Archive for August, 2008

My Journal for Psychiatric Nursing Concept 04

Tuesday, August 26th, 2008

I don’t know if it’s just coincidence or whatsoever. I am now fond of reading Paulo Coelho books. Recently, I finished the book “Veronica Decides To Die” which is about insanity that coincides with our Maladaptive Disorder concept. I have read in that book that “Insane” persons are afraid to come out at the asylum or mental institution because they don’t have the courage to face the world outside because of the social stigma attached to them even if they are already well or at least manageable.

I have proven this right because during one of my duties at the National Center for Mental Health, I have learned that my patient was finally discharged after years but on her way home via ferryboat, she jumped at the ocean. In that incident, I immediately concluded that there is anxiety and fear in her heart that is hindering her to be “normal” again. I feel that she doesn’t know how to start her life over again outside the walls of the institution. She also puzzled if she will still be accepted by her family and friends after what she have gone through.

This is not to judge my client but I feel that the wellness of a mentally challenged person depends on how other people treats them especially with their loved ones. Patients have the strong will to get well but are just lacking the courage to step out of their own worlds. We must have an accepting, understanding and caring attitude when dealing with them. We should be non-judgemental and give them that best possible encouragement for them to continue progressing.

Another thing that I learned was, mentally challenged people chose to stay because at the mental institution, though they are labeled as crazy or insane persons, they can be free of everything they want to do and be what they want to be without judgement because after all “that is what they are”. They don’t need to follow the norms and conform with the standards implemented on the normal world. In the institution, they are all the same but they have their own world and don’t care about others.

I also learned that not all patients in the mental institution are abandoned by their loved ones because some of the patient’s families opted to admit their loved one for proper management of the patient.They are concerned with the client’s safety and health status. For me, it is the best way a family member can do rather than letting the mentally challenged person stay at home without proper attention but families should bear in mind that they must maintain their responsibility with the patient (visiting etc.) and not just financial support.

I know these thoughts and realizations are not so interconnected with each other. It is just that I have learned so much in a day so pardon me for the “Flight of Ideas” (Oh! I think I just have a Maladaptive symptom. LOL!)

Little realizations NOW can make a big difference in the FUTURE.

My Journal for Psychiatric Nursing Concept 03

Tuesday, August 26th, 2008

During our first day of exposure at National Center for Mental Health, our group showed mixed of emotions… Some of them were excited, some of them were scared and some of them were nervous. I belong to the excited one. However, a part of me was a bit afraid because I am clueless on how to treat and deal with them. My fear subsided when our clinical instructor taught us on how to interact with them.

We were assigned 2 students per patient for our security. My partner and I was able to interact with the patient effectively though at first, we ran out of questions to ask. Good thing our patient was very spontaneous and has a lot of stories to share. We knew how she get there, about her family background and on how is she doing now and her relationship with her co-patients. We validated the data we have gathered and it was correct though she failed to give us some details about her stay at the institution maybe because she already forgot due to time, she doesn’t want to talk about it or she doesn’t trust us enough. Throughout the interview, I almost felt like I am talking to a normal person. I wasn’t afraid at all and I clearly understand what she was talking about.

On the other hand, I can’t help but think of why most people fear these kind of persons— crazy, lunatics, insane as we would label them. They are trapped with that stigma that tends “normal” people to become disgusted. Yes, they are capable of hurting themselves and what more of other people right? But if you would come to think of it, they are just protecting themselves. Yes, they have unusual attitudes as well as behaviors but it can still be treated. They are not capable of thinking properly and deciding for themselves correctly but when you spend time with them, you will see how weak they are inside, how they need someone to talk to and someone to hear them, how helpless they are with their situation.

I believe mentally challenged people are also like us, normal people, who just failed to cope with their problems and conflicts. They feel they are alone and defenseless. They aren’t as strong as we are and that is why instead of fearing them, we should extend our arms to them and help them to get of the darkness they are into. I know they also wanted to get out but doesn’t know how to and lacked courage to do so.

At some point I think normal people are the once who should be feared for they have the right way of thinking and be capable of doing things mysteriously. I mean, if you would compare it with people who are mentally challenged, normal people doesn’t show any signs and symptoms of such disorders and is capable of pleasing you where in fact, under their good looks is their dreadful motive. Looks can be deceiving. We should be careful with our judgements.

