I was looking forward to clinical Friday morning, because I was hoping to be able to get to visit the Chemical dependency floor. Which is exactly where I was assigned. We began the morning listening to report given between the night and day nurses. They both did a really excellent job in their report details and including my classmate and I in the discussion of the patients. Once we finished report we went to look through charts and find people who would be especially interesting to talk with. After we had searched through charts, most of the patients were up and moving around for the day. I was able to help my nurse take vitals on some of the patients, which basically means but on the pulse ox. and blood pressure cuff and hitting the inflate button, but it was still exciting to be able to actually do something with the patients. I was also able to attend FLASH again this week. It is really a fun opportunity to see physicians, pharmacists, nurses, case managers, psychologist, etc all working together for the patients benefit. After FLASH we returned back to the floor and participated/observed their recreational group therapy session, which was a lot of fun, they were playing Yahtzee. The occupational therapist was extremely friendly and jovial, it was interesting to see the patient playing with her and with each other. When recreational therapy was over, we had the opportunity to attend their group therapy session, which was specifically a process recording session. Group therapy each day rotates to a different “session”, sometimes they do a process recording, there is also spiritual therapy, and some others. The process recording is pretty much just a rundown of how everyone is doing/processing since they have been admitted. We all went to lunch and then after lunch we had an amazing chance to just sit in the group therapy room and talk with the patients.
The recreational therapy session and group sessions were really awesome. Both of the different therapists were fantastic and really facilitated the discussions. The recreational therapist stressed the importance of how games can reduce stress and even distract us from wanting to pick up our vice and go through with something we will eventually regret. The group session was great because the level of participation, which the patients put into it. It was reiterated to me that the key to a good group therapy is participation by everyone involved. I think that the most poignant part of the day was talking with this one particular patient. She was a 41 year old female, how has done many many different drugs on and off for the past 20 years. Just recently everyday for the past 4 months she has been doing an unknown amount of crack. The patient looks about 60 years old, has most of her teeth missing, and has also lots a ton of weight. Looking at her you would think that she was high and not in her detox, this poor woman has been seriously messed up by drugs. As we sat in the group room and spoke with her she was so emotional about how she felt she’s let down her mom and her mom has tried so hard to help her and how she is so scared to change. She explained how she is very scared to change and she doesn’t know what her future will look like. It was really emotional talking to her, it made me really think about my own life, and really made me grateful for all of the good choices that I have made thus far in my life.
I remember writing a couple weeks ago that I wanted to have more patient interaction, so I really went out of my way this week to speak with patients. I knew that I couldn’t be afraid to ask open-ended questions in order to delve further into the patient’s thoughts and feelings. I was pleasantly surprised with myself, I usually get a little bit nervous when trying to speak to patients about “touchy” subjects, but I really went out of my comfort zone, so I admit that I am pretty proud of myself. I wish that I would’ve had some more time to talk with the female patient I mentioned earlier. I think that she really appreciated my classmates and I listening to her, and she really wanted to talk it out. Today, I recognized that my therapeutic communication skills were crucial, when I used silence in order to allow her to open up and feel comfortable talking. This has taught me that most of the time patients just need someone to talk to and someone who is willing to listen.
I was really happy with this past week of clinical and am looking forward to using even more therapeutic communication skills. Listening is so crucial to our practice of nursing, whether it is on the surgical floor or on a psychiatric floor. It is so hard for a nurse to sit down and listen to every patient’s story because of all the other demanding parts of the job, but I need to remember that it is important to my patients that I show I am caring, even if it sets me back a little in my charting or whatnot. I hope to someday implement being able to spend a little extra time with every patient, because I know that the more I know my patients the better that I can help to treat them.