Shelbyville

Chapter 4

              "Well today hasn't quite gone as expected," Janet stated with a heavy sigh as she collapsed into a chair inside the breakroom. She nearly spilled her coffee that she held tightly clenched in her stubby hand. "Days never go as expected in here," she muttered after taking a long sip of her coffee. I smiled sympathetically even though she had already squeezed her eyes shut in response to the taste of her coffee hitting her tongue. "I would never make it through the days without coffee," she continued with a sigh.

"I swear coffee was made for nurses," I agreed taking a seat beside her eyeballing curiously the patient charts sprawled on the table in front of us. Janet opened her eyes startled almost as though she forgot I was there. I took a tentative sip of my coffee eagerly anticipating the opportunity to sift through the patient's files, but trying to maintain polite social graces simultaneously.

"Let's start from the beginning," Janet suggested setting her coffee aside and reaching for room 201's chart, Steven Carter. I tried to hide my disappointing knowing that I would have to wait until the very end of this time to read about Stacey Adams.

"Steven Carter," I mumbled opening his chart.

"The charts have way too much information in them, you could read for days on each patient. Most of the information in the charts is useless. Mostly sleep totals, and a log of their daily activities. The useful information is their court documents and notes from Dr. Morrison, but even the notes from him can get repetitive," she informed me as I began leafing through his file.

"He's 54, schizoid personality disorder, unspecified psychotic episodes. He's been here for about five years now. He has an allergy to Depakote and penicillin..." Janet continued to drone on about the patient's history. It's always interesting hearing different nurses give report, because they always highlight different information. Report consists of the patient's diagnoses, allergies, medical history, medications, acute symptom exacerbations, and new changes to the patient's plan of care. Psychiatric nursing is a unique area of medicine because the assessment and focus of care is different. In a regular general hospital, the nurses would focus on IV access, breathe sounds, cardiac rhythms of the heart, and any sort of ambulatory devices the patient needed. In mental health, the focus was on level of functionality, level of orientation, consciousness, depression, anxiety, violence, how much the patient was eating, sleeping, medication compliance, and participation in treatment.

I hated the idea of having to sit still and listen to Janet go into excruciating detail about each patient, but I knew I needed to be polite. No one likes a know-it-all, especially on their first day, besides, how else am I going to find out information about my patients?

"None of Steven's charges are particularly horrendous, but he's a habitual offender, he's been in and out of prison for about oh, three decades?" Janet paused for a moment trying to recall if her recollection of that piece of information was correct. I shrugged obviously having no idea and being unable to confirm or deny the information. "Anyways, he's pretty harmless and compliant with treatment. He likes to spend most of his days just wandering around." She stopped to take a drag of her coffee. "Any questions about him?"

"I don't think so," I lied realizing I had missed the majority of his medical history.

"Travis Jones, 47, he's another harmless one, a bit of a drama queen, borderline personality disorder, major depressive disorder," Janet rolled her eyes. "We all know they can be divas," she continued a sigh escaping her lips. "Multiple failed suicide attempts." All of Travis's criminal charges were related to his aborted attempts at taking his own life, arson, drug possession, illegal possession of firearms. After the fourth detailed description of Travis's attempted suicide, Janet gave up and told me that if I wanted to read anymore, I needed to consult his chart.