Our clinical began early Friday morning the 19th of February. As a class we had already received the clinical assignments for that day, I knew that I would be working in Springhill 1 and also getting the opportunity to learn in the clinical. I was extremely excited to be able to visit the clinical and learn from the nurse practitioners there. The first thing that my classmate and I did was stop by our assigned unit and introduced ourselves to the nurse working the unit. He informed us that there were three girls in the next room on restriction because they were elopement risks. These girls had been planning an escape and they took of into the woods earlier in the week, they had been missing for several hours before they were finally apprehended and brought back to San Marcos treatment facility. My classmate and I were even more excited when the nurse asked us if we wanted to observe the girls. Due to the fact that they were on elopement restrictions they could not leave the unit, at all. Their teachers came to them, their food was brought to them, they did not leave. We were able to talk with them and ask them what kinds of things they were drawing. Once we had gotten a good idea of what was going on with the girls, my classmate and I decided we would go to the clinic and see what experiences the nurse practitioner had to offer. I was able to do heights, weights, BP, HR, and temperatures on two new admits, which was really fun. I was also able to be in their initial psych interviews for the facility, which was a really awesome experience. That was truly the majority of my day and it was a great experience.
As I was watching the three girls, who were the elopement risks, I was really studying the dynamics of their little group. I observed their drawings, to see if they would provide any clues as to how they were feeling, another thing that I wanted to observe was their interactions with adults in the room. All of these things were very fascinating, each girl was very unique in her mental health status and they really were kind of a “unlikely” group of friends, based on my observation. Although being in the clinical was a lot of fun, it was also kind of depressing. As I listened in on the psych assessments, I really felt like crying. These kids have been through so many trials in their lives and it just feels never ending for them. I have no idea how relate to them, so it makes me feel really inadequate as a future nurse. The one kid who really got me the hardest, was an 11 year old girl. She had been brought to San Marcos the evening before and so I had the opportunity to preform her vitals and height and weight. As I sat and listened to her story I was absolutely mortified. She has been sexually abused by her biological father since she was about 4 years old, he made her drink alcohol and gave her “pills” and this is when the abuse began. Ever since that her father has forced her to sexually assault her 8 year old brother, and her 6 year old sister. Her father even told her to kill her mother, which she had been attempting to do. She reported that she could her his voice often, telling her to touch her siblings and kill her mother, but fortunately she hasn’t heard his voice in a couple of days. I was absolutely floored, I could not believe what I was hearing. I couldn’t believe that she was so open to tell. I can infer that perhaps the reason I was so emotional to this little girl was because she was so helpless. Her father had been abusing her for 7 years and no one knew or did anything about it. I get really emotional with these kinds of situations because I have a wonderful dad, who supports me and loves my sisters and I just wish that no little kid had to go through something like this, especially not by their parents.
When I look back on my day and all the skills I was able to practice and all the client’s that I was able to meet I am satisfied. I feel like I was very professional during the psych interviews even though they were upsetting, I really didn’t let it show. I had very in depth conversations with the nurse practitioners and the students, which was helpful because they taught me so many things. Being able to take vitals reminded me that even though these are psych patient’s vitals are VITAL for every patient. They could reveal underlying issues, they are needed to observe as a baseline, I really guess I had never thought about how crucial vitals are to every patient. Overall my day was very satisfying.
Today I recognized the RN role when one of the RN’s was practicing outside her scope of practice and the nurse practitioner had to bust her because of it. It was something as simple as a client and if he needed crutches or not. The nurse practitioner had the x-ray to confirm that this patient’s foot was not broken, just badly bruised. She told the nurse that under NO circumstances was he to receive crutches. The RN went behind the nurse practitioner’s back and tried to get him crutches, thankfully the lady in charge of medical supplies called the NP to confirm the order. The nurse practitioner then informed her that this client would not be receiving crutches. It was very interesting to observe the actions of this RN, who had deliberately defied the orders of the NP. I was reminded today of the scope of practice I have as an RN is different compared to the scope of practice I will have as an advanced practice nurse. It was just a very thorough reminder that I need to stay within my scope of practice and listen to the provider.