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.

 

Behind Locked Doors

Senior Student Nurse in Psychiatry – June 1976

I drove through heavy iron gates and parked my car at the large state mental hospital campus on the edge of the city. After I studied the campus map my professor had given me, I walked toward the locked mens’ ward where I was assigned for the quarter. As I walked, I silently prayed, “Dear Lord, Please protect me and put your hedge around me. Give me wisdom in every situation, and let your love shine through me to these men.” I looked at the old red brick building apprehensively and pressed the buzzer on the intercom beside the door. “Yes?” answered a woman. “I’m a student nurse reporting for duty from the University.” As the door buzzed, I pushed it open and entered.

My professor told me I would lead therapeutic groups with six men who had been institutionalized here many years. Some had a history of rape and murder. After entering the locked nurse’s station, I began to read each patient’s thick chart and took notes. I observed the long line of somber looking men as they lined up at the nurse’s window to receive their medications with a glass of water. After each man swallowed his pills, he opened his mouth so the nurse could inspect to make sure he had not pocketed any pills to hoard them for an overdose.

After the patients received their medications, I walked into the large dreary day room. The sickly pale green walls, single bare light bulbs hanging from the 12 foot high ceilings, and iron bars over all the windows would make anyone feel depressed. The men wandered aimlessly around the room or sat at the table staring into space dressed in their shabby pants, shirts, and shoes. There was a hot wire running around the perimeter of the room where they lit their cigarettes. Some of them spit on the floor. One man took off his clothes, seemingly unaware that there was anyone else in the room, and wandered around naked. The stench in the smoke filled room was nauseating.

I asked the staff person to point out the six men I would have in my small group.  I approached each of them and pointed to the small room where we would meet. After we all sat in a circle, I introduced myself and asked each of them to tell the group his name. I then asked an assigned question and waited for each of them to answer. I was trying to learn the skill of “therapeutic silence” and wait for the person to answer. I waited and waited and waited, but some of them never answered! The whole group was rather pointless in my opinion.

I dreaded my clinical days and began to lose weight. I saw the depths of the depravity of man as never before and continually thanked God for saving my soul. I concluded that reformation does not work, because it does not deal with a person’s sin nature. The only solution is regeneration, a new birth spiritually, as Christ said, “Marvel not that I said unto thee, Ye must be born again.” John 3:7 I am so thankful for God’s promise to all who receive Him as their personal Savior, “Therefore, if any man be in Christ, he is a new creation; old things are passed away; behold, all things are become new.” II Corinthians 5:17  But I am grateful I had this quarter, because it taught me more about the importance of communication, and how to talk with people about sensitive topics.

I also took Personal Finances (3 hours) and Audio-Visual Teaching Techniques (4 hours). I had the joy of attending the graduation ceremony of my roommate and her brother in the University football stadium. I will miss our sweet times of fellowship, but I know God will lead her to the right teaching job.

Reflection

As I reviewed my classes in the college of nursing, psychiatry was definitely the most difficult course for me emotionally and as a believer in Jesus Christ. Amazingly, after I became a Nurse Practitioner, my first job was at a 120 bed psychiatric hospital, age 5 through adult. I was responsible for the admission History and Physical examinations, and diagnosing and treating their medical problems. I also managed the patients who went through alcohol and heroin/opiate detoxification.

The medications that are available today to treat mental illness are much more effective than the few that we had in 1976. I believe some types of mental illness are from chemical imbalances, genetics, poor diet, and side effects of other medications. Other types of mental problems are a direct result of sin that only salvation by Christ Jesus can solve. Still others are from demon possession. As I read about the demon possessed man in Mark 5, it says that no man could bind him with chains, and he lived in the mountains and tombs, crying, and cutting himself with stones. Oh, the agony of that man! But after Jesus cast out the demons, the people came and saw him “sitting, and clothed, and in his right mind.” Mark 5:15 What wonder and joy that each of us can now have the mind of Christ!

“For God hath not given us the spirit of fear, but of power, and of love, and of a sound mind.” II Timothy 1:7

I worked at the psychiatric hospital for 4 years until it closed. I recently stopped by to take a photo of the campus and there were large “NO TRESPASSING!” signs everywhere. The owner approached me angrily and asked why I was taking a photo? I said I used to work there, and it was for my memory book. He asked which doctor I worked with, and after I told him, he grudgingly said, “OK”. So I still don’t have very good memories of psychiatric hospitals…. Here is my one photo he permitted. This is the administration building behind all the trees.

Psychiatric Hospital where I worked as a Nurse Practitioner 1998-2002

Psychiatric Hospital where I worked as a Nurse Practitioner 1998-2002

If you would like to comment, have a question for me, or a prayer request, please feel free to contact me at pamela.aprn@gmail.com  Have a blessed week of looking unto Jesus!

