Psych Nursing

For those of you that don't know it, in nursing school you go through several rotations, much like students in med school do. In my particular program, our rotations are about 5-6 weeks of our 8 week classes. Fast paced, but enough time to get a feel for what you like or do not like about a particular area of nursing.

Thus far, I've been on an Orthopedic Unit, in a nursing home, on a Med Surg Unit, a Mother/Baby Unit, and currently I am on a psych unit in one of my local hospitals.

Ortho and Med Surg...meh...they're ok. I could do it. Wiping butts and pushing meds, helping patients (oh...excuse me...CLIENTS...) get cleaned up. I particularly enjoy giving injections for some odd reason. I think its the most nursey-nurse thing I've done yet, and there's something about the actions of putting the med in the syringe and giving the injection that I find appeals to me.

Mother/Baby? LOVE. I loved it. Healthy patients who, for the most part, are celebrating the addition of a new life to their families. Some sad stories, for sure. Despite the sad stories, and the methadone baby, born addicted to Percocet that I saw to most of my day in the nursery, and the little guy who was clearly born with genetic abnormalities who was transferred to the Children's hospital....I adored the nursery. I watched a baby be born and tended to many others that day. It was my favorite day in nursing school, and I am preparing to launch an all-out assault on the nurseries at the hospital where I work to allow me to precept there later this year.  

Nursing home? Please, God, no. Geriatrics is not my forte by any means. It was too overwhelmingly sad to me to see these elderly who had dementia, couldn't remember who or where they were....I didn't think it could get any more sad or overwhelming than the nursing home.

Until Psych.

The unit I'm on is divided into 4 sub-units. 1 regular adult unit, 1 child/adolescent unit and 2 special treatment units for acutely mentally ill patients.

I was on the special treatment unit for the most acutely ill this past week. It was a bad day. I was surrounded by patients who are so ill that I found it hard to believe that they could be helped in their current state. Very few--if any of them--were grounded in reality for more than a few moments at a time. One man on the unit has been institutionalized for 47 years. Forty-seven years of his life he has been an inpatient in a mental health facility.

At this facility, we sit on the unit, my partner and I, and color. On the other few units I've been on there, you get a crayon and a coloring sheet in front of somebody and they just start talking. Its amazing. I think its safe to say that after these next 2 weeks of clinical, I won't be coloring any time soon. My neck aches the next day from having my head bent over my coloring all day. My instructor is an art therapist, and she has a seemingly endless amount of coloring sheets.

In the last few weeks, I've had discussions with heroin addicts, bi-polar patients, schizophrenic patients--my schizophrenic patient was my favorite. He was physically imposing and scared the shit out of me half the day. Until he got a crayon in his hand. Then he told me about his life, his history of hospitalizations, the voice that talks to him constantly and doesn't allow him to sleep.

There are many reasons I'm finding this field doesn't appeal to me. I'm used to being up on my feet for 12 hours, checking on my patients, giving them meds, taking them juice, talking with them and their families. Physical exhaustion comes with the territory. But this class--this is a pure 12 hours of mental and emotional exhaustion. You constantly have to be vigilant. Don't turn your back on the client...make sure you know where their hands are at all times...don't ever stand directly in front of them, you have no idea if or when they will strike out. One patient spent half of the day pacing circles around the table where I was seated. He never spoke. I was unnerved.

These units are supposed to be therapeutic, but outside of the art therapy groups that we run for them, I don't see any of that. I see nurses and techs not interacting with the patients unless they're being told its time to eat or time to take their meds. Psychiatrists are in and out. They spend maybe a few moments with each patient, and they're gone again. I wonder how this is helping any of them, outside of the medications. It just doesn't seem right.

And here's the thing that keeps coming back to me. Most especially when I spent time on the regular Adult unit: that could have been me.

I've suffered with anxiety for as long as I can remember. I remember it as a kid, a teenager, a 20-something, and beyond. For most of my life, it came and went. Inconvenient, scary, but manageable.

Until.

My oldest was about a year old. The anxiety had kicked up quite a bit in the months after his birth. Probably a combination of being a new mom and the stresses that come with that, and a healthy dose of Post-partum Depression thrown in just for fun. When he was about a year old, I dropped my basket, so to speak. In a matter of a few months, I became so overtaken with anxiety that I could not function. I would have massive panic attacks any and all hours of the day--particularly while driving. I'd started a new job that was intensely stressful and I was isolated all day, being piled with more and more responsibility. One day I had chest pains and ended up in the Emergency Room. After x-rays, a CT scan during which I reacted to the contrast (listen to your patients when they tell you they're allergic to red dyes and iodine, please) and a blank look on a doctor's face, I left AMA. When I saw my own doctor she handed me a prescription for Xanax and a handful of Lexapro samples. My therapist wholeheartedly agreed that was exactly what I needed.

