This week at clinical I was assigned to the Springhill 2 group, which is the older girls. I am going to be there until 11:30 and then I was going to head over to shadow the CNC. We began the day going to our unit and looking through interesting charts, my classmate and I were looking for common themes in each chart, the two we found most often were sexual abuse and self-harm. In almost every chart those are two of the most common things we observed. Once we had sufficiently looked through the charts, spoken with the unit nurse, and gotten permission from the teacher we had the opportunity to go and observe the girls in their classroom setting. We stayed until around 11:00 and then left to go and meet up with the CNC. After our lunch my partner and I were both given permission to follow the CNC who is a wonderful instructor. She looked through charts with us and told us interesting stories about things that have happened since she has been working there, she told us about interesting patients, it was a lot of fun talking with her. The CNC also gave us an interesting look into some of the psychiatrists that work there. She mentioned this one physician, who no one wants to work with, she was able to give us some advice about how to handle situations when we become nurses in the field. After post-conference we went back to New Heights, instead of returning to Springhill 2, only because the CNC had told us that the group therapy at New Heights was going to be really excellent that day. I can honestly say it was a very interesting group. Very strange dynamics between the boys, there was a definite “cool kids” group, and a “not-so-cool” group. There was this one kid in the group that really loved to irritate the leader of the “cool” group, it was very obvious that these two boys did not get along.
I really enjoyed being able to go down to the classroom on our last day at SMTC. It was a pretty normal classroom, the girls were quiet and well behaved, some of them sat on stationary bikes and pedaled, it helps kids that have a lot of energy because they can burn off that energy and focus. My classmate and I thought it was very interesting the book they were reading and discussing, it was about a boy being kidnapped by his father and it was just very odd to us, given all the things that these girls have been through. I am just not sure if that was an appropriate book, but we were only there for about 30 minutes, so I guess we can’t judge a book by it’s cover. The CNC told us about several incidents that have occurred over the past 16 years that she has been working a SMTC, there have been female workers attacked and beaten. She told us these horrific stories not to scare us, but to remind us that you can never assume that you are safe in the mental health world, you must always be aware of your surroundings and make sure that you’re safe and the patients are safe. She told us about a patient that had been at SMTC for many years, she had made headline news and she was a really big deal at the time, an 11 year old girl that killed an absolute stranger in cold blood, because her mother made her angry. The CNC was telling us that this case made a huge splash regarding how young is too young to be put in prison, and does a young girl actually know what she’s doing when she murders. It was a very interesting topic for discussion between the CNC and us, we were able to talk about a lot of the different aspects of the mental health field. Group therapy was enjoyable to watch because the boys were all so different and interacted very uniquely with each other. I immediately knew who the “agitator” of the group was. He made a comment about one of the boys not wearing his head phones during therapy. The second another boy commented that the therapist doesn’t like electronics in group and he needed to take the ear buds out the “agitator” immediately changed his position regarding the headphones. He told the second boy that what he said wasn’t true and how he needs to not be telling others what to do (even though the first boy head started the whole discussion). It was a fascinating interaction to observe.
If I could repeat today, I would change how l didn’t get to speak with the clients. Although it was really nice to talk with the nurse’s and have those interactions, I do wish I could’ve interacted with more clients. I did love get the CNC’s perspective about some difficult physicians she’s worked with and how to handle difficult situations. This taught me sometimes being strict with a physician is necessary in order to keep yourself and the client safe. I also learned about different interactions that group therapies can have, and saw for the first time a true split personality during group therapy. This had an impact on me because I was able to observe how the therapist handled the situation and that can help me when I am a nurse and dealing with lots of different personalities.
The biggest thing that I took out of today was you can never underestimate a psychiatric patient. You can never assume that you are safe, you can never assume that the clients won’t turn on you. Having your guard up and being skeptical can save your life. I will never forget the things the CNC told us and it’s applicable in all aspects of nursing not just in psych, you never know what is going through your patient’s head, so you must take precautions with all patients and always be aware and prepared.