Feb 20 2008
Last week was our first half day on a Psychiatric nursing floor. To say my classmates and I felt like fish out of water would be a huge understatement.
To enter this acute psych unit, a nurse has to unlock two doors; he warns us to always check the corners of the doorways for patients who might try to dash out an opened door. As we step on to the unit, a thin sprightly man in a large red T-shirt walks past us at a furious pace and greets us with a hello. We learn he paces miles each day from one end of the unit to the other.
Imagine an ‘L’ shape floor with rooms lining the halls and a large stark but sunny common area in the middle of the floor. The common area is lined with chairs with about 10 people sitting in the chairs. Most of them are directed toward a large-screen TV in the corner, while a few stare straight ahead. We enter the nurse’s station, which they call the fishbowl, and indeed it feels like one when patients press their faces into the window to look at us. It also feels a little like a command center because we can easily look out at all the action in the common area. Well, inaction would be a more apt description.
We spent some of the morning pressing our nurses for a clear idea of what it is they do exactly, what the nursing plans are, and what we could do. We were on “med-surg mode,” which meant we were ready to go, and we were hypervigilant about being scolded for sitting down, chatting, or otherwise not doing much. Med-surg broke us in, alright. At first we couldn’t even sit down and relax for more than 5 minutes. Gradually it became clear that med-surg mode wasn’t Psych mode. Psych nursing is its own thing entirely. I’m still figuring out what it is exactly, but in the meantime we were to try to talk to the patients and assess their condition, watch certain ones while always keeping our back to the wall, and try to engage them with games and crafts. The disorders on this unit range from schizophrenia to major depression and suicidal ideation to alcohol withdrawal.
Taking a deep breathe, I introduced myself to some of the more ‘present’ looking patients and tried to chat. One person was tearful and didn’t want to talk because he was thinking about his wife. Another looked like Spock. He replied slowly with one or two words, then proceeded to stare at me without blinking for some very long minutes. Oh how I fumbled with my hands! I awkwardly placed my hands in my pockets, behind my back, across my chest, and in front of me in a teepee formation, all during just one brief conversation. Hmm. Yes, I think I’ll go now.
Games sounded like a good idea. A nurse assured us at least one or two people would come flocking to us. We found a brand new deluxe Uno set and set up shop at a card table. Oh we had high hopes…but we sat in vain. We tried to rope in some of the more talkative folks, but one gentleman whom we thought held the most promise shook his head and said, “No, no, I can’t even think my way out of a paper bag.”
Mission defeated, we retreated to the fishbowl to gather our wits and read up on the folks we interacted with. Then it was lunchtime, and the end of our first morning. We vowed to have a better plan tomorrow.