For those of you wondering what happened on Thursday after Wednesday's fiasco........well, it was another peculiar day. We arrived at our usual time and went through our usual meetings, only the second meeting, the one with the entire staff, was performed with the truly disruptive patient (we'll call him the assclown or AC for short) was up to his antics. AC danced around, practiced his karate moves, banged on the windows, screamed profanities and was his usual AC self. We ended up not leaving the conference room for the next few hours and, ultimately, leaving the floor entirely at 11am. The lunatics do run the asylum evidently, at least at RPC. The attitude on the floor remained that of the neglectful parent better off ignoring the problems than dealing with them. Moving on.
Our new floor is one that deals with long term care patients. Patients who have been in the institution for better than 25 years in some cases. My patient had been in and out of RPC 40 times since he was 16 (61 at present). Some may wonder why you would let a person out again after their 10th, 15th or 20th admission. I do. Especially after talking to him.
My patient claims the following things: he is the wealthiest man in the world (trillions); he has located more than a half dozen nuclear weapons in and around Rochester; he is a psychic who has used his ESP to assist in the arrests of hundreds of criminals; his psychic ability makes him immortal; he is being poisoned by the staff (who work for the mafia), but has an antidote he takes daily; etc. The litany is interesting but also continues uninterrupted for long stretches. Other patients tell similar tales of oddness including the need to do abdominal exercises to "strengthen your testicles and strengthen your seed." It is so peculiar I dont think I can adequately describe it. That said, it is much much better than the other floor because they are all well medicated, have a strong rapport with staff, and the staff seems to work very well together.
ECT (electro convulsive therapy) was interesting to say the least. First off, I had no clue that they still shocked people. The second "shocking" (get it? :) thing about it was how short the duration of the actual therapy is. It encompasses all of 10 seconds of the hour the patients come in. There is no way to describe how it feels to be sitting and talking with someone and then, 20 minutes, later they are laying on a gurney, paralyzed and unconscious, getting pumped with alternating current. Within 20 minutes of this experience, they are up and walking out the door with the only caveats on their behavior being abstinence from alcohol and signing contracts. The therapy evidently works by directly stimulating your brain and, in this manner, helping to cure symptoms of depression. Interestingly, it also causes memory loss. Perhaps it just makes the patients forget what it was that was depressing them in the first place.
There is little else to add at the moment. Classes are still stupendously dull (we are having an entire 2-3 hour lecture on APA style in the research class......I expect to be admitted to RPC shortly thereafter) and there is little else to remark upon. Another week begins.....hopefully it is quick.
Saturday, September 22, 2007
Wednesday, September 19, 2007
sofa king crazy
Be careful what you wish for. Today there was definitely some excitement on the floor. Unfortunately, it wasn't like finding a $20 bill in your jacket pocket exciting. It was more like, "is that a bee in my car?" exciting.
To being the story, I should state that I had only slept 4 hours last night. I have no explanations as to why my body inexplicably determined that 2am was an appropriate bedtime, but it did. So, as I ambled into the rotation today, I will in a less than stupendous mood. We went through the usual morning progression of meetings and then things got weird. The new patient, a young muslim male in his early 20s, appeared outside of our conference room. The conference room in question is behind the nurses station and, oddly, located next to one of the quiet rooms that patients use when too much stimulus exists for them to maintain functionality. Odder still, the rooms are separated by windows that lack any mechanism to shield the persons in one room for those in the other. The patient was evidently sent to the quiet room to chill out, but that isnt what he did.
What he did do was begin to yell invectives and hop about like his ass was aflame. He also began to tap maniacally on the glass. He then spotted a classmate of mine which he believed he knew and then began to direct his vitriol towards her directly. Exclamations about where he would stick his "hairy muslim dick" (with a creative use of adjectives) leapt from his tongue with the alacrity of lies from the lips of Alberto Gonzalez. This scared my classmate to no end and awoke in me the big brother protective instinct. While we were instructed to keep our eyes averted from his antics and ignore his entreaties, I could not help but want to leave the room, wrench his scrawny arm behind his back and drag him into the room to offer formal apologies. But we arent allowed to so much as speak to him at risk of our academics, so we gathered our things and relocated. He followed to our new room and we eventually spent the remainder of our day on an outdoor patio without much interaction at all with our patients.
