Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
As an RPN who has worked 3 years on an acute psychiatric floor as a staff and program nurse, I felt that I would be less nervous and much more prepared than most for a mental health clinical placement. It is well known I believe that “nursing students often express anxiety and lack of confidence regarding communicating with patients diagnosed with psychiatric illnesses” (Kameg, Mitchell, Clochesy, Howard, & Suresky, 2009). Although I may have been correct about being more prepared than others who are new to this area of nursing, I was wrong about feeling less nervous.
When I am at work and interacting with patients who are well known to me, I have a sense of confidence and a built trust with them. In clinical, I once again felt the very common student feeling of needing to say the right thing to the patient, not saying the wrong thing, and not “sending them over the edge.” I found that not knowing the patients and not receiving a full morning/evening report about the floor patients caused anxiety as to how the patients might present when I attempted to engage with them.
Without knowing much about them, I felt less prepared than normal to interact with them and was anxious that I may say the wrong thing and cause them distress, or instigate an incident. I felt that due to my 3 years experience that I should be able to comfortably and therapeutically interact with mental health patients in placement. I had forgotten though how unpredictable mental health patients can be when acutely ill. Therefore, I did not engage with patients who were on a 1:1 observation or in the PICU as I often do while I am at work.
In a study of 160 students, 52% of the students in mental health clinical identified witnessing psychotic behavior, threatened violence by patients, and verbal abuse by patients as the most frequently cited critical incidents and 86.4% of the students as a result of the critical incidents: fear, discomfort, shock, confusion, sadness, anger, and embarrassment (Kameg et al., 2009). This being said “numerous studies indicate that students’ negative attitudes, fear, and anxiety can hinder both learning and development of the therapeutic relationship” (Kameg et al., 2009). I therefore had to find a way to overcome my anxiety.
Once it was time to find a patient to conduct and Mini-Mental examination with, as well as have a 10-20 min conversation with, my strategy was to talk with staff nurses to gauge who may be a “good patient to talk to” and to read their charts and patient notes in order to see who may be a more stable patient to interact with. By preparing myself this way, I felt more at ease with starting a conversation with the gentleman I eventually spoke with. I had also been alerted to the fact that this patient could also behave inappropriately sexual at times. Therefore, I took extra care to be aware of my body placement in relation to him as well as conversation topics.
My interaction with this patient, I felt, was somewhat superficial and because it was short and was focused on orientation/introductory topics, I was not able to discuss any concerns the patient may have had or provide any therapeutic assistance. When in my workplace, it is common for me to have one to one conversations with patients when they are acutely distressed.
The mental health placement and subsequent assignments have forced me to take a closer look at my patient while working as an RPN. Since taking this course, and participating in placement, I find myself stopping myself and taking more time to critically think about my response before I engage with psychiatric patients on the unit where I work. I was recently approached at work by a teen with suicidal ideation and 4 attempts in 24 hours and was able to use silence and various open ended and reflective questions in order to have a more therapeutic discussion than I may have had previous to my new learning.
It will be important use such interactions to continue to fine tune my therapeutic communication skills. I am also lucky to have the opportunity, unlike most RPN to RN students, to be able to interact on an almost daily basis with these patients and have the chance to continue my learning in this field. I feel I may never have the “perfect” response and will never cure a patient in one interaction, but feel that through years of experience, and new RN learning, I will be better equipped to provide support and assistance in the mental health nursing setting.
References
Halter, M. (2014). Varcarolis’s Canadian Psychiatric Mental Health Nursing: A Clinical Approach. Saunders; Toronto.
Kameg, K., Mitchell, A., Clochesy, J., Howard, V. & Suresky, J. (2009). Communication and Human Patient Simulation in Psychiatric Nursing. Issues in Mental Health Nursing. Retrieved July 27, 2017 from http://s3.amazonaws.com/academia.edu.documents/43195376/Communication_and_Hum an_Patient_Simulati20160229-28032- mzg87p.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1501270011 &Signature=AG34%2BjZM7f07zzuZ1VNXR6LDblo%3D&response-content- disposition=inline%3B%20filename%3DCommunication_and_Human_Patient_Simulati. pdf
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