Today is my first day of clinicals at a hospital and I am on the neuro floor. I went to the hospital yesterday and picked my patient, and then spent the rest of the day creating a care plan for him. I have to admit that I am a little nervous about this clinical because the patient just attempted suicide and is on a strict suicide watch. On top of that, I read in the chart that he is very angry and cussess at all of the nurses. He even threw a phone yesterday! I just started my Psych Nursing class two days ago so I'm not sure how to handle this patient. This clinical is for my med-surg class, not Psych. Is this normally the type of patient you see for a med-surg rotation?
Jan 14, '10
i read and answered your other care plan post. why is he on a neuro floor? i worked neuro early in my career. assess neuro system. don't aggravate him. use therapeutic communication. see the weblinks for information about therapeutic communication skills on post #38 of this sticky thread:Health Assessment Resources, Techniques, and Forms
- health assessment resources, techniques, and forms
Jan 14, '10
Thank you for your response. I should have added that the patient has bipolar disorder. I am watching the video from your link on the neuro exam that shows how all the cranial nerves are tested. Is this testing something that gets done everyday? Every shift? Or just when the patient first arrives on the floor. I have read up on therapeutic communication and know to avoid asking "why" but is it appropriate to ask the pt questions such as how or what they were experiencing when they decided to attempt suicide? I really don't want to upset this pt anymore than they already are.
Jan 15, '10
This is an initial and thorough neuro exam. Then, you only test a cranial nerve you know is damaged each time you do an assessment. Ask about his suicide attempt once you establish rapport and trust with him and feel it is right and he is willing to talk about it. Don't force the issue.