Why we should be put in such an awkward position is the first big question. The second might be why nothing was done to remove this patient from the floor. A litany of others might follow. But, despite any of these things we will be back there tomorrow. I hope we arent asked to endure the day again.
On a sidebar, another patient on the floor apparently came out of his room, penis hanging loosely from the front of his boxer shorts covered in what the social worker described as 'semen' telling that same social worker to come over and 'suck his dick' the evening prior. Maybe psych isnt quite the place for me......or anyone for that matter.
To being the story, I should state that I had only slept 4 hours last night. I have no explanations as to why my body inexplicably determined that 2am was an appropriate bedtime, but it did. So, as I ambled into the rotation today, I will in a less than stupendous mood. We went through the usual morning progression of meetings and then things got weird. The new patient, a young muslim male in his early 20s, appeared outside of our conference room. The conference room in question is behind the nurses station and, oddly, located next to one of the quiet rooms that patients use when too much stimulus exists for them to maintain functionality. Odder still, the rooms are separated by windows that lack any mechanism to shield the persons in one room for those in the other. The patient was evidently sent to the quiet room to chill out, but that isnt what he did.
What he did do was begin to yell invectives and hop about like his ass was aflame. He also began to tap maniacally on the glass. He then spotted a classmate of mine which he believed he knew and then began to direct his vitriol towards her directly. Exclamations about where he would stick his "hairy muslim dick" (with a creative use of adjectives) leapt from his tongue with the alacrity of lies from the lips of Alberto Gonzalez. This scared my classmate to no end and awoke in me the big brother protective instinct. While we were instructed to keep our eyes averted from his antics and ignore his entreaties, I could not help but want to leave the room, wrench his scrawny arm behind his back and drag him into the room to offer formal apologies. But we arent allowed to so much as speak to him at risk of our academics, so we gathered our things and relocated. He followed to our new room and we eventually spent the remainder of our day on an outdoor patio without much interaction at all with our patients.
Why we should be put in such an awkward position is the first big question. The second might be why nothing was done to remove this patient from the floor. A litany of others might follow. But, despite any of these things we will be back there tomorrow. I hope we arent asked to endure the day again.
On a sidebar, another patient on the floor apparently came out of his room, penis hanging loosely from the front of his boxer shorts covered in what the social worker described as 'semen' telling that same social worker to come over and 'suck his dick' the evening prior. Maybe psych isnt quite the place for me......or anyone for that matter.
Tuesday, September 18, 2007
trying to stay motivated....in spite of school
As my blog attests, the last few weeks have not provided much fodder. What I had hoped would be an experience replete with wild stories and interesting people has instead devolved into 16 hours a week in a clinical that leaves much to be desired. Instead of being involved in any nursing activities, we spend our hours playing Sorry and Uno with the patients and try to eat big chunks out of our days. We spend the first two hours of each day in meetings, the first hour with our group and the second hour with the staff on the floor. We then meander out onto the floor around 9:15 or thereabouts and, at 9:30 the patients have their first group. We can attend or not at our discretion, but if we dont attend we have to go sit in the back conference room and, ostensibly, read their chart for the 100th time. The group lets out at a quarter past 10 with the next commencing a half hour later. They lunch at noon and we often leave. When we return to the floor we try to soak up the last remaining hours chatting with our patients or writing our daily SOAP note (not worth explaining). Sure, there are a few colorful characters, but none on our floor.
Unfortunately, the classes are no better. The psych class is just as dull as the rotation, only it only takes up 6 hours (though it seems like so much more). The instructor is very fond of the sound of her own voice. It is unfortunate that I do not share her interest in it. Unlike some classes where you find the instructor reading from the powerpoint slides, she reads around them. Both kinds of instructors have their disadvantages, but neither imparts much knowledge.
The research course, which I had been looking forward to, has been a BIG disappointment thus far as well. It has been more focused on how to look up an article than how to read and evaluate research. I evidently mistook the title. I thought we would learn not how to understand research and better evaluate it......instead we are learning little more than how to use the library's computer system. To quote my roommate Krista, "Boo."
We also have a lab course that has proven, thus far, to be quite disjointed and uneven. We spent an hour today learning about ABG lab values and then the second hour practicing sterile technique while we removed a bandage around a PICC (peripherally inserted central catheter) line on a dummy. Think changing a bandage only with sterile gloving and a mask.
