Derek Cantu
NURS 342-Behavioral Health
Mental Health Clinical Journal (4/1/2016)
Today’s clinical took place at San Marcos Treatment Center. The day started at 0830 in which we all met in the administration office then went to the medical record room to discuss the clinical day. Kenzie Cunningham, Michael Davis, and myself were all assigned together. Michael and I switched rotations to be with the CNC. I started out with the CNC in the New Heights boys side. Kenzie and Michael were placed in the New Horizons 1 boys side. I was with the CNC until 1130 and that is when I went to the cafeteria to talk with some of the students. After lunch, I went with Kenzie which was to the New Horizons. While being there we also went to one chemistry class and then reported for post conference. After post conference we returned to New Horizons 1 for group therapy.
Being with the CNC started out slow today, but eventually picked up towards the end of the shift. At first, I was looking at the students’ charts while the CNC was doing other work on the computer. The CNC was friendly and asked me if I had any questions for her while I was with her. She is currently in school to receive her BSN. The first thing we got to do was help a student with paperwork for their pass weekend. The CNC was required to gather the student’s medications and write down all the information that was needed. After doing this, she then had to give the case manager the medication paperwork and medications. At this point, the CNC job was done for the student’s pass weekend. After this, we got assigned to do an admission that was being admitted. Before we went to the new admit, the CNC had to gather all the new admits information and read over other charts of the new student’s. The patient had been living with his father in El Salvador but his mother had just recently received custody of him. One barrier I noticed in the admission process was the new admit did not speak very good English. It was his second language while Spanish was his primary. The admission process lasted about 30 minutes that including gathering all the student’s information and mental health disorders that were the reason for admission. After this was done, the information was taken to a case manager and at that time I left to go to the cafeteria to talk to the students. I sat and talked with three students today at lunch. The conversation ranged from what classes they liked, what they wanted to be when they grew up, and little arguments that I would try to settle. The students were talkative and did not have problem carrying on a conversation with me. All three got their equal share in talking and all wanted to know what it was like to be in college. They asked about nursing as well and what all I would do as a nurse. Talking with the students at lunch was a unique experience that I found very helpful with mental health communication. After lunch Kenzie and I went and sat in on a classroom. One thing I noticed and question is the level of teaching and comprehension that takes place in the classroom. After sitting in on the classroom, the amount of teaching that took place was interesting. It has a different standpoint that what it is like to be in public school. The teacher was unsure about some of the material she was teaching and I am not sure whether it was that effective to the students. The techs also had more authority than the teacher. I personally felt that the tech had more authority than the actual teacher of the class. The teacher was not the one threating the students with punishment, but it was the techs. This is very interesting in my opinion. Another event that follows will highlight more on a similar issue. After post conference, we went to group therapy which was very eventful. A fight broke out between two students that caused the techs to get involved and separation had to be done as well. The fight broke out after a student got mad when an incident with a tech broke out. I personally feel like it was provoked by the tech. The other student that was involved in the fight has a trigger of loud noises and screaming which a lot was taken place. At this time, the two students stood up and made movements toward each other. Punches and kicks were taking place but the techs took control by separating the students. This was not done easily by the techs. The students had a burst of energy and strength. The nurse was then notified of this and she had to order what they consider a emergency medication. Another tech was called in which I am calling the head tech. When the nurse went to give the emergency medication the student yelled at us to get out which we did. The nurse came back later and told us that the tech questioned why she had student nurses watching and that it was not appropriate. It takes me by surprise that a student tech asked a registered nurse this. The contradictory thing about it was that the other techs were actually in the room and we were outside of it. I would have not be able to kept my cool if I had a student tech question my authority especially when I was a registered nurse. We did nothing wrong and were doing what was outlined in our clinical guidelines which was to follow the nurse. I thought this was very inappropriate and the tech had no right to question the nurse.
The events that took place today were pretty slow until the fight broke out in group therapy. It actually took me by surprise and gave me a rush when it all happened. I don’t think the tech arguing with the student handled it in the appropriate manner and instigated the outbreak. When looking back, it was very interesting to see and gave us the perception of what can take place in mental health. The therapist also had to get involved which the outbreak and almost got hit by doing it. The situation happened very quickly and all the other students just watched as it happened. After this situation, I felt like the rest of the day ran pretty smooth. It was nice to talk to the students at lunch and get to interact with them casually. Today I felt like my greatest accomplishment was interacting with the students because I was able to apply things I had learned in class. I felt like today was a good day as the nurses I was around interacted more with us and actually got me involved and gave me information on things they thought I should know.
The things I used today will help me just in general communicate with all types of patients. Being in nursing, all types of patients will come in and that could be any age or problem. Communication is a crucial key when you have to figure out what is wrong with a patient or what is bringing them in. I will need to make the patient feel comfortable and gain their trust in order to provide the appropriate care they may need. Also, I learned of what may happen if I ever have a noncompliant patient that needs some type of medication. Overall, I felt like I learned things that will help me in future and will be very helpful.