotional and spiritual level, also allows for therapeutic detachment which is needed in order to be able to do more for the patient. In as much as the nurse steps into the patient’s shoes, he/she is able to stand back, assess the patient’s situation and see it for what it is whilst maintaining professional objectivity because it also allows for an intellectual discernment.
Glad to see that you used references to describe therapeutic detachment...this is healthy and keeps you from countertransference and sympathy
DeleteWeek #4
ReplyDeleteThree weeks at my mental health clinical site went so fast like three days. My initial impression about the facility –Baltimore Crisis Response Incorporation (BCRI) was a first –aid treatment center for mental illness or psychiatric emergency. Also I did not know that it is a residential or inpatient center. However, I was pleasantly surprised when I learnt about the operations and various activities of the center.
I was not frightened when I got there because I deal with clients who have mental health issues at my job. The difference is that those at my clinical site do not stay long in the center for treatment or therapy. It was however an informative and educative experience.
The clients initially were not receptive thinking that we are just going to bother them. So we were seen as intruders. But after the first week, they changed their attitude to us particularly when my colleague led the first Group meeting on Nutrition and served them free fruits and candies. All of them were treated to good and sweet fruits.
The staff were receptive, friendly and pleasant from Day 1. They were very helpful too. The Director of the Center and Charged Nurse gave us talks which were very informative.
I hope to learn more and enjoy the remaining weeks of the clinical rotation
How nice of the Director and Charge Nurse to engage students. That's a plus in my book. You will find that patients are suspicious by nature. They have been physically,mentally, sexually and spiritually abused. They are rightfully guarded. Consistency, genuineness, honestly and respect is the key to getting in.
DeleteWeek 4: It’s been four weeks since your arrival to designated mental health hospitals and/or community settings. Reflect upon your encounters in the environment with the patients/families and the staff. How is empathy demonstrated by psychiatrists, by nurses?
ReplyDeleteThis is my fourth week of experience in psychiatric mental health clinical. For me, this has been a period of gaining new information and having double experience. At first, I was posted to spring grove hospital which on my first clinical day I went there; unfortunately, we were not able to see a patient. On the second day of my clinical, I began community mental health experience which is excited because opportunity was giving to us to research and search for resources used by the homeless and mentally ill client. Another thing I benefited was knowing the correlation between homelessness and mentally ill. However, I have not had an opportunity to encounter a client, family member or his or her environment, but, the good news is, we will be going to spring groove on Thursday morning (20th) to work with patients, thereafter, we will also visit some agencies for homelessness.
Glad you enjoyed the first half of your clinical experience. See you in a few hours at the Grove. Its sleep time ...just finished commenting and grading all the blog postings.
DeleteWow I can not believe three weeks have passed so quick. I really enjoy the mental health environment. It has been a pleasure working with and learning so much about mental illness. Even though the patients have illnesses, they are still human beings. I believe that the patients are lacking support and attention that they long for. In clincal we completed a group with the patients that was titled, "Minimizing and coping with stress." During and after the group the patients expressed some concerns that they had with their environment. Majority of the group expressed that they do not get any attention and that they feel like they are alone. After this group session, I noticed other reasons why the patients feel the way that they do. I initially started off the semester not really like mental health, however, now I can see myself working in this field. As for the staff, I believe that they lack certain skills that should be required to work with the mentally ill, for example, therapuetic communication. I have heard some of the conversations the staff members have with and about these patients and I find it degrading and unappropiate. Everyone situation is different, however nursing care should focus on the client holistically.
ReplyDeleteInstitutionalization much like the prison will breed apathy by employees. Why? This is a long term unit. The chronicity of mental illness and no improvement day in and day out is another factor. Staff are genuinely fearful of the forensic nature of their jobs and feel they have not received appropriate training to address the needs of patients with mental illness and maintain their own safety. How they talk to the patients is often their way of maintaining control. Can't make excuses for the staff but talk with them one on one...start out by saying you don't know how to engage the patients therapeutically in dialogue, what do they suggest? You will find out that they do have the knowledge base...
DeleteThe weeks have gone by faster than I expected. It doesn’t feel like we’ve been on the unit that long but I think that might be because we went to the Alzheimer’s forum. I will say that I do feel more comfortable than I was on the first day. The patients are warming up to us and talking to us more so that makes our day more interesting. I still don’t really like the environment of being locked in and the smell is horrible but I usually get used to it as the day goes on. I don’t really have much to say about the staff. I don’t really see them do much. I see the techs doing head counts and helping with meals. I also observed the medication nurse give out medications to the patients. As majority of the time the staff is standing or sitting around and I guess they are just observing the patients’ behaviors.
ReplyDeleteObserving and maintaining safety for all is a major component...please scroll through some of the other postings...I have explained the function and roles of the RN is detail...Feel free to engage the RN or any of the other staff when you are back on the unit especially the SW...they are a hoot.
DeleteInitially when thinking of a mental health clinical I was filled with feeling of nervousness and anxiety. I must admit that before being equipped with the proper knowledge and exposure I had many false preconceived notions about doing a clinical at RICA or any other mental instituation. Before, when I thought of a mental institution I thought about all white rooms with padded walls and patients in strait jackets. After visiting RICA I learned that I was sadly mistaken. I am pleased to report that there were no padded rooms or straight jackets (that were visible). The institution is extremely modern and well kept and each patient was treated with the utmost respect by the staff. My patient was also not what I expected. I was expecting an unruly, out of control, loud patient who would be completely disrespectful. However, he was the exact opposite and has never given me or any of the staff a minutes trouble sine I started the clinical. My patient and I have a great time talking, playing cards and other board games. Overall, this has been a great clinical experience because it exposed me to something that I was unfamiliar with and now I feel that as a nurse I will be better prepared to handle all types of patients and give them the best quality care possible.
ReplyDeleteSounds like you have a change of heart about patient care with adolescents at the beginning of a long road of hospitalizations across their lifespan. Those with the best prognosis, stay consistently on their meds and have strong support systems.
DeleteSpring grove hospital has been a good experience thus far. The staffs are very welcoming and are quick to advice about patients. Before starting the clinical, I was a bit apprehensive about being in the mental war; I’m more comfortable in being in the unit. I interact with most of the clients. We even engage in playing games and talking about life in general. Although I know I still have to be very vigilant because some of the patients are aggressive and still very delusional, my fear of being in the unit has subsided. I've learned a lot in being on the unit and from the different tasks that have been appointed to me. Being there has made me very self-aware and has shown me how to communicate therapeutically with patients. I do feel a little sad for some of the patients there that are there just because they have no place to go. I feel like there should be another place the patients can live besides being in a locked unit. When my group had a group meeting with the patients, One of the patients stated “I am really happy you all are her with us to talk to us and help us, because most people look at us like we are so different and they put us on the back burner” after that I said to self, I have to be a part of making a change of how the way people think and how mental health patients feel like no one cares.
ReplyDeleteHuman kindness goes a long way...just watch your back...
DeleteTime flies; we are already in fourth week of our clinical. I am assigned to Spring Grove hospital center and I did not get chance to interact with the patient yet. But we are working on our group project about community mental health. It was fun to work in this group project and we get to learn about the mentally ill and homeless people in community. We are going to visit some centers that take care of homeless as well as mentally ill patients which will be a new experience. We will be going to Spring Grove hospital center from this week and I am excited as well as nervous for that. Overall, I get to learn about the mentally ill patient at hospital as well as community.
