On February 5, 2016, we all as a clinical group arrived at San Marcos treatment center at around 8am. Each of us had our own apprehension as to what we would be expecting that day, I know that for me I was feeling way out of my comfort zone. We were given very detailed and thorough instructions by Mr. Winston, one of the directors there. He told us all about what kinds of diseases we could potentially see, what age groups there were, and most importantly how to handle certain dangerous situations. We were given the tour around the beautiful campus, we saw the ropes courses, the cafeteria, the schoolyard, and where the children sleep. Our instructors gave us the plan for the day, we were all to go and either eat lunch or meet our unit in the cafeteria to chat with some of the students, after we are done in the cafeteria we would get the chance to go back to the unit and review our patient’s charts. After we reviewed the charts we were instructed to meet back together at 2:30 before the units started their group therapy. At 3:30 we were headed back to our units and observed group therapy before leaving for the day.
My day was filled with highs and lows. I really enjoyed observing the group therapy, talking to students at lunch, watching the children’s interaction with one another, and reading through their charts. When I met some of the children at lunch I had begun to form my own diagnoses on these children and I was so surprised when I read their charts. I couldn’t believe what I was reading in these charts. Most of their diagnoses I had guessed correctly, but some of them I totally guessed wrong. I had the opportunity to read why they were admitted or when their mental illness began and I was truly heartbroken. I couldn’t believe how some of these children had been living, what kinds of abuse they suffered, and the lengths they had gone through to try to end their lives. There was a common theme I noticed with all of the boys on the unit, no matter what their diagnosis was, each on of them had the same sort of behaviors; aggression or abusiveness, and destruction of property. I truly don’t know what the correlation is but I would assume that because boys are usually more aggressive and more physical by nature, when they have a mental health crisis those behaviors are exacerbated. Today I felt frustrated when this boy in the unit was discharged way before he was ready to be. His adoptive, 70 year old, no wife, father had come to get him due to some false allegations the boy had made about his roommates. His father had arrived and the boy was crying and wanted to vomit because he was so afraid of him. Many of the nurses and staff believe the boy is being sexually abused by his father. It was frustrating because no matter how hard the nurse had advocated for this boy to stay at the facility and no matter how much evidence about the boy’s abuse she presented to the therapist and doctors, no one would listen. So we all watched as this little boy went back to a dangerous environment.
Looking back on all the events that transpired that clinical day I am just so glad that I was able to be there and learn so much. I am so lucky that I had an amazing nurse that wanted to teach us everything and let us be in important conversations. The impact that the boy being discharged had on me was a feeling anger. I am so mad that the system would allow this kid to go back with this man, especially when the child was begging to stay. It really isn’t fair to this boy, he can’t defend himself, he is trusting all of these adults to protect him and I think that they did the opposite of protecting. The nurse truly did everything that she could to help and protect and be the boy’s advocate, that is something that has stuck with me.
Being able to assess the whole environment like bathrooms and why they have to be a certain way, and watching the staff, nurses, and therapists interacting with the student and how they do it. I learned that in a psychiatric setting the best tools I have our my eyes and ears, I have to be able to read body language and scan the room for anything that is out of place, and being able to listen to each patient is crucial. Whether you are just listening to show them you are there for them or whether you are listening for some hidden message that could save their life. I know for a fact that I don’t want to work in a psychiatric facility but I can still take the things that I learn in psych and apply them to all patient, such as using all my senses when evaluating patient’s, being their advocate and fighting for them. All of those things are just called being a good nurse.