worst day ever!!So I'm in my psychiatric rotation in my nursing program and this requires going to a hospital and working in a psych ward twice a week. Today was my second day being at this specific hospital. We are not given the full responsibilities of the registered nurse, but we get quite a bit of responsibility. We are assigned one patient and we are supposed to talk to them and find out as much information as possible to find out why they are in the psych ward. We have to do what is called a "behavioral assessment," which digs a little into a person's life and background to get the required information. Some patients aren't cooperative. Some patients have conditions where they are unable to cooperate and then there are the people who do not cooperate because they are pretending to have a condition where they are unable to cooperate. Of those three...I bet anyone can guess which one I got today. I am unable to share any personal information about the patient so for the sake of this story I will call her Betty. I was assigned to Betty knowing that she has been known to experience the catatonic state. This is where a person is completely unresponsive to any outside stimuli. So today I leave the nurse's meeting so that I can start the day with Betty. I get everything ready that I'm supposed to have for the day, write my name beside the name of the RN I'm supposed to work under for the day, look up the meds that Betty is supposed to get for the day, find the 15 minute check sheet (I have to check on Betty every 15 minutes to make sure she hasn't become violent or gotten herself into trouble) and then I start off to find Betty. I see my instructor who introduces me to Betty. Betty is sitting in a chair at a table in the small lounge area of the psych ward. She is not responding to anything anybody is doing around her. I am told to grab Betty's breakfast tray and get it ready to help feed her. (at this time my instructor is being very demeaning and making me feel like an idiot because I don't know what I'm doing....in my defense...who knows what to do with a person in a catatonic state if they've never had any experience with it before?) I am told to place the straw with milk to Betty's lips frequently to see if she will drink anything. Also, at this time my instructor is grabbing the DSM-IV (a huge book of mental diagnoses and information about them) so that she can order me to research the different types of catatonic state. I'm sitting with Betty's chart and the DSM-IV right beside Betty at the small table and I'm pretty close to her so that I can keep trying to get her to drink or eat something. She will not eat or drink anything. I keep noticing though that she smiles every now and then. Especially when something is going on around us. This is when the nurse's aid comes up with the equipment to take Betty's vital signs. She explains to Betty that she's going to place the cuff around her arm to take her blood pressure and this is when Betty jerks her arm away and glares at the nurse's aid, but she returns to her "catatonic state" in her original position fairly quickly. So...trying to be the good nurse, I say something about how I see she's moving around now and ask if she'd like something to drink or eat. Now she's not responding again. So I go back to my work again. My instructor decides to come over and try to feed Betty, but she is not responsive...until...my instructor starts to pick up the orange juice carton on Betty's tray and Betty decides to jerk at it and kind of...act like she's gonna lunge at me or something, which causes me to jump, but she returns to her "unresponsive" position instead and she's got a really big smile on her face like she's about to start laughing. This is when my RN comes up with Betty's meds. The RN cleans off Betty's spoon and places one of her meds on it and Betty allows her to place the pill in her mouth, but then she turns her whole body and spits it out as hard as she can onto the floor. This time, my instructor tries to talk to Betty and see if she'll explain what feelings she might be having. (that's a big question with my instructor..."how do you feel about that?") Being unsuccessful...my instructor walks away to help another student. I'm sitting there doing work for about a minute or two and at this time the patients are all starting to walk around the halls and there's a lot of commotion right around where we're sitting. All of a sudden..Betty stands up and throws the table that I'm working on sending it and all her food and my books flying and she yells "I've had enough of this crap" (this is the editted version). ALL the nurses are in the hall now trying to quickly and quietly move all the patients and students away from Betty, without moving too quickly (kind of like Betty's gonna pounce on them or something if they do). I decide it would be a good idea to pick up her chart and important papers so that they won't get ruined by Betty's spilled breakfast, while the nurses try to calm her down and get her to her room. They aren't successful for a while...she just keeps yelling that she'll do what she wants. Then she stomps off to her room. I'm pretty much freaked out and don't understand what I did wrong, because I really feel like it's my fault that I didn't prevent that scene from happening. I feel very overwhelmed and I go to the nurse's station (i've kept my composure pretty well so far) and then all the nurses start coming up to me and asking if i'm ok, was I hurt, they kept telling me it wasn't my fault that she did that, they were saying how if they were a nursing student and that happened that they wouldn't be handling it the way that I did...that they'd be leaving, etc. This all caused me to feel even more overwhelmed, so I went into the med room...which is locked and small so not many people can get in there. I try to calm myself down and keep from crying (i want to curl up into a ball on the floor and burst into tears). I wash my hands and wipe my books off. I regain my composure. I'm doing ok. Then as soon as I walk out the door my instructor assigns me a new patient. This means MORE paperwork to fill out and MORE interaction with a new patient. Luckily she was a nice..somewhat normal person and the rest of the day wasn't so bad (except the constant nagging of my instructor...i swear she hates me or something). This was a very long post...i apologize, but i needed to get it off my mind and figured this would be a good way to do it. | 