I don’t know if I was lucky that I have interacted with people who are mentally challenged (because people often chose not to…) but one thing is for sure, people need not to be afraid of them because inside them, is a heart that is longing for love and acceptance.

My Journal for Psychiatric Nursing Concept 02

Tuesday, August 26th, 2008

During the first day of our exposure in the National Center for Mental Health, we have had a self-awareness awareness activity facilitated by our clinical instructor. Our group had a sharing about our dreams, fears and frustrations. I won’t tell it anymore because it is confidential. With that activity, I felt our group become more bonded. Incidentally, the day before, we also had a self-awareness activity facilitated by our lecturer where in, we will write other people’s positive and negative qualities and vice-versa but unfortunately, we haven’t got the chance to explain what and why have we written such things and so, we got our duty time to have an open-forum regarding that since it is related anyway. Again, I will not emphasis on what have we discussed anymore but one thing that I have learned is that “Difference in perception can alter your intentions…”

Before making a decision or doing things, we think of the pros and cons it will bring as well as our intentions whether it is good or bad. I believe everyone never intends to hurt anybody — or at least for me. Being a good person, I intend to do no harm to others both physically and emotionally but it’s a sad reality that with people’s indifference it becomes the other way around. Instead of you being the hero, you become the zero, which equates to no good.

The open-forum that we had really made me into a conclusion that indeed, people have different understanding of things, they may think of it negatively which make you earn points on them to take grudges or hard feelings on you unconsciously. I sometimes can’t understand why people judge your action incongruent to what your real purpose is but still I understand. I try and think that there are certain factors about people which affects their line of thinking, maybe that is just their personality— to be pessimistic, maybe they have problems and they are very sensitive, maybe that is what her previous experiences taught him to be or the worse is, he possesses all of those factors.

Encountering such people is inevitable because that is the way our lives here on earth goes. At times, it frustrates me because what is the point of me thinking for the good of others if they would look at it as something hurtful for them? Nevertheless, with that incident, I just said sorry for having offended them because I believe that is the right thing to do. I will just continue doing what I know is good regardless of what their judges would be but only this time, I would be more careful with my words and actions. I just hope people will approach me whenever I happened to hurt them. That is one way of me improving myself— no hard feelings.

My Journal for Psychiatric Nursing Concept 01

Tuesday, August 26th, 2008

One thing that I learned— “LEARNED” today is, “Anxiety can KILL a person.”

We had our duty at the FEU-VINES laboratory and we were presented a scenario wherein we should revive the dummy in cardio-pulmonary arrest. We were taught on how to revive him and we clearly understood the lesson transpired to us. Our group even reviewed the procedures and got it right but during the actual simulation, we let him die.

Looking back to what had happened, I knew we were so nervous that we forgot simple things to take into consideration. I always experienced anxiety whenever we are being graded in doing nursing procedures especially if I am doing it the first time, during revalidas, return demonstrations or clinical exposures. I believe that nursing students are guilty of this same situation. I know it is normal to be anxious during “first times” but if I am going to kill a person just because of this anxiousness then it not OK anymore.

I can’t determine on what level of anxiety I belong but I am definitely not on the PANIC level LOL! Anxiety causes mistakes and not-so-good grades, which I despise. I have experienced this kind of anxiety many times but I still can’t conquer it. Good thing, I am not that perfectionist type and I have this philosophy in life that “It’s ok to fail or not to do the thing properly if it is the first time but if it happened again on the second time, then I am a dumb ass.” Rationale for this is that, the first “encounter” is your reference on how the things… it enables you to formulate strategies or techniques the second time you encounter the same situation in the future. This philosophy helped me cope as well as the inspiring and motivational words of my group mates. I am basically an optimistic person and I thought “at least now, with my mistakes I will learn and I knew how it feels to have a patient did (though it is just a dummy), I will not let it happen again and so I will always do my best.” those thinking made me feel relieved and so I am ok now.

I learned that, I need to improve in composing myself in times like that. I need to stay calm to be able to perform my duty correctly. I need to believe in myself that I can do it and not to question myself if I can do it. Lastly, I need to put everything that I learned in mind in my heart for me to always remember things. To sum it up, I had a very memorable experience today and though I was frustrated, I still enjoyed our simulation.