ReplyDeleteI am excited to hear your presentation on the state of homelessness and mental illness in Baltimore and learn more about the agencies you visited. Prof. Hart's group is also visiting agencies that work with those with mental illness. You will get to compare the hospital experience with community assistance. See you at the Grove in the am....
DeleteSince coming to spring grove I had learned a lot about the way that psych patients act. It’s one thing to read the signs of mental illness in the book but it’s a total different experience to see and experience it in person. I have conversed with patients with schizophrenia, bi polar disorder and various others we have learned about this semester and it has been very enlightening. As far as the staff, I have noticed that a lot of the people that work in brick cottage 4 do not talk to the patients like human beings, mostly they talk to them like they are children in a very demeaning manor. I often feel uncomfortable listening to the way the nurses talk to the patients, it’s like they don’t even care that they could be hurting their feelings. I understand that the patients can be very challenging at times and the nurses may be dealing with issues in their personal life but I feel that its not a good enough excuse to not treat the patients like humans. It may not be that during the day but the evening staff seems to always feel annoyed and on edge. I feel much more comfortable conversing with the patients than I did the first week. I am learning their names and who is social and enjoys our company and who doesn’t.
ReplyDeleteEveryone that employed in nursing at the Grove is not a psych nurse but a nurse who work at a psych facility. There are real challenges to working with a mixed population of forensic and psych patients. The biggest challenge is the fear of being hurt which is real on any given day. Historically, and often times patients are seen not as human. There are some cultures who do not necessary believe psych is a real discipline but believe that the patients are possessed. There will always be good nurses and poor nurses...You get to choose what type of nurse your want to be.
Deletewow! Time goes by fast. I am at spring grove mental institute, first of all the smell of that place drives me crazy, and I am not sure if any of the nurses do any work at all, because they just sit around and do nothing. Secondly they do not interact with the patients at all. However, the few weeks we've been at spring groove I have learned a lot from the patients and our clinical instructor. Being here has helped me understand things better. What I love about clinical is interacting with the patients; we engaged in many activities with the patients, and they seemed to enjoy it.
ReplyDeleteThe smell drives me crazy too!!!! lol! I was beginning to think it was just me!!
DeletePsych RN use observational skills and utilize their support staff to be the eyes and ears of the unit. You have to remember that the unit is a long term chronic unit. Some of the patients have been their several years. The nurses are involved in med management, maintaining safety, planning care with the treatment team, they do groups too and as an advocate meet with their patients for one to one therapy session once a week. Before you arrive, vital signs, treatments are done. Talk with the charge nurse and ask her questions about her duties...you will be surprised....
DeleteSince beginning clinical rotation for psych I have become more comfortable with talking to patients. I was required to lead a therapeutic group, in which I was extremely nervous in performing. Once I started and began to get participation from the patients I was able to settle my nerves. I am currently doing my clinical rotation at Baltimore Crisis Response Inc. The staff is nice and accepting, which is refreshing because in past clinical settings some staff were not so welcoming. The patients have been welcoming and supportive to us as students. I have found them to be open and willing to talk to us. So far I am enjoying my psych clinical.
ReplyDeleteWere you surprised by the response of the staff and patients? Hope your first attempt to lead a therapeutic group will not be your last in nursing in general....remember to have clear learning objectives and plan out your group
DeleteSince starting the clinical at RICA, my prior misconceptions have changed tremendously. I find myself enjoying going to this particular clinical location because for the most part the kids that are here are awesome and have a lot of character. Also a majority of the time spent at this clinical is interacting with the kids either through them directly talking to us or them just wanting to play a game. Also I like this clinical because the kids seem to really enjoy the time that the clinical group is there and are often disappointed when we leave. The environment of RICA is somewhat clean and the kids have their own individual rooms to give them adequate space. The staff are good with kids and give them boundaries while still attempting to maintain a mutual level of respect. The staff are polite to us, but they are not overly inviting. While Ive been at this clinical site for four weeks, I've only interacted with my patient a few times due to the fact that he either doesn't feel like talking or he's in seclusion/"the quiet room". One of the best aspects about this clinical is getting a clear picture of a disease or condition by seeing it in the patients, it really helps with infusing the descriptions from the textbook.
ReplyDeleteSounds like you are off to a good start...RICA is the best kept secret in the State, much more modern then any of the other state hospitals.
DeleteIt has been three weeks since my arrival to Spring Grove, and I’m singing a different tune. I love psych clinical now. I enjoy talking to the patients and watching their behavior. I have not felt as anxious lately…I’m warming up more and more each visit. I love the fact that there are forensic patients on the unit because I would like to be a forensic nurse, and I’m learning that psychiatric nursing plays a major role in forensic nursing. The old look of the building and the smell still bothers me at times, but I’m getting used to it. Me and my patient are building a great therapeutic nurse-client relationship, and I actually think about him during the week, and I look forward to seeing him on Tuesdays…as well as some of the others. I’m starting to think about the termination phase of this…I hope it isn’t too hard.
ReplyDeleteAfter getting over the initial shock of the 100+ old building, no computers, poor lighting and cold temperature, its not so bad...glad you are acclimating and building a nurse-client relationship
DeleteFor me, being enclosed in a psychiatric unit it stressful. I understand that every door being locked is for the safety of the client, but at times I don’t feel safe. The thought that I cannot just runs gives me a heighten level of fright or flight. The staff is all dressed down so it is hard to distinguish nurses from other staff. Some of the staff is not so nice to clients while others are caring and genuine. The clients seem to be moving in a positive direction. One kid drank a bottle of mouth wash and was confined. This incident disturbed the milieu a great deal.
ReplyDeleteNot having a key can make one feel trapped....uniforms are often a barrier to communication...one of the reasons we came out of white uniforms...most psych units, nurses wear professional attire, its only been in the last few years that nurses started wearing scrubs, usually colorful tops and solid bottoms...being professionally dressed keeps you on even footage with other professionals of the health care team. Nurse will often wear a white short lab jacket to perform tasks. PS the staff has keys (lol)!
DeleteBefore arriving to Spring Grove I had a picture in my head of how the facility would look. Beige walls, white floors no furniture, and a sad and creepy feeling. to my surprise when approaching the Red Brick Cottage the outside looked like brick homes but the inside was more like the picture I had in my head. The patients were actually walking around in their own world( most of them) while others looked as if they could be part of the staff. The head phones confused me at first but then it was explained that the head phones were used to keep the voices out of their heads (distraction). The staff well what can I say they were all surrounded and sitting near the entrance. I guess that was to keep an eye on every one and to keep them from the door. It was surprising that most of the time you did not see any of the nurses on the floor. I thought to my self that's weird or maybe it's the norm for a psychiatric hospital. For myself I never thought I would be able to actually carry out a conversation with a truly mental patient. Come to find out I was wrong I have enjoyed conversing with the patients an realized that even though some of us may have problems mental or otherwise we are all human.
ReplyDeleteSurprise...you state that you are enjoying talking with the patients...good...the early stage of the nurse-client relationship...sharing, offering of self...milieu management requires awareness of the location of all patients...so sitting in the hallway gives you a bird's eye view...Go and talk with the nurse and as about all of her duties...the techs serve as the eyes and ears...
