Tuesday, December 7, 2010

Final thoughts on Ferguson!


Last week was my last week at Ferguson. It was really interesting to see the way that the residents reacted to us leaving. Some of the residents got SUPER clingy during the last week and wanted to be with us the whole day, others didn't want to even come down to see us because they didn't want to say good-bye. A few of them were really upset that we were leaving and one even cried because she didn't want us to go. It was definitely an experience to see all of the different reactions and learn how to respond to them. After our last clinical we went out for lunch with our instructor and then we headed to the CHS building to listen to our instructor present his master's presentation. It was really great because after he was done, the master's committee asked us how we felt about the clincal we had, since he was talking about it. We got to all talk and pretty much help to defend his presentation and it was just really cool. We all made him cry :)

So for clinical every week we write a journal entry answering questions about how the week went, so I felt a good way to sum up my time at Ferguson would be to just post some of my responses from my final journal entry. I know they are kind of long but I want to have them on here to look back on, plus I think they are a good view of what I learned. ALSO I made a paper chain to count down until GRADUATION! Only 243 days left!

1. What do you see as the role of the nurse in this clinical area (Either Psych/Mental Health in general OR a community setting like this…or both)?

The role of the nurse in this clinical area is one that is very widespread and varied, meaning that the nurse has many roles. The nurse is an observer. She must be aware of all of the things going on with those that she is caring for, and she must watch closely in order to assess for changes in physical health or mental status. It seems that through working with the same people repeatedly and for a long period of time, the nurse can actually learn the patient’s patterns and behaviors and predict when they are going to have problems. The nurse also needs to be an advocate. By observing what is happening with those that she is caring for, the nurse can then advocate for the things that they need. In the hospital setting this may be safety precautions, medication changes or a sitter. And in the community this may be finding a new case worker, helping with insurance or disability coverage, or advocating for the patient to be placed in a hospital or rehab center. The nurse can also be a trust worthy person in the lives of the people that she cares for. Many mental health patients are in need of someone to talk to and someone to trust, and nurses can be that person for their patients. One other important role of the nurse is an educator. The nurse can help work with mental health patients to help them to understand their conditions and work towards managing it. The nurse can help the patient to find things that may trigger an episode and find things that may help them to feel safer or more content. The nurse has so many important roles in this clinical area and these few are just a sample of them.


6. Please list what you feel your strengths are in Psych/Mental Health nursing. Please list areas related to this clinical specialty where you think you need to continue to grow and learn.

I feel that I have several strengths in Psych/Mental Health nursing. I feel that I have a good ability to connect with people in a short period of time. I have been told by several of my nursing faculty that this is something that I’m good at, and I feel that I have seen that a lot in this rotation. Often I only have a few minutes to talk with a resident and I feel that in that short time I do a pretty good job of connecting with them and developing a quick relationship that makes them feel a little more comfortable. I also feel that my communication skills are good. In this rotation these skills have improved drastically, and I think that I do a good job at feeling comfortable talking to the residents and making them feel comfortable as well. I am not intimidated to approach many of the residents and I am able to carry on conversations well. I also think that I have strength in being a good listener. Many residents simply need someone to talk to, and someone who can listen and understand what they are feeling. That has been one of our biggest roles at Ferguson, and I feel that I am good at being a listener without self-disclosing or offering my advice when it is not needed.

That being said, there are still areas that I need to improve upon. Though my communication skills are improving all the time, I still have a great deal more to learn. I still have a lot to learn about communicating with people who are hallucinating and with people who are schizophrenic. I also still need to learn more about communicating with people who are depressed or suicidal. There is still a lot of work that I need to do to work on these skills. I am trying to work on not being judgmental but there is still a definite need for improvement there as well. I also need to continue to learn more about mental illness. There is still so much that I don’t know about many mental health conditions and as I learn more about them I will be able to better understand my patients and the things that they are going through.

7. What did you learn during this clinical rotation? What did you learn that you didn’t expect to learn?

I have learned so much more from this clinical than I could have ever expected. I have learned so much about myself and about the biases that I held that I didn’t even know about. I expected to learn a lot about mental illness and about people with mental illness, but I didn’t expect to learn as much as I did about myself. The more I learn about the residents at Ferguson the more I feel my own stereotypes being broken down. I have learned that so many of these people have come to be homeless because of situations that are truly out of their control. They did not become homeless because they are lazy or stupid, or because they were too drunk to get a job. Many of them are homeless because they are mental ill or because they were abandoned by family and friends and couldn’t take care of themselves. Knowing their stories has completely changed the way that I will view homeless people for the rest of my life and will absolutely affect my clinical practice. I have also learned that these people are not very different from me. They all have the need to be cared for and cared about. They have feelings and emotions. They worry about the same things that I worry about, and they are upset by the same things too. They may feel or express these emotions in ways very different from my, but the feelings are the same. Treating these patients like they are different or outcasts is not the way to best help them, they need to same things that any other patient needs, maybe just in a different way. I have also learned that there are so many things that these residents need in order to function on a day to day basis. They need the help of doctors, case managers and social workers in many instances, to help them with all of the things that they need. I didn’t know that there were even that many resources available for people with mental illness, and knowing this will definitely help me to find places like these anywhere that I am practicing.

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