amelia's plum

I am easily seduced by the shiny new things I learn in school. Knowing how to flush an arterial line or being able to obtain blood for lab tests from them. Putting in foley catheters. I've only done three so, yes, there is a definite thrill to doing that properly. And the last man I did it on was so kind, he said he didn't feel a thing. Of course he was also suffering from some confusion so who knows what the reality was there. Doing an EKG, it's deceptively simple but how cool that I got to do one in the ER. The fact I've now given so many shots it seems old hat to me, I never thought I'd feel that way. I'm still a bit OCD about preparing all my meds for patients and making sure I know as much as I possibly can because the game part of nursing school is knowing more about your patient than you're instructor does. If you're on top of that, and practice safely, and are friendly and take care of your patient, well then you're golden. But as much as I absolutely love learning all these new things I always come back to my first love, psychiatry. Whenever we have presentations where we're able to choose what we want to do I always pick the psychiatric aspect of what we're covering. I've presented on the psychological impact of burns. The fatal pull of the Golden Gate bridge, the world's number one suicide magnet. I had way too much fun researching that topic. Don't get me wrong some of what I read was heartrending but I just loved learning all about suicide magnets and whether deterrents are effective (they are). I've got a presentation due thursday where I'll be looking at substance abuse in the critically ill patient and I find the treatment of this patient population in healthcare really need of change. It's yet another area where healthcare is failing. It's all so flipping short sighted, treat the physical symptoms of withdrawal during the patient's hospital stay, possibly a five minute psych consult if someone is really on top of things and then the hospital sort of wipes their hands of the situation when the patient is discharged. For all that I learn about healthcare being an interdisciplinary plan of care it does a huge disservice to patients when it comes to mental illness. These critically ill substance abusers and the med seekers I saw at the ER, they need help. They need someone to be patient and to try to get through to them and get them set up in some sort of intensive outpatient program where they can work on their addictions. Otherwise they become frequent flyer's at the hospitals and just wind up costing the hospital so much more money in the long run. Why can the hospitals not see this?! Statistics say that 6 out of 10 substance abusers suffer from mental illness but I stubbornly refute that statistic. If you get addicted to substances you are not a happy, functional person. I think everyone that abuses substances has an underlying mental health issue. One really interesting chart that I found on one of NIH's websites regarding drug abuse is that those who suffer from bipolar disorder have the highest rate of substance abuse. No real surprise there but guess who comes in second? People who suffer from panic disorders with agoraphobia. They are almost equal to bipolars in the incidence of substance abuse. It fascinates me because those disorders seem so different but they both have really high incidences of self medication. And I just want to know the patient's background, to see where they're coming from in order to self medicate to deal with life. To me, psychiatry is the narrative aspect of medicine. Psychosocial care plans were my favorite to write up because I just like trying to understand what people do, functional or not, in order to cope. And this one psychiatrist whom I got to hear lecture and work with patients at the beginning of this semester (that I can't believe is almost over) he was like a rock star to me he was so incredible at his job. I want to be that good at what I do.