Gives a whole new meaning to being objective...

"Just keep your head low and don't say anything"
"She's unreal...and it's absolutely terrifying"
"Just do your homework"
"Don't be dumb"
"Be respectful, don't say anything that you don't know what you're talking about or can't back up"
"She's scary...it's scary...it's hard...people cried..a lot!"

These are things that students were saying about their experience in mental health and their comments about the instructor. Going into mental health, as I have mentioned before, has such a negative connotation to it. There's such a stigma attached to mental health and even going in as a nursing student I was still having a hard time letting go of that stigma, well, that was until now...

So here's my journey through mental health...day one...we were all sitting in the main lobby of the hospital waiting for her to show up and we're all discussing what we think it will be like, pondering what might happen, deciding who we thought the student would be that she would "pick on" etc.  And then she arrived. It was quickly made clear that we are in no way, whatsoever, to question her. For example she told us to all go put the new parking permits that she had for us in our cars. Someone else, however, decided to say, "There are other students that need parking permits, why don't we just give them to them." to which she replied, "Do not question me. I know what I'm talking about. Unless your parking permit says exactly what mine say then you are to go put these in your car." ......Needless to say we told the student that was 'talking back' to just shut up and do what she says and not questions her! It took a while for some students to learn not to question her authority or to question if she was right or wrong....but once everyone realized that she knew what she was talking about and was there to be a resource for us things started to be a little more smooth!!! :)

At UNMH they do ECT (electroconvulsive therapy) on patients that suffer from depression. Our instructor sent several of us down each day so that we all got a chance to see how that happens (I'll talk more about that in a bit). So she sent the students that had a background in mental health to ECT and then the rest of us went to the in-patient part of the hospital.

Prior to "letting us loose" to go speak with patients our instructor took some time to ask us all what our fears were. Those included, but wasn't limited to: being afraid of what to say to the patient, being afraid of "setting them off", being afraid of the unknown and how the patients would act....the list was endless. So we were reminded first and foremost that every patient that is "committed", so to speak, is there for one of three reasons; they're a risk to themselves, a risk to others, or grave passive neglect. It's not easy to be hospitalized on an in-patient mental health unit. Secondly, we were reminded that any question we had for them has already been asked and they're essential questions. We were also reminded to never go in the patients room, if the patient started to get agitated we were told to tell them ,"thanks for your time" and walk away. We were prepared and given information to prepare us as much as possible. I think it made some of us feel a little more intimidated and a little less sure of ourselves and what our experience was going to be...but ready or not...here we went...

Now, in this rotation we don't perform any hands-on care with the patient, no giving meds, no doing head-to-toes. It's simply a chance to watch how things are done, talk with the patients and hear their story, watch and listen in on their group therapies (including art and dance therapy). We were given two things to try and find out with each patient that we spoke with. We had to decide if they were there with a cognitive or mood disorder and why they were admitted (e.g. risk to self, risk to others, grave passive neglect).

My first day I was sent to the geriatric ward. There I had the chance to talk with three different patients. One was there for risk to self, another was there for grave passive neglect...and the other I couldn't quite figure out! :) I had the chance to participate in dance therapy...which was a very humbling experience for me and all of my fellow nursing students. It was an extremely emotional day, to say the least, and an eye opening experience. We were encouraged to try and increase our objectivity and the way that we looked at our patients....something I'm still working on and learning about! I got home and had a massive migrane, I cried, tried to take a nap, but couldn't, got dressed to go for a walk, but never made it out the door. It was a really hard day!

Day two...was a little better. I was still intimidated but feeling not as hopeless. First thing I got to go to ECT! That was a really amazing experience. Somewhere in the back of my mind I still imagined ECT as being a patient tied down on a board, with huge electrodes stuck to their head and just a weird, terrifying experience. It was completely opposite. For those of you who don't know ECT is used for patients that suffer from severe depression, schizophrenia, and in some cases, mania. It's used as a last result for these patients when their medication just sin't working any more. The patient is put under a short-acting anesthetic, they're given a muscle relaxant so that their body doesn't convulse while experience the seizure. A blood pressure cuff is blown up on the patient's foot so that the muscle relaxant can't reach those few muscles that way you're able to watch the seizure and count how long it lasts. Once the patient is completely asleep the doctor then puts the electrode on the top of the head which causes a seizure to go from head to toe. The seizures I saw lasted about 20-40 seconds. Once they've had the seizure the patient slowly begins to wake up and they're then taken back to their room! The procedure itself is only about 10 minutes. It's very fast...and not nearly as traumatic as I had imagined.

After ECT I spent the rest of my day in art therapy. Essentially they set up several large tables, put lots of paper around them and have all kinds of paint, chalk, pencils etc. The patients are let out of their wards and allowed to come out and express their emotions on paper. There was a professional musician there playing the cello, so it was a very soothing, relaxing, enjoyable set-up. I had the chance to speak with a couple patients...one was in the middle of a hallucination, one was delusional...and it was so heartbreaking. So you can guess how things were when I got home..I had a a huge migrane, I cried...and so on and so forth!

The other two days got better! It was still an extremely emotional experience, but I was learning more about these patients. They aren't there because they're bad people, and they're not there because they're awful people....they're there because they have a real sickness and they have real problems that need to be treated and need to get under control. This experience really gives a whole new meaning to being objective and being open to see things with a new perspective.

All-in-all...mental health was an exciting experience. I had a phenomenal instructor that did an amazing job at teaching us about mental health disorders and how to increase our objectivity when working with patients. She taught us how to better use the tools that we already had in our toolbox! I think I can speak for my fellow students by saying that we all left these clinicals with a greater sense of confidence in our abilities to interact with our patients that are going through a mental health crisis. I can say that it takes an amazing person to be able to work every single day in the mental health unit...and that person is not me!

So there you go....that was my mental health rotation!!!