Clinical Reflection On Mental Health And Illnesses
In my placement today at Mayo Hospital, Mankato under Wendy the nurse supervisor in the locked unit, I was caring for 52, 38, and 66 year-old patients, whose names are Mark, Joe, and Willy (Pseudonyms) who were admitted for mental behaviors related to Anxiety, Depression, schizophrenic episode of bipolar type and Delusional thoughts besides their past medical history of Hypertension, Diabetes 2, and kidney failure respectively. Being a nursing student, mental health and illnesses were subjects of today's study and thus how they are associated with altered thinking, changes in mood, mental distress, and impaired ADL functioning varying from mild to severe.
The mental illness issues always depend on the type of mental disease, the individual, the family gene, and the socio-economic environment. Having entered the quiet locked care unit, I found some good-looking people who had been separated from the society due to mental disorders and each of them had a story to share on how they ended up in this given care unit. Having spent 6. 5 hrs. With these mentally disturbed clients, I discovered that these people need a quiet environment to make meaning out of life and importantly need someone to share thoughts with. This is in relation to their promotion of well-being, prevention of mental disorders, and the treatment and rehabilitation of their mental disorders.
With today's real-life experience and new discoveries in the mental world, I would rate my placement 10/10 with a promise to keep working closely with these patients by offering psychosocial nursing interventions (PRN) to help them back to their pre-crisis phase of life In this placement, I was set to achieve some patient-centered goals at the end of the 6. 5 hrs. spent with them. Thus, my greatest achievement met was working with a patient whose diagnosis was depression, anxiety and delusional behaviors which made her belief at some level that people in her room had plans to kill her sister's dog and later turn on her life. And now she was hiding under the beddings and did not want anyone close to her in the name of helping with ADLs. From her chart in a nursing note, I learned that she has always planned to travel to Africa to have her honeymoon in Serengeti in Tanzania. With the Serengeti idea, I went into her room and introduced myself hoping to discuss the Tanzanian's Serengeti with her. On noticing my ascent at the introductory part, she uncovered her head and asked me if I come from Serengeti where her honeymoon is likely to take place in a few days to come. About her honeymoon place, I acknowledged to have known the place but as a matter of fact, my origin was from a different country (Kenya). At this point, I realized that I needed to keep the conversation running and by so doing, I realized that our relationship was growing strong by every hour.
Further, I offered to find the "people who had planned to kill the dog and her" and surely confirmed to her that I didn't find anyone in the room but promised to keep vigil to ensure nobody came up for her "life" and the dog wasn't in the room with her but is safe back home with her sister. She thanked me for being kind to her and seemed not to be fear anymore. Now she was open about her depression, in which she mentioned about anger normally caused by her dad when he displaces on her mum when drunk and asked about his failed responsibilities as a husband and father at home. She further identified deep breathing, exposer of feelings/behaviors and identifying the triggers as strong uses to reduce her depression/anxiety feelings.
My biggest challenge was dealing with a patient who had lost her first husband through world war 2 and she got 2 consecutive divorces afterward. She had lost every member of her family through cancer and now she had decided to die in whichever way possible. This patient was admitted with suicidal ideation. With the bedside report, followed with close observation of her age in relation to mood and affect, I found myself having mixed feeling and lacked skills in solving her issue at hand. Not any of my nursing interventions could make a difference in changing her behaviors. The patient remained tight-lipped with no eye contact throughout the shift, thus prompting me to ask myself where I had gone wrong in terms of therapeutic communication and approach. After failing to this point, I went back to search for ways of approaching with a clear mind that I should have taken more time with the patient to encourage her to express her feelings with an assurance that I was there for her help at any time she wanted me to help.
Having missed this crucial part, I plan to be keen and apply the mental skills that I am learning this semester to enable me to handle such cases by offering more time for depressed clients and encourage them to express their feelings as they are to find a solution to their psychological needs. It was great to work with these clients in my life. The multidisciplinary team was working around the clock to ensure that cares and treatment for the patients were up to date. It was very encouraging to learn that team focused on each patient at a time and finely assessed what was working and not working to change the approach for care and treatment to enhance a quicker healing process of the patients.
Every single meeting held in the behavior health unit involves all disciplines at a roundtable conference to discuss the progress of the unit with the residents' needs and supports they may need. The director of the unit also kept reminding the nurses on the unit to impress the psychological PRNs than medication PRNs first in any case of psychosocial behaviors, meaning medication should come as the last result of nursing intervention for any nursing diagnosis.
