Unit Psy
Unit Psy
Unit Psy
An Internship Report Submitted to the School of Health and Human Services of Saint
Monica Higher Institute in Partial Fulfilment of the Requirement for the
Award of a Bachelor of Science Degree in Nursing Sciences (BNS)
BY
This piece of writing is dedicated to the patients of the psychiatric unit at the
Laquintinie Hospital, Douala.
Acknowledgements
I give glory and honor to the most high God for life and strength He provided me
with, for the realisation of this practicum exercise.
I appreciate the entire SMHI staff as well as friends whi created a conducive
learning atmosphere for me.
Not forgetting my extended family, loved ones well wishers from the Church and
neighborhood whose presence served as grease to my elbow.
TABLE OF CONTENT
Dedication..........................................................................
Acknowledgements...........................................................................
CHAPTER 1: INTRODUCTION..........................................................................
4.1. Strength............................................................................
4.2. Weaknesses..............................................................................
4.3. Opportunities.............................................................................
4.4. Threats.............................................................................
References................................................................................
CHAPTER ONE
INTRODUCTION
Nursing can be referred to as an art as well as science which deals with the
rendering of care to individuals by a trained personnel, from a recognized
institution. Before the completion of the academic program for an award of a
Bachelor's degree in nursing, It is expected that the student understands the
practices in some specialties and how to render appropriate care to patients. For
better comprehension and application of the theories learnt at school, the students
were sent to the specialty unit (psychiatry) to engage in learning by keen
observation and performance. In this report, the student will point out some
practices pertaining to the nursing approach at the psychiatric department. This
practical exercise was carried out at the Laquintinie Hospital in Douala for a period
of one Month.
This unit comprises of three separate buildings: two linked by a corridor and the
third being a cabanon (where aggressive and agitating patients are kept) with
10rooms. At the entrance of the unit is the 1st building with the major’s office on
the right and the doctor’s office on the left. A little bit further and to the left is the
office of the doctor’s secretary. Following the corridor to the 2nd building is the
hospitalization wards for patients who are relatively calm and cooperative. The
wards are able to contain at least 30 patients. They are organized as follows;
Coordinator’s office
Admission room 5 (two beds)
Admission room 7 (six beds)
Admission room 6 (six beds)
VIP 4 (one bed)
VIP 4 (one bed)
Handing over is a process which entails a conversation between the exiting team on duty and the
team entering, about the state of the patients throughout the shift, those on medications, the
number of patients in the ward, those who were discharged, those newly admitted and number of
deaths, as well as the equipments of the unit.
For a number of days during morning shifts, the student ran errands for the senior nurse ("Major"
) on behalf of patients.
*Morning Duty
Upon arrival at 7:30a.m., the student changes into her uniform and accompanies the nurse for
duty. She partakes in the taking over process. The nurse looks into the report and patients files
from which she gets information of the patients on treatment, when and what medication. Being
aware of how the previous shift was spent, the overall atmosphere and state of the patients, the
student goes into the wards and cabbanon for a nurse's round. Here, she checks on the patients by
viewing them, conversing with them, enquiring from their carers or neigbors about them.
After rounds, the information gotten is recorded in the patients file. Treatments are then prepared
and served to the patients respectively. Those in the cabbanon are being restrained by security
officers in order for the medications to be served. After this, charting is done in the files of the
patients.
At 4pm, the vital signs of all patients in the regular wards are checked. They include the blood
pressure, temperature and pulse. However, patients on critical conditions have their vital signs
checked more frequently.
Throughout the day of a regular duty period, the nurse is involved in admitting new patients,
serving medications, discharging others, listening to patient's complaints and attending to their
needs which may include changing of bedsheets, assisting them take their medications and do
some selft care activities.
*Night duty
Upon taking over at 5:30pm, the student changes into her uniform and accompanies the nurse for
duty. Nurse's rounds are done as during a morning shift and the findings recorderd in the
respective files of the patients. Patients are seeved medications respectively. Vital signs are
checked by 6 a.m. and charted.
