Thursday, May 20, 2010
Only those in the same field, or those that have more experience with them will understand this. There is a show called "Stand up for Mental Health" created by David Granirer, a counsellor. He taught stand up comedy to those who have mental illness as a way for them to fight the stigma, to educate the public, and to counter discrimination. It's worth a look. Here's the website http://www.standupformentalhealth.com/ I didn't get to see it when they came to my little town but maybe next time :)
In line with this, I wanna talk about self-awareness... one of the most important skills to master when you are a nurse. The things that our patients have done before entering the hospital can sometimes be in conflict with our own values and beliefs. One needs to be able to withhold judgement, and keep oneself in check. This doesn't just apply to psychiatry.It goes the same for addictions, forensics etc.
For me, one of the hardest issues is suicide. When my patient is suicidal, I feel I need to exert more effort in taking a few moments before starting my interaction with the patient. Personally, it is very hard to be assigned to someone who wants to end their life. My personal values conflict with this. Especially as a brand new nurse, I'm still honing my therapeutic skills, and trying not to view actual cases as clear-cut textbook cases- as those are the ones I am used to. "Given situation A, steps 1, 2, and 3 have to be performed". That's not exactly how it goes in psychiatry. It is a science and an art at the same time. And I have a long way to go in learning to apply both the science and the art aspects. It's still a work in progress... Everyday, I bank on some experience and supplement the textbook knowledge that I have.
Nonetheless, I find that this helps me when assessing suicidality of a patient. Textbook, I know, but it's an important tool to incorporate in the interaction. It's from Shea's Psychiatric Interviewing.
o Presenting hx of a serious suicide attempt
o Presence of acutely disturbing psychotic processes suggestive of lethality
o Indication from the interview that the patient seriously intends to harm self (single most important indication of suicide potential)
The presence of any one of these should warn the clinician that suicide may be imminent risk
Friday, May 14, 2010
Enough rambling, what I really wanted to write about is how being organized plays a major role in good patient care. As a new graduate nurse, I find that adjusting to the routine of the unit and the full scope of practice is facilitated by having an organizational strategy that works for you. I personally prefer having a sheet of paper or a small notepad (I'd actually pick the paper over the notepad because you can shred it afterwards- that way you don't have to worry about it getting lost and then confidentiality becomes an issue). I then put a tick box beside each task that I need to do for each patient throughout that shift. When I've done that task, I put a check mark on the box. That being said, it also means setting aside a few minutes before the start of the shift to think of what those tasks are, what the priorities for each person are and what the strategy is going to be for the first hour of the day which is really the bussiest.
Today I had two discharges and an admission. It doesn't seem like a lot, but I haven't really done all of that on top of a full load of patients before. It seemed like the 8 hours wasn't really enough, and I often found myself thinking, "I don't think I spent enough time with that patient." That's the real big change from being a student nurse. As a student you have much more time to be with the patients, having a lesser patient load and a limited scope of practice- no taking and processing orders etc. I also found myself looking at my "cheat sheet" many many times just to stay organized. The more organized I am, the more efficient I am with my 8 hours. Here are some organziational tools I found online. Obviously it needs to be adapted to your specific area of practice.
Clinical organization sheets - Nursing for Nurses: "http://www.sunyorange.edu/nursing/docs/internet_nursing_I_assignment_2_new.doc
http://www.mc.maricopa.edu/dept/d31/nur/learning_objects/brainsheet.html - report sheets for 1, 2, 3, and 4 patients
http://www.minnesotanurse.com/work_sheets.htm - sample worksheets for nurses
http://allnurses.com/forums/1683581-post5.html - a post that has links to 4 report and time management tools that can be downloaded and printed out"
Saturday, May 8, 2010
I was on my lunch break at work and one of the other nurses was talking about the origins of mother's day. It apparently dates back to the greek era when a day was devoted to worshipping Cybele-the greek mother of the gods. This holiday makes me miss my mom so much more. As I said in my story I grew up with my father. My parents separated, and me and my sister moved to live with our father when I was 11. My mom lives in another country. We keep in touch mainly by phone and by email. I have seen her last in 2007- just after I got engaged. My sister is more fortunate to have seen her twice in the past year. She doesn't have the same time and financial constraints as I did since starting nursing school. But now that I am working, I'm planning to visit her this fall.
I love my mom very much. Although she wasn't physically there she was a great support for me and my sister when we moved here. She was, and still is my confidante. She has had her share of battles in this life and I really hope and pray to God that this year will be a good one for her. She said she's starting to like someone- that's a very good sign. See, my mom has been burned by bad, and I mean bad relationships, and because of this, she became obsessed about work and excercise. Now I can see that there is a balance. She seems happy :)
My favourite memory of my mom when I was little was my first jump into the pool. I can vividly remember her telling me to jump, andshe will catch me. She had a pink and black bathing suit on. It had diagonal patterns on it. She had long black hair and teased bangs (ok, this was early 90s people!) I was so scared, I didn't want to do it, I said I was gonna drown... but I did eventually jump after the coaxing from my cousins and all the other people around me. She caught me, and she held me and said, "See, do you think I'll ever let you drown? Mommy will never let anything bad happen to you."
I love you, mom. I am who I am because of you. Happy mother's day to all moms out there! You are all deserving of the world to worship you for your unconditional love.
Friday, May 7, 2010
Spicy tuna roll (pretty strightforward- tuna and spicy sauce)
Smoked salmon and cream cheese roll
(just what the name says plus crabmeat)
Just writing about it makes me crave it more!!! But i'll hold off for now and maybe i'll just make a pot of tea... yes... that's what i will do.
Oh getting back to nursing, I received my new hire package in the mail today for my other job. I am so excited! So many forms to fill out though! Confidentiality agreement, union stuff, payroll stuff, HR and benefits. Thank goodness no more upfront fees! I need mt first paycheque! :) That's it for me guys! Take it easy and happy nursing week! Au revoir!
P.S. I found this status on facebook you guys may want to post it too..."Being a NURSE means you carry immense responsibility and very little authority. You step into people's lives and make a difference. Some bless you, others curse you. You see people at their worst and best. You see life begin and end. You see people's capacity for love, courage, and endurance. IT'S NURSES APPRECIATION WEEK. REPOST IF YOU ARE A NURSE, LOVE A NURSE, AND/OR APPRECIATE A NURSE!"