This week was my first week at the San Marcos Treatment Center. I was placed with an RN in the unit that contained Adolescent girls. I was not sure of what to expect at this facility, since I had never been here before nor worked with this type of age group. Although I have interned at a Pediatric Clinic and worked at a Day Care, I had never been exposed to working with adolescents who have mental disorders. However, I still knew that this vulnerable population still needed to be treated respectfully and advocated for. Coming from a facility in which the nurses wouldn’t even acknowledge the students, having been paired with an RN who was informative, helpful, kind, and did not neglect her patients was very refreshing. Nonetheless, today, I recognized that evidence based practice is essential, when observing the mental health associates (MHA) interacting with the patients. Many of these MHA’s were very rude and disrespectful to the patients. They made it seem as if they forgot that these adolescent girls were patients who deserved to be treated with respect and their safety must be promoted. These MHA’s would talk to these patients as if they were just talking to another group of their peers outside of the facility. They would curse, make rude jokes/comments, and talk about them among themselves right in front of them. The way that these MHA’s acted made me realize that they may not be aware of proper evidence based practice in regards to providing respectful and safe patient care. Although I am unsure of the policy the facility has regarding the use of ear buds or carrying around backpacks with long straps (that could potentially be used as a weapon to self-harm or harm others) I still think that the MHA's are responsible for not allowing patients to use these items. I’ve learned in class that evidence based practice should prohibit the use of or accessibility of these items to patients who are at risk for self-harm or harming others. Due to the Metal Health Associates lack of nursing evidence based practice, I believe that the use of this practice is essential in ensuring the patient’s safety and respect is being addressed.
Hearing the Mental Health Associates talk to the patients disrespectfully and make hurtful “funny” jokes towards them made me feel very uncomfortable. As a student nurse who has been taught to respect all patients despite their age group, developmental levels, or condition, hearing these associates who are supposed to be acting professionally failing to do so made me feel frustrated. At the time, I was thinking about perhaps mentioning to them that perhaps they should talk to the patients with more respect and not joke around with them so harshly because of how it could impact them mentally. However, I decided to not step over anyone’s toes on my first day and instead just mentioned it to the nurse and to my instructor. Thus, I handled my reaction to this situation by using this situation as a reminder of how not to treat a patient and how I, as a future nurse, should respect all patients and observe all surroundings for potential safety hazards. This situation challenged my assumption of how all personal is stated to be trained in properly talking to and caring for these patients, because if this was true then the MHA’s would be more cautious of potential safety hazards or their disrespectful treatment towards the patients. This experience has definitely opened my eyes as to how important it is to know about proper evidence based practices and patient care while trying to maintain a safe and respectful environment with all patients.
Although I wish we had more interaction with the patients, I did learn a lot through this experience. This experience has taught me that what we learn in class about evidence based practice and the importance of maintaining a safe and respectful environment are practices that should be used throughout our entire nursing career regardless of which facility or population one is working with. This event has definitely impacted me by seeing the type of nurse I don’t want to be, someone who is disrespectful, doesn’t maintain professional boundaries, and doesn’t consider patient safety hazards. Although the nurse in this facility which I shadowed did an excellent job and making sure she maintained a respectful therapeutic environment, I think that this facility needs to consider perhaps reminding some of the MHA the importance of treating patients with respect and ensuring their safety. Everyone in this facility should work as a team to ensure proper centered care, so hopefully some of the MHA's start realizing that they are working with actual patient’s and not just babysitting adolescents as they may sometimes think.
I will use the knowledge gained through this experience in the future, by reminding myself of the importance of evidence based practices and providing respectful and safe patient care. When a circumstance like this occurs again, I will remember to inform my instructor about it and make this experience a learning experience of perhaps what not to do while providing patient care. This experience will definitely alter my future nursing career by allowing me to see that all patients, regardless of age, condition, or developmental level, deserve the same respectful care as everyone else. Since I wish to work with kids in the future, this experience has allowed me to see that professional boundaries must be implemented into my future patient care.