Maegan Taylor
Clinical 342
Mrs. Dutton
Clinical Journal #5
Today we were to report to Methodist Specialty and Transplant Hospital at 0630. To start we were given a little background information on the hospital and the psychiatric department and then a short tour of each unit. After the tour we got our assignments and were off to our designated units at about 0900. Mackenzie and I were assigned to the Level 1 unit were the patients with schizophrenia and major psychotic disorders are placed.
When we got there that were finishing up their FLASH discussions, so we went in and listened to what each of the nurses had to report on their patients. It was interesting to hear about all of the patients on each of the units and the different kinds of problems that happened on each of them. For instance a patient on the chemical dependency unit refused their medication and the nurse withheld it, but a patient on the Level 1 unit refused their medication and they had to restrain them in order to give it via injection. After this we went to the unit and asked the nurses who we could follow for the shift, and we were each placed with a tech. This to me was shocking because we were really supposed to be following the nurses in order to understand the nursing process there but I shortly realized that the techs are the ones that have the most patient interaction so it would be more beneficial for us to follow them. Stephanie (one of the techs) let us know that the boy’s group therapy had just started and took us over to the group room on the boy’s side. When we entered the room there was just one man sitting there talking to the therapist and she explained to us that he was the only one that wanted to participate in group today and that we were more than welcome to join them if we wanted to. She spoke about relaxation techniques but the guy did not really want to participate in that so instead she just asked him questions about how he was doing and feeling and what he did in order to calm himself down. He started talking about things he does to relax and then jumped to his mom and then to food and then how his mom threw it away and then how he was storing his food in a “squirrel refrigerator” and so on. It was interesting to see someone with their thoughts changing so quickly like that, and really put what we’ve been learning in class into perspective. He also explained to us that he really liked to draw and showed us the hover board he was inventing. He also told us hat he was working at Whataburger and that he was working on a cure for HIV/AIDS with his urine. I thought that even though he had all of these ideas that are “crazy” he was a pretty interesting guy and really thrived from talking to people (even if he was the only one doing the talking). After the boy’s group therapy was over, we went back into the nurses station and Stephanie explained to us that that particular boy that was is group is “in love” with her and draws her and writes her love letters and that it would be a really good idea to read through his chart a little later. She told us that she needed to do her 15-minute round and asked if we wanted to meet all of the patients. We agreed and went around to every room and she explained what each of the patients was in there for and some of her experiences with each of them, on both the boys wing and the girls wing. After that we went to the girls group therapy where they also talked about relaxation techniques. There were only two women in there for the first half of the therapy session and then another patient came and sat through the ending. The women actually participated and went through deep breathing, muscle tension and relaxation and then guided imagery. I actually participated in the activity and felt like I could go straight to bed afterwards because I was so relaxed. When group therapy was over we went back into the nurses station and review a bunch of the charts. It was so crazy to see the difference between what the adults have in their charts versus what the children had in their charts. At about 1200 we went to lunch and talked a little bit about how our day was so far and then ate and went back to the unit. From the time we got back to the time of post conference, we just reviewed charts and talked about some of the things in the charts that we were unclear about.
Before I began client care today I was worried most about how the patients were going to react to new people in the unit, especially because we were on level 1. I know that there have been students on the unit in the past couple of weeks but I am kind of curious if it affects these people to constantly see new faces on the floor. The one thing that I didn’t agree with in our particular unit was the fact that the nurses hardly ever left the nurses station (which we talked about in post conference). I just think that especially because the nurses are supposed to be doing hourly rounding, they should be out interacting with the patients and not just sitting in the nurses station gossiping or just zooming in on the patients with the camera system. At one point in the shift there was a patient standing at the window for a good 10 minutes just waiting to be recognized and then when they did see her, they were rude to her and seemed irritated that they had to help her. This kind of upset me because this is not giving these patients the good care that they need and deserve.
This has taught me how important patient care is to the patients and also the importance of actually seeing the patient with your own eyes. When we actually go in and see our patients we can use all of our senses to detect of there may be something going on. I think that this was a good lesson for the future because it really showed us some good things to do, with the techs, and some bad things that we should not do, sitting in the nurses station gossiping. I think that this made me want for myself to strive to be a better nurse and stay away from some of the things that were going on today.