Interview with the Psych Nurse

[xwill327, ASN, BSN, RN]

It’s great when a psych nurse can be empathetic to their patients from the education they received in nursing school combined with previous patients they have cared for. I believe they can give even better care when they had experienced it first hand. Countless times patients have yelled at me, “you have no idea what I am going through.” My one colleague has experienced being admitted to an inpatient psychiatric unit. I wanted to understand her experiences and how it impacted her career as a Registered Nurse in Psychiatry.

We worked together and I was immediately drawn to her passion for the field of psych nursing and just her as a person. We became close and were able to share stories about work and eventually our life struggles. We disclosed personal experiences with each other. Not only was she a runway model (super cool), but she also struggled with an eating disorder and mental illness. To my surprise, she had been admitted to an inpatient psych unit. I had always wondered what it would be like to be the patient. Here are some views of the psych nurse as the patient:

Has anything on the job ever triggered you from personal experiences?

My first week on the floor, I was called to a behavioral health crisis on the medical floor: essentially meaning a medical admission lost their mind… I was called in to help restrain an anorexic patient who was refusing treatment. She was not a danger to herself or others and restraining her would go against my ethics, as well as, and more importantly, it was against the law. I did nothing though! I just stood there, watching her be tied down so they could enforce the treatment that she had refused. All I could think of was, “what if I had been restrained for my anorexia turning my hospital stays.” It would have been nothing less than scarring. That thought repeated in my mind as I remembered back to a time when I still denied my emotional disturbances, just as that girl was as she screamed she was fine. Since then I have learned to be an ally to ED (emotionally disturbed) patients, as I know the world of medicine as a whole for the most part avoids them like the plague!

How do you feel when you know you helped someone who had a similar issue as you?

I will always think back to this one patient in particular who I will refer to as K. If I can think back to someone I feel I helped, it would be her. I was placed on a one-to-one with her following her attempt to hurl herself through the glass window in her room. She was placed on a suicide watch one-to-one which meant one person watching K. Usually this job is given to a PCA (patient care assistant) or a Behavioral Health Tech. However, we were short staffed that evening so as charge nurse I took the role. I had to be within arm distance of her at all times. To say the least, K. was not having me when I entered the room. My close proximity only bothered her more. Despite her attempts to avoid even eye contact I continued my attempts to make conversation. After my relentless conversation prompts, she began to engage with me. We began to joke and she laughed with me. I stayed with her for nearly three hours that evening. The next day K. approached me and said, “I think I get what you were talking about with good things still having a bad side and bad things having a good, like last night, bad-I tried to jump out a window, good- we got to talk and have fun.” My heart sunk and it remains the largest thank you of my career. I am not out to save the world; that would only be a disappointing pursuit. But, if I can help a suicidal patient laugh for a couple hours, I cannot go home with my head hanging down.

What is your take on the inpatient experience? Is it beneficial? How would you change it?

I don't know if you meant my personal stay in the psych ward or my time working in them. Seeing that I have now experienced both I can say that after my 4th stay I stopped attempting to make light and accepted I would do anything for them never to have happened. Despite this speaking in terms of my work they each had enormous importance. My first stay at 18yrs I learned how to relate to the fear that comes with admission and of its great unknown. My second, I learned the shame that comes along with it and the anger when you have to be admitted against your will. My third stay was due to a head trauma, not psych symptoms, I was placed in the ward purely because of my history. There, as I came back to reality from the two cracks in my skull, I found out what is was like to lose your voice to your overshadowing past. My fourth stay I went in attempting to get ECT, which I was denied. Already a psych nurse at the time, I had far more insight into the world of outpatient but not inpatient. I learned about the frustration in delaying the discharge process. Only because of my further protest did my 72 hour letter not continue to stretch in time. Most patients don't know their rights: such as a 72hr letter to demand discharge.

Are you open with your coworkers on your background or remain private?

I remain more than private. I was having vicious side effects causing me to shake and tremor constantly. I looked like a wreck as well. To explain this I would blame my other and more acceptable meds treating for my epilepsy. At times, I went as far as to claim having other disorders to explain my symptoms away. My anorexic appearance I denoted to marathon training despite not having worked out in a year for fear of increased hunger. I wish I could be more honest with my coworkers but the way they talk about these disorders and how they talk about the patients afflicted… I just cannot imagine them thinking of me that way.

How do you strive to break the stigma of mental illness? How can others in your opinion?

I strive by simply getting up everyday. I have a fortune I carry in my wallet that has the quote, “Heroism is the endurance for one more moment more,” which is far easier said than done. It was only recently that I have admitted to myself I am in fact disabled by my disorders. Despite being crippled by them my unwillingness to let them win as well as at times pure denial of them… has allowed me to achieve both personal and professional success even when it seemed everyone else assumed I would fail. How others can break the stigma is to talk about it. If there were simply more numbers of people talking about their disorders, I truly believe even more would come forward and the rest of the world might not be so uncomfortable.

Thank you to my colleague and cheers all!