Mental Health Experience
Mental Health can be defined as a state of emotional and psychological well being in which an individual is able to use his or her cognitive and emotional capabilities, function in society and meet the ordinary demands of everyday life. (The American Heritage Dictionary. 2009) With that being said, as nurses, we work with many mental health patients. Working in home health has given me the opportunity to work closely in the home of some very “mental” patients.
One in particular is M.M. She is a 62-year-old female that lives in a low-income apartment in Harriman, TN. She has been diagnosed with depression and schizophrenia. She attends Ridgeview outpatient clinic weekly and gets all of her medications thru them. The nurse at the outpatient clinic sets up her medications in zip lock bags for three times a day, dosage and labels each individually morning, noon and night and the dates as well. I was called in to perform lab work and to provide educational teaching regarding the medications and to monitor if the meds were being taken right. My first call to the patient was to introduce myself and inform her that I would be coming to visit her and what time I would be there. When I arrived at her apartment she was waiting for me in a chair outside of the building. She led me to her apartment and was fairly quite at first. Her apartment was small but very clean. She was very proud of her apartment and showed me around. I explained to her what I was going to be doing, and also explained that I needed to look at her medication as well. She was a little leery of me at first then I began to ask all about her, her family, what she liked to do. I just really explained to her that I would get to know her whole family background, and would even know what she liked to do and eat before my visits to her were over. I spent a couple of hours with her performing a whole assessment, as well as building a trusting relationship with her. She became very friendly and started talking more about her self and even started singing to me. When I reviewed her medications with her, she knew what they all were and when to take. She did not know the correct names of them, but she did know why the medications she was taking were being prescribed to her. She was aware of her illness and even talked regarding some of the “spells” of aggression and paranoia that she has. She is disabled and has a 7th grade learning comphrension, but is still very smart. Her right leg is shorter than her left and it causes her to lose balance and walk with a limp. When she was younger, she was made fun of a lot. She stated that was the reason she didn’t go back to school. Her lower extremities were very swollen and even her shoes were too tight. After getting her some shoes that fit, she was more willing to accept my weekly home visits to check on her. Her childhood was bad. Her father was violent to her and her sister. She became someone different growing up to be able to cope to the hardships life had given her. She was married young. Her husband died about 15 years ago but she doesn’t remember why. She has one son who very seldom comes to see her. She has one sister who actually lives in the same apartment complex and they drink coffee together everyday. A community bus comes 3 times a week and she goes to church regularly. She is a Christian. She sometimes hallucinates and can be very aggressive. When she is on her medication the “spells” are less, but some people in her building are scared of her. She is lonely and so desperate for friends, companionship and does not like to be alone. As I became her nurse, I would see her 2 times a week for assessments and medication changes due to weight gain and edema. I became her friend as well. She would call nearly every morning at work to let me know where she would be, even if I didn’t come to see her that day.
When the referral came to home health regarding the admission of this patient; it was highlighted that patient was very aggressive and psychotic at times. Use judgment when visiting and to be safe at all times. All the nurses were a little leery of seeing her and we even thought about having two nurses go at the same time for safety issues. Me being with the company the longest said why don’t we wait and see how the call goes first. When the initial call was made I determined that I would see her first. On assessing M.M., the holistic approach was better to be aware of what was going on with the “whole” person. A trusting relationship was formed and M.M. had no issues ever regarding me as her nurse. Mental health patients also can tell when they are being just worked on or if the nurses really care what happens to them. When discharge was coming near, I found a local community center that provided a daily lunch and activities. I got her set up where a van would come daily to take her there. She loved the company and was thriving when I discharged her. The one constant I think is to believe in yourself and try to not make judgments regarding the mentally ill. Provide support through community, friends and family. Provide them with a sense of well being and of belonging. They are people too and they deserve just as much help as the next person. I saw her at Wal-Mart recently (which the van had taken some community people to shop and talk) and she yelled at me at the end of an isle. She came hobbling over to me and hugged me and introduced me to every person she was with and their names. She told them I was her nurse.
Reference

The American Heritage® Dictionary of the English Language, Fourth Edition copyright
©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved