Need advice for student nurse!

Thunderwolf, MSN, RN · Nov 2, 2005

You ask for clarification if you are not following the conversation. When folks talk about themselves or their issues, it is very important to them. Folks not only want to be heard, but understood as well. So, seek clarification or a rephrase. I encourage you to use our search feature at the top of this forum. This topic has been discussed several times. I wish you the best in your clinical.

funinsun · Nov 3, 2005

Hi,

Definetly agree with Thunderwolf about the clarification/rephrasing issue.. Something small that may be obvious,that helps me is identifying with the patients as much as possible-for example, they like a certain music, tv show , (oprah worked for me), sport, etc. and you do too, say so! A lot of patients know/feel that they are different or that they are seperate from the outside world, so knowing that someone likes/dislikes similar things seemed to perk some of them up and allow them to feel like they are actually having a conversation with someone that understands something their saying even though it wasn't necessarily 'psych' related.. The subjects would be within reason though of course and without any personal info of address and things of course.. Hope this helps a little..

GalRN · Nov 6, 2005

I work as a psych/detox nurse as well as having a family member that has chronic schizophrenia. I've learned that this population loves to have someone to talk to who will really listen. They are sick of being stigmatized and are usually willing tell you what they are going through, some will even teach you about their illness. I remember talking to a woman who had dissociative identity disorder when I was a student. She was very knowledgeable about her illness and to this day her explanation of the disorder is the one that I use. Many patients can teach you something of value, whether it be how it feels to have their diagnosis or how they deal with a particular drug side effect.

A few tips on getting started- Ask them how they're feeling today, if they're having any side effects from meds, and go from there... If they seem knowledgeable about their disorder ask them how it affects their life on a daily basis. If they are psychotic you may not be able to have much meaningful interaction, but they'll probably remember that you treated them kindly when they get clearer. And if someone doesn't want to talk, let them know that you'll be around if they change their mind. Don't push them, they'll seek you out if they want. Its normal to be nervous at first, as long as you treat them as you would want to treated you'll do ok!

colleennurse, ASN, RN · Nov 8, 2005

Thanks Everyone for the replies! I still have not had a patient of my own yet at clinical. The first week I was assigned to an observational assignment at a continuing day treatment program. I think it was a good way to start because I did have the oppurtunity to interact with some people, but I wasn't under any pressure to complete any assignments or anything :) I will definately take all of your advice to heart. I just don't want my nervousness/anxiety of being a student to spread to the patients and I do not want to come across as phony, because I know they will sense it! I did try to search this forum for past discussions and either my computer stinks or I am doing something wrong, cause it did not work. I only clicked the GO button once and it would tell me that I have to wait a certain amount of seconds to search again, so who knows. I think that I just need to relax and remember that these are people too!

stnursebee · Nov 9, 2005

Hi

I am a student nurse in mental health, in the UK. I am currently in my 3rd yr now. I know how you feel, it is very strange at first. The first 2 hrs on my first ward I felt like an alien. Over the first few days I spent time going round each patient and introducing myself with my name and telling them that I am the new student on the ward, and I gestured a hand shake (most returned with a hand shake). This appeared to work with most patients as they said that they dont always know who is who on the ward. I then made a note (in my head) of anything they appear to be interested in and use that to help the conversation. This of course does not work with everybody (and I dont know what type of ward/place you are in), but from my experience they liked and understood the introduction. But dont take it to heart if the response you get is not a good one, they are all there because of their mental health problems. Oh yes, and dont be afraid to say that you dont understand what they are saying and ask for clarification, its better than getting it wrong (this could frustrate them more). One patient totally ignored me when I introduced myself, and I just made no big deal out of it and carried on with the interaction briefly. I agree, you need to relax, and even if you get as far as saying 'hello my name is ..... and I'm new to the ward etc then you have made a start, and you can also make a note of what they are doing for the next time that you talk to them.

I'm not sure how your placements work as I am from the UK but I thought I'd reply to your post anyway. I hope this helps abit. I hope that it works out for you. You'll find your way.

Becks

danu3 · Nov 16, 2005

Just a quick edit. The thing I am most concerned about is how to respond if they say something that doesn't make sense. How do you handle that, I can't imagine you would just ignore it?? Thanks again :)

This suggestion is not from a nurse. This is from being a volunteer in the chaplaincy service of a local hospital within the psych unit. What I find helpful if the person does not make any sense (e.g. highly delusional) is try to listen to the emotions behind it instead (i.e. fear) and see if the emotion can be address (you might not be able to and that is ok). What else, if you are in an acute setting, logic will not work because the patient is not logical at that time until the meds kicks in. So again listen to their heart, not their brain.

What else, lots of time, just your kind presense will speak volume. You don't have to say much. Listen to the "theme" underneath their conversation as that might tell you something about them, about their dreams, their desires, their emotions, their frustrations, their pain, their suffering... Sometimes you might be able to use the same "theme" to communicate with them.

-Dan

Thunderwolf, MSN, RN · Nov 17, 2005

This suggestion is not from a nurse. This is from being a volunteer in the chaplaincy service of a local hospital within the psych unit. What I find helpful if the person does not make any sense (e.g. highly delusional) is try to listen to the emotions behind it instead (i.e. fear) and see if the emotion can be address (you might not be able to and that is ok). What else, if you are in an acute setting, logic will not work because the patient is not logical at that time until the meds kicks in. So again listen to their heart, not their brain.
What else, lots of time, just your kind presense will speak volume. You don't have to say much. Listen to the "theme" underneath their conversation as that might tell you something about them, about their dreams, their desires, their emotions, their frustrations, their pain, their suffering... Sometimes you might be able to use the same "theme" to communicate with them.
-Dan

Excellent post.

YES