Psych Clinical

Tarabara · Jan 25, 2011

I had my psych rotation last semester and I had all the same thoughts you're having. I was really scared about just talking to people too because I can be very shy at first. At my facility they had a big room where the patients eat their meals and also have a tv, it was sort of a rec room. Every time at clinical our group would take out a puzzle and start putting it together in the middle of the room and many of the patients came up to us curious about what we were doing and joined in. It was a great way to break the ice, and they actually a lot of the time started the conversations by asking us questions. I would suggest you and your classmates do something like that because its a great way to interact with them without the pressure of just walking up to someone and bombarding them with questions. You'll be surprised at how many patients actually are happy to have someone there to talk to and will come up to you. We also played games like scrabble and that. Good luck to you!!

DayDreamin ER CRNP · Jan 25, 2011

Chances are, you aren't going to have 6 hours of patient contact. We had pre- and post-conference at every clinical which took up some time. We also had to go to group sessions with our patient.

I actually enjoyed my psych rotation and learned a lot but part of that was due to a GREAT teacher.

You will use psych and therapeutic communication every single day you work as a nurse. I'm a 2nd semester senior and I work as a tech and I cannot tell you how useful psych has been for me. If you take HESI exams you will need your psych experiences for sure.

Don't worry too much about not saying the right thing. Hopefully, your teacher will give you goals each visit and you can go from there. My only advice is to allow your client to talk and pauses in the conversation are perfectly fine. Give them time to think and then answer. You'll be fine!

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metricalpound · Jan 25, 2011

My mom is a pysch nurse - it's all about communication.

kalami08 · Jan 25, 2011

One thing to keep in mind--all these patients are VERY used to people spending lots of time just talking to them - it's a big part of their therapy. So don't feel awkward! They're expecting you to ask to talk to them.

I agree that in the beginning it can be easier to sit down and play a game with them. Maybe an easy card game, where you don't have to think too much, and can talk as you play.

Another thing I found works well is drawing. Sit down with someone (or even a group) and ask "Do you want to draw with me for a little while?" Ask them, "Draw the animal you would be if you could be an animal." You'll get some really interesting animals, and when you talk to them about why they chose them, many will really start opening up - at least, that's what I found when I tried it.

Surprisingly, another thing that really worked for me was this. During some "down time" when patients are just relaxing, go up to a small group, introduce yourself, and say, "Would anyone like to chat with me for a little while?" You will almost always get at least one person who really wants to talk - sometimes more, and then you have to ask them to take turns!

I know that normally you are assigned one patient to work with, but once you have talked with them for a little while, just make sure that your instructor is ok with you talking to other patients. It shows initiative on your part, and plus, it's easier for you to talk with someone who really wants to talk to you. :)

Good luck!

ImThatGuy, BSN, RN · Jan 25, 2011

I hate it when people think of bathing as a skill.

dudette10, MSN, RN · Jan 25, 2011

I mostly listened during psych clinical, rather than talking. You do however, have to approach the patients and create an environment in which they would like to talk to you, which can sometimes feel awkward. Once they get going though, it's mostly listening and occasionally prompting/redirecting.

I think a lot of people are nervous with psych clinical because it's very different from other nursing rotations. Good luck!

turnforthenurse, MSN, NP · Jan 26, 2011

Communication is a big part of their therapy! But trust me, you won't be sitting there for 6+ hours talking with your patient. From my experience in psych clinical, patients would talk to us for maybe 15min and then would want to be left alone. Some will talk your ear off but I find those patients are difficult to understand (I had a patient who had schizophrenia, but his speech was soooooo garbled and of course I had to do a process recording on him so I basically had to guess what he was saying to me...my instructor understood :lol2: The patient himself was very pleasant and was always laughing and having a good time, so that was a plus). We also had long pre and post conferences and we were usually given an hour to an hour and a half for lunch.

~Mi Vida Loca~RN, ASN, RN · Jan 27, 2011

Hi all,
This semester I have to go to clinical three days a week. On Thursday and Friday I have adult/older adults where I get to do all of the nursing skills that I have learned so far. But, on Mondays, I have psych clinical. Today we had orientation for it. I'm a little more comfortable after orientation, but I'm still very nervous. During our psych clinical, they won't let us practice our main skills like passing medications, baths, etc. Instead it's basically all COMMUNICATION for 6+ hours! Basically we each get a patient and we are expected to spend the day with them communicating. Orientation was a shorter day so we only get to join a group to meet some of the patients.
My problem is that communication is actually my weakest nursing skill. I'm dreading next Monday. I can't imagine having to spend 6+ hours TALKING to someone/following them around. Most students worry about saying the wrong thing (I do, too), but I worry more about... what the hell is there to say for several hours?
Does anyone have any advice? I'm just really nervous. I can't wait until this semester is OVER! May where are thou? lol.

Communication is one of the most important parts of being a good nurse. If this is your weakest area than this will be especially good for you. Psych is such an important subject that gets brushed off way to much and faces more judgment than probably any other area. Don't go into it looking at it as "oh man 6 hrs, what the heck can I talk about for 6 hrs" and so on. Start letting the conversations flow and listen to your patient and you will be surprised how quickly the time can go bye and you find yourself wishing you had more time. It will most likely be broken up conversations.

Clinicals are what you put into them.

Good luck