Clinical Journal 4/1/16
On this clinical day the nursing staff, students, and patients were involved. Upon arrival, we had a brief discussion of what happened the previous clinical day, and what to expect for the current day. I was assigned to the unit with preteen males. The nurse there was Mrs. Utley. She was extremely helpful in explaining things to us, and told us many stories of what she has seen at the facility. She explained that there was one boy who kept exposing the wires on outlets, and at his last facility he did that and shocked a nurse. She had been dealing with this issues for a week, and the provider wasn’t doing much to help the situation. Finally halfway through the day, the provider said that the boy would be transferred to another unit. Mrs. Utley expressed that this is typical in that she tries to look out for the safety of everyone, and sometimes nothing is done. We later sat in the cafeteria with some of the students and talked to them. I learned that one student wasn’t allowed to have a drink at lunch because he would wait until he left and drink it really fast by the trash can. I didn’t think it was very fair to not allow him to have a drink because of this, but I didn’t want to step on any toes by questioning it. When he told me that he looked very disappointed and confused, and I felt sorry that I didn’t have a solution for him. After lunch we had post conference, and then we went back to our unit for group therapy. In group therapy two of the boys got mad at each other and charged for each other, but a tech interfered and prevented the fight (even though the boys tried for several minutes to get around the tech). They wound up having to call for backup, and the boy who started it was given an injection of Benadryl to calm him down.
The fight during therapy it was stuck out in my mind the most from this clinical day. I was glad to experience the situation and see how everyone handled it, especially the nurse. I finally felt that I was learning the role of a mental health nurse. It was interesting to watch the role of everyone and to see how calm everyone remained. The therapist kept the other boys engaged in therapy, the techs separated the boys to different ends of the unit and tried to talk to them and calm them down, and the nurse called the provider to obtain permission to administer an emergency medication. The entire time I was trying to get closer to the techs or nurse to see how they were communicating with the boys and were trying to resolve the issue. I think everyone handled the situation smoothly and professionally.
This event has taught me how to handle difficulty, and even risky situations. It taught me how to protect myself but also the patients. This showed the importance of therapeutic communication and the importance of safety for everyone involved.
I will use this experience in the future to learn how to communicate with patients and how to calm them down in high intensity situations. If I ever go into mental health, I will know to act fast and call the provider about an emergency medication. I will also keep in mind how the nurse explained the medication to the patient, and allowed him to decide for himself if he wanted it. She was not pushy or forceful and just taught him about the medication and how it could help.
Today I felt sad and frustrated when I was talking to the boy in the cafeteria and learned that he wasn’t allowed anything to drink at lunch. I wish I could have advocated for him and reassessed the fluid restriction with the tech/nurse.