April 5, 2012


So, I need to purchase about $200 worth of books for this assessment class, PLUS have access to basic medical tools. Though why the tools if actually hitting a knee with a hammer and other related tasks are only worth a small fraction of the grade? And of course, I already have two assessment textbooks at home…and of course, the syllabus specifically states that for assignments I MUST use the assigned textbook. I wondered if I've registered for the right section, so I shot my advisor an email to ask before I gave Amazon my money. And yes, it is correct.

All this for a 5 week class that is supposed to be 100% online? Feh.

On the brighter side, the school bookstore actually had a cheaper price than Amazon for most of what I needed, even the new versions…how rare is that? So I ordered used anyway since I'm rather peeved I have to buy yet another set of assessment and care planning books. I saved about $50. Sweet.

Pity the program didn't accept the last RN-BSN assessment class for credit though.

I read the course syllabus…at least I WILL be reading this textbook, and often: the first week's reading assignment is so large, it reminds me of the days of Nursing Fundamentals. So knowing that I will actually use this textbook takes away some of the sting of having to buy it. I'm starting on the reading as soon as possible: the teacher kindly posted the first week's readings online, in case people have a delay in receiving their books. I'm also glad that i'm taking this during what looks like to be a famine stretch in the per-diem front, as I will have my hands full.

I've been using some of the tips I learned yesterday to deal with our histrionic patient. So far, so good. I never thought in a million years I would say this, but I am far more comfortable handling patients with borderline personality disorder. But practice makes perfect, right?

Maybe it's because at 2 years on, I'm still relatively a baby in the world of psychiatric nursing and perhaps my elders are really actually wiser, but I do think about what follows and question this at times:

I fully understand the importance of limit setting and enforcement. I do. I also understand the importance of self-assessment and how I need to handle myself in an emphatic yet neutral manner towards them. But if a patient comes in to see me about something, I am going to talk to them if I can. I may not make them tea and cookies, but I'm going to take the minute or three to listen. Or I may tell them to come back later when I am free. I'm not going to say, "it's nothing, you're fine, go back to group," at least not without hearing the patient out first to see if it is nothing. And if it's nothing, then I'll tell them they're fine and go to group.

But sometimes I feel like the some of the staff takes things to the extreme—they seem so quick to brush off a patient or set rigid limits that seem to be over the top. Or they treat a patient on the cool-to-cold side. Or they downplay the patients' concerns as just being part of their Axis II-ness and don't seem to listen or even question if there is something really behind their behavior or concerns. They're very quick to do that once they learn it's an eating disorder patient, no less.

And maybe they are. And maybe they're not and they really listening and being therapeutic and it just doesn't seem like it. I don't know.

My supervisor said that the skills in handling different populations comes with experience. True that. I have to remember that eating disorders is not the usual population I deal with. I have to learn not a whole new language (since essentially psych is psych is psych), but just a different dialect.

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