Clinical Observations, Part 1

At the moment I am doing my mental health rotation in which I work with patients with behavioral disorders. I am thoroughly enjoying the experience and can picture myself working in mental health in the future.

Some thing I noticed recently is of nurses' expectations for the patients. Our S.M.A.R.T. (Specific, Measurable, Attainable, Reasonable, Timely) goals are a bit different from other nursing areas. For instance, one might be for the patient to only rely on PRN anxiolitics only six days out of seven and instead utilize coping strategies for one day to reduce agitation. For some behavioral patients, that is a tall order. For others, that is an attainable goal.

Our job as mental health nurses is not to diagnose patients. Our job is to treat and help manage the treatment of our patients, especially because in this area, many cannot do so themselves. For example, for someone with ulcerative colitis who also suffers from bipolar disorder, sticking to a safe nutritional diet can be challenging if not near impossible for those that cope through eating. Nurses must help manage the ulcerative colitis exacerbations as well as the bipolar disorder.

That being said, mental health nurses have to be far more observant in changes in patients' behaviors than nurses in other areas of healthcare. What seems like laziness and sitting around is actually persistent monitoring of patients and charting their behavior in a subjective, non-judgmental manner.

For an example of how difficult this type of writing can be, take a moment to look at a person nearby and describe them without using words such as "cool," "nice," and "cute." Post your observations in the comments below. It is can be a very arduous task if one is describing multiple patients with similar behaviors.

My point being, each patient is an individual and one is most reminded of that in behavioral health.

Spring: A Time For Renewal

Well it certainly has been a while hasn't it?

Oh there is so much to update! For one, Spring is almost certainly upon us in the Pacific Northwest! The past few days there has been the typical Spring weather fluctuations - and I will not lie, I am very much enjoying it.


That being said, I have returned to running after a brief lapse to accommodate increasing physical fatigue secondary to demands from academia as evidenced by an ever-aching knee, sleep deprivation, and frequent dehydration from increased caffeine intake.

Spring always reminds me of renewal in the most basic sense - "the replacement or repair of something that is worn-down, run-out, or broken"- in that I can either scrap whatever failed or failing endeavors I was attending to or return to them with refreshed vigor.

I love that I have options... They provide hope.

Frazzled by Learning, Astounded by Knowledge

With all the studying I have been doing lately, I have rarely taken even a moment to appreciate how much I already know. Instead, I have (as usual) become slightly overwhelmed at how much I do not know. 

Tonight, as I was sifting through my overloaded email inbox, I found this gem:

Language
by J. Mark 

It's tragic
the way that everything falls away
when you name it:
those there, looming over this
here, their darkness,
their ability to catch the light
from that, there, hanging brightly.
It sounds so ridiculous to say it that way,
but there they all are:
the sun in the sky
over the small green earth, the peaks
that pull the horizon so close, so high,
glowing, their valleys blue-black
with shadow.
In our eyes they are the mountains
that we were promised: immutable.
But in word
they may as well be made of sugar.
They melt under their names
as under a hot running tap.
I could say nothing,
I should
give up singing these empty psalms,
hold your face tenderly between my hands
and turn it towards the view 

The idea that something as simple as describing something can be so complex in a multi-dimensional way.  It may just be deliriousness from sleep deprivation, but this poem reminded me that I know things that other people (or rather, other little people) do not know yet. For that, I should be mind blown. Yes, I am sure children will grow up and learn all about the sun and the stars - but will they know the things I know about schizophrenia, GERD, or animism? They might... but then again, they might not.

My clinical advisor recently reminded me of the quote, "Anything you learn becomes yours." That makes me feel pretty well off.

My 21st Birthday

On the dawn of my 21st birthday, I spent some time reflecting on my life thus far.

The eve of my birthday was spent at my aunt's house, eating nachos and watching re-runs of the Olympics. I browsed the internet and ate more than my fill and finally caved in for the evening. I thought I would read instead of watching an episode of Pretty Little Liars on Netflix (DON'T JUDGE ME), thinking that watching Netflix would keep me up. What a mistake I made! The chapter I read kept me up for hours, leading me to my internal reflection.

The thing is, I have felt so much regret about my childhood and adolescence for as long as I can remember. For a long time now I have strived to live virtuously in the present and work towards a better future. Only recently have I truly accepted I cannot change the past and as I lay thinking about my life so far, I cried out, thanking God for the way my life is now. Despite the troubles I have had, I have moved past them to become the woman I am. That is not to say I am perfect, but I feel more comfortable in my skin than I have ever felt.

I promise, this all sounds more dramatic than I intended it to be. The emotions I experienced that night were fleeting, as all emotions are, but gave way to a sort of enlightenment. I am not, nor will I ever be back in my past. That in itself is a blessing. I suppose this all sounds a bit fantastic and ridiculous, but I have waited a week to express in writing the thoughts and feelings I endured that night to ensure that the experience was not entirely delusional.

Of course, once I awoke the next morning it was all about the joy of being with family and finally being "of age." Although 21 years old is commonly recognized as being of legal drinking age, it means a bit more for me. I consider it an inevitable right of passage in which I become a "proper" adult.

I noticed even before my birthday how attitudes have changed upon acknowledgment of one's age. Pardon my colloquialism, but since when has age been such a big deal? That being said, I will enjoy finally being able to drink legally. The only problem I can foresee in the near future is what drink to try next.