Mental Health Nursing...aka Crazy People Management (and I mean that in the nicest way)

So I am a horrible blogger, as you can tell by my massive library of blogtastic musings. All I can say is that I'm inevitably lazy, but when I DO write something, it's because it's worth it. Thus, a little blurb on the mental health community.

What I learned in my psych rotation will always be valuable to me, this much I know. I learned that people (it could be anyone really) have the capacity to (at any moment, anywhere) crumble into tiny little human jigsaw pieces right in front of your very eyes. And, it may not be their fault...it may be genetic, chemical, or situational...but there is a good chance that they will expect you (as the nurse or ultimately the smidgeon saner person in the room) to put them right back together as if by magic. This expectation is a strange one to take on when it does not involve applying bandages, poking the patient with needles, or monitoring labs (not to say you don't do these things, just not as much). Even patients who hate you, who don't want you around to fix 'em up, seem desperate for a solution. A very, very subjective, guesswork, kind of solution...because not everything goes away with a pill...and if it does, there's a chance you won't be able to sit still, stay awake, or worse...poop. So, how do you, someone who feels seriously lacking in the knowledge department, relate and communicate with the broken individual? Luckily, we were given a few tips..."Therapeutic Conversations" abounded...and there was a lot of "what's better? tell me more about that? and how did that make you feel?" going on. Of course, it's a little more complicated than that, and to be honest, much harder to put into action with real people. I practiced on unsuspecting friends :)

I had a variety of patients while on this rotation; some were addicts, others depressed/suicidal, there was the occasional manic, and the amazingly entertaining yet unsettling psychotic patient. Some of them were adults, others adolescents, but all of them were mind-bendingly interesting. Their charts were like soap operas and Dateline mooshed together, and sitting in the "day room" while the patient population went about their business was more captivating than people-watching at a gay pride parade.

One conversation involved a subject switch that left my head spinning. I seriously had to recover, mentally that is, when a discussion went from the benefits of yoga to fireball chucking demons in literally two sentences. I also had to resist the temptation to get into a philosophical discussion with a manic young man concerning the idea that water is the most living, non-living thing in the world (because it has different states and is fluidly adaptable of course). But this was just the tip of the iceberg...what about the woman who sat in the day room and stuck a banana in her nether regions, but then was mortified just hours later? Or the teen who was raped by every member of her family (including her grandmother), but greets the staff with a beaming smile and a card trick every day?

This is heavy stuff people. More power to those psych nurses, cuz I ain't one of em.

The Wonders of the Rectum

Yesterday, my last day on the orthopedic unit, I had the pleasure of inserting my first rectal medication on a 54-yr-old man. Butts are a funny thing, and here's why: the rectum is like some sort of crazy space-age vacuum hidden up there in your crack. Never before have I witnessed (nor felt) a more effective sucker-upper. I barely inserted the bullet-shaped laxative in the guy's chocolate starfish, when ZZZOOOOOP, up it went. "That's it??" I exclaimed in wonder. I need to tell my Dyson vacuum relatives about this...somehow...we must...harnish the power of the pooper. Imagine this, a vacuum designed after the human GI tract. For fun we could just make it into like a little dude with his pants down. As you vacuumed, it would be like he was scooching his ass along the carpet! We could make the hand-held vacuum accessory look like a dog for obvious reasons. Oh, the green we could acquire Mr. British Dyson man!

Note: For all who are wondering, I did indeed double-glove my insertion hand. My instructor said that if I went in without the extra protection and something tore, I would never be the same again. Always, ALWAYS listen to your instructor when it comes to bum precautions.

The OR and ED

So, for most of the many readers of this super popular blog, me being in nursing school is no surprise. I entered this new kickass journey in June, and I am currently undergoing my first ritual rite of passage in the form of Med/Surg I. Within this class, I must go to clinicals: real world experiences at real hospitals with instructors looking over my shoulder going "oh shit you idiot" in their nervous-for-their-license kind of way. My Med/Surg I clinical is on an orthopedic unit, but the sign spells this orthopaedic...I wonder every day if I am stupid or if my hospital is in some way trying to look smarter by spelling stuff all British-like. In any case, there are a lot of hips and knees getting bionic on my floor, and I spend approx 12-24 hrs per week being disorganized and pretending to be competent. Usually this is not the most exciting healthcare environment, but this last Wednesday proved different...mostly because I left the unit and headed to the more active areas of the hospital. I spent the majority of the day in the OR watching BRAIN SURGERY, sweet. Cut, cut, saw, saw, zip, zap, whoop there's that tumor, close to Patsy Cline, whambam, thank you ma'am. Believe it or not, it was boring. Cool for about the first hour, then I was about as "Crazy" as good ol' Patsy. It wasn't until I ventured into the ED (Emergency Department, for all you people who watch too much tv and think it is called an ER) that things really got goin. As soon as I put my bag down I struck gold, trauma. Patient confidentiality is a big deal, so I won't say so much, BUT the patient had overdosed on diabetes medicine and stabbed themselves in the chest. I witnessed the real deal, CPR, tubes, lines, epi, the whole bit. I nearly audibly growled when they made the EMT student do the chest compressions...because yes I wanted to do it...pick me I say! Nevermind the person lying there, dying, it's my freakin turn damn it. Anyway, after all that went down and the ODer stabilized a bit, I got to go attempt a straight catheterization on a larger, somewhat hairy, non-english speaking woman. This was difficult and I felt like a moron when I was unable to get the darn tubey up the pee-hole. Luckily, four other experienced nurses couldn't do it either and the poor woman bled before they stopped trying...so I guess not lucky for her, but lucky for me and that's what we are focusing on here, me. In addition to this, I got to start my first two IVs (I almost asked to take the first one out and bronze it, but I'm sure that wouldn't have gone over well with the "broken arm and jaw guy"), draw some blood (don't worry I left my vampire fangs at home, but I was thinking "What would Buffy do?" the whole time), and irrigate a nasty chin wound. I also met a nice homeless veteren who was pretty much veinless due to years of drug abuse. He had cool tattoos. Also interesting was the large psychotic man who I happened to see bashing into a wall and then a door held closed by 5 ED security and staff members. He wanted everyone to praise Jesus OR ELSE. And so we did, believe me you would too (especially after hearing how he put a nurse in the ICU only a week prior). And so, skipping some boring stuff and less exciting things, three hours later my ED trip concluded...that is until I walked toward the waiting room to get my belongings and happened upon a man having a seizure and vomiting blood right there in the triage area. I followed him and those taking care of him into one of the rooms and got some seizure pads, but once again the EMT student stole my thunder and took the IV stick. What a bastardo. Anyway, I then took the opportunity to leave when my homeless vet somehow downed an entire bottle of pills that no one had seen stashed in his bags...I know, it seems heartless to just walk out on someone who served our country and paid the price, but I'm pretty sure he was fine...totally fine, and afterall my feet hurt and I was totes beat.

P.S. This was not the best first blog, but I am still totes beat and my sense of humor is only at 50% right now. Consider this my first nursing reflection, ooyah.