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.

Correlation Does Not Equal Causation.

This post stems from an experience I had today. I apologize if I may seem a little harsh or unfair in any way - it might be due to residual shock, anger, or exhaustion.

I was pulling out of a parking space, looking both behind me for other cars and in front of me for the car parked next to me. My car's tail end was already sticking out in the isle when I looked back and saw a car barreling towards me. The isle was not wide enough for her to pass me and I was clearly in the isle so I paused a moment to see if she would slow down. Noticing that the car was not slowing down, I immediately pulled forward, back into my stall. The car honked repeatedly as it swerved and passed. I turned back around and saw that the car had slowed down and the older lady driving the vehicle was glaring at me. I honked back at her and mouthed "slow down," automatically furious that she had almost hit me. She continued to honk and glare and finally drove off.

Now I know it seems like an overreaction to the situation, but it brings to mind a stereotype of young and older drivers. I understand that young drivers may not have as much experience with driving, but that does not necessarily make them poor drivers. Nor does that make experienced drivers good drivers. That does not make experienced drivers poor drivers either. What I am saying is, one should not place judgement or blame based on the looks or age of a driver. Just because I was probably the less experienced driver in the situation, does not automatically make it my fault.

For now, I am grateful that nothing happened and I hope that the woman is no longer in any hurry and/or will not cause any accidents in the near future.