First one down

Although I have a stack of homework to plow through for tomorrow, I need to write down last Wednesdays clinical before I forget it all...which is likely to happen because my days are starting to all run together! Last Wednesday showed me how brutal this term will be. Class starts at 8am for lecture and than I get enough time to eat lunch before I have to report at College Hospital for my clinical shift till 11pm. Now, don't forget Tuesday consisted of a clinical, Thursday holds another class, and Friday....7 am pediatrics lecture! So by having this crazy Wednesday, it throws me off for the whole week....hints the dark circles under my eyes. :)

I was nervous when I arrived at the hospital. There is no question about that. I think we all were. In our pre-conference we took a math exam and than everyone just sat there. Silent. No one knew what to expect. We all had our own vision of what this clinical would be like and I don't think any of them were positive. Of course, my sweet professor can sense our worries and fear. She put a positive spin on everything and took us on to our units.

Brooke, Rommel, and I were assigned to EICU. ( Not the very dangerous, but not the high functioning....somewhere in the middle. A transitions unit.) When we arrived on the floor, the staff was very welcoming...one of the night RN's was a graduate from our school! The patient's...wait, I need to call them clients now....the clients were just sitting down for dinner. We didn't want to disturb them so we grabbed a few charts and headed into the visiting room to familiarize ourselves with their charting system. It came time to head out to pick our client. The only area we can be with them is called the day room. It's like a large family room that opens up outside to the smoking patio. When in the day room, everyone is within eyesight and they are kept a close eye on. I initially choose a young man, about 21 years old, to try and approach. I saw down next to him at the table and said hi. No response. I than asked him his name and introduce myself. One word response. I sat in silence for a minute and than tried to continue the conversation but it was going no where. He pulled his hood over his head and I took that as a sign he wanted to be alone. I wasn't going to push it! I'm glad too because later he was sitting there talking to himself, cursing up a storm, and I'm afraid if I had been talking to him I would have set him off.

I turned to look across the table from me to where a Hispanic lady, about 50, was finishing her dinner. I smiled at her and she returned it. Ok, so far so good. I greeted her and introduced myself. She did the same. Alright two for two. We may have a conversation here! And did we ever. After that she talked for 2 hours straight...I'm not kidding or exaggerating either. I've always seen the words, "pressure speech", on mental health assessment forms but I never knew what it was until that night. Some of what she said I could not make out due to her accent. But here is a snippet of what I did learn....remember, she suffers from a psychotic disorder so these are all just thoughts running around in her head.....

• The water at the hospital is poisoned. I should only drink Sparklett bottled water because that is safe. All other bottles the staff opens up and drops in white tablets that poisons people. And, I should never touch the tap water. It may kill me.
• I should never walk the streets in LA. ( Like I would anyways, right?!) She went into great...and I mean great...detail about what would happen to me if I did.  Enough so that if I hadn't been so completely exhausted by the time I got home I probably would have had a massive nightmare. Needless to say, I will never walk by an alley again...ever.
• She apparently was once a cosmotologist from Mexico. She did manis, pedis, and hair. But someone broke into her shop....and later on it was her car that was broken in to....and stole her license. She than made a plan as to what she would do to pay them back for stealing her job. She also blamed it on America.
• Don't ever get a shot. Why? Because it too is poison. When they gave her a shot ( i'm assuming when she was admitted because she was belligerent and dangerous to herself and others.) she waited till the needle was removed before she pinched her skin on her arm and squeezed all the poison out. Otherwise she would be dead. 
• They even come after white girls like me. Who? I don't know. 
• She thought my scrubs looked like Popeye and Olive Oil. Awesome. I usually say they are a mix between Merry Maids, Top Chef, and a sailor, but Popeye was truly genius. 

I could go on for another 20 bullet points on different things she said. One of the interesting aspects of the conversation I noticed was that while she was rambling off all of this, I could literally see how the thoughts and images were just racing around inside her head, unable to straighten them out. Her face held this blank look to it...almost as if her eyes were hollow and you could stare right through the dark, black pupils. Something I have never experienced before.

Before we left, I flipped around in her chart to gather information I would need for my assignment due tomorrow. I wanted to see her admission note so I knew why she was brought in. It was against her will, meaning she was there on involuntary status. She was admitted because in a psychotic moment, she stabbed her roommate with a dinner fork and than chased her neighbor with a kitchen knife, threatening to kill him because of "what he had done." I'm glad I found all this out after we had been talking for 2 hours!

The unit wasn't so bad....but not the field of medicine for me. I do think i will enjoy this clinical though. As long as I never let my guard down! I noticed last week how easy it can be to forget that each one is unstable so I need to make sure I am cautious of that last night. It was a good first week though and I am interested to see who I can converse with tomorrow!