Mental Hospital @ Orange

Psych Journal #1

The day started off with excitement and a thirst for a new world and exploring different realities in College Hospital in Costa Mesa. We were oriented through hospital safety procedures for new students and some introductions. The real fun began when Erin (my partner) and I was assigned CSU which meant Critical Stabilization Unit. We didn’t know what we were up against, but we were told that this is the psychotics, schizophrenics, and hypersexuals of the group. Not to mention that the hospital already contracts combative and difficult patients from other hospitals.

It took me about an hour of observing the patients, the medical staff, and how they interacted before I finally felt comfortable to talk to them. I quickly flashed all PMAB training before my eyes, don’t get yourself caught in a corner, never be alone in a patient’s room, make sure you always have line of sight with other medical staff, and try to talk patients down when they escalate.

Some of the interventions and actions that I did on my first week were:

· Attend group discussion about drugs of abuse and psych symptoms

· Interview 5 patients as well as exchange pleasantries with others

· Learn about the daily routine of the patients, and paperwork with the staff

· Teaching on patient dealing strategies

· Look out and reorient patients who have low levels of consciousness that are in danger of falls.

· And do laundry

There were three patients that were interesting to me and here is a copy of my notes for these patients:

S.

Upon interview pt sounded normal. Appearance included shaggy hair, decrepid teeth. Behavior: interested in talking to students upon asked. Cognition: patient denies being abnormal, and doesn’t know reason of hospitalization, but is informed about length of stay. Pt. reports that she wants to go to the “village” where they would “help” her and treat her better than here. Pt. States that she wants to leave and is eager to talk to her nurse or doctor to get better. Further questioning directed from info on chart about trying to kill her mother, pt states “I don’t know. I didn’t do nothin’ to her. Then she called the cops”. Pt. was thanked for her cooperation and sent back to bed.

J.

Pt. states “I am CIA, FBI, and Secret Service” and believes that he escapes from College Hospital by table rocketship or chair rocketship to the moon. He fixes “computers in space to prevent a white out back on Earth. It is important.” Tried to orient reality by asking location, year, date, and name. Pt. knew location and name only.

J.

Pt. appears docile. Established rapport by asking him about his showers which he really liked a lot. States that “new meds weren’t working so they switched it to my old ones to receive anxiety”. Upon asking if the medication was working and if he was still anxious, pt. responded “It’s better and I feel less anxiety”.

Observations:

Patients are dependent on food, smoke breaks, and telephone breaks and staff use this as a way of controlling behavior. Staff was very patient with the patients. I particularly liked C’s and J’s style of therapeutic communication, focusing on the patient’s needs while maintaining structure. Many nonverbal cues seen such as flat affect, constant nodding, lack of eye contact, too much eye contact, pacing, word salad, tremors, catatonia, snapping fingers, and repetition of words.

Overall it was a very interesting night, however 12 hours in Psych ward was way too much to handle because of the intensity and anxiety of always having to watch your back and never really feeling secure. Had to do a couple relaxation techniques in the beginning, however throughout the day, attacks lessened. Fatigue set in after a while, but overall learned a lot of stuff.