Final week of placement - finished!

Today was the last day of my placement! It has been awesome. This week I spent lots of time with the psychiatrists sitting in on their daily meetings with the patients where they talk about how the patient has been feeling, how their medications are going, how they've been behaving on the ward (good or bad), whether they can have their leave increased or restricted and plans for after discharge. It's been really interesting, and because I've been having quite a bit to do with the patients' care the doctors asked me what I think about the patients' mental state too.

I also got to teach yoga and meditation again this week because one of the patients requested it. Four people came to the class which is the maximum number that can fit in the room.

Sat in on a few Mental Health tribunal hearings as well. This is part of the Civil and Administrative Tribunal and is an actual legal proceeding with a tribunal member, two independent doctors, the patient's psychiatrist, and nurse. In the first hearing I went to the patient was very articulate, eloquent, answered the questions and talked about his mental illness (bipolar) with a lot of insight. It was surprising because most of the time he is really annoying and immature and non-stop talking about anything and everything. I told him I was impressed and he said he behaves and speaks differently when he's in front of the judge. I told him he should at least try to be like that all the time and he would be out of here a lot quicker. The second hearing I went to was a patient that was completely delusional, thinks he is a world champion kick boxer, international secret agent, knight and saint, a billionaire and the list goes on. He also thinks he has a really fit amazing body. The reality is he looks like a homeless bum and has a huge gut and lots of health problems, and is unemployed and living on the disability support pension. He thinks they must be confusing him with someone else.

Today I went in with the doctor (who is African) to review the mental state of this patient. The patient mumbles and rambles quite a bit and uses a lot of jargon which makes it difficult for the doctor to understand him. So I had to help interpret. Then we went and reviewed another patient who was delusional that he and his parents were murdered when he was a baby, and that he is a clone of his former self and his 'parents' are imposters. He also believes that he has a silicone computer chip in this thumb that he can set off atomic bombs that are located in Croatia and because of that a local gang, the Cro Boys are after him and want to kill him. He only feels safe in the psych unit. In addition, he says he is Jesus Christ and that's why all the Jews and athiests want to kill him. If that wasn't enough stress already, he also has bikie gangs after him, the police want to kill him because he is privy to the knowledge that some police officers use drugs, and he needs to get surgery that will stop him from being able to get an erection because he is due to start military training (also a delusion) and in the army it's not allowed to masturbate or have erections. He asked me to organise this for him because it's his body and his right. "What are my chances for approval?" I just said "I'm not sure".

There have been a lot of delusional patients this week, very paranoid, shouting, smashing things, verbally abusing staff and each other. The atmosphere has been crazy. Also it was really hot the first two days this week and then it's been hot and humid for the last three days so that makes it even worse, and the patients have more trouble sleeping. There aren't enough beds in the high dependency unit (only 4 because one of the rooms is unoccupiable due to a leaky ceiling), and there are probably around 10 patients that need high dependency care at the moment. But they have to be in the low dependency unit instead and that upsets all the other patients because the environment's not as calm, and they get wound up.

Anyway, all in all the placement has been a fantastic experience. All the staff have been so wonderful, caring, patient and keen to pass on knowledge. They've also been very complimentary and encouraging, giving me lots of (but not too much) responsibility. I've been encouraged by quite a few of them, including my clinical educator who did my assessment, to pursue a career in mental health nursing. I could certainly see myself doing it for a few years, and there is no shortage of jobs, just a big shortage of nurses it seems. They even said we hope you come back and work here. At the very least, it is a very good referee to have on my resume for my job hunting this year and for grad positions.

Big drive back to Melbourne tomorrow.