blushing and other ways to destroy your flat-affect cred:

This semester's lessons thus far have focused on mental health and illness and a holistic look at a person in their 'natural' habitat and the nurse's role in his or her lives. When I do get to see or call my friends and someone inevitably asks, "hah's school?" [because in my head, everyone has a wicked yinzer accent] I have to explain that such things are nearly impossible to learn from a book. One must experience these things in order to truly learn them.

At the suggestion of my first clinical instructor, I have been practicing small mindfulness chunks -- an active process involving awareness of what is happening in the present moment and observing the world without judgment. She acknowledged my almost pathological need to view life through a funny and cynical and judgmental lens and encouraged me to suspend these thoughts every so often. At first, I met it with resistance. I take great pride in my sense of humor, dark and biting though it may sometimes be. But I fake-promised my boss that I would give psych nursing a fighting chance, so I may take care of him down the road. And practiced it, I have.

Ironically, the more aware I am of the present, the more I realize I judge and feel I must judge. Judging my own actions can be helpful to a point. The key is learning when to stop -- too much and I halt my progress. today, man, I realized that I have a lot of work to do.

I had my first real experience with a psych patient today. The client's attention to detail was unflattering at best. A clean-catch urine sample was required of this client. Even before I finished the sentence, the client dashed across the room, grabbed the supplies from my hand, and slammed the bathroom door in my face. Not a moment later, the door opened again, and the client handed me the specimen container. Let's just say aim is not a strong suit in this one, and I hadn't had time to acquire gloves. I accepted it with my best emotionless expression and said, "I thank you for your prompt action. I'll go fill out the lab paperwork now."

The client glared at me and replied, "You're practically red. You can wash your hands, you know." Curse my pale skin and red ears, ruining my hard-earned poker face!!! GARRRRR. But possibly unsterile urine is dribbling down my arm. How does one suppress the dubious effects of the SNS in such times? Better consult my clinical instructor once more... or get a tan. whichever is more painless.

Later, the client asked me what was in the cup of medications administered earlier in the morning. Truth be told, I was not in the med room for the entire process, so all I saw was the nurse pulling an anti-anxiety med and an NSAID to use in conjunction with a stronger opioid to attack pain originating in the bone. Apparently, these were the worst possible answers, each drug prompting a different fixation. First, I had to address the over-the-counter drug that was proven ineffective in past experimentation. In the client's words, "I was eatin' 'em like candy and nothin' happened." I, thankfully, have no concept of what bone pain feels like, but I also imagine that since that one time I had eight teeth removed resulted in opioid 'scipts, over-the-counter meds won't cut through pain like that alone.

I explained the delicate process of finding an acceptable balance of medication, in order to be the most effective in terms of comfort and minimizing side effects of the heavy-duty drugs. The client seemed to digest this information, dismiss it, and ask me about the anti-anxiety coverage -- and another fixation began. How long does it take to kick in? What does it do to my brain? My body? What else can I take if it doesn't work the way I need it to? How can I know it's working?

Living with anxiety must be an exhausting enterprise -- and a cycle not easily broken. Anxiety over the actions of anxiety medication, anxiety concerning how long it will be until relief is found, anxiety just in case the prescribed medication isn't enough to control the anxiety already brewing... just thinking about it makes me want to take a nap. I empathized with the client as best I could and talked the client down to a place where the feelings were identifiable and then the phone rang.

I ran off to find my nurse and explain to her in no uncertain terms what I had accidentally done when I thought I would be helpful by answering a call light, which up until that point had consisted of questions like, HEY, WHAT'S FOR LUNCH? DO YOU DRIVE A TRUCK? The nurse explained to the nurse practitioner [in the kindest way I've ever been called a tactless little shit] that the client may have found out in less than ideal terms that an NSAID had been added to the pain management regimen and that a conversation should be initiated to address the other measures used in conjunction with the offending medication to get the pain under control.

I apologized in every language I knew how, and the nurse replied, "Hey, HEY. Mistakes are how we learn. Keep this."

mmmmmmmmmmmm.