Describe your mental health rotation

[Mabel 29]

I just finished up my four week mental health rotation for my LPN clinicals. It wasn't what I expected. We basically sat around for most of the eight hour shift. We observed a few of the groups each day - stress management, art therapy, diagnosis / medication explanations, etc. We went outside on smoke break with those who had earned that privilege. We played cards and board games. Is this normal? It was our instructors first time teaching on a college level (she normally teaches high school students). I just feel like I was missing something. Did anyone have a different experience in mental health?

[BeccaznRN, RN]

I am in a BSN program (pre-licensure) and you just described our mental health rotation word for word. Lots of talking with the patients, attending group therapy, etc. We were also required to visit community sites, such as a support group, adult day care, etc. and we also got to shadow a nurse at a school for children with behavioral problems. We had to turn in some assignments also but that was about it. I considered it a break from our hectic clinical days in med/surg!

[truern]

Just what you described....except we did have an ice cream social for the clients one day. And we brought puzzles, books, etc for the unit...we also donated a wooden game box with Scrabble, Monopoly, cards, etc to the unit in honor of our clinical instructor who was retiring. She said it was the most meaningful gift she'd received from her students.

We "contracted" with a client to be part of their care team. We kept that client until they were discharged.

I also got to spend some time on the medical unit...suicide attempts, etc.

[RedSox33RN]

I just finished my Mental Health rotation, and did the same thing, but for 6 weeks. We listened to a LOT of conferences between the treatment teams, and sat and talked a lot with patients. We had a lot of autonomy, but I found it incredibly boring. We couldn't give meds, do assessments, and since it was a locked unit, were told which patients to "not" talk to or interact with. I'm just glad I'm done with it!

[Imafloat, BSN, RN]

Psych wasn't my favorite. We spent a lot of time with our assigned patient. We had to do physical assessments on them and give them their meds. We had to chart about their day and attend groups with them. We had to lead the groups from the middle of the quarter to the end. We had to communicate therapeutically with them and attempt to facilitate them gaining insight. We were in a locked down psych unit and I felt like a prisoner.

[LadyStar42, LPN]

Folks.....Is there something wrong with me??? I really enjoyed my MH rotation. I sat in on a role-playing session (which was awesome) and sat in on several group sessions. We were encouraged to contribute. There was no one, even in lock down that we couldn't interact with. I read all the charts I could get my hands on. We weren't assigned 1 patient, we wrote a care plan on our choice of all the patients in that unit. We rotated through all the different units, both opened and closed.

At the risk of sounding like a "know it all".....

The thing in MH is that there are very few meds to give. It's Mental, not Medical. You can't give these folks a pill and fix their problem. It takes a lot of therapy and teaching to help these folks. I watched pro Mental Health teams work together and was in awe. These people know their stuff and how to use it.

Future MH nurse LadyStar42

[Imafloat, BSN, RN]

At the risk of sounding like a "know it all".....

The thing in MH is that there are very few meds to give. It's Mental, not Medical. You can't give these folks a pill and fix their problem. It takes a lot of therapy and teaching to help these folks. I watched pro Mental Health teams work together and was in awe. These people know their stuff and how to use it.

Future MH nurse LadyStar42

Maybe very few psych meds, but there was more than once that I gave 20 plus meds. Glad you loved psych, that is what is fabulous about nursing, there is something for everyone, good luck in your endeavors.

[Mabel 29]

Thanks for your input. I guess my experience was typical for a small facility. I'm glad that some of you enjoyed it. I was just really bored. We didn't do assessments or pass meds. Because of licensing issues the census was capped at 12, so that limited the amount of patients we could interact with each day. I'm not saying that I will never work in mental health, but I don't think it would be my first choice.

[Daytonite, BSN, RN]

i think i might know what your disappointment was over. i was very lucky (?) that we did a clinical rotation at a v.a. psychiatric hospital when i was completing my bsn. talk about psychotic and schizophrenic people! we were put on a locked unit with men who had been taken off all their medication for their schizophrenia in preparation for taking part in a clinical study for a newer medication. therefore, they were exhibiting symptoms of their disease and, boy! was it stressful for everyone. we saw it all and you had to be very careful with every word that came out of your mouth. still, they also had daily group meetings and activities, the therapeutic milieu must be maintained, you know.

some years later i was working at another large v.a facility that had 3 locked psych units and they had patients that were, how unprofessionally can i put it? oh yes, nuts! i was an iv therapist at the time and occasionally had to go there to start a saline lock on someone having shock therapy or some test requiring iv access and it was still scary. sometimes the patients would follow me around. i once saw one of their patients who had privileges to go out of the locked unit stand inside an elevator and refuse to let anyone else get on it while he ranted away about something or other. nurses from the psych unit had to "talk" him out and take him back to the locked unit. i also saw a number of patients in leather restraints in their lock down room.

looking back on it, i would have gladly traded my clinical rotation with yours. psychotic patients with active symptoms can be unpredictable and dangerous. these kinds of patients, however, are probably what you are meaning that you had expected, i think. the v.a.s take on a lot of them because they can afford it. most all civilians types, however, are out on the street because they can't afford that kind of hospitalization or many insurance companies have put severe restrictions on the psych inpatient care they will cover.

[Sheri257]

I LOVED my psych rotation, mostly because it was in a criminal psych facility. It was fascinating, and dangerous ... an RN got stabbed one night before we came in ... and the facility was on high alert. Also, a patient got out of control and there was a major take down while we were there.

It's mostly what you make of it. I could have sat around all day but I spent most of my time talking to the doctors and staff, really learning what goes on there, why certain meds work and others don't, how they handle problems with malingers, the legal system etc. The charts were sometimes disgusting but, never boring. I also spent a day with hospital police following them around and asking them about how they handle security problems, drug problems in the facility etc.

I'd have to say it's the most fascinating rotation I've done so far ...

:typing

[steelydanfan]

I LOVED my psych rotation. We were there for 3 months, in a County Facility, got to see some amazing diagnoses (Folie a Deaux, anyone)?

I read my Psych text cover to cover BEFORE my first clinical day, because it was just so damned INTERESTING.I was constantly challenged; and somehow still was threatened by my instructor with a possible "F" grade for failing to be theraputic enough. (This was the same person who wrote me a glowing recce after my preadmission interview with her)! Sheesh!

Anyway, I passed with a B (I guess nursing students are not REALLY required to CURE terminaly insane people),

and have liked the science ever since.

I'ts a very helpful part of your education.