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Sorry so long.....
Today a colleague of mine told me something that upset me. Upsetting, because I have heard it too many times, and not just from my colleagues, but from my patients as well. I'm a nurse who work multiple jobs, but one of my jobs just happens to be as a mental health nurse. I was trained and educated through school and nurse meetings "to avoid dismissing physical symptoms as part of psych illness without appropriate assessment." For this reason, every psych patient that comes to me and complain of physical symptoms, I assess. Some have been moved from the psych floor, to a medical floor, because they are genuinely physically ill. To me a good psych nurse see's individuals, are good communicators, listen's and empathize. This truly is a field where "silence is golden," since some patients just wants to be heard. Like the schizophrenic with the flat affect, who thinks someone is conspiring to kill them, because of his auditory hallucinations, and the stress and sorrow of the family members, who are afraid that the person they once knew may harm them or their self. Or the suicidal bipolar mother who once had a career as a sales person, that stays up late at night at times due to insomnia because she thinks it is normal and this is what all mother's do, what about the days she can't seem to move herself from her bed because she is too tired, and can't seem to focus, the high's and low's, or shall I say the fluctuating moods of bipolar disorder, and the neglect, financial problems, inability to communicate, stress, compensation, instability and parenting that it causes family members. What about the bread winning dad who had his first psychotic break and could barely function at a child's level, who is paranoid of his wife and kids and can't remember having a conversation with you or what was said, the dad who was perfectly healthy 3 months ago? And the wife who is searching for answers and hoping that medication will cure him, but you can't make that promise. Never mind the depressed student who don't like to share too much with people or parent's. Who has parent's who paid all this money for his law tuition and flunked out and now lives on the streets, because he's too embarrassed to go home to tell mom and dad, he failed them. Who withdraws himself from his relationship with his girlfriend, whom you later read in the newspaper about, successfully committing suicide. In the past, mentally ill patients were locked away in asylums with chains on them, it was thought that they were possessed by demons. Then assessment and diagnostic studies allowed the medical professionals to study the brain. This showed that some schizophrenic's had a significant amount of gray matter loss, that goes undetected for up to 5 years. The more gray matter lost, the worst their symptoms become. There will come a time when we all must take sides, maybe for your parents, kids, or your spouse, since we can't just live on hope alone to do what nobody else will do. Nursing to me is more than giving pills on time, it's also advocating, being compassionate, believing in recovery, and thinking critically enough to help solve problems that life throws at you. Since I am a nurse and patient advocate first, I will assess the schizophrenic when their having complaints of headaches, or the bipolar who is having chest pains, and the depressed patient who is losing excessive weight, while my colleagues continue to find time to sit around the report table and laugh at me. It may be funny to them for me to ask for a CT Scan for the schizophrenic, or request an EKG for the bipolar patient, as well as ask for labs or diagnostic studies for the depressed patient who has lost 50 pounds in a year. If these tools are negative, then maybe I can suggest to the schizophrenic, Haldol, or to the bipolar patient, Ativan since they may be experiencing an anxiety attack, and educate the depressed patient about Celexa or Abilify and provide them all with a therapeutic milieu. But how can I say it's your mental illness that you are feeling, if indeed I did nothing else to wean the physical aspect out. The stigma of mental illness lives on. Sad, but true. Mental illness can not be cured and sometimes it is even hard to keep the individual under control. If I learned nothing else, I learned it could happen to anyone. It is more than the diagnoses I mentioned above, it can also be addiction and etc. If someone is sick medically, individuals say I will pray for you, you rarely hear that when an individual is sick mentally. Remember there are multiple things that trigger schizophrenia, bipolar disorder, depression and addiction. I will leave you with a quote I saw tattooed on my anorexic patient back like a scroll "Look ma, I finally have control, you may have tried to dictate my life, but my way of coping shows I have won."