A regular night duty is similar to that of the morning, except for the fact that patients are not
discharged at night.
*Off Duty
Being off duty is an official period of not being at work for a period of time as stated on the duty
roster. The students can rest better and prepare for the next working period.
The objectives of the practicum were also taken to heart and nursing care of patients prioritised
during this exercise.
The treatment protocol for patients at the psychiatric unit usually comprised of ;
DRUGS COMPONENTS
HALOPERIDOL Drug Class: Antipsychotics
(Haldol) injection Therapeutic effect: for treatment of some disease
5mg/kg IM/IV/Oral conditions like mania in bipolar disorder,
schizophrenia, agitation delirium, hallucinations in
alcohol withdrawal and psychosis.
Side effects: Tardive dyskinesia (movement
disorder) and neuroleptic malignant syndrome.
Contra-indication: Older patients with dementia,
pregnant women and those with Parkinson's disease.
Information of Patient
Name: XX
Gender: Male
Age: 22years
Occupation: Business
Nationality: Cameroonian
Patient's Social history: Consumes Thai, Caillou, cigarettes and other drugs.
Medications prescribed:
Relay medications
Polytoxicomania refers to a behavioral and mental disorder which entails a state of abnormally elevated
affect, arousal and energy levels that can be as a result of poly drug abuse.
During an episode of mania, there is an experience of rapidly changing emotions, moods which are
mainly influenced by surrounding stimuli, anxiety or anger can result can also result from mania.
In the same vein, mania can also be referred to as a psychological condition which leads to the
experience of veey intense moods, unreasonable euphoria, hyperactivity and delusion. It may be
dangerous enough to cause insomnia in an episode or cause the victim not to eat well.
-Flight of ideas, -Elevated mood , -Pressure of Speech, -Decreased need and desire for Sleep, -Increased
Energy, -Hyperactivity
*Causes
Patient XX was a victim of poly drug abuse and as such, a victim of polytoxicomania. Poly drug use
means using more than one drug at a time. Depending on the type and quantity, combining drugs may
amplify pleasure but can also present risk of heart attack and other negative effects. The greatest risk is
"Combined drug intoxication" which is a common cause of emergency visits and increased mortality of
its victims.
Some side effects of this combination are ; Coma, Seizures, Heart problems, brain damage and
respiratory failure.
-Risk of returning to previous unhealthy social life °Considering that the patient was being
hospitalized following the third episode of his
illness and his return to the same residence upon
discharge, the patient was counseled against the
tendency to return to an unhealthy social lifestyle.
°He was encouraged to stay away from the
truggers of thus unhealthy practice and get
engaged in productive activities like family
commitments, School or even relocating.
Perceived lack of Adequate Knowledge of the °Considering the fact that this patient was being
Underlying Condition hospitalized the third time and was not a regular
student, it was necessary to educate him on his
underlying health condition.
Risk of not taking medications regularly °As expected, a mental health patient has to be
followed up in order to ensure medications are
taken as prescribed. This is due to the tendency for
patients to stop taking medication when they feel
better.
4.1. Strength
The rooms and office were kept clean by the ward maids.
Some nurses showed concern and offered counsel to the patients.
4.2. Weaknesses
4.4. Threats
The presence of uncleared bushes ariund the hospital posed a threat to the security of
patients health as it could act as a breeding ground for mosquitoes and snakes.
When the student were many in number during night shifts, they were asked to go out in search
of where to sleep. This left some sleeping on benches with bugs and the lose of money.
Conclusion
The period of time spent for practicals at the psychiatric unit of Laquintinie
Hospital Douala was interesting and productive. Under supervision or by
observation, i was able to gain knowledge and perfect my skills. Despite the
challenges faced at the hospital, objectives were attained and it will be a delight to
have such experiences again.
REFERENCES