Friday, September 14, 2007

Got to Keep the Loonies On the Path

Today was our psych rotation. We did this last year and I was a little nervous, mostly because I didn't know what to expect. This year I wasn't nervous at all since I'd already been there and seen some actual psych patients before.

Our society treats mental illness as something to be feared or laughed at. I tend to look at it as any other medical condition. It is treatable and the patient has the potential to be able to function well enough to work, have relationships and take care of themselves. I think the public's view of mental illness is that these people are doing it to themselves somehow. Their behavior is judged as being bad or scary. I see it as this is how the disease presents itself and the person who has it is not to be blamed for it.

I also find it interesting that most people are looking for a reason for a person to have a mental illness. There are many theories about why people develop mental illness, but I think for the most part looking into the source isn't very productive. I think time is better spent figuring out what to do about the disease once it's here. We can't change the past. It is good to have information about a person's past to better understand things, but from what I've seen so far it really doesn't do much to plan the patient's care. Leave the naval gazing to the scientists. As practitioners we should do as much as we can to treat people with the tools and knowledge we have available to us now.

This attitude carries over into how the insurance industry and government pay for mental health services - which is to say very poorly or not at all. If society took this situation more seriously and realized that many things are treatable, the patient's would be so much better off. Instead, mental health is still the red-headed stepchild of health care and it's a horrible, horrible oversight.

It's a vicious cycle. A person becomes unstable for whatever reason and winds up in the psych unit or hospital. They get on meds and their behavior levels out. Then because they can only stay a little while, often before their meds start showing any signs of working, the person is released from the hospital and don't get the support they need to keep getting their treatment. They go off their meds for many reasons; finances, side effects, the belief that they aren't doing them any good, then their abnormal behavior returns and they're back in the hospital.

But I don't want to get off on a tangent about our crippled health care system. That would take forever. I also can't educate the public as much as I would like. All I can do is educate people one at a time.

Maybe I'm still in the throes of nursing school hubris and I believe we can fix anything, but I don't think so. I try to look at things realistically, or at the very least scientifically. I'm old enough to be jaded about almost everything anyway, so I don't feel that I am indulging in magical thinking. What I really believe is that I am living in an interesting time in history where we have the potential to do so much, but beaurocracy and short-sightedness have us in a bind. I wonder if we will look back this time 20 or 30 years from now and wonder why we didn't do more with what we have?

Could I work as a psych nurse? It wouldn't be my first choice, but I could easily do that. The worse part of the job for me would be to have to constantly confront my own issues and keep from having my buttons pushed. It would be exhausting to constantly ward off the manipulation, verbal abuse and possible violence from the patients. Over time it would take its toll I suppose. I would also feel constantly frustrated knowing that we could do more for these people than we actually do.

If I couldn't find a job in a hospital, in an OR, in a NICU or some other area that interests me more, I would consider a stint in a psych hospital.

I'm tired and need a nap. I have to work tomorrow and 4 a.m. is such a sucky time to have to get up in the morning, not to metion the 10 hours of being on my feet. For now though I need the money and I want to keep my dialysis skills up. Oh, for those of you who don't know me, I work as a dialysis technician to pay bills while I'm in nursing school.

More musings about nursing school will follow. I just need to chill for a while.

No comments: