Mental health. Depression. Mania. Hallucinations. What mental images do these words evoke for you? Going into this semester, I remember promising myself that I would face my psychiatric clinicals with an open mind. Though I have never had any interest in pursuing mental health as my full-time career, I realize how essential it is to all fields of nursing. Still, nothing could have fully prepared me for the emotional rollercoaster I would face in the psych ward.
I've always been the kind of person who likes to "fix" things. I guess that is one of the reasons why I want to become a nurse! I find it an exciting challenge to read through a patient's medical records, study their labs, collaborate on a care plan, carry it out, and hopefully discharge them with a relatively stable health status. Though there are the ever present "frequent fliers" on the hospital floors, most of the patients are able to come in and out of the hospital feeling confident that they are going to have their needs met.
I think one of the biggest struggles I faced on the psychiatric unit was my utter feeling of helplessness as I faced some of the patients. We were told that our job was to simply be there to talk with them, listen to them, record what they told us, and attempt to apply the therapeutic communication skills we had just been tested on. I went in feeling relatively confident that I could do this, but my misplaced security was quickly shaken. My clinical professor told us when we arrived that every single patient we would interact with was either there because of a suicide or homicide attempt, and they had all been at great risk to themselves or others. Walking through the unit, I felt like I was in a prison. The walls were very simple, with no hanging decorations that could be possibly used as weapons or means of violence. The trash cans were lined with paper bags; there was no plastic to be found anywhere. The doors were all firmly locked, and the observation rooms were bare of everything but a small cot, connected to the floor. I didn't feel at all like I was in danger even when I heard stories of intense violence; it was a very safe place but SO dreary. As I looked into the eyes of the patients, I saw so much pain and heartache. My nursing mode sprang into action, and I longed to help them, but I was faced with emptiness. Yes, the little girl in front of me looked healthy, was eating well and clearly taken care of. Yet she told me proudly that she had tried to end her life multiple times, and she didn't seem at all taken aback by her blatant confessions. To so many people on the ward, life was just a cycle of risky behaviors, hospital admissions, medications, discharges, and a return to a state of sadness and fear. Nothing I could do would silence the voices they were hearing or aid them in escaping from this endless cycle of negativity. I was surprised to realize that I felt no feelings of repulsion or shock even as I heard horrible stories of violence and sadness. Instead I felt consumed with pity, a desire to heal the brokenness around me and the sickening realization that I didn't know how.
Where was the cure? Where was the hope in a place so full of pain? I came home in tears, so frustrated with myself and grasping at any source of comfort as I recalled the intense scenes I had witnessed. Why wasn't there anything I could do to "fix" this? The most beautiful, perfect words came from my uncle as he described the ways that he has found to deal with the unspeakable things he has had to witness in his many years working as a police officer: "You need to accept and understand that dealing with truly damaged and broken people is a sacrifice, and you will lose a piece of yourself in the process, but those are the people who need you the most...It will be hard at first, but unfortunately [you] need to learn that the world, in a lot of ways, is a dark, evil place. That's why it's important for [you] to be strong and resolve to be a beacon, push back that darkness and not be consumed by it. Somebody has to do it. Somebody has to do the hard things."
My first clinical experience in the psychiatric unit taught me many things. It taught me that there is so much pain around us that we often can't even see. It taught me that we need so desperately to open up to the people around us and be honest about our struggles so that we can find the help we need. It taught me that there are real voices and forces of darkness in the world, and sometimes the only thing we can do is resolve to be a light in a world so deeply impacted by sin. Sometimes the best tool in my nursing toolbox is not going to be my IV tubing or my trusty syringes. It's going to be a spirit of humility and love and a heart overflowing with prayer for the brokenness I see. I may not be able to help all of my patients in the ways that I think I should be able to, but I can rest in the assurance that God is not surprised or taken aback by any of the raging emotions of His people. He was willing to enter into them Himself, and He sympathizes with our weakness. How absolutely incredible it is that we have a Savior Who knows our struggles and entered into them Himself that He might come alongside us in our darkest times and gently guide us back into the light.
"For we do not have a high priest who is unable to sympathize with our weaknesses, but we have one who has been tempted in every way, just as we are--yet was without sin. Let us then approach the throne of grace with confidence, so that we may receive mercy and find grace to help us in our time of need."
To be a nurse or to pursue any career of service may require that we give up a piece of ourselves. but in the end it is worth every anxious thought, every bitter tear, and every moment of frustration. There is always some joy, even in the saddest of situations. Throughout my experiences I was able to see glimpses of hope all around me. It was in the eyes of the lady who told me she was finally getting discharged on her birthday. It was in the eyes of the young mother who told me about her baby girl, waiting patiently for her at home. It was in the eyes of the nurses as they saw their patients finally begin to make progress towards a fresh start and a renewed sense of purpose. Thank God for promising to give us the grace we need to carry us through every situation, and thank God for new opportunities to extend this grace to others!!
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