DeleteJasmine Davis
ReplyDeleteBlog 4
Now that I have been in clinical a couple weeks I am beginning to feel a lot more comfortable. I have been able to hold discussions with patients and not be so apprehensive. After leading a group on simple exercises I felt a lot better about being teaching the patients and answering there questions. From being around the patients and getting to know them individually it made it easier not to stigmatize them but rather view them as individuals. Since I have evening clinical we get a lot of time with the patients in the game room and I have just as much fun playing the games as the patients do. With my patient in particular, she has her moments where she is stable and because she is elderly, it’s like you’re talking to your sweet old grandma. This makes it easy to do her interviews because she is so willing to talk and give a lesson. However, it never ceases to amaze me how immediately after she says something sane she then says things that show how extremely delusional she is. Many of the patients seem to have their moments of reality where they seem to be just like me and you and then they do or say something that is completely abnormal. That actually was one of the surprises for me because I incorrectly assumed that once you are titled mentally ill you are always “out of it”. But these patients aren’t having delusions and hallucinations every minute of every hour. The staff seem to be nice. I do disagree with the fact that all the staff go to dinner at one time except for one who is left alone to monitor everyone. During that time we noticed the patients were extra sneaky. As far as the facility I still find it old and creepy.
When the cats away...the mice are indeed sneaky...good observation...enjoyed your description of milieu activities
DeleteIt’s been several weeks since your arrival at designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
ReplyDeleteBefore I started my clinical rotation at BCRI, I had fear of the unknown. I had already conjured up this image in my mind of clients who exhibited the “market mad man” syndrome. I imagined walking into a chaotic “terror unit” replete with individuals who would scare the life out of me. I imagined some pacing back and forth with no rhyme or reason and muttering unintelligible words to themselves and imaginary people; others spewing forth expletives, some in various stages of undress and yet others with faces contorted with fury, eager to attack anybody in sight. I also pictured an overworked frustrated staff that would probably take it out on a bunch of poor nursing students.
But I breathed an audible sigh of relief and even laughed at myself for letting my imagination run so wild. I was pleasantly surprised by the group of clients we encountered on the first day and on subsequent visits. The clients are high-functioning and conversant with their medications and their diagnoses. One told me he was on Zyprexa and Congentin. They actually enjoy the presence of students and most of them actively participate in the group therapy sessions. They are also cooperative in one-on-one conversations. With more visits, I have gained confidence and even begun to look forward to meeting with the clients and practicing my therapeutic communication skills. They are able to verbalize their goals and needs which range from finding a place to stay (many have substance abuse issues and are faced with homelessness), and the need to comply with medication and other forms of treatment. Last week, I had an opportunity to be the charge nurse and enjoyed discussing the plan for the day and activities with the actual nurses on the floor and members of the crisis response unit (CRU). There is a multidisciplinary team at the facility comprising doctors, nurse practitioners, nurses, patient technicians, case managers and members of the CRU. There is an atmosphere of mutual respect for each other’s role and team work.
I only took issue with esthetics because the facility is housed in an old high-rise building that has seen better days. The hallway looks a bit drab and the floors could do with a new coat of waxing. The curtains need to be replaced and the general décor improved. But I guess these aspects do not compromise the delivery of quality mental health care to the patients.
You can't judge a book by its cover. Quality is the key. Sounds like clinical is going well...glad you have gained confidence in your nursing abilities.
DeleteSince being at my facility for three weeks now I have encountered many strange/abnormal behaviors among the adolescence, particularly the girls. I have seen demonstrations of sexual behaviors or gestures among the girls and most importantly I have witnessed lazy and inadequate staff members. For me, my thoughts and concerns are mainly about the staff’s behavior towards the patients, and less about the patients’ behaviors. Because first off, the staff are supposed to be trained professionals whose duty is to care for the patients effectively; which I believe they have failed to do. The staff members in my opinion are paid to do nothing, which is sad because parents and the state trust them for the care of theses adolescents who need the best care, but sadly they are not receiving it. The adolescents are sent to these facilities for a reason, which is to receive treatment for their mental health disorder therefore its normal for me observe odd behaviors among them; but for the staff to demonstrate poor conduct and inadequate care is unacceptable. But on the bright side I truly enjoy going to my clinical site and observing the adolescent girls interact amongst each other.
ReplyDeleteStrong opinion...Nurses or Techs or both...when you say lazy what do you mean? How do you quantify poor conduct and inadequate care? Are they providing custodial care? RICA is not a hospital but a residential center? Does that make a difference? Just questions????
DeleteIts been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
ReplyDeleteAs a member of the Community Mental Health clinical group, for the past three weeks, I have been working in my “designated psych unit” – the city of Baltimore. My patients have been the mentally ill and homeless population within the community, and the staff have been the various agencies and programs within the city that exist to serve the needs of the client, which is the community.
My thoughts and feelings about the environment is that it can at times be harsh and insensitive to the needs of the vulnerable members within the community. This is why there is such a great number of homeless and mentally ill members within the city of Baltimore. On the same note, amazing organizations such as My Sister’s Place and Healthcare for the Homeless causes me to know that there are some patches of warmth and consideration for the needs within the city, as evidenced by the excellent services they provide. Examples of these services are three meals daily, job training, transitional housing, and educational programs. Other services include medical care, dental care, addiction treatment and case management. These are services that “the staff” provide for the community, which is the vulnerable population. These services cause me to realize that the environment is not as cold and heartless as it may appear, but that there is genuine care and consideration that exists.
All of these things make me feel encouraged about the types of services that are available in the city to respond to the needs of mentally ill and homeless individuals. As for myself, there is a greater sense of readiness and willingness to join the team of those who serve within the community, both now (perhaps on a voluntary level) and in the future once I am fully licensed as a registered nurse.
Excellent posting...I think you have a good understanding of the plight of homelessness and mental illness.
DeleteWeek 4 Blog
ReplyDeleteBefore I arrived to Spring Grove, I felt a little nervous. When I first arrived to Spring Grove I thought, “Wow, this place is beautiful”. The landscape and entire campus is just beautiful, but I just felt a little bit of sadness for some reason. I think it was because of the trees and how some people spent their last moments before they ended their own lives.
When I got to the Red Brick Cottage, the patients were excited to see us. They all got up to say “hi” and the ones that were too shy to speak were stretching their necks to see us coming through the door. Then as I looked around I thought that this place was not very comfortable for anyone. For the most part the patients were all great. Some of them were not as nice as we would like, but that was expected. I also noticed that the staff wasn’t wearing any uniforms or scrubs that would easily identify them as staff. The only hint someone would get from staff would be the badges.
The food was not very appealing which triggered more sadness, because well, the food the patients were eating every day just didn’t look at all too good to eat.
I met my patient, and I finally got what Professor Day-Black was saying about how the patients were like little kids. It kind of made me smile because some of the patients really have a sort of innocence to them like kids would. It was still frightening when some of the patients began to argue back and forth to each other because they were easily 4 times my size and all I could imagine were two huge men wrestling toward me. I was somewhat comforted by the security because he was laughing and cracking jokes about the situation so if he wasn’t worried I shouldn’t be right? No I was still nervous. My patient is delightful and makes my experience well worth it. I really enjoy this clinical now because of how fun and enjoyable the whole experience is.
