First Day in Psychiatric Nursing Clinicals

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    Last week was my first week in Psych clinical rotation. Needless to say I was nervous. We all sat in on report and I was told as I brought out my pad and paper not to take down any notes (as I was told by other instructors) but to just sit and listen for the entire day. Thats hard for me to do since I'm used to running here and there and looking for things to "do" instead of just listening. We were told about one patient who was severly depressed and along with her slew of other medical problems, she was afraid and distrustful of medical personel.

    After report, we went to the community meeting where all of the students were supposed to sit scattered throughout the rest of the patients and staff and where we were going to be introduced. As I was watching everyone come in, I saw this remarkable lady with lovely, well done hair (but somewhat frightened) come in and sit right next to me. I knew from her discription that she was the one who was frightened by medical personel.

    Now, on other rotations I helped clients in ways that were more measurable physically. But just the fact that she sat down next to me and said "hello" will probably be one of the most memorable experiences on this rotation. I feel that this was a real big success for her and this made me feel much more at ease. Maybe I had some sort of demeaner about me that made her feel more comfortable.

    I think I will have a much better experience now that I had that small success with her.
  2. 16 Comments so far...

  3. 0
    Sounds good to me....(a psych nurse for 30 plus years).
  4. 0
    FYI, still a good feeling (even after 18+ years)
  5. 0
    Psych female patients tolerate and adore me. It must be my handsome, tall, and boyish looks.

    Of course, I did have one that threatened to beat me upside the head (I was slow giving her meds), but she became friendly at the end of the shift.
  6. 0
    Quote from twinmommy+1
    Last week was my first week in Psych clinical rotation. Needless to say I was nervous. We all sat in on report and I was told as I brought out my pad and paper not to take down any notes (as I was told by other instructors) but to just sit and listen for the entire day. Thats hard for me to do since I'm used to running here and there and looking for things to "do" instead of just listening. We were told about one patient who was severly depressed and along with her slew of other medical problems, she was afraid and distrustful of medical personel.

    After report, we went to the community meeting where all of the students were supposed to sit scattered throughout the rest of the patients and staff and where we were going to be introduced. As I was watching everyone come in, I saw this remarkable lady with lovely, well done hair (but somewhat frightened) come in and sit right next to me. I knew from her discription that she was the one who was frightened by medical personel.

    Now, on other rotations I helped clients in ways that were more measurable physically. But just the fact that she sat down next to me and said "hello" will probably be one of the most memorable experiences on this rotation. I feel that this was a real big success for her and this made me feel much more at ease. Maybe I had some sort of demeaner about me that made her feel more comfortable.

    I think I will have a much better experience now that I had that small success with her.
    Good for you : in the vernacular, perhaps this woman (patient) -
    1. felt that you, as only a student, couldn't endanger her life again, or cause her more bodily harm. and
    2. wanted to communicate a message to you, as one human with another. Perhaps to let you know "Shed your nervousness, I am a human with feelings, emotions, dreams & hopes, not unlike yours; and I intend you no harm, either". or
    3. also wanted you to know, that you are capable of learning how to reach out to hurt individuals, and help them access their own positive internal resources for happily transforming their life...

    Have you ever wondered how *you* can help "psychiatric" - people make such wonderful discoveries ? Now, perhaps this woman isn't yet blessed with helpful resources inside herself, or she's been conditioned, drugged, and worse treated into forgetting them, or whatever. Tho,
    it wouldn't be the 1st. time, some "patient" is helped to Free themselves, & begin enjoying life anew...
    More humanitarian considerations worth giving some devoted thought to, eh?
    Last edit by happy&healthy on Mar 30, '05
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    [QUOTE=PHTLS]Psych female patients tolerate and adore me. It must be my handsome, tall, and boyish looks.



