Student Question

[RNin2007]

To anyone who answers this, I really appreciate your time. I am a fourth term junior BSN student and we start our clinical rotation for mental health next week. My placement is in the lockdown facility at the hospital. Only two students were able to be placed there, so I feel very lucky to have this experience.

Can anyone tell me what to expect? Is there a good way for me to prepare for clinicals or any handy assessment tools? I crossed my fingers, toes and eyelashes that I would be able to get placed at this facility, so I am hoping to make the best of my time there and learn from my clients and hopefully offer some hope and be a good listener.

Could you tell me, in your experience, what type of groups that the students ran and how they did it? This is one thing that I know we will be doing, along with a psychosocial assessment.

In orientation last week, we had a panel of people living with mental illnesses come and speak to us. It had a tremendous impact on me to see these people openly tell their stories with us, and how much personal strength they had to be able to live with their illnesses and share with us students. I do have some experience getting to know a few people who had schizophrenia, manic depression, bi-polar because I lived next door to one of the apartment complexes that support the MI living in the community. One of the residents used to garden and my kids would come over and help him. He would just light up whenever my kids were around, and often thanked me for trusting him (it broke my heart sometimes, because I realized that he was aware of the stigma of MI, and was concerned about my view of him).

Thank you...to anyone that takes the time to help prepare me for the next 10

weeks !

~J

[RNin2007]

Aww, c'mon...someone take a hit.

~J

[HarryPotter]

Hi

I have been i Psych as a RN for over 30 years. When I look back to when I was a student, I found that the staff really helped me and I took my cues from them. I don't remember leading any roups right away, but, when I did, it was not alone.

My best advise is to ask questions and get feed-back from the staff. In terms of the patients, go with your gut, you seem to be a very sensitive person.

[Psychaprn]

Hi

I have been i Psych as a RN for over 30 years. When I look back to when I was a student, I found that the staff really helped me and I took my cues from them. I don't remember leading any roups right away, but, when I did, it was not alone.

My best advise is to ask questions and get feed-back from the staff. In terms of the patients, go with your gut, you seem to be a very sensitive person.

I agree with the above. Just remember-be yourself and be warm, non-judgemental and professional. Don't touch anyone without asking first-so as not to startle them or make them uncomfortable..Always leave a clear exit for a patient who is anxious -don't sit between a patient and the door. Irving Yaalom has written several excellent books on group therapy. Psych. nursing is fascinating, never boring and unpredictable. Pay attention to your gut and when in doubt ask for help. The most important thing isn't your educatiion or experience but that the patient senses your warmth, humannity and honesty. Good luck! Make sure to be aware of any feelings that get stirred up inside you and make sure you get clinical supervision from your instructor. If you are really serious about psych-please get your own individual psychotherapy to help you clarify any issues you may have and to teach you what it feels like to be a pt. Please keep us posted.

[RNin2007]

Thank you for the advice. I am looking forward to this rotation...I am sure I will learn a lot. I did a search on this forum and found some old threads that had great info as well (the first time I searched I didn't put the right search terms together).

:)

~J

[rn/writer, RN]

Go in willing to learn and ask questions.

Watch other staff members and note the things you would like to copy as well as those you wouldn't.

Be wary of patients who try to build your ego by telling you that you are the first person to really listen to them.

Be very away of attempts to use you to split staff.

Never turn your back on a patient in an enclosed area.

Keep accurate counts of things like writing utensils, eating utensils, scissors, staplers, and anything else which is handed out and needs to be collected.

Find out the Policy and Procedure for letting people on and off the unit and for handling phone calls. If you think HIPAA is tough in other areas, it's scary tough in psych.

Learn about the meds, especially their side and adverse effects. EPS comes to mind.

Learn about the various diagnoses.

Show kindness but not weakness or favoritism to patients.

Learn from other staff good ways to de-escalate tension on the unit.

If you find yourself becoming irritated or stressed out with individuals or groups, find healthy ways to vent and blow off steam. :angryfire

Look at the various flowsheets and information sheets on the unit and become adept at using them.

Learn how to speak to patient's family members properly.

If you are given keys, put them on a wrist bungie that never leaves your arm except to be used. Never, ever, ever set your keys down anywhere. Sometimes, that's the only way to tell the difference between patients and staff.

That's all I can think of for now.

[CharlieRN]

I agree with everything you have been told except carrying keys in a visible manner. I was taught in nursing school never to play with or swing my keys in an area that patients might see me. Visible keys have the same psychologic impact as a guard's billy club. Keep them in your pocket until needed.

Learn good "door hygene". Know what is on the other side before opening doors. The sequence is, unlock, open, walk through, close, make sure it is locked behind you. Never let a door you unlocked stay open after you leave it. Never unlock a door for someone else unless you are sure it is ok for them to pass that door. If someone you don't know, says they are staff they should have keys of their own or ID. Real staff will be fine with you being cautious.

I can't imagine them asking a student to lead a group except maybe something recreational or possibly med education.

Try to address the sanity in the people you serve. Even the craziest person has sane elements, even the sanest has their crazies. You are most helpful to them when you focus on their strenghts. You will learn alot about yourself if you can spot your own "crazies".