It is interesting how you describe the peacefulness and calmness of the outside setting and its contrast with 100+ old buildings. The food is on a cycle menu...Unless the patient has family or some income, its three hots and cot but I heard its better then the food served in the jail. Traditionally, psych staff do not wear uniforms. Scrubs are optional. Badges and keys sets them apart from the patients.
DeleteIts been three weeks since my arrival at red-brick 4 at Spring Grove Health Center. For the most part, I’ve grown in my bearings of how to best deal with those with mental illness.
ReplyDeleteFirst of, the environment is certainly not to my liking, and certainly not to a lot of the patient’s likings either. There are designated places for recreation, eating, sleeping, and TV watching; all of which are scheduled and the time allotted has to be respected. This certainly deters from the feeling of home, even when a significant number of the patients refer to this place as their long-term home.
Second, my attitude towards the patients has evolved into actually developing an understanding of their situation. They are simply patients who intend of having a having a physical ailment as I’m used to seeing, they have a mental illness that affects their behaviors. Even though I’ve heard this sentiment lectured numerous times, I think I have finally gotten an insight into what it entails.
Third, I’ve observed that the staff are respectful and courteous to the residents. Not once have I observed any demeaning or degrading behavior portrayed to the residents by the staff. The only negating aspect of the job that I’ve seen(I’m probably biased), is the amount of sitting, observing, and charting that goes on. I personally don't think I could bare to sit that much. I guess one isn't forced to sit down and can very well stand so long as they fulfill their job requirements.
Finally and overall, I think I have finally got my wits together on how to be comfortable with myself while dealing with those with mental illness.
Self-awareness is a plus. You have provided a very good overall to your experience thus far. Psych RNs do alot of sitting, observing and charting...but they do other things like keeping 35+ patients and 5 staff safe every shift is an art
DeleteIt’s been three weeks since your arrival to designated Psych units, what are some of your thoughts and feelings about the environment, the patients, the staff and you?
ReplyDeleteFor me the clinical experience has being great so far, since the first day I couldn’t wait to report to clinical. However, clinical at BCRI like any other site has its challenges, the first thing is the parking situation. Because we can’t use their parking space sometimes we have to park four to five blocks away from the building, due to street cleaning you have to be vigilant about what side of the street to park your car on. But once in the building the clinical is very informative. Professor, Hart works at BCRI when she is not teaching, this allows the students to work very closely with nurses at the site. Overall the staff is very helpful in answering any question we may have, they have positive attitudes, and at times they even go out of their way to make sure we feel comfortable with clients. Professor, Hart is very knowledgeable and respected by the people she works with at the clinical site. As an advocate for the patents I truly believe the building really needs to be remodel in order to uplift the sentiment off both the patients and the staff
Heard they have a new building project on the way...Prof. Hart is knowledgeable and well connected...you will find the psych is a small specialty thus real psych nurses all know each others especially the good ones...sorry about the parking situation
Deleteit has been three weeks since i started going to Spring Grove and so far i have had an amazing experience. the nurses are very friendly and the environment has help me to learn a lot. my first day at the unit i remember thinking how i was going to interact with my patient and other patients on the unit. and up till now i can actually say it was an amazing experience. my first interaction with my patient was at the medicine station. I had the privilege to work with the nurse who was giving out the clients’ medicine and through this; i got to meet most of the clients and also associated names with faces. It was at that moment i met my patient; he was oriented and appeared stable. I told him i was going to be his student nurse and i will be looking forward working him every Tuesday. He sounded delighted and willing to cooperate. One thing I observed at the medicine station was that most of the patients knew the medications they were on; they quickly questioned a medicine they were not familiar with.
ReplyDeletei enjoy the environment and its quite easier to interact with the patients. on my second week one of the patients was aggravated and hallucinating. that has been the odd experience and so far i really enjoy my three weeks experience.
Glad you were exposed to the medication administration process...the nurses pride themselves in making sure the patient's know their meds and side effect.
DeleteThese last couple of weeks at clinical have been very interesting. I love my clinical group we get along so well. I love working with our professor that we have. I am used to working on an actual psych unit in a hospital so these cottages are very new to me. I feel very closed in because the space is so small. I be having thoughts that what if the patients decided to riot and take over the unit how will the staff react to that because it is very little of them and so many patients. When I come on the units it smells so bad because the patients do not take showers and they where the same clothes every day. It is there right though. I like interacting with the patients they have a lot of stories to share. Don't know if they are true but they sure are interesting to hear. My patient is really nice and laid back he is always happy to see me and share how his week has been. I sat in on rounds one morning and they were talking about a patient who was causing conflict between some of the staff. I asked did the patient have borderline personality and they said yes..I immediately knew they were using the splitting mechanism. Can't wait to see what the next couple of weeks will be like in clinical.
ReplyDeleteBravo...
DeleteIt has been 3 weeks since I started going to RICA and so far Ive had a great experience. The nurses there are very welcoming and eager to answer questions and teach you anything you may not know. The clinical aspect is great, its amazing to me how intelligent my client is, I was shocked to learn just how much information he knew about his own illness, reminded me never to judge a book by its cover. Even though we are not allowed to administer any medication however we had to learn about the medications and even gave a presentation of a medication of our choice. The most complicated part of the day is after the clients have had dinner, they get very active and dont want to go down for their quiet time as a result some of the clients get very aggressive and even curse out the staff. Usually once the staff reminds them of the consequences of their actions they usually do what theyre told.
ReplyDeleteIts so important from the onset of mental illness, that the client learns how to manage symptoms. The nurse is key to education to help with adaptation to their level of wholeness (Levine's model). Psych RNs need to be/stay current in medication actions/side effects and cutting edge (evidence-based) treatments to help the client manage effectively. Its most important that you be able to identify normal adolescent growth and development trends and what is abnormal acting out behaviors. Everyone needs limits and consequences for inappropriate behaviors. This is the premises for societal norms.
DeleteWhen I first walked into the Psych unit, the first thing that came to my mind was how old the building was. Today being my first time on the unit (RBC 4) to meet with the clients, I was comfortable with them to an extent because I have been working in group home facilities for about 6 years. My observation about the patients is that some of them a really friendly while some kept to themselves due to their diagnoses. I felt really bad for some of the patients because they do not have their freedom. About the staff, I would say they are student friendly and were willing to teach and share necessary information with the students.
ReplyDeleteGlad you had a positive first day at the hospital. Now the challenge is help the patients to prepare for community living. You and your clinical group have assess the prevalence/incident of homelessness/mental illness in the community. The goal in the community is to stop the revolving door syndrome. What are the resources to help those living with mental illness? Where are the gaps/barriers to mental health care in the community. Looking forward to your presentation.
DeleteBefore the semester started, I dreaded Psych clinical. I remember talking about it in the hallway with my friends. I wish there was a way to get around it. My best friend is a psychiatrist and she has been looking forward to this experience. She is so passionate about psych that I didn't want to hurt her feeling by telling her I truly do not look forward to the experience. I thought she was weird for choosing psych when she can be a family doctor, a surgeon, or something else. Initially, I was not that happy when my group was assigned the community. But after a while, I said to myself, maybe this was an answered prayer. I don’t have to be locked up all day with this patients. What an ignorant way to think right? But Boy! Was I wrong? I LOVE MY PSYCH CLINICAL. I love the environment, the staff and the patients. Everything about psych is interested. I had my first patient experience today and it was interesting to see what I have been reading in the books displayed right in front of my eyes. The milieu was quite for the most part but the hallway was busy. I saw patient pacing back and forth and some talking to themselves. I had an opportunity to offer self by helping one of the patient get her hair done. It was interesting how my conversation with her was seamless. I asked her all this questions and she answered every one of them. I thought it would be difficult to get them to talk, but it was not. The staffs on the unit were exceptional. They were willing to teach. One taught be the importance of locking one door, before opening the other. Another thought be the importance of having a staff in the hallway all the time. I had the opportunity to do a head count with the tech, and I also enjoyed that. In addition, it was also great to see Professor Day-Black demonstrate therapeutic communication with the patient. Every patient she spoke with left smiling. She is really gifted and an asset to Psych mental health.