Except.

Taking medicine scares me. One of those fun phobias. I was terrified they would worsen the problem and allowed myself to get to the point where I walked out on my job, got in my bed, and stayed there. For about a month. Walking into the bathroom brought on intense panic. Walking outside? Forget about it. I was a mess. I wasn't eating much. Wasn't sleeping much. And still in abject terror when I thought about taking the meds. Incidentally--I now know that this thing I'm afflicted with is called Panic Disorder. Look it up.

Finally, my husband gave me an ultimatum: Try the meds. If you don't, I'm taking the baby and leaving.

The thought of being without my son was more unbearable to me than the thought of the meds. I took them. My sisters (also interestingly both on similar meds) cautioned me I would feel strange for the first few weeks and really want to stop taking them, but to keep on. They would work.

And they did. And it is the best thing I have ever done for my own health. That little white pill that regulates my serotonin levels has saved my sanity. It is my equalizer. It keeps my panic away and allows me to function as a normal human being.

So you can see how being on a mental health unit where no one has an equalizer may hit a little too close to home for me. One thing we're taught in nursing school is "know thyself." Examine your own thoughts and beliefs so that you can know what to put aside when you are working with patients. I do my best to put my own baggage aside, and I want to help as much as I can in the limited amount of time I have with these people.

So, I color and make collages, and encourage these very emotionally frail people to share with me the darkest corners of their minds, in the name of therapeutic communication.

And after this semester, I never want to do it again.

When you have little boys...

I once heard someone say, "The definition of a little boy is noise with dirt on it." I don't know who came up with that, but man, is it ever true.

I find myself at home with my boys today. School and daycare are closed, and so I took the day off to hang out at home with my 2 little dirty noise balls. They're my squirrels. They are affectionately known around the house as Stink Pot, age 8 and Small Blond and Bitter, age 5.

Currently, SB&B is in his underwear, riding his scooter in circles around me, negotiating for an orange soda. His attempts began at 9 this morning, and when the answer was no, he called me mean. Are you figuring out where the "Bitter" part comes from? He just heaved a big sigh and said, "I'm sooooo thirsty!!" in the most pitiful voice he could muster.

SP has already broken the light cover over my bed this morning, when he hit it with a ball. Oh well. I needed to wash my comforter anyway....

These are the things that happen when you have little boys. They break stuff. They argue with each other. Heads get bumped, stuff gets lost. You find yourself stepping on Legos and cursing, chase them out of the kitchen, wipe faces that are dirty again approximately 10 seconds later. You find Transformers in your fridge and Hot Wheels cars in your bed.

But here's what else happens when you have little boys...

As their mom, you are loved above all others.

When they are hurt or sick, scared or sad, they look to you to make it better, because you always have. And if you're lucky enough, you can make it better. Though you know there will come a day when you can't, you do your damnedest to fix the boo boos, hug away the bad dreams, snuggle the fevers and kiss away the tears. Because you're Mom. You are their nurse, their teacher, their comfort, their all-knowing.

When you've been gone all day for a 12 hour clinical, and you walk in the door, the first thing you hear is "Moooooommmmmyyyyy!" and you are covered with hugs and kisses because they missed you.

When you're driving down the road, and out of nowhere you hear from the back seat, "Mommy? I just love you."

When they climb onto the couch to snuggle with you and say, "Mommy. You're so pretty. You're the best mom ever."

When they ask me what I got on my test or how my clinical went that day and I tell them, and they high five me and say, "Great job, Mom!"

When SP knows I'm not feeling well or I'm having a bad morning, and he gives me his most loved and favorite stuffed elephant to take to work with me so I'll feel better.

These are the things that make every moment, every struggle, everything worth it when you have little boys.

And to think I wanted girls.

Be Grateful...

Since by definition, this is my blog, therefor my soap box, I'm gonna step up on it for a bit.

Here's a story...

I don't like peanuts. For the majority of the first half of my 20's, I lived on this stuff which was basically peanut butter and grape jelly in the same jar. As a result, I just don't like peanut butter anymore. Or anything with peanuts, aside from an extremely occasional Reese's Peanut Butter Cup but--who could blame me? They're too filled with crack-like goodness for even me to turn down.