Registered Murderer

Saturday, August 16th, 2008

I always envision myself as a registered nurse since I took up B.S Nursing. I even affix “R.N” after my name (which is indeed a violation) and see if it sounds good. Also, I always put the phrase “Future RN” in one of my accounts on the web. To my delight, yes, it does fit my name so good. It even feels good.

However, during my VINES rotation, there was a sudden change of cold weather.

It brought deaths of my patients… (dummies considered as real patients)

Then, I found a new profession…

“RM” a Registered Murderer (instead of RN, which is a Registered Nurse)
(We joked about it but on the other side, it isn’t funny)

From Day 1 to Day 4, I wasn’t able to save lives. All the patients who needs resuscitation was left not resuscitated despite of all the efforts because of a few little mistakes.

I killed Hal (refer to my previous post)
I killed the baby with a case of cord prolapse (but I saved the mother, being a high-risk pregnant)
I killed another baby who coded after delivery (it should be Pedi Blue but he wasn’t available during our simulation)

Fatality with just simple mistakes pffft! Mistakes that I won’t elaborate anymore.

I REALLY NEED TO STUDY AND IMPROVE MY CRITICAL THINKING

(during simulations and not just on theories)

My time being a student is not getting any longer. Oh well, at least I learned. Next time, I will be very careful with my actions because in the near future, DUMMY TIME IS OVER.

Experience Deprivation

Thursday, August 14th, 2008

One thing I learned at our VINES exposure yesterday:

Never compromise the experience you can have into something lighter just to avoid or prevent frustrations. Let the worse comes to worst because with the worst, you will gain the best learning you can ever possess.- dianne

It’s just sad that some of the experience that I should have experienced was not met because (I don’t want to talk about it. Conflict just around the corner…LOL!) Maybe that experience will happen again years from now and it sucks (I feel our group {just the 6 of us} are the only ones who didn’t experience it). It’s so disappointing because I really want to experience everything into its fullest even if there are frustrations rather than experiencing a little with no frustrations (with the same learning) because it’s harder to accept the learning if you are not satisfied with your experience.

Now I am only left to count years… *sigh

IKILLEDAPERSONTODAY.

Thursday, August 7th, 2008

I killed a person today.

I thought what I know was enough to revive Hal but I was wrong. I let him die— well, our group let him die.

Our group was assigned to the FEU-VINES (Virtual Integrated Nursing Education Simulation) Laboratory for our duty on Acute Biologic Crisis concept and with this concept, we will going to simulate a cardio-pulmonary resuscitation to the mannequin named HAL. The scenario was, the client was coding (with our clinical instructor controlling his status) and we should revive him the best way we could according to what was taught to us.

During the simulation, we have given too much epinephrine to Hal without the interval of 3-5 minutes that made him more critical and so, still with constant compressing and hyperventilating, at times defibrillating, our clinical instructor just said, ok Post Mortem (meaning, we didn’t revived him.) Then, stopped and pronounced the time of death.

My critical mind tells me, “We we’re used to our AHSE (Associate in Health and Science Education) days to just assume things and not “really” do the procedure that is why we forgot to say “After 3 minutes blah blah blah…” which killed Hal. I learned that “To assume is a mortal sin.” Also, our adrenaline rush and increase of our excitatory neurotransmitters leads us to forgetting things. — That was I, using Rationalization.

Though Hal is just a mannequin, he was still my patient and I was frustrated because our efforts was not enough to revive him as much as we do want him to survive. (In VINES laboratory, mannequins are treated as “real” persons).

I was on mixed emotions because I felt like a real nurse (we are even called “junior nurses”) in that scenario but I was saddened by the fact that we didn’t revived him. I enjoyed the simulation because I learned a lot of things but I was dismayed for the little mistakes we’ve made. Nevertheless, this will make me to bear all the things I’ve learned today in my heart and not repeat the same mistake over again.

Don’t worry. I am Ok now. =)

FEU VINES Laboratory

Thursday, August 7th, 2008

Today was my second time entering the newest and only-in-FEU laboratory for nursing education because we are assigned there for our duty. The first was during my level III first semester revalida but it was not yet fully functional. You may often hear FEU nursing students saying:

Duty kami bukas sa VINES…
Nakapunta ka na sa VINES?
Ansaya sa VINES… the best!
Wow, sosyal… sa VINES kayo…
Excited na ako mag-VINES…

Which leaves you clueless about what you just heard. Worry no more because I am here to orient to on what is a VINES Laboratory.