I am sure this whole blog post will come off negative.....and that wouldn't be inaccurate. The reality is that this will change in the coming weeks. I have another 2 1/2 in psych and then it is back to acute care (which will be another round of wiping ass and changing bed linens, but at least it will be a bit more medical than anything we are doing presently). In spring, we get into OBGYN and pediatrics, which will likely prove much more interesting. Until then, I will keep slogging along and keeping the end goal in mind.
Unfortunately, the classes are no better. The psych class is just as dull as the rotation, only it only takes up 6 hours (though it seems like so much more). The instructor is very fond of the sound of her own voice. It is unfortunate that I do not share her interest in it. Unlike some classes where you find the instructor reading from the powerpoint slides, she reads around them. Both kinds of instructors have their disadvantages, but neither imparts much knowledge.
The research course, which I had been looking forward to, has been a BIG disappointment thus far as well. It has been more focused on how to look up an article than how to read and evaluate research. I evidently mistook the title. I thought we would learn not how to understand research and better evaluate it......instead we are learning little more than how to use the library's computer system. To quote my roommate Krista, "Boo."
We also have a lab course that has proven, thus far, to be quite disjointed and uneven. We spent an hour today learning about ABG lab values and then the second hour practicing sterile technique while we removed a bandage around a PICC (peripherally inserted central catheter) line on a dummy. Think changing a bandage only with sterile gloving and a mask.
I am sure this whole blog post will come off negative.....and that wouldn't be inaccurate. The reality is that this will change in the coming weeks. I have another 2 1/2 in psych and then it is back to acute care (which will be another round of wiping ass and changing bed linens, but at least it will be a bit more medical than anything we are doing presently). In spring, we get into OBGYN and pediatrics, which will likely prove much more interesting. Until then, I will keep slogging along and keeping the end goal in mind.
Thursday, September 13, 2007
Vacate is the word
I have officially completed week #2 of my psych rotation. That and a hill of beans of course get me nowhere. It reinforces just how quickly time passes and how queerly short-lived these courses are. I have my midterm on Tuesday after a sum total of three actual class lectures. A big fat whatever.
As far as the classes go thus far, they are very disappointing. the psych lecture is kind of like watching a Jerry Bruckheimer movie.........except that it costs exponentially more and is far less entertaining. The class, like the movie, lasts about 3 hours and, after its over, you immediately forget what you saw. I thought I had contracted a terminal case of ADHD, but it turns out in surveying other members of the class that I am not alone. Ah well, hopefully the tests arent difficult.
The rotation continues to be interesting. The amalgam of disorders clustered together on the floor is quite arresting. there is one patient with a facial tattoo (among many other tattoos.......I think I can safely assume that NO ONE makes a facial tattoo their first), another that has bouts of mania expressed by singing and dancing, and yet another that claims millions in the bank if he can just get out. The sad thing is that once these patients do get out, where do they go? They either go to group homes or are sent to temporary housing (essentially a half-step up from living on the streets) and in most cases they relapse and end up in trouble with the law and return. In no way can you 'cure' any of these people. Thats what makes it really interesting though.....and probably incredibly frustrating too.
Speaking of temporary housing, my own situation is now tenuous. Tia and I are not nearly homeless, but we are also not really that far from needing another place to live. In the past week, the condo has fallen through (much to our delight considering what a massive tool the seller has been and Tia's desire to return to school somewhere other than ROC in the fall), there are now possible house renters (that it too much a story to detail here), and the possibility remains that it could be put back on the market..........or we could stay here. God knows what is going to happen. Hopefully we will soon too.
I need to go write my journal and catch up on assignments.
As far as the classes go thus far, they are very disappointing. the psych lecture is kind of like watching a Jerry Bruckheimer movie.........except that it costs exponentially more and is far less entertaining. The class, like the movie, lasts about 3 hours and, after its over, you immediately forget what you saw. I thought I had contracted a terminal case of ADHD, but it turns out in surveying other members of the class that I am not alone. Ah well, hopefully the tests arent difficult.
