Thursday, October 7, 2010

A little behind

I just reazlied I haven't written about the past two weeks of mental health! Between midterms, Colorado, and constant paper writing, I haven't had the time to sit and write. So, I think I will wrap up two mental health clinicals in one....and I'll save last night's for it's own entry.

Three weeks ago Brooke and I were places on the GICU, Geriatric Floor, at College Hospital. I went into it thinking it would probably be similar to being in a SNF or Long Term Care for geriatrics. But it wasn't. We were on the floor in time for shift report. Al the patients were in the day room doing an activity so we decided to sit down and join them. The table we sat at had two ladies both working on their own thing. I started talking to the lady across from me and in the middle of our conversation she began slurring her words. She told me her mouth felt weird, her tongue was not normal and she couldn't move. Immediately I knew she was experiencing EPS (Extrapyramidal symptoms) which is a pretty severe side effect to medication that needs to be treated right away. I went and told her nurse, who did nothing. I wasn't about to let her get worse but I knew the nurse would get mad if I went around her. I debated and than decided to let the RN get mad at me and I went straight to the med nurse to report her symptoms. They quickly gave her Cogentin for an antidote and she went to her room to rest.

After that, I went over to chat with an older gentleman who was coloring a picture. During our conversation a lady came up to me and started talking, asking me why I was there. I told her how I was a nursing student and was just there to hang out. She looked at me and said, "You are here to talk to me? Who sent you? What do you want to know? Why did you choose me?" It took me a minute to respond and by the time I had she was sitting down, blocking me into a corner. Great. #1 rule is ALWAYS have a way out. She asked me if I was going to publish her story in a journal because she didn't want her information out there. " No mam, I don't work for a journal. I actually am just here to chat and join in our the activities for a bit." By this time, Brooke had come over to rescue me but somehow got sucked into the conversation as well. The lady started telling us about how she was gassed the night before with the "orange gas" She stated that it came through the ceiling vents and that we shouldn't look up because "they" are watching us. She talked about the "little latino men" who were creeping through the smokey hallway and how they took everything out of the room. She talked continuously, most of it not making any sense at all. At one point she was pretty agitated and I thought she was going to lash out. My only way out would have been to fling myself across the table. That would have been a site. The interesting thing was, in all of her rambling and scattered thoughts, there was some truth to the story. Their floor had just been under repair along with getting all the floors cleaned. Their were "little latino men" who had been roaming the halls, there was a strong, gas like smell, and the smokey hallway had been there too. I've learned you have to pay close attention to what people say because in all of that scatter is always something that they are trying to get across.

Later that same clinical day ,Brooke and I were sitting at yet another table talking to another gentleman. We could hear a patient who was pretty upset yelling in the hallway. She came storming in the day room and was threatening all the staff. No one else in the room would make eye contact with her, they just looked down and continued to work on their activity. Through out her aggressive outburst, she was rigt behind Brooke, swinging her arms around pretty close to her head. I mouthed to her, "Be careful" and she slowly scooted over a bit. We continued chatting with the gentlemen at the table when the lady decided to act out again and was walking by our table. Brooke and I would have liked to get up and leave the room, but we were stuck because we would have had to walk past her and she was acting out on anyone in her way. She came right behind me and I could totally feel her presence. I didn't want to acknowledge her in case it would upset her, so I just sat still. I could see Brooke's face expression change and for some reason my gut told me to lean forward, so I did. Thankfully because she had been swinging to get me but missed and ended up going for the man next to me. Thankfully, the nurse was able to calm her down and it was time for our dinner break! Whew!

The following week we were assigned to NICU...which is a high acuity unit. There were a few new admits that day, police drop offs. Our teacher placed the only male student with us that day which made both of us feel a little better having him right there. Each of us met and interacted with someone and although we were only on the floor for a short time, we learned alot. One of the patients had EPS, so we were able to see that again with different presenting symptoms with this case. We watched an new admit assessment interview and were able to talk with him about what he has been struggling with.

Although mental health is not really my thing, I love how each week is so different and I walk away with a new appreciation for the field every time. It's crazy to think I just have 2 more clinical days at this site!!!

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