VINES is an acronym for Virtual Integrated Nursing Education Simulation. It is the first and only full operational virtual nursing laboratory in the Philippines. It provides a realistic, state-of-the-art, joint commission compliant, and controlled safe environment for the students to practice safely in supportive environment before the students can enter the real world of healthcare. It is designed to replace the healthcare setting and facilities development of skills by using a simulated healthcare setting.

So in short, this is a hospital-like laboratory wherein it is divided into different areas: 6 bed wards, Medication room, Clean Utility room, Nurses’ lounge, Ante room (I am not familiar with this), Isolation/Private room, Control room 1&2, Intensive Care Unit 1&2, Emergency room, Operating/Delivery Room complex, Holding area, High Risk Pregnancy unit/Post- Anesthesia Care unit, Nursery and Central Supply room.

There are also mannequins (GERI for geriatrics, MIKE and MICHELLE for pediatrics, NOELLE for maternal and neonatal birthing, PEDI BLUE for neonates, CPR SUSIE for CPR, HAL for Acute Biologic Crisis) on which most nursing interventions can be practiced and variety of equipment that can be found in the hospital setting including a hoist, patient monitors and infusion pumps, a bedside sink and table.

If you want to view FEU’s VINES laboratory you can watch this video:

Before I forgot, VINES laboratory is equipped with cameras and microphones to monitor the activities in the laboratory. It is something like the “Big Brother”. Cameras are capable of zooming-in and zooming-out and rotating 360 degrees.

Our laboratory was also featured on GMA 7’s Saksi. Here’s the video:

No wonder why FEU is being branded as the Fastest Earning University LOL! It is good to know that our tuition fee is going to something, which could be of great help for our learning. We will be oriented on hospital settings in which at times we aren’t able to know or experience with the “real” hospitals. Lucky for our batch because we were able to utilize this laboratory when it is fully-functional already. During our simulations, our Clinical instructors would tell the prices of each mannequins and equipments for us to take care of those things and believe me, our tuition fee is not enough to pay for those just in case.

VINES laboratory have a high tech simulators that will make you say “Wow!” “Bongga…” “Sosyal!” “Wala sa bundok nito…”. It really facilitated my learning very well. I enjoyed it very much. I appreciated nursing procedures, which was discussed to us and I was able to practice it (in nursing, you will not know how it goes if you don’t perform it). This I believe is FEU’s edge among other nursing schools mushroom-ing (LOL!) nowadays and I am definitely proud of it (because I paid for it. LOL! Kidding…).

My source is from the VINES Code of Professional Behavior— Student Information handout. This is not a sponsored post. LOL!

*the video is from feuvineslab

FEU’s E-Learning…

Saturday, August 2nd, 2008

Far Eastern University, Institute of Nursing has this rotation of schedules for duties and lectures. They shift schedules every grading period to rotate the students equally in their clinical exposure and not to come in conflict with their lecture days. Two days will be spent for lecture, three days for clinical exposure and one day for our rest day.

Last preliminary period, I have a Monday-Wednesday duty days and Friday-Saturday lecture days which make Thurdays a rest day for me which I haven’t felt because of busy schedule.
Now that we are on the Midterm period, my schedule is now Monday-Tuesday lecture days and Wednesday-Friday duty days, which make Saturdays my rest day. It’s a good thing for I can rest for two consecutive days considering that the next day is Sunday.

If you would connect this blog entry to my “E-learning Blues” post, Saturdays are now my E-learning day and I was able to attend it. Finally! Though I arrived late, I was able to finish at least 2 topics. I was somewhat dismayed when I learned that the E-learning people closed the module that I am previously doing which means that I can’t continue it anymore and gives me a 0(Zero) mark on each quizzes in that particular module. Poor me! Anyway, I will try to finish the module that I am into right now which is about Acute Biologic Crisis.

Congratulate me for I have attended my E-learning the second time! LOL! *claps for me… I have my e-learning schedule on all Saturdays of August. Hopefully (Again…) I can attend to all of those.

Inkling:
What a long introduction… BOW!