Clincals coming up for my pysch rotation

beauty912 · Aug 25, 2010

Hi,

Glad to hear that you're so excited about psych! I'm a new grad and hoping to get into a psych nursing position as soon as I can. One of the things that really helped me out with my psych clinical was reviewing my psychiatric nursing care plan book. I ended up using many of the interventions given for different situations/ issues. Also, you will want to review therapeutic techniques, such as active listening, open ended questions, etc. Good luck!

Davey Do · Aug 29, 2010

21police:

It's good to hear from students excited about their Psych rotation.

It would seem that one of the most difficult areas to tackle in a Psych setting with a chronic Schizophrenic experiencing the manifestations of their exacerbation is a realistic conversation. Things like auditory and visual hallucinations, delusions, tangetial tracking and other psychotic symptoms tend to get in the way of a good, down-to-earth conversation.

Of course, we're to ALWAYS speak to ALL of our patients in an objective, therapeutic manner. Sometimes that's sorta like trying to nail Jello to a wall. It can't be done. Unless one is merely being textbook and concrete. That gets old real fast.

Many feel uncomfortable talking with a person exhibiting symptoms of psychosis in a realistic manner. They often believe they should try and talk them out of their psychosis. Usually by attempting to critique the psychotic's perception of reality. That doesn't work. If a psychotic person can be talked out of his delusional false fixed belief, then they're not delusional.

So, go with the flow. Allow the individual to discuss their perspective. Not only is it an interestingly learning experience, it's also entertaining. Some of the most intersting people I've ever met were psychotic. And intelligent.

If you're there doing clinicals, you might as well make the most of it. Interviewing the psychotic individual is quite an experience.

Or, you could just talk to those diagnosed with Major Depressive D/O. They're usually grounded in reality. But they can be really depressing.

Good luck to you in your clinicals, 21police. Let us know how they turn out.

Dave

chevyv, BSN, RN · Aug 29, 2010

Be the sponge, :lol2: We use lots of lpn's where I work so you may not have too long to wait. Don't be afraid to ask questions and dive in! Have fun. I sure did and still do.

21police · Aug 29, 2010

Thanks everyone!!!! And DaveyDo I've done that with dementia pts just on the advice of my instructor and was able to calm down and befriend many a pt this way. I do try and orient during the conversation, but listening and asking open ended questions has worked the best for me at least when it comes to dementia pts. I've looked up some care plans already and can't wait!!!!

mtdnk · Aug 30, 2010

Best thing you can do first, review the concept of the therapeutic relationship and the core skill in establishing it- therapeutic communication techniques. Once you become comfortable just being with a patient and interacting, you can begin to incorporate assessment of symptoms, etc.

pinkiepie_RN · Sep 1, 2010

Therapeutic communication is definitely a good thing to remember. Also, look up information on dealing with crisis situations. As a student, you probably won't be expected to deal with them first hand, but you might witness them and it helps to be able to process what's going on.