I used to have a co-worker who, while lactose intolerant (he'd get embarrassed when I ordered pizza for our department, and specially ordered him one without cheese), had a thing for chocolate. Most especially, Mr. Good Bars. At some point or another, I think he saw one of the guys bribe me with chocolate, or bring me some when I was having a bad or particularly hormonal day.

From that point on, every day he would come into the office and slide me a Mr. Good Bar, wrapped in a paper towel and taped like a gift, across the counter in front of my desk. If I wasn't at my desk, he would leave it in front of my keyboard. Now, this guy wasn't particularly outgoing or jokey in any way, and being Asian, he had that sort of aloofness and distance that is such an ingrained part of that culture. (No judgment folks, it is what it is.) So when he decided I was worthy of a daily candy bar, that meant on some level I was OK with him. And that's pretty badass.

Have you ever had a Mr. Good Bar? They're Hershey Bars. With peanuts. Remember how I feel about peanuts?

Did I ever tell him that?

Never.

Every day, I thanked him with a smile. And took the candy bar home for my son. Or sometimes I put it in my drawer. Occasionally I still finding paper towel wrapped Mr. Good Bars in my desk. And they make me smile. Because he took the time--every single day--to do something nice for me, it would have been beyond rude and ungrateful for me to say "Oh. Sorry. I don't like peanuts." And I don't operate that way.

I'm trying to teach this to my boys. I see it catching on. Every night, no matter who cooked or what they had for dinner, they say, very sweetly and in unison, "Thank you, Mommy/Daddy for making us this delicious dinner." It's a start.

Unless you live under a rock, you're aware that Friday was Valentine's Day. Yes, ok--it is an over-commercialized day to trump up what "Love" is supposed to be, but too many people buy into that. Like one day is supposed to make the difference or tell you how much your significant other loves you. Like the difference between whether they love you or not is dependent on whether they got you a mushy card as opposed to the cute and funny one.

Did they go into that store and pick out a card with you in mind? Well. If your name is on it, it would appear they did. Did they get you a mixed bouquet from the store instead of calling the florist and spending 5 times more to have it brought to you in a van? Hey. You got flowers. Someone picked out those flowers. For you. On a totally made-up day that has nothing to do with how much, deep down, people are supposed to mean to each other. You show that every day, not just because the calendar tells you its that day you're supposed to send someone flowers and get them the good chocolate. That shit feels so much better on a random day anyway, just because they thought of you that day.

So I think the moral of the story I'm getting to is this:.

Smile.

Say, "Thank you."

And know that even if you would have preferred something else, you're receiving a gift from someone who took a moment to think about you.

Take the damn candy bar, already.

And be grateful.

Sunday

I have a husband who is working, 2 children who are playing Handy Manny, 2 assignments and a group project to work on for my psych nursing class. I have to meet my group at 5pm. There are 4 loads of laundry screaming to be done, a bathroom that probably could stand to be cleaned and 4 boxes of clothes to unpack from when we moved in....4 months ago.

I do, however, have dinner cooking in the crock pot, so that's something.

This is my life. I work full time, I am in nursing school full time, and I have a husband, 2 boys, and a house to maintain. Oh and a full DVR of shows I'm never going to have the time to catch up on. I am the tiredest woman you know. I fall asleep in my living room sitting straight up pretty regularly. I have dark circles under my eyes that only seem to fade on the few breaks I get from school, only to return within a week of the semester start. A family of 3 could probably vacation on the bags I have under my eyes.

Despite it, I love my crazy life. I melt down from time to time--who doesn't?--but I learned a long time ago to be thankful for the blessings you have and to focus on the good. I have a lot of good. I have a husband who has never once complained about picking up the slack my schedule leaves with the house and kids. My boys are smart, loving, great kids who are very proud of their mama as she navigates the twists and turns of nursing school, even if they are sad to see her walk out the door for 12 hour Saturday clinicals. I have a handful of the best, most supportive friends that a girl could ask for.

I'm lucky. Never doubt that I know it.

I'm also profane, cranky and probably a little oversensitive from time to time. So don't think everything you read here is going to be rainbows and sunshine spilling forth from my ass. It surely will not. I cope through humor, sarcasm, and a whole lotta venting. Oh. I'm also unapologetically opinionated as hell.

Welcome to my circus. Grab some peanuts & cotton candy, and wait for the parade of clowns. They'll be along anytime.