Category: NSG 328

One thing I learned from this experience was that when working with a group of fellow student nurses (or later in life other healthcare professionals) it is extremely important to not only actively listen to the patient, but also the other people around you conducting the assessment/interview of the patient. When working with other nursing students in order to work well with each other we needed to listen to the questions being asked by others in order to formulate the next set of questions that went off of what the person  before you previously said. This is so important for cohesiveness and in order to not confuse the patient by changing the topic every time a new person speaks. We all had to work together to find out crucial things about the patient but also tried to make it as cohesive as possible as well. One challenge that our group struggled with occasionally was trying to fit a suicide assessment naturally into conversation. We found it was easiest to bring this up when they are talking about things they struggle with or things that upset them because it gives a good segue to the suicide assessment. It is uncomfoortable in conversation to bring up the suicide assessment after talking about protetive factors or other uplifting things for the patient. 

The most important thing we learned about mental health assessments is there is seriously no way to tell how the conversation will pan out. You can plan all you want about questions you would like to ask the patient about their diagnoses, medications, history, and experiences, but the conversation is going to be run by the patient and the nurse needs to adapt their questions to the flow of conversation and base everything off the answers that the patient is giving you. There is no script! Some questions you may not be asked or may not be answered fully but that is okay because you could always go back to the patient and ask or maybe the conversation just never flowed to those topics and went a totally different direction but that is okay. It is all about making the patient comfortable and giving them a safe space to talk about their experiences and whatever else they want to talk to healthcare staff about! I feel as though I do a good job of rolling with wherever the conversation takes us and never getting caught off guard. I am good at adapting and letting the patients steer the direction of the conversation. After the first simulation I felt ready for clinical and after the second simulation and after having clinical I feel like my conversational skills with patients and my therapeutic conversation skills have improved greatly.

1. Why do you think there is so much stigma associated with mental illness? What factors do you think contribute to self-stigma?

2. In what ways might a person’s culture impact their response to mental illness? Consider, for example, how religiousness/spirituality might intertwine with a person’s conceptualization of wellness and illness.

1. I think that there is so much stigma associated with mental illness due to mental illness being so much less studied than physical illnesses. In the history of medicine, physical illnesses have obviously been studied for a much longer period of time than mental illnesses because you can see physical illnesses with your eye and mental illnesses have to be described by patients subjectively. I think it is also really hard for people to look inward and recognize that there may be something wrong with their thought process or something mentally is wrong instead of just being able to look down and see an injury. Factors that could contribute to self stigma is putting too much pressure on yourself to be perfect which then increases stress levels and challenges a person’s abilities to cope. Sometimes people are really hard on themselves when they do not think or act like other people do naturally and have a really hard time accepting that and attributing it to their mental illnesses. 
2. Some cultures value being very strong and not showing weakness such as asian culture and the culture of toxic masculinity in America. When people are discouraged from expressing their emotions it can lead to emotional distress and can be harmful to a person’s mental health. It is not healthy for a person to bottle up emotions and force themselves to not feel those emotions freely. Religions may attribute certain emotions to being harmful and restrict people from seeking medical help and instead seek spiritual help. This can be detrimental if the mental illness could successfully be treated with therapy, medication, etc. Sometimes people only associate physical wellness with being healthy but a healthy person has healthy physical wellness and mental wellness.