ReplyDeleteThe conclusion of my long essay is that I love this experience so much that I wish 432 was just clinical. But again, how would I learn what to do without going to class first? All am saying is I just might be a psych nurse like my friend predicted. I have learned from this experience never to say never because I just might be a psych nurse at Spring Grove someday. Wow! I can’t believe I just said that, but it is true. The ‘me’ back then, will think the ‘me’ now is crazy for saying that. I love this clinical experience so much, and I am taking up my friend’s offer to shadow her in the psych unit during my Christmas break.
Psych nursing is indeed a calling. Every nurse is not equipped to deal with challenges that chronicity of the disorders and/or unpredictability of the behaviors bring. It is rewarding to see small changes and provide guidance/support to those who live with mental illness daily....Welcome to my world!
DeleteMy experience at Baltimore Crisis Response, Inc. or BCRI has been great in providing a better understanding in the field of Mental Health. The clinical has really strengthen my knowledge in the roles and skills of mental health nurses. The opportunity of conducting my own group therapy with clients has helped me to improve in the usage of therapeutic communication. The facility is in an apartment building and convey the feeling of a home with the ability to leave anytime. The staff are very friendly and I enjoy hearing the stories of the staff experience in working in mental health. Nothing was like I expected. BCRI provide mental health and substance abuse services in the least restrictive environment possible.
ReplyDeleteMisconceptions is not unusual. BCRI has provided excellent services to those who need crisis intervention and short stay hospitalization to stabilize and grow.
ReplyDeleteBlog #4 – Maedin Kebede
ReplyDeleteWow!!! It has been 4 weeks
Spring Grove has a very beautiful land escape and natural views. I feel fresh going there. I love natural views. I wish Spring Grove – the Red bricks cottage #2 be modified to meet the needs of the pt. It would have been the best therapeutic place for the pt. as well as for the staff. Pt. would benefit if they have an open space where they can garden flowers, vegetables etc. In performing this type of activity will direct them to be calm, enjoy fresh air, be productive, and have open space to pace around….
I do not have the fear that I had in the first day, I know their names, call their names and say hi to them and i watched their smile. I observed that Pt. knew their meds and its purpose too. They have choices to get water or juice at med. Pass time. I also watched certain pt. requesting PRN meds. There is a head count Q 30 Min. We had group activity and 18 pt. attended. After the warm up and stretching exercise, we served them with snacks. They were eager and happy to get the snack. I felt empathy for them. Finally we gave them the chance to share their individual experience in anger management. They were open and we shared our experience too.
I strongly like the www.silverado.com/ whose goal is to transform the lives of those touched by dementia ……….etc. Can’t Red Bricks cottage at spring Grove and other mental illness facilities have the same goal?
INITIALLY I WAS AFRAID AS WELL AS NERVOUS WHEN I FIRST WENT OUT FOR CLINICAL. I REALLY DIDNT KNOW HOW I WOULD BE ABLE TO DO IT. ONCE I GOT THERE AND THE STAFF MADE US FEEL COMFORTABLE ALONG WITH OUR CLINICAL INSTRUCTOR, THE ANXIETY STARTED TO DECREASE. ONCE I WAS INTRODUCED WITH MY CLIENT THE RELATIONSHIP STARTED FROM THERE. WE INTERACTED WELL AND WE GOT TO KNOW ONE ANOTHER. I SAT WITH HER DURING HER ACTIVITY AND WE TALKED BRIEFLY. THEN I STAYED WITH HER WHILE SHE ATE DINNER AND I ALLOWED HER TO ASK ME SOME QUESTIONS ABOUT MYSELF. SHE WAS UPSET THAT I HAD TO LEAVE BUT SHE UNDERSTOOD. THE NEXT WEEK SHE WAS SO EXCITED TO SEE ME. NOW WE ARE VERY OPEN WITH ONE ANOTHER AND WE BUILT A THERAPEUTIC CLIENT- NURSE RELATIONSHIP.
ReplyDeleteI'm really enjoying my experience so far at Spring Grove Hospital. The environment on my unit is actually laid back. The unit is usually pretty quiet when I'm there. Most of the patients are sleep or watching television in the morning when I get there. A few patients like to stay out in the hallway walking back and forth. When the activity room is opened, many patients like to go play pool or get some air outside. As far as patients go, there are a select few who disruptive and start trouble. I was surprised to see how happy the patients were to have us there, but I understand why.
ReplyDeleteThe staff on our unit have been very inviting and are willing to help us during our stay. I like going to the morning report to see how the staff comes together to solve issues. Going to the morning report shows me exactly how important the social worker's role is. It seems like there are more social workers than nurses at times. The individual treatment plan is my favorite part of the morning because I get to see how each patient's case is unique. Mental health nurse's roles are pretty different compared to nurses in the hospital. Many times, it looks like they are just relaxing, but they actually do a lot of monitoring and documenting.
Since arriving at Spring Grove, I have grown to like mental health nursing even more. I find many of the patients very interesting. When interacting with the patients, I find out that many of them are very intelligent. Though, mental health nursing is not my first choice specialty when I graduate, I definitely want to work in that field sometime in my career.
My designated clinical site is SGHC Red Brick #4 and I have a love-hate relationship with the unit. I will first start off with the cons of the unit. I dread the smell and the overall uncleanliness of the unit every Tuesday. It is not an environment I can see myself making a living out of. Also I feel unproductive because I am still so used to a nurse doing more than just sitting and documenting and observing. I do not feel like I am learning as much as I should be.
ReplyDeleteThe pros of the unit mainly surrounds the actual patients and my clinical group. Seeing the patients really brings the textbook to life, it makes what we learned in class real. Another thing I have come to appreciate is how the patients show gratitude for our presence. Some of the patients just wants someone to talk to and it's satisfying knowing my peers and I can do that for them. My clinical group makes the experience enjoyable as well, there is never a dull moment with this group.
The overall environment of the unit is very unpredictable; we've had slow days and we've had some intense days. I appreciate the experience that this facility has given me.
The clinical site designed to me is RICA, thus far, it has been a faculty in which, I have no contingencies with. The patients there are extremly friendly. As I expected, I personally feel as though these girls in whom I work with arenot mental ill and just want to talk. My client loves to talk and I love to listen to her tell me about her work week. The staff are friendly to me and fellow colleagues and they are extremely helpful in our journey of becoming nursing and theyre very delicate with us. I really enjoy this tight environment.
ReplyDeleteMy clinical site that I was disignated to attend was Spring Grove, Red Brick 4. I am really have a fun time with the clients of Red Brick 4. The staff is wonderful and inviting, as is the clients. I enjoy very much talking to my client. he was able to open up to me and was able to tell me thing that Spring Grove doesn't know about him. Almost all the clients there know me by my first name.