    Either that or it's all down to your obvious modesty!
  8. 0
    Quote from Cheerfulsong
    Good for you : in the vernacular, perhaps this woman (patient) -
    1. felt that you, as only a student, couldn't endanger her life again, or cause her more bodily harm. and
    2. wanted to communicate a message to you, as one human with another. Perhaps to let you know "Shed your nervousness, I am a human with feelings, emotions, dreams & hopes, not unlike yours; and I intend you no harm, either". or
    3. also wanted you to know, that you are capable of learning how to reach out to hurt individuals, and help them access their own positive internal resources for happily transforming their life...

    Have you ever wondered how *you* can help "psychiatric" - people make such wonderful discoveries ? Now, perhaps this woman isn't yet blessed with helpful resources inside herself, or she's been conditioned, drugged, and worse treated into forgetting them, or whatever. Tho,
    it wouldn't be the 1st. time, some "patient" is helped to Free themselves, & begin enjoying life anew...
    More humanitarian considerations worth giving some devoted thought to, eh?
    all psych patients have their own stories...listen to them, with a grain of salt, but recognize the humanity, and pain apparent in many of them....of course, there are some who will try to lie and manipulate you. But you'll be surprised how a little compassion can go a long way. Listen to your instincts too....from a nurse who did 4 months externship/PRN work in inpatient psych.
  9. 0
    Quote from thorv1stjob
    all psych patients have their own stories...listen to them, with a grain of salt, but recognize the humanity, and pain apparent in many of them....of course, there are some who will try to lie and manipulate you. But you'll be surprised how a little compassion can go a long way. Listen to your instincts too....from a nurse who did 4 months externship/PRN work in inpatient psych.
    What is an externship? What's the difference between that and an internship? Sorry if this is a dumb question, but I would really like to know.
  10. 0
    Quote from ARNPsomeday
    What is an externship? What's the difference between that and an internship? Sorry if this is a dumb question, but I would really like to know.
    I recently asked the same thing. Externships are for baccalaureate students and usually take place over a ten-week period between the junior and senior years. The student must meet qualifications for this experience (usually high GPA during nursing school). Not every BSN student qualifies. The student pays tuition to the sponsoring university for the experience and chooses the unit or specialty area. The student is then assigned a preceptor on the floor who must evaluate the student's experience. The preceptor is carefully screened according to preset criteria and must be working a fulltime schedule. The student works every shift that his or her preceptor works during this period (days, nights, weekends; usually exceeds 400 clinical hours during the 10-week period). The student is also paid by the hospital (usually at NA salary). The student is generally able to do everything the RN can do (per P & P exceptions, such as giving experimental or chemotherapy medications, certain procedures, etc.). Again, this is all under the careful supervision of the preceptor.

    Interships are an abbreviated form of externships. Internships can be utilized for all nursing students (LPN, ADN, and BSN) and are currently much in vogue. This takes place during the last semester and usually consists of 120 clinical hours for RN students and 90 hours for LPN students. The student is paired up with a suitable preceptor and completes the required hours on a hospital unit. The student is then evaluated by the preceptor at the end of the internship experience. The student is not paid by the facility.

    Both interships and externships seem, at first glance, to be the resurrection of the old "diploma school" model. The big difference, today, with renewed emphasis on work-based learning, is that this is done under the careful scrutiny and direction of university or college-based nurse educators.
  11. 0
    My psychiatric clinical experience was truly horrible. My rotation was at a childrenís facility that had a fairly poor reputation in the way the staff treated the kids. I guess I was subconsciously preparing myself for the staffís behavior, that I let myself be completely blindsided by the childrenís histories and stories. What evil things some people can do to kids, is just mind boggling. It was the most hellish 6 weeks Iíve ever been through. Then my conscious starts working, and It made me feel even worse, in that I felt if this experience touched me so much, I should be willing to do something to help, and to change things, but I just donít think I could work in that situation. I would be wanting to strangle some parents, and be constantly trying to figure out how to smuggle some of those kids out of there in my bag and take them home.
    It take a special, special person to work in these areas, and I definitely look up to you.


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