On the 8th of April during clinical I was assigned to the chemical dependency unit. I was assigned to shadow the charge nurse for the day who was helpful during the day. She had assigned me a patient to study for the day who had been fishing and using alcohol with his uncle. He had a lot of anxiety and was often angry. He had been diagnosed with suicidal ideation and was detoxing from alcohol.
There was one incident that had made me alert and just a little anxious. A PT had just gotten off the phone and we had later learned that she had been fired. She stormed out of the dining room and began screaming with a loud voice “I wan’t to get out of here.” She had picked up an object like a sign and threw it in anger across the room. I was currently with my PT whom was detoxing from alcohol and taking his vital signs and asking him about his anger. After the initial shock of the screaming I was worried that my PT was going to escalate also so we had moved him to his room to remove him from the situation. The PT who was detoxing from alcohol was given Ativan to help him calm down because he was angry for no apparent reason and was anxious and had an elevated HR and BP. A couple hours had passed and after lunch he had become anxious again and his BP was 170/102 and 110 HR. He was angry again and so we gave him clozapine. I started to think about serotonin syndrome as he had just started some ssris. This was dismissed by the charge nurse as she said “I don’t diagnose.” I’m not sure what had happened after we left the hospital but I would like to have known if his HR and BP were soley elevated because of anger and anxiety or was there another underlying process.
Overall I learned a lot about the power of just talking to a PT and how that can be therapeutic. I felt like the PT detoxing from alcohol was beginning open up to me. I learned that he used music to drown out his anger and decrease his anxiety. He was a man who was anxious and needs some outlet to express his anger and find effective coping mechanisms other than drinking. I feel as though my day was well spent and I learned a lot.