ReplyDeleteThere's a lot that goes on behind closed door with respect to the nurses and staffing. I would say that the nurses do a lot with observation and documenting. I have no problem with the way that they handle things there. My initial thoughts was that I would be more scared than anything, but now I actually look forward to my Thursdays now.
Blog closed
ReplyDeleteWhat I can say with most certainty regarding my experience in these last few weeks at my allocated clinical location is that my thoughts and feelings surrounding the environment, patients and staff, have changed gradually each time clinical has taken place. The first time I was there, for example, I felt nervous and even a little scared. The clients at the facility were waiting near the door to greet us on the first day, and while some were cheerful and welcoming, others eyed us with quiet suspicion. One man amongst the crowd even made a loud statement that incorporated sexism and racism into one packaged deal. It was interesting to say the least. Having said that, our clinical instructor guided us around and told us about with whom to be careful and even whom to avoid. She encouraged us to open up and get familiar with the area and the people within safe rules and guidelines. By the second time we came to the site, we were already playing cards and watching Wii and pool games while conversing enthusiastically with many clients. The staff were nice to us and could tell that we were excited to be there by day 2, so our time there has become more and more comfortable. I think that the staff can see that we are putting forth effort and really care about the clients, so they treat us as part of their team. Overall the experience has become far more comfortable over time for us, so hopefully we are benefiting the clients through our work there.
ReplyDeleteI have actually enjoyed my clinical site (BCRI). I can confidently say I have learned a lot from the nurses and clients. The clients are more willing to share their experiences. This week my client told me all his medication side effects. I was amazed when he listed all the side effects of his medications. I have enjoyed our group sessions and am pleased when someone raised their hands to ask questions. Am still in the process of using therapeutic communication to relate with the clients. The staffs are so welcoming, especially Nurse S.S I learned a lot from her when I was sent to the detox unit for observation. So far it has been a wonderful experience but I do not have plans to be a psychiatric mental health nurse.
ReplyDeleteI am really enjoying my time at Spring Grove. The environment is different from what I have experienced so far during my time at nursing school. The patients are becoming familiar. It’s really interesting to take what we have learned about the different disorders in our lectures and apply it to the patients around us. At first, I was hesitant because I did not know what to expect. As the weeks progressed, I feel more comfortable around the patients. Some of the staff are friendly and a great resource to the workings of Red Brick Cottage #2. They were a great resource in learning about the patients and learning the procedures of a mental health facility. I feel that I have a learned a lot during my clinical period.
ReplyDeleteMy clinical experience has been great! There has been a progressive change from the beginning of my clinical experience to were I am currently. Initially, I was very apprehensive going into clinical. The idea that patients were dangerous with no regard for others is what I stigmatized. Currently, I am more comfortable with the environment. The patients understand their boundaries and are seldom out of control. They enjoy our presence and have warmed up to our visits. The staff are more supportive in our visitation and are willing to share the milieu for clinical maturity. During the last week, I realized my stereotypes of the mental health arena have diminished. The patients do not seem as bad as I envisioned and are teaching me more about mental health then that I thought I could learn.
ReplyDeleteFlorence Amaikwu
ReplyDeleteWeek four Blog
My experience at Baltimore Crisis Response, Inc. or BCRI has been great in providing a better understanding in the field of Mental Health. My clinical experience at Baltimore Crisis Response Inc. has really improved my knowledge in the roles of a mental health nurse. The group therapy with clients has been of a tremendous help for me to improve on my therapeutic communication techniques. The staff are very friendly and I enjoy hearing the stories of the staff experience in working with mental health patients. The nurses are welcoming and eager to help us learn from their experiences I am learning a lot from my clinical site. I look forward every Tuesday to going down to BCRI because it is a good place to learn how to become a good mental health nurse.
Week 4 Blog four
ReplyDeleteMy clinical site was at RICA in Baltimore, my experience so far was very good and the environment is clean. When l first got there, l was anxious and nervous to meet my client at the mental facility. I was scared because I do not know what type of client that l am going to meet, and the kind of nurse that will be there. Surprisingly, when I hit the floor on the very first day, met with my client who was very pleasant, the charge nurse on duty was so nice and other clients were showing off because they saw new faces. The second day continue with no issues on my unit, my client was willing to cooperate, the LPN that was charging that evening was so nice to us, and this made it so easy as well as relaxing for us. It was very empathetic seeing those cute kids with mental challenge disease such OCD, ADHD, Anorexia nervosa, depression, behavior disorder etc. They nurses that work in this facility has so much patience to deal with each individual, because the client curse them out in a minute when they can’t get what they want. As for me, l really like the place, the teamwork spirit in my group, the clinical instructor teaches and guarded us well. I have good experience so far and will like to work as a mental health nurse.
Before my first clinical day I was very nervous. My biggest fear was that the clients might be violent or become agitated while we were on the unit. Now that it has been three weeks many of the clients recognize us when we come in. To my surprise they are welcoming and open to engage with us. It’s a great feeling when client recognize us and tell us about their day. Another concern of mine was that I would not be effective in communicating with the clients. I was worried that I would not be able to see past the clients’ illnesses and may not be comfortable speaking with them. Through conversing with patients in the milieu, I have learned you cannot judge a book by its cover, or a client by their chart. I have observed the nurses on the unit constantly have to be on their toes. Clients wander around the unit as oppose to other units where most clients stay in their private rooms and the nurse does not have to worry about clients interacting with one another. Every clinical day I learn something new, and I am always looking forward to the next day.
ReplyDeleteBefore I started my clinical experience at Spring Grove I have to say I was not sure what to expect. The first day did not go well for me I was afraid. The second and third week have been much better and I feel at ease. I have spoken with my client as well as a lot of the other patients and the experience has gotten better. I am much more relaxed and actually feel pretty comfortable and confident that I can handle this responsibility. The patients are very interesting and for the most part are very easy to talk with. I feel like they enjoy talking with us and I am happy to help them if this makes them feel that someone is interested in them and what they have to say. I have learned a lot about the different disorders as well as the duties of the psychiatric nurse. I really don't think psychiatric nursing is for me but It has been an interesting and informative learning experience.
ReplyDeleteAt first, I didn’t know what to expect from a residential crisis center. Crisis to me had always meant out of control so I had envisioned BCRI having patients that were consistently out of control. However, I have learned that the patients are at BCRI voluntarily and are free to leave at any time. The environment is set up to have a “like home” feel to it since it is in an apartment building. The patients are mostly different every week and it has been interesting getting the opportunity to talk to different kinds of patients with different mental health challenges. The staff has been pretty friendly for the most part and do look to do what’s best for the patients. It is nice to get another view of mental health nursing besides being in a hospital or institution.
ReplyDeleteSo far I have been enjoying my clinical experience at the Baltimore Crisis Response Center. On the first day I wasn't really sure what to expect, but as the weeks go on I have become more comfortable with speaking with the clients. Their participation in group therapy is very impressive because they are really engaged in what is being taught and spoken about. When I did my group about personal hygiene I was a little nervous that no one would participate and that I was going to forget what I wanted to say. Yet, I executed the session very well and the group discussion was great because of the participation from the clients. This is the best experience I've had so far in clinical.