The rotation continues to be interesting. The amalgam of disorders clustered together on the floor is quite arresting. there is one patient with a facial tattoo (among many other tattoos.......I think I can safely assume that NO ONE makes a facial tattoo their first), another that has bouts of mania expressed by singing and dancing, and yet another that claims millions in the bank if he can just get out. The sad thing is that once these patients do get out, where do they go? They either go to group homes or are sent to temporary housing (essentially a half-step up from living on the streets) and in most cases they relapse and end up in trouble with the law and return. In no way can you 'cure' any of these people. Thats what makes it really interesting though.....and probably incredibly frustrating too.
Speaking of temporary housing, my own situation is now tenuous. Tia and I are not nearly homeless, but we are also not really that far from needing another place to live. In the past week, the condo has fallen through (much to our delight considering what a massive tool the seller has been and Tia's desire to return to school somewhere other than ROC in the fall), there are now possible house renters (that it too much a story to detail here), and the possibility remains that it could be put back on the market..........or we could stay here. God knows what is going to happen. Hopefully we will soon too.
I need to go write my journal and catch up on assignments.
Thursday, September 06, 2007
Camelot
When I think of Camelot, I used to imagine King Aurthur and the Knights of the Round Table......now I think some mentally imbalanced person is probably whipping a chair at someone. Its all contextual I guess. Spending time with people you would actively avoid on a city bus is a different context to be sure. When they say Camelot on the loudspeaker, you just hope it isn't occurring on your floor as that means something has gone awry and the calvary had to be called. So long images of Merlin, hello images of violent psychotics.
I dont mean to paint an overly dreary picture. Truth be told, we have heard the call of 4 Camelots in the 2 days we have been on the floor, but none have been in our unit. The unit I am working on is comprised of the shorter term 'consumers' whose length of stay rarely extends beyond a season. The hospital does house longer tenured residents on other floors (one gentleman just passed away who spent 44 years, the latter 2/3 of the entirety of his earthly existence, in psychiatric care), but we are not privy to their units. The floor I work on is coed, with adults ranging from 18-64 years of age, and with varied levels of mental impairment. We are each assigned a patient and my own is in his late 30s and presents asymptomatically, which is good because it is easier and bad because it may not present much of any interest. He has a very short history medically and seems wholly in denial that he has any problems to contend with. It will be interesting following him from the snapshot view I got from today on through the weeks to see if he begins to accept that he has some issues to work out (which he assuredly does even if they aren't outwardly manifesting at all times) or continues to assert that all problems and issues in his life manifest largely in those around him leaving him blameless. We shall see. Other classmates have patients that display somewhat more readily their impairments. I was anxious about this rotation, but I am now just excited to see what happens. At the very least, the likelihood that I will be cleaning up poop in the next month seems nearly nonexistent :)
I am off to seek out textbooks online for which I will pay an exorbitant amount for up front, enjoy reading little or not at all, and then sell, recouping very little monetarily because, in those few scant months, the newest edition will have been released with such earth altering changes as a new font in the preface, a superfluous rewording to page 346 and a flashy new cover photo. Admit it, no one misses that part of college.
I dont mean to paint an overly dreary picture. Truth be told, we have heard the call of 4 Camelots in the 2 days we have been on the floor, but none have been in our unit. The unit I am working on is comprised of the shorter term 'consumers' whose length of stay rarely extends beyond a season. The hospital does house longer tenured residents on other floors (one gentleman just passed away who spent 44 years, the latter 2/3 of the entirety of his earthly existence, in psychiatric care), but we are not privy to their units. The floor I work on is coed, with adults ranging from 18-64 years of age, and with varied levels of mental impairment. We are each assigned a patient and my own is in his late 30s and presents asymptomatically, which is good because it is easier and bad because it may not present much of any interest. He has a very short history medically and seems wholly in denial that he has any problems to contend with. It will be interesting following him from the snapshot view I got from today on through the weeks to see if he begins to accept that he has some issues to work out (which he assuredly does even if they aren't outwardly manifesting at all times) or continues to assert that all problems and issues in his life manifest largely in those around him leaving him blameless. We shall see. Other classmates have patients that display somewhat more readily their impairments. I was anxious about this rotation, but I am now just excited to see what happens. At the very least, the likelihood that I will be cleaning up poop in the next month seems nearly nonexistent :)
I am off to seek out textbooks online for which I will pay an exorbitant amount for up front, enjoy reading little or not at all, and then sell, recouping very little monetarily because, in those few scant months, the newest edition will have been released with such earth altering changes as a new font in the preface, a superfluous rewording to page 346 and a flashy new cover photo. Admit it, no one misses that part of college.
