My Clinical Experience on a Psychiatric Unit

The world of mental health was not unknown to me. I had to manage family members with mental health problems, and I knew it was not easy. I always wondered to myself, How does one with mental health problems live? They try so hard to live a normal life, but their brain is going against them. I seen it with my own two eyes, so stepping on a psychiatric floor was no new news to me, until I had my clinical experience...

My alarm rings at 5:00 am, and I press the top floor button to a Behavioral Health Unit. Two units into one; an inpatient unit, and a Crisis Intervention Service (CIS) unit. "Where am I going today?" "What am I going to see today?" My thoughts as I am reading the nursing report: "Oh goodness, this patient has schizophrenia!" I never seen anyone with schizophrenia before. I have only seen movies such as "The Soloist." "What is going to happen?"

First Time Speaking to a Patient with Schizophrenia:

My first encounter meeting a patient with schizophrenia was unexpected. I sat down with the patient and introduced myself. "Good morning. I'm Happiness and I am your student nurse for today." I trembled over my introduction; I am thinking. "Is this patient seeing hallucinations right now? Do they realize their own condition? They greeted me back. "Good morning. What a nice name!" At this point, all my preconceptions went away.

Speaking to a patient with schizophrenia was not what I expected. It was a normal conversation as if I was speaking to someone without schizophrenia. I asked my assessment questions to them, and they replied back with an expected answered. During the conversation, the patient would talk about the delusions they were experiencing prior to admission, except, they said it so causally, as if it was real. Was it real? It was real to the patient, but their delusions was impeding their functionality in life. That's it. This patient was not "crazy." They simply had a different reality that clashed with societal norms. We can all attest that our people can normally can clash with societal norms (AKA "socially awkward". But this particular patient just has imbalances in their brain (high levels of dopamine) that causes them to not be functional, which leads to hospitalizations. Now, I am not saying that all my patients with schizophrenia had the same symptoms. If you look in the DSM-5, schizophrenia is classified as a spectrum disorder, with many signs and symptoms that varies from person to person.

Now, I am comfortable talking to patients with schizophrenia, I began to see these people beyond their disorder. They are not schizophrenics; they are people living with schizophrenia.

The Face of Depression

My patients with depression were the most happiest and easiest people to talk to. Yes. Happy. Artistic. Charming. My feelings towards this observation was so confusing. I would do my morning assessment with these patients and they were so polite and easy to talk to about anything. They had jobs, went to school, and they just lived life...normally, as you would say. But, as I read their report:

"Patient came in for overdosing on sleeping pills on the way to work."

"Patient came in for attempted suicide by hanging their self."

"Patient brought in by EMS for overdosing on oxycodone, morphine, etc."

"What?" This patient was literally just making me laugh. This patient literally just told me they never thought about killing their self. This patient just showed me a beautiful painting of nature with vibrant colors. It was one of the biggest realization in my mental health rotation. The feelings of depression did not match the patient's face. Honestly, that was worst thing I could see. These patients are not only internally dealing with the sickness of depression, but they have to keep a facade of happiness just to...well I actually don't know. It was scary. It gave me a deeper insight about depression. I am still confuse about it, but I understand that these patients need just as much attention and care like any other serious psychiatric disorders.

What Did I Learn?

I learned that I have a lot of work to do after graduation. I want to revisit this field and see what can I do to give these patients the proper care that they have been lacking all of their life. From seeing patients as young as 18, to as old as 70. Mental disorders do not spare anyone when it comes to race, age, gender, and more. I witnessed that there is a lack of adequate care from health professionals. However, there are great health professionals who are putting all their effort to advocate for these patients. The world of mental health is vast, with various areas to go into, with many people who need care...those in the light, but many in the dark...

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