ReplyDeleteInitially i thought going to Spring Grove Hospital was like going to an untamed jail with out of control mental health patients acting up at all time because of the stories that i heard about the facility; they have the worst psyche patients. But that has not being the case at all, its being very quite and well controlled. I started out very nervous going there but now i feel more relax and comfortable engaging in conversation with the patients.
ReplyDeleteSGH cottage 4 is a small unit that houses about 40 patients, 39 as of yesterdays count. Its double locked at all time and stuffy. I feel like it should be open for fresh air daily but that's not the case.
Its interesting to watch the patients weekly, some of them pace the hallway all day, others sleep in the day room, some keep to themselves and still most of them are happy to talk to the students. All these patients have their story and some just want a listening ear.Like my instructor said "the fact that they are sick doesn't mean they are stupid".One thing i noticed is that these patients watch each others back like a team working toward the same goal, to get out of there.
The staff in my unit are nice, helpful and patience to answer all our questions. In most part they just watched and redirect the patients. Overall, i think its a good experience in SGH 4 with my fellow students.
Before this class I never had any experience with patients that have mental illness. Thus, I was anxious going to Baltimore Crisis Center and caring for patients. However, once I got there I found out that all of the patients are there voluntarily and they are actually in a stable condition. Because of that I became calm and more comfortable with the patients. Also, I noticed that the nurses are very cooperative in sharing their experiences and knowledge's. For example, yesterday I had an opportunity to go to the substance detox unit to observe the patient care. The nurse that I found in there was very nice and were willing to share her experience and her knowledge about admitting patients and caring for them. Throughout this clinical session I am learning ways to incorporate therapeutic communication skills when caring for patients; but I don't think psychiatric nursing is for me.
ReplyDeleteInitially i thought going to Spring Grove Hospital was like going to an untamed jail with out of control mental health patients acting up at all time because of the stories that i heard about the facility; they have the worst psyche patients. But that has not being the case at all, its being very quite and well controlled. I started out very nervous going there but now i feel more relax and comfortable engaging in conversation with the patients.
ReplyDeleteSGH cottage 4 is a small unit that houses about 40 patients, 39 as of yesterdays count. Its double locked at all time and stuffy. I feel like it should be open for fresh air daily but that's not the case.
Its interesting to watch the patients weekly, some of them pace the hallway all day, others sleep in the day room, some keep to themselves and still most of them are happy to talk to the students. All these patients have their story and some just want a listening ear.Like my instructor said "the fact that they are sick doesn't mean they are stupid".One thing i noticed is that these patients watch each others back like a team working toward the same goal, to get out of there.
The staff in my unit are nice, helpful and patience to answer all our questions. In most part they just watched and redirect the patients. Overall, i think its a good experience in SGH 4 with my fellow students.
I already knew that Baltimore Crisis Response Inc. was a different type of psychiatric environment based on the name of the facility. It doesn't have hospital or institution in the name so I didn't know what to expect when I got there. My first time on the unit I was pretty surprised when I got there because it looks nothing like a hospital. It reminds you of a dormitory. There are conference rooms and the "cafeteria" on the first floor. The second floor houses the nurses station, patient rooms and group rooms. The third floor has a detox unit on it. It was nothing that I expected. The staff are in casual attire and they just have badges on their necks. The patients are also in their own clothes. The nurses' station is very very old school lol. The patients are there on a voluntary basis so the atmosphere is very different than a hospital. The patients are admitted based on the type of "crisis" they are having. Most of them appear to calm and collected and the turn over is pretty quick. You don't typically see the same patient each week. The patients are usually receptive to students. Most of the staff are very friendly and they love interacting with us. I used to be nervous but now I'm pretty comfortable when it comes to interacting with the patients. I think I'm finally starting to get the hang of it.
ReplyDeleteBaltimore crisis center is unlike any other mental health unit. A lot has changed since my first reaction to the mental health center. The patients and every experience I have come upon so far has led me to be more open minded about the place. When I first arrived at the Baltimore crisis center all I noticed were the big dim rooms filled with patients sitting around. Send patients were watching TV while others were having conversations. When you first walk in the room you can’t help but notice the nice and inviting patient. They smile, say a kind hello and are always willing to share their past experience or the chief diagnosis for being checked into a mental health unit. Patients are the best part of Baltimore's crisis center. They are by far the most grateful inspiring people I have met in my two year clinical rotations. The staff and patients relationship is also positive. The nurse appear to be well invested in their patients care. Although I didn't have a great feeling about this mental health center in the beginning, I have now come to appreciate it.
ReplyDeleteWeek 4
ReplyDeleteSo far clinical has been a interesting experiences. The staff is friendly and welcoming and the patients, well let’s say they have their days. I enjoy doing group at clinical because for the most part the patients are very interactive and they do enjoy speaking with the students. I like that my site is not an actual hospital because it’s easier to get to know patients because they are seeking help. I am learning a lot and I see myself starting to take a slight interest and the mental health field. The patients have autonomy and I can get a lot of my assignments done because they don’t mind talking to students. Overall I am having a great experience and I am looking forward to finishing this rotation.
I am working at BCRI, some of the patients seem so hopeless that it is sad they are only there for a short period of time. The amount of resources they are given in such a quick period of time is almost a whirlwind of information and when you are medicated heavily some of this information is hard to process. As for my experience i wish i could get more from it. Fortunately for me i work on a mental health unit already so i get a supplemental education from that. I get to spend 12 hours a day interacting with patients and i see all sorts of mental disabilities. Being that mental health areas aren't a normal hospital setting it can both be more rewarding and more of a challenge. I get to interact with more patients at a time which is nice but i also have to know more about all of the patients on the floor since they are all interacting i need to know how to properly respond to situations to keep everyone and myself safe. I'm glad i got to learn the therapeutic communication more to enable me to do this.
ReplyDeleteThis comment has been removed by the author.
ReplyDeleteClinical experience at RICA-BALTIMORE will be with me throughout my nursing career. The facility has children with different emotional, behavioral and psychological problems. I have been on older adult psych unit but not on adolescent. The environment at the facility in the evening time are quiet sometimes and can be rowdy and loud sometimes. Some of the staff do not utilize therapeutic communication, it seems like they get loud like the clients as well. There are more of peer pressure, cursing at the staff and fighting in the adolescent psych unit compare to the adult psych unit that I have been before. Also there are more anger and conflict management that trigger some of the episode in the units. Honestly, I feel remorse about the various issue that some of these children are facing. The childhood trauma, nightmares and predicament that they are facing are just sad. Reading through my client chart and post-conference with my clinical groups with different stories on their client are just overwhelmed for these children to experience such traumatic events and emotional damage that will be with them throughout their life.
ReplyDeleteBesides these concerns, RICA-BATIMORE is a nice environment to work in, staff are very welcoming and supportive of our student teaching and activities. Like my client express that, he tried to stay out of trouble to maintain his point, so that he can attend volleyball and finally go home. Am thinking of applying there for a nursing position after getting my license.
I have been at Spring Grove for about 4 weeks now. I enjoy interacting with the patients and seeing the clinical manifestation of the different mental health illness. I wasn’t fortunate enough to see the patients with their family members. However, the staffs are very friendly and interact with the patients. For example, there is a male staff that plays pool with the patients and a female staff that plays cards with the patient. I had the opportunity to go to rounds with the psychiatrists, social workers, and the nurse and I realize the empathy they demonstrated for the patients. One instance, there was a patient that was left at the hospital from birth and had no family that is at the facility. The doctor was so compassionate and said that it is hard for anyone since is like living in a world alone and they were his family. That was really nice of them. So far, my experience had been a learning experience and a pleasure.