Behind Locked Doors

Senior Student Nurse in Psychiatry – June 1976

I drove through heavy iron gates and parked my car at the large state mental hospital campus on the edge of the city. After I studied the campus map my professor had given me, I walked toward the locked mens ward where I was assigned for the quarter. As I walked, I silently prayed, “Dear Lord, Please protect me and put your hedge around me. Give me wisdom in every situation, and let your love shine through me to these men.” I looked at the old red brick building apprehensively and pressed the buzzer on the intercom beside the door. “Yes?” answered a woman. “I’m a student nurse reporting for duty from the University.” As the door buzzed, I pushed it open and entered.

My professor told me I would lead therapeutic groups with 6 men who had been institutionalized here many years. Some had a history of violent crimes, such as rape and murder. Upon entering the locked nurse’s station, I began to read each of their thick charts and took notes. I observed the long line of somber looking men as they lined up at the nurse’s window and were handed their medications with a glass of water. After each man swallowed his pills, he opened his mouth so the nurse could inspect to make sure he wasn’t pocketing any pills to hoard them for an overdose.

After the medication time was finished, I walked into the large dreary day room. It was painted a sickly pale green and had single bare light bulbs hanging from the 12 foot high ceilings. There were iron bars over all the windows. The men were dressed in shabby pants, shirts, and shoes and wandered aimlessly around the room or sat at the table staring into space. There was a hot wire running around the perimeter of the room where they lit their cigarettes. Some of them spit on the floor. One man took off his clothes, seemingly unaware that there was anyone else in the room, and wandered around naked. The stench in the smoke filled room was nauseating.

I asked the staff person to point out the 6 men I would have in my small group.  I approached each of them and pointed to the small room where we would meet. We all sat in a circle and I introduced myself and asked each of them to tell the group his name. I then asked an assigned question and waited for each of them to answer. I was trying to learn the skill of “therapeutic silence” and wait for the person to answer. I waited and waited and waited, but some of them never answered! The whole group was rather pointless in my opinion.

I dreaded my clinical days and began to lose weight. I saw the depths of the depravity of man as never before and continually thanked God for saving my soul. I concluded that reformation does not work, because it does not deal with a person’s sin nature. The only solution is regeneration, a new birth spiritually, as Christ said, “Marvel not that I said unto thee, Ye must be born again.” John 3:7 I am so thankful for God’s promise to all who receive Him as their personal Savior, “Therefore, if any man be in Christ, he is a new creation; old things are passed away; behold, all things are become new.” II Corinthians 5:17  But I am grateful I had this quarter, because it taught me more about the importance of communication, and how to talk with people about sensitive topics.

I also took Personal Finances (3 hours) and Audio-Visual Teaching Techniques (4 hours). I had the joy of attending the graduation ceremony of Jane, my dear roommate, and her brother, Allen, in the University football stadium. I will miss our sweet times of fellowship, but I know God will lead Jane to the right teaching job. Her brother, Allen, who also attended the Bible class on campus, asked my sister, Linda, for a courtship, so that was exciting! I pray they will honor the Lord and seek Him first in all things.

Reflection, 2014

As I reviewed my classes in the college of nursing, psychiatry was definitely the most difficult course for me emotionally and as a believer in Jesus Christ. Amazingly, after I became a Nurse Practitioner, my first job was at a 120 bed psychiatric hospital, age 5 through adult. I was responsible for the admission History and Physical examinations, and diagnosing and treating their medical problems. I also managed the patients who went through alcohol and heroin/opiate detoxification.

The medications that are available today to treat mental illness are much more effective than the few that we had in 1976. I believe some types of mental illness are from chemical imbalances, genetics, poor diet, and side effects of other medications. Other types of mental problems are a direct result of sin that only salvation by Christ Jesus can solve. Still others are from demon possession. As I read about the demon possessed man in Mark 5, it says that no man could bind him with chains, and he lived in the mountains and tombs, crying, and cutting himself with stones. Oh, the agony of that man! But after Jesus cast out the demons, the people came and saw him “sitting, and clothed, and in his right mind.” Mark 5:15 What wonder and joy that each of us can now have the mind of Christ!

“For God hath not given us the spirit of fear, but of power, and of love, and of a sound mind.” II Timothy 1:7

I worked at the psychiatric hospital for 4 years until it closed. I stopped by today to take a photo of the campus and there were large “NO TRESPASSING!” signs everywhere. The owner approached me angrily and asked why I was taking a photo? I said I used to work there, and it was for my memory book. He asked which doctor I worked with, and after I told him, he grudgingly said, “OK”. So I still don’t have very good memories of psychiatric hospitals…. Here is my one photo he permitted. This is the administration building behind all the trees.

Psychiatric Hospital where I worked as a Nurse Practitioner 1998-2002

Psychiatric Hospital where I worked as a Nurse Practitioner 1998-2002

If you would like to comment, have a question for me, or a prayer request, please feel free to contact me at Pamela.aprn@gmail.com  Have a blessed week of looking unto Jesus!