Mental Health Reflection Paper
I have had many positive interactions with patients throughout my few years as a nursing student/nursing assistant. One experience that sticks out to me in particular, happened last summer while I was working as a CNA at a surgery center back home. There were a variety of things I was responsible for such as bringing in patients, taking vitals, and helping patients get dressed after surgery to name a few. I was typically the first and the last person that patients saw as I was bringing them in and wheeling them out. The patient experience that stood out the most to me came when I least expected it.
The client’s reason for visiting was to have carpal tunnel surgery on her dominant hand. This was a very common surgery that was done at the surgery center so I was expecting a routine patient. However, this was not the case as there were other physiological considerations (That I was not yet aware of prior to greeting patient) such as that this patient was deaf and bound to a wheelchair. Also, there was no translator available for the client so she had to rely on her daughter who was technically not supposed to be in the pre and post op areas due to COVID protocol. This was very difficult for the patient as her daughter was her only means of communication and was only let in for a brief time. It was easy to see how anxious and upset this made her through her body/facial expression. This was also reflected in her vitals as they were in a higher range. I saw this and did what I could to help her relax. I provided the lady with warm blankets and was able to communicate with her a little bit using what I had learned in my American Sign Language class from last year. I could tell this helped because I immediately saw her smile almost in relief. I think that it was very comforting for her to know that there was someone else in the hospital that could speak her primary language. This was very encouraging but also made me question why the surgery center had not better prepared for this case. I believe that if the staff had been informed about this patient, and had been provided with a proper translator, the patient’s experience would have been much more relaxed. This made me reflect on the importance of meeting client’s psychological needs (anxiety from no translator) and how it directly relates to the physiological outcomes. With elevated vitals and a lack of solid communication this could have been grounds to cancel the surgery altogether making poor use of each other’s time. I think after working in a surgery setting for such a long time healthcare workers may forget how stressful surgeries can be for some patients. It is a nurse’s duty to address these patient needs and to educate patients on their surgery. This will reduce stress levels are have more positive implications on care.
Following the surgery, I made sure to stop by to check in on the patient. I saw the nurse had been writing things on paper then showing it to the patient. I was able to help the nurse out a little with sign language but this was a really slow method of communication. When the patient’s daughter was finally able to come in, this is when things were able to move more smoothly. This made me to reflect on how communication would impact the patient’s feedback and education. Since this client was no longer married or in the workforce, her daughter was her only supporting factor and means of translation. This was a little concerning because if her daughter was not around to translate a question or communicate pain, who would she have to turn to? I think that definitely leaves the client at risk for neglect and feeling helpless. With that being said, the patient was given handouts and her daughter was able to translate the education points that the nurse had to say, but I felt as if the healthcare team could have explored her social supports a little more to help ensure her a strong recovery.
In the biological domain, some nursing diagnoses I would make are impaired self-care and impaired physical activity. This patient being deaf and bound to a wheelchair makes things difficult when preparing for home care. If the daughter is not around at all times, it has to be ensured that someone with the ability to communicate/help the patient is there. If there is ever was a situation where the client was in pain, or had to use bathroom, or was hungry it would be important that these needs are met to prevent trauma or distress. In the social domain, some nursing diagnoses would be impaired social interaction and ineffective role performance. Because this patient is retired, she had picked up on the hobby of knitting. With her dominant hand being casted up this takes away from her abilities to do what she likes. It would be very important to find something else she enjoys for the time being to keep her occupied. Also, I wouldn’t want her to be alone for extended periods of time. She became anxious when she was alone at the surgery center so it would be important to refer her to a local support group for deaf individuals if she was not a part of one already. In the psychological domain some nursing diagnoses would be risk for hopelessness/powerlessness and risk for depression. Again, as previously mentioned, she relies on her daughter for a lot of her communication. It is crucial that she can communicate her thoughts, needs, and questions to someone. Her daughter seemed very on top of things which was encouraging however caregiver burnout can happen so being involved with community supports would be helpful. My long term goal for this client would be to have make a full recovery and be able to return to her normal daily activities with minimal assistance. This will be done through attending physical therapy and meeting with a local deaf support group on a weekly basis. Being with other deaf individuals who may share similar experiences would be very therapeutic to her recovery.
Finally, as I was wheeling this patient out of the surgery center, the patient’s daughter thanked me for being so comforting and told me that I had made the clients day. Not only did this feel rewarding but it gave me more confidence in myself as a nurse. I was able to help make someone who was so anxious for their surgery feel much better about themselves. I think that this experience taught me a lot about mental health and its direct relation to patient outcomes. I think we as a society tend to overlook the mental health of others and what causes it forgetting about the physiological implications of it. As we have seen stress and anxiety from simple needs not being met can increase our blood pressure, heart rate, recovery from illness, immune system, etc. This can have negative long and short term outcomes and could eventually lead to worse things such as substance use, depression, or even suicide. Each patient is unique and will have their needs met in their own way. We must be conscious of these needs and continue to make improvements in way we provide care every day.
