nervous about psych clinicals

[melmarie23]

We began our psych nursing course today and clinicals start this Thursday. I've been told time and time again by my peers and instructors alike that I do very well with clients and that I do such a great job in interacting and talking with them. However, today my professor and clinical instructor (who is another professor in the department) was said we will have to unlearn everything that we just learned in Fundamentals. That Psych nursing is different and its not taking vitals, passing meds and all the other typical "nursing" stuff, but rather a lot of talking with our clients. I totally understand that, and am very intrigued, however when I volunteered for a role play exercise with my professor, I had NO idea how to refocus the conversation back to my client (i.e. my professor who was playing the part). When she went off on a tangent about how cute my glasses where and asking where did I get them, I went blank because I knew I shouldnt respond with "thanks, I got them at such and such place" and felt for the first time that I had NO idea what to say or do.

I understand how and why a therapeutic communication is supposed to work, and understand Peplau's model and the stages of development for a therapeutic relationship, however talking/interacting with a person in this manner seems so......I dunno, awkward I guess?

A long winded post later and I guess my original question was this: Will this style of communication/working relationship between nurse and client get easier? I fear that I will go to the unit on Thursday and Friday and just totally freeze come time to talk with a client, and thats not at all what I want!

[melmarie23, MSN, RN]

You all are so great. Thanks so much for sharing your experiences. I know I am just letting my nerves cast doubt upon myself. I will be fine. I just have to keep telling myself this.

We also had our second lecture today and I walked away a bit more at ease. I think once tomorrow is over and done with, I will be feeling better about this rotation.

Again, thank you.

[muskylounge]

About 20 years ago I was med level 1 certified and took care as a tech MR patients with dual diagnosis of different varieties. 8 men in a long term facility and most were explosive type disorders. This 9 month job had help me gain some idea of what Psyche clinical would or could be like. Our ADN program would not let us work with the MR patients so we either worked on the adult or adolescent unit. I had an absolute blast. MY favorite times where in "group therapy" sessions on the unit both adolescent and adults. The out patient was not as interesting for me.

I found for me the most important part of therapeutic communication at Psyche was purely LISTENING. Silence was even OK. As my Psyche instructor pounded in our heads "Silence is Golden". Just that they knew, I was there for them genuinely, not to judge them. Just to be there to be of any help I could be.

Let us know how it goes after your first week! :)

Musky

[melmarie23, MSN, RN]

I feel sooooooooooo much better. These last couple days were great on the unit. I am now feeling a bit silly about how much I was psyching myself out about this rotation.

The psychiatrist on my team is amazing. I am in awe on how well she interacts with these patients. Just being in team and pulling some of our patients in to interview has been such an experience. I've learned so much just watching her interact with these individuals. Its been very rewarding.

I had a good couple conversations with patients today and am very much looking forward to next week's clinicals. I am excited to go to clinical which is awesome. It was silly to even worry.

[pinkiepie_RN]

I feel sooooooooooo much better. These last couple days were great on the unit. I am now feeling a bit silly about how much I was psyching myself out about this rotation.

The psychiatrist on my team is amazing. I am in awe on how well she interacts with these patients. Just being in team and pulling some of our patients in to interview has been such an experience. I've learned so much just watching her interact with these individuals. Its been very rewarding.

I had a good couple conversations with patients today and am very much looking forward to next week's clinicals. I am excited to go to clinical which is awesome. It was silly to even worry.

Sounds like you're in for a treat! Have a great time and keep us posted on how things go throughout the rotation!

[Forever Sunshine, ASN, RN]

I was scared out of my mind. But I heard from other students who have done the psych clinical that they actually enjoyed it.

To be honest, I thought I was going to get attacked and beaten by the patients. The patients are for the most part HEAVILY medicated. The signs you see in them(screaming, shouting, tics, etc) are usually symptoms of their medication.

One of my clinical days I was on a classic psych unit. You name it, and it was there. I don't know if it was the phase of the moon or the barometric pressure but the patients were OFF THE WALL.

But in psych there is alot of communicating with patients. I was most worried about what the hell am I going to talk about with these people. They like to talk about weather, their hobbies, your hobbies, their families at home. and food. Oh my god food is a favorite with some of them!

Just remember keep your guard up but not too up, make yourself look like someone they can trust and talk to. Alot of psych patients just want someone to sit and talk with them. The staff on the unit doesn't always have time to do that. But if the patient doesn't want to talk to you. They will let you know.. either nicely or ..not nicely lol

Remember limit setting and listen to your gut when finding a patient to talk to.

If you have some downtime, look at some of the charts and see if the patients story matches up to the truth.