Derek Cantu
NURS 342-Behavioral Health
Mental Health Clinical Journal (April 9, 2016)
Today’s clinical was back at Methodist Transplant and Specialty Hospital in San Antonio. The day began when four classmates and myself went to observe what takes place during ECT. The day started at 0500 which was bright and early. After observing ECT I went to the Level II floor of the psychiatric part. This is where I stayed until post conference took place.
ECT was interesting to watch. It was nothing like I had anticipated it to be. ECT has come along ways since what is was displayed to be in the older days. The amount of technology that has been improved since when it was first invented has greatly changed over the years. Everything was very organized and the nursing staff was very organized with their process. Each nurse had a specialty in which they did in the admission and pre-op process. One nurse was in charge of vitals and paperwork, while the other two did IV starts and connecting the pads to the patient. One thing that I found interesting was that the patient dictates when they receive ECT. The patient chooses when they want to do it and whether they need to come multiple times in the week or not. One patient had even complained on how she did think that the shock was working and needed to be increased. The doctor listened to the patient and increased the dose of electricity. The process was very quick. The amount of time it took for the whole process to take place was no longer than five minutes if that. The process started by the patient identifying themselves then they were put to sleep. While being put to sleep, the anesthesiologist also gave them a paralysis. This would prevent the body from moving while receiving the ECT. The way in which the ECT was monitored was the toes on one foot would be the only thing twitching which would notify when a seizure was taking place. This indicated when the seizure was over and then the brain seizure would go for as long as 10-15 seconds longer. For one particular patient it went longer than expected and the doctor ordered a prescription of Versed to help the seizure stop but the patient came out of it right after he ordered it. The amount of time it took for the patients to wake up and regain movement was about 30 minutes. After this, the patient was given water because one medication they received would dry them out in order to prevent any complications during ECT. ECT was very interesting to watch and it was such a quick process. After watching ECT, I was put on the level II floor of the psychiatric section. This was a busy day because the hospital was doing a switch to another floor so they could clean a section of the hospital at a time. This required a lot of staff members in order to accommodate the transition. One patient on the floor was blind so she had to be introduced to the new floor to make a new transition. She was taken by a tech and shown around in which she felt everything. While making the move, all the patients charts had to be changed to the new area. All their clothing had to be moved over that was in storage which was done by myself on this day. Some patients had so much clothing that they brought in that it was crazy to move. The most one patient had was five full bags of items. Another interesting thing that happened was a patient of the nurse I was with had a discharge for a patient who was going to jail. He had made threats against the president which was why he was going to jail. This was an intense process as well as stressful because the hospital security did not give the nurse much time to gather all the patient’s documentation. The security did not want to make a scene, but the exact opposite took place.
Looking back at the day it was very eventful and long. A lot took place on this day. Today I felt my greatest accomplishment was when I was able to partake and help with the transition. All the nurses were stressed so it was one thing I could do to help them out. This day taught me that no matter what takes place it is important for the nurse to remain calm and not let all the stress get to them. The nurse I was with for the day had a lot on her plate but took it one thing at a time and held her composure. Seeing ECT was interesting to watch because how simple it was. It was nothing like I had expected it to be. It was so simple and quick. In retrospect I realize that all nurses must work together especially when a day like this clinical day did take place.
The knowledge I gained today will be helpful to know in case I ever go into this field. I do not see myself going into mental health. One thing that will help is if I ever have to move floors in a hospital. I will have to remain calm and just continue doing my job as a nurse. No matter how stressful it may be I need to be able to continue doing my job. Being able to do my job in stressful situations will be exactly what I look forward to. Overall, I feel that the transition will be something that helps me in the future and be able to adapt to any situation that I may have to be in.