ReplyDeleteThe pass three weeks at my psych unit has been a huge learning experience. When I first arrived at the facility I was very hesitant and nervous about the situation. The environment is not the most ideal place for any person but, that is not something I can control. The facility is very old and ran down. In my opinion, the environment is not very therapeutic for the patients. For example, many of the items in the activity room are broken or not fully functional. Sometimes being in a nice, clean, and refreshing environment can put someone in a better mood and I feel like that could be true for the patients.
ReplyDeleteThroughout these 3 weeks I have become a lot more comfortable with the patients. I know a good portion of the patients by name and a great majority of them are very friendly. We have many opportunities to interact with the patients in the milieu and it is great getting to know the patients. I find myself really enjoying myself at clinicals, especially since I have worked pass my uncertainties from the first few weeks. I have improves my therapeutic communication skills a great deal and I am excited to finish out the last few weeks on the psych unit.
During this past three weeks my perception of a mental institution has changed a lot. During my first day at the clinical site (Spring Groove) I was very uncomfortable and extremely nervous. I did't know what to expect from the patients, the staff and the environment. Now that I got to know the patients and had the opportunity to work with then alongside with the staff, my nervousness has decrease.
ReplyDeleteThe enviroment at Spring Grove is almost as a prison, the patients have no automnomy or sense of freedom, I mention to my clinical instructor that I felt so bad for the client for living in such conditions and in a old building that has not been taken care of. My instructor responded to my comment by saying that, the environment may not be the most ideal place but that at least it offers the patient a warm place to live since some of the clients have previously been homeless. At that moment my perception of the environment totally change. The staff at Spring Groove are for the most part very quiet and do not interact with the student much. In the other hand the patients are friendly and love interacting with us. The patients are my favorite part of clinical. It is very interesting to see the different personalities and how every week they act a little different than the previous week as they become more comfortable with the students.
These last few weeks have helped me to become fully aquainted with my patient. He now knows me by name and seems open to my asking him questions. The other patients on the unit also recognize me and my clinical group. We get a lot of participants. The environment is ok and the staff are cool to work with; they have no problems answering any questions we may have. However, the other week(11/5), we were faced with a bit of a challenge. Once arriving to clinical and speaking to the patients and staff as we walked in, we were asked if we could give them a minute while they(the staff) get settled. So my professor and clinical group went to our conference room to continue pre conference. Later we went to the milieu to converse and interact with the patients, we were told it's too loud and that it's "quiet time." Upon going back to our conference room, the charge nurse was asked about the length and days of "quiet time". We were told that it's from 3-6, when shes's there.
ReplyDeleteThis made me feel awkward and uncomfortable the patients were waiting for us to come back out.
We did come out to the floor close to six and went to the game room and set up for our group therapy. Group therapy was a success! The patients stated they enjoyed group and told us that they wanted us to give them a holiday party. We told them that we'd look into it.
One of the patient's told us that he normally doesn't participate in group, but by coming to ours he's learned new things about himself that he actually enjoys and he's happy that he's been going to our group.
Overall, I've enjoyed clinical with my clinical group!
Blog Week 4
ReplyDeleteAlthough before I start visiting my psych unit I had a prior knowledge about inmate with mental health, but I watch the inmate as a correctional officer not as a mental health nurse. But now that I have the opportunity to have a hand on care on the patients with mental health, it feels so strange. Initially when I got there I was scared and not confidence at all to perform my duties. But now I feel more confident and nothing scares me to conduct a mini mental assessment, an IPR, and even to conduct a psychotherapy group to a lot of patients at the same time. I have also developed a good rapport with not just the patients alone but alongside the staff working at the Baltimore Crisis Response Inc. I have had the opportunity to assess a client at the detoxification unit, and also had the opportunity to go out with the response team that actually had to go on the street to pick up patient that calls in requiring help. Right now my feeling is that by the end of this course, I would have gotten all necessary skills and knowledge that I require to be a psych nurse kudos to my professors.
I feel very comfortable and somewhat attached to the clients on the milieu they are always very excited to see us and look forward to doing group. My patient is kind but withdrawn we established a good relationship. Week three we faced some difficulty... when we arrived at the unit we were told that the patients were on quiet time for 3 hours this made it difficult for us to spend time with the clients. We did pre-conference and discussed our plans for group and stood outside of the dayroom until quiet time was over. Group went really well the clients had a great time and enjoyed the snack and the reflections after group each week the number of participants increased. All of the clients are a pleasure to work with and most of them know us on a first name basis.
ReplyDeleteI have a to admit I like my psych clinical way more than I thought I would. My patient is not really sociable but I have built a relationship with her and many other individuals in the milieu. I absolutely love group therapy. I have watched individuals over the last couple weeks go from just peeking in through the window to greeting us at the door when we arrive wanting to know what we have in store for them. Week three was a little uncomfortable for me. I think my colleagues also felt the same way. When we arrived we were told that the milieu was having "quiet time" for three hours. I found this weird because this new to me and while my patient was allowed to interact with me, the other patients weren't and they wanted to. The staff was also not very warm and welcoming that day either. However, group therapy changed the mood. As always we had a good time and learned about the patients and from them as well. This clinical has been a pleasure.
ReplyDeleteI have a to admit I like my psych clinical way more than I thought I would. My patient is not really sociable but I have built a relationship with her and many other individuals in the milieu. I absolutely love group therapy. I have watched individuals over the last couple weeks go from just peeking in through the window to greeting us at the door when we arrive wanting to know what we have in store for them. Week three was a little uncomfortable for me. I think my colleagues also felt the same way. When we arrived we were told that the milieu was having "quiet time" for three hours. I found this weird because this new to me and while my patient was allowed to interact with me, the other patients weren't and they wanted to. The staff was also not very warm and welcoming that day either. However, group therapy changed the mood. As always we had a good time and learned about the patients and from them as well. This clinical has been a pleasure.
ReplyDeleteThis comment has been removed by the author.
ReplyDeleteMy clinical experience so far has been going good. I have become comfortable with being on the unit. I still think that the unit seems a little small but this may be contributed to the fact that I value personal space. The patients have really opened up to us and look forward to us coming every week. Interacting with the patients and hearing their stories has been very rewarding. Most staff members have been very inviting and open to answering any questions we might have. However, as time went on I started to notice that some staff members rarely interacted with the patients and at one point subjected them to prolonged quit time hours. Learning of that really annoyed me because that staff member was being reactive instead of therapeutic. After the first day of clinical I was extremely hesitant over the idea about having to go back but after seeing that our presence breaks the monotony while hopefully making a difference makes it worth it.
ReplyDeleteBefore actually going on the unit I drove to Spring Grove the day before so I would know where I was going. I never knew actually where Spring Grove was and the ride kind of freaked me out especially since it was getting dark when I went. However, when I arrived to Spring Grove and walked on the unit it was not as bad as I thought. What I was shocked about was to see the patients lined up waiting to take their medication. Our clinical instructor was very knowledgeable of the milieu and told us who we could work with and who we needed to stay away from. The staff was helpful...most of them and made us feel welcomed. Overall my first experience was a ice breaker and it wasn't as bad as it looks.
ReplyDelete