When preparing for our mental health simulation, I wrote down specific questions that I would prioritize for each patient’s domain. I was confident that as a team we would be able to address each patient’s needs and provide appropriate education within the allotted time. What I found from the actual experience was that the conversations flowed organically, and the patient’s responses guided the conversation and our priority questions. Needless to say, I did not use my scripted questions.
From the simulation experience, I was reminded of how mental health is not black and white, and patient care plans are consistently evolving based on the patient’s mental and physical status. While I did not use my pre-composed questions for each patient, I found that by allowing the patient’s responses guide the conversation, we were able to isolate the nursing care priorities in a more effective way. The realness of this simulation made it one of the most rewarding nursing learning experiences that I have had thus far. Amidst the challenges, we were able to make some progress with each patient, and quickly learned what worked well for certain patients and what did not work well with others.
Some of the challenges that we faced, particularly with the patient experiencing mania, was prioritizing the right questions to ask while remaining professional and maintaining a positive rapport. I had to interrupt this patient on multiple occasions to ask my assessment question, which sometimes caused her to derail the conversation to a different topic. Using the nursing process as a conversation framework, we were able to help refocus the conversation. We collectively asked assessment questions for each domain and tried not to jump to different topics in order to help maintain her focus. This effort worked better towards the end of the assessment after we had time to discuss the remaining areas we wanted to assess. The nursing process framework helped us determine those priorities, and while her thoughts were still scattered, this initiative did help ground her more towards the end of our assessment period.
With our patient experiencing schizophrenia, we found that maintaining a positive rapport and helping him feel safe was critical for him to respond to the questions thoroughly. This caused our assessment to progress slower, however we did feel that we were able to build a therapeutic relationship with him. Due to the slow progression, I did not ask him questions that I realize I should have vocalized sooner such as his addressing his support network and substance use. Towards the end of each patient interaction, our group moved more fluidly through the questions, and we were able to address some of our priority concerns quicker.
This simulation experience felt a little like a rollercoaster, however it was extremely helpful in determining areas of my patient assessment that I needed to improve upon. I valued how each patient situation was unique and required a different approach. As future nurses, we will need to adapt to patients with various backgrounds, values, diagnoses, and preferences. Based on this experience, I am confident that in the clinical setting, I will be able to assess my patient better, and prioritize their needs in a more efficient way. I look forward to being able to improve upon my mental health skill set as I progress in this program.
