November 30, 2010

Life on the depressive unit

The most recent BSN class is drawing to a close...after the hell that was Informatics, Diversity was a breather:  1/4th the weekly workload and only two main projects.  Though I will admit that I didn't get as much out of Diversity as I did the other class...because I didn't have to do as much work.  Go fig.  The next two semesters will be fun:  two classes at the same time for each.  Plus at one point, I need to figure out how I'm going to squeeze one of my two remaining liberal arts classes in there. 

I'm back to floating.  It's not my idea, though I don't mind it.  But whenever a nurse is needed somewhere and they look at our unit to provide it, I'm the one who gets sent .  It gives me experience and cheers me up, because I get to see different patient populations...which is nice when I'm feeling a bit down on psych nursing and wondering if I should attempt to break into med-surg.   The experiences remind me why I like psych in the first place.

Speaking of first places, the first place they always send me:  the depressive unit.  This is where all of the "sad" people go.  It's mostly depression, SI with or without a plan, actual suicide attempts, and the temporarily detained.  Lots of drama.  Lots of personality disorders.  Lots of tears.  Lots of medication seekers who are after the benzos and Schedule II/III narcs. 

Floating is definitely a good chance to keep the therapeutic communication skills sharp.  Whereas in detox I can be blunt, use the word "why", and break half of the rules in the communication book because most of our patient population are frequent flyers and we've been through this dance several times before. 

I have to admit it can be hard.  I guess that's because sometimes I expect it'll be like the textbook:  have a 1:1, talk to them, teach them a bit and boom, patient is 20 times better and no longer depressed/suicidal/crying.  It's amazing what can be accomplished in the world of textbook nursing.  For the most part, the patients do feel better after the 1:1...but their problems aren't solved and they're not all cured.  And I know this.  And I know I can't solve all of their problems and say some magic words and boom, all happy.  But sometimes I do wish it was that easy. 

Even though the depressive unit isn't really a place for psychosis, occasionally some sneaks in.  I got to see a couple of psychotic issues I haven't seen in a while.  Audio hallucinations (more of the background commentary type than the "kill them!" type), thought blocking, paranoia, and mania.  Good opportunity to refresh my skills in dealing with those issues too. 

I dug the psych textbooks out, and I'm making it a point to read up on at least one thing a day...both to help me at work and to help me start preparing for the board certification exam.  Granted, I have several months to prepare, but with the BSN and everything else going on, best I start some of it now.

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