The Psychiatric Hospital

December, 1998 – New England, USA

I have now completed my first six months as a Nurse Practitioner in a 120 bed psychiatric hospital. I thank God for my boss, Dr. T., who is a Family Practice Physician and an excellent teacher. The hospital has an adult unit for acute psychiatric problems, a second adult unit for detoxification of patients from alcohol and opioids (heroin and oxycontin mainly), a teen psychiatric unit, and a pediatric unit for ages 5-12. I thank the Lord that He closed the door four years ago to the Adult Nurse Practitioner (ANP) program and redirected me to a Family Nurse Practitioner (FNP) program. Otherwise,  I would not be qualified for this job since I need to treat the medical problems of the children and teens.

When patients are admitted here, Dr. T. or I must do their admission physical examination and record it in their chart within twelve hours. We have a full time MD who works all night and does the exams of patients who are admitted after we leave. I am becoming an expert at doing a neurological exam of the twelve cranial nerves. I am also improving in my examination of ears and eyes with the otoscope and opthalmoscope.

Image result for nurse using otoscope

I developed my skill in using an otoscope for ear, nose, and mouth exams.

In addition to being certified in cardiopulmonary resuscitation (CPR), I also had to be certified in handling violent patients without hurting them (Nonviolent Crisis Intervention). I learned how to break a strangle hold in case a patient tries to choke me. I never wear a necklace or scarf to work since a patient could use it to strangle me. If I feel uncomfortable about being alone with a patient in the exam room, I request one of the aides to be present with me for safety. I always keep myself between the patient and the door so I can escape the room if I feel threatened.

The hospital is under investigation from the state because a child died last year. The staff did a face down restraint when the child came violent, and he suffocated. Tragically, they were unable to revive the child. So the state investigators come every day and read each providers’ progress notes, including mine. How I ask God for wisdom in my job! It is sometimes difficult to work under such scrutiny.

“If any of you lacks wisdom, let him ask of God, who gives generously to all without reproach, and it will be given him.” James 1:5

Dr. T. and I write the admission orders for the patients going through alcohol and opioid detoxification. The nurses use a scale to measure the patient’s withdrawal symptoms which guides them to administer the correct amount of medications to prevent the patient from having a seizure or dying.

It is so sad to see patients’ lives wrecked by alcohol and drugs. Only the person who receives Jesus Christ as his Savior can truly be delivered from these deadly addictions.  I pray for each of them to look unto Jesus Christ and be saved. How I thank God that He has put a song in my heart and prevented me from ever using alcohol or drugs by His grace. By following Him, He has spared me so much heartache and grief.

“And be not drunk with wine, in which is excess, but be filled with the Spirit, Speaking to yourselves in psalms and hymns and spiritual songs, singing and making melody in your heart to the Lord.” Ephesians 5:18-19

Reflection

I thank the Lord for all I learned while working in psychiatry for those four years. It was sometimes difficult to see lives so broken. But my experience with psychiatric assessments was  extremely helpful in every other job I had the remainder of my nursing career. A person’s mental condition often strongly impacts his physical condition.