Sunday, September 02, 2007
Popping off the top of my esophagus
I cant believe it has been two weeks since my last posting. Which means I have spent a solid two weeks dealing with only my own concerns and not those of some poor bedridden individual. I also cant believe that the holiday is winding down.
It was a pretty wonderful, though overly rapid, break. I definitely feel like I needed a few weeks to recuperate mentally from the grind of the summer. Tia and I spent the first week in Florida with my parents and, despite the inhospitable heat and humidity that greeted us, the trip was really great. We spent a good portion of the break poring over the sands of Venice beach on the gulf coast trying to locate the now elusive prehistoric shark teeth that I spent many summers searching for with my family growing up. Unfortunately, they had recently pumped some new sand on the beach and effectively buried most of what you could locate. They were harder to find than Lindsay Lohan's dignity.
The trip to Florida, as busy at it was and as much as I enjoyed seeing my parents, sped by furiously. It still seems as if a week's time could not have transpired between our arrival and departure. The extra 5lbs of girth about my middle section reminds me that it was no mere figment however. If you are reading this, I love you mom and dad and thank you for a wonderful holiday.
The second week has been spent largely reading leisurely, trying to return to routines, and dealing with the vagaries of life that so often try all of our patience. I wont recount any of the details of the mundane aspects of it other than to say that I abhor dealing with car insurance, buying a house/condo FSBO is maddening when you are dealing with the most obtuse seller in the history of realty, and financial aid and associated monetary school concerns remain enigmatic and frustrating.
I would love to attest to my readiness and willingness to return to school, but I am not one opposed in any way to idle time. Sure, there are times where I have yearned for activity and, lacking the money to find many to occupy my time, have bemoaned my financial situation and longed for the days when I will return to school if only to finish and begin accruing money instead of hemorrhaging it, but a few deep breaths and the feeling comfortably passes. I have really tried to enjoy this week something that I think we, as American people, often take for granted.......spending our time off doing little or nothing of import or note and, quite simply, just relaxing.
Speaking of relaxing, I am off to do a little more before school begins anew and I will be afforded almost none until the winter holidays. The next term starts on Tuesday with Psychiatric nursing to begin it all. I am sure there will be plentiful stories then.
It was a pretty wonderful, though overly rapid, break. I definitely feel like I needed a few weeks to recuperate mentally from the grind of the summer. Tia and I spent the first week in Florida with my parents and, despite the inhospitable heat and humidity that greeted us, the trip was really great. We spent a good portion of the break poring over the sands of Venice beach on the gulf coast trying to locate the now elusive prehistoric shark teeth that I spent many summers searching for with my family growing up. Unfortunately, they had recently pumped some new sand on the beach and effectively buried most of what you could locate. They were harder to find than Lindsay Lohan's dignity.
The trip to Florida, as busy at it was and as much as I enjoyed seeing my parents, sped by furiously. It still seems as if a week's time could not have transpired between our arrival and departure. The extra 5lbs of girth about my middle section reminds me that it was no mere figment however. If you are reading this, I love you mom and dad and thank you for a wonderful holiday.
The second week has been spent largely reading leisurely, trying to return to routines, and dealing with the vagaries of life that so often try all of our patience. I wont recount any of the details of the mundane aspects of it other than to say that I abhor dealing with car insurance, buying a house/condo FSBO is maddening when you are dealing with the most obtuse seller in the history of realty, and financial aid and associated monetary school concerns remain enigmatic and frustrating.
I would love to attest to my readiness and willingness to return to school, but I am not one opposed in any way to idle time. Sure, there are times where I have yearned for activity and, lacking the money to find many to occupy my time, have bemoaned my financial situation and longed for the days when I will return to school if only to finish and begin accruing money instead of hemorrhaging it, but a few deep breaths and the feeling comfortably passes. I have really tried to enjoy this week something that I think we, as American people, often take for granted.......spending our time off doing little or nothing of import or note and, quite simply, just relaxing.
Speaking of relaxing, I am off to do a little more before school begins anew and I will be afforded almost none until the winter holidays. The next term starts on Tuesday with Psychiatric nursing to begin it all. I am sure there will be plentiful stories then.
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