Adolescent, My Dear Watson

Mental health clinicals have officially begun!  Thursday we oriented to the hospital and to psych nursing with our clinical instructor, and got to tour the units.  Because it is a large medical center, there are dedicated units for child and adolescent clients separate from adults, as well as a chemical dependency ward.  We had thought originally we’d be able to rotate through and spend a couple of weeks on each unit, but the child/adolescent staff wanted whoever was working with them to have more continuity.  So the six of us had to duke it out: 3 to adults (chemical dependency is still being negotiated), 2 to adolescents, and 1 to children.  I ended up on the adolescent unit, which I am super pleased about.  The staff has really welcomed us and put us right to work with taking morning vital signs, charting the basics and sitting in on group therapy sessions.  Next week we’ll be expected to carry our own clients while we’re on duty, which basically means being available for 1:1 therapy, charting, and being responsible for reporting on them to the next shift.  Jeepers!

Locked inpatient units are typically short-stay, which means the kids we met Friday likely won’t even be there by the time we report Thursday morning.  Thank the insurance industry – I’ve heard from two different staff up there that mental health is the unwanted step-child of insurance companies.  Because time is so limited, it is vital that we work efficiently to understand the clients’ perceptions of why they were admitted and why they need support, and determine whether it is safe for them to go home.

I realized while sitting in on group therapy how little actually separates us from them.  How much environment makes a difference.  How situations completely out of their control have resulted in vulnerability, brokenness and a lifetime of wondering “Why?”.  And how I or any one of my peers could have ended up on that same unit if things had happened only slightly differently – there was a girl recently admitted who reminded me so much of myself at 16, it was uncanny (and a little bit scary).  I wonder how many of the clients down on the adult unit were also admitted as adolescents or even children.

It’s heartbreaking to hear their stories.  But I can only hope that something we do will make enough of a difference that they won’t have to come back.

More stories to come.  Break out your tissues…

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