A little freaked out. Need advice.

[phinur]

Hi everyone,

I need a little advice on a situation that has me rethinking going into Psych. I am a student in the RN program, and will be graduating in December. I am in the mental health clinical right now and absolutly love it. I really would love to do this when I am done with school, but a situation happened last night in clinical that has totally freaked me out and made me rethink things and since most of you have lots of experience in psych, I was hoping for advice.

I was leading a group activity that was an assignment for class. Basically, people would talk about something they like, get a prize, and someone else who also likes the same thing would stand up and name something they like. It did help people come out of there shell a little and begin socializing. After it was all done, I went to lunch with my instructor. When I came back, the RN called myself and my instructor into a room and said A man in the group said I was hitting on him and made him feel uncomfortable. Well, first I am a straight male, and second I wasen't anywhere near him during group. In fact I didn't even know his name. My instructor and 3 other students where in the group and where as confused as I was, they decided to go and talk to the patient (a Bioplar patient.) He then said I had given him an extra piece of candy and he thought I was comming on to him. Everything is fine now because I had whitnesses, I understand to always try to have someone with you when with a patient but I know if I go into psych, there will be times that I will not be so lucky. It could have been his word against mine. My instructor told me she really thought I would do good in Psych and said this stuff happens to her also.

I am sorry about the long post, I just am a little confused. Has this happened to anyone else? How, as a soon to be new nurse should I deal with this in the future? Any advice would be greatly appreciated.

Thanks.

[Orca, ADN, ASN, RN]

In psychiatry you will always be dealing with people with altered perception and poor coping skills. Patients like these can interpret just about anything as a personal affront or romantic interest, or anything in between. It isn't a reflection on you that this patient took offense. I have had patients who I haven't even talked to start yelling things at me for no apparent reason. It goes with the territory. The best advice I can give is not to be alone with patients, and to remain calm.

Your instructor used very poor judgment in confronting this man - especially taking other students along. This could have easily been perceived by the patient as a personal attack, and it could have quickly escalated into a major incident.

I was in a situation a few years ago where a female teen who was bipolar and in a manic state 'fell in love' with a male co-worker. Had to be ultra careful as EVERYTHING he did or said she interpreted as being about their 'relationship'.

This brings back memories. I have had two female bipolar patients who became enamored with me for some unknown reason. The first patient was about 19. She stated in explicit terms what she wanted me to do to her sexually. I had to repeatedly set limits with her. It only slowed down when her lithium kicked in. The other was about 40 (and a physician). She did the same thing until her meds kicked in. Even as she was improving she tried to talk me into going to work for her in her practice. I passed on the offer.