September 14, 2010

UCLA MSW Field Internship: Exposure to the Other Four Senses

Trying to describe my internship at an inpatient psychiatric unit, feels like trying to explain stage-fright to someone who has never been on a stage... or better yet, someone who doesn't even know what a stage is.

I have interned only two days at UCLA Harbor Hospital, and I can already tell I have my work cut out for me. The psych ward is staffed with two doctors, four residents, three to six nurses (depending on the shift), and two to three clinical social workers. The ward has 24 beds (12 of which are currently in use), a nursing station, two seclusion rooms, a cafeteria, and a place for patients to lounge. The office I share with my supervisor is tucked behind a hallway on the floor of the ward. The office door is always bolted, and the office comes equipped with a panic button (something I hope I never have to use). 

The image I just described might sound familiar. Nearly all of us have some notion of what a psych ward looks like, probably due to Hollywood's portrayal of them in the classic film, One Flew Over the Cuckoo's Nest, or more recent films, Girl, Interrupted and Gothika. I have to say that Hollywood does a pretty good job of depicting what a typical psych ward looks like: a white, sterile environment, with patients wandering the halls in hospital gowns.

While these films accurately depict the scenes of a typical psych ward, they only offer a loose sense of what it is really like to be present and interacting with patients in the unit. To give a more compelling idea of this reality, I'd like to push beyond the sense of sight by detailing how my other four senses (hearing, smell, touch, and taste) are actively engaged in the psych ward.

Hearing: The most shocking part of working in the psych ward are the sounds I hear: patients screaming, singing, shouting, rambling, crying, mumbling, etc. I was quick to learn about Code Green (combative person/elopement risk/person with internal disaster), when an unruly patient burst into rounds and had to be restrained by security and the nursing staff. Later that day, I encountered one patient who, according to the nursing staff, had been belting out lyrics for six hours straight, and had to be moved into seclusion so she wouldn't disturb other patients. Lack of sound is surprisingly shocking as well. In contrast to the patient who was singing, I met another individual who has not uttered a single word for over a year.

Smell: Being a state hospital, UCLA Harbor receives its fair share of homeless individuals. Regardless of whether the patient is homeless or not, patients are encouraged to shower everyday. However, no one is forcing them to do so. As you could imagine, it's not the most pleasant to conduct a psychiatric intake interview when someone hasn't showered for multiple days or weeks. On the bright side, all hygiene is documented in a patient's chart, so at least I know whether or not they have showered prior to when I interact with them.

Touch: Physical interaction with patients is limited, nonetheless, it happens. A patient, for instance, reached out to shake both of my hands, and held them for what felt like an eternity. His hands were shockingly cold, dry and frail. Moments later, he volitionally fell on the floor. When I grabbed his arm to help him up, I was shocked by how light his body was.

Taste: I'm not sure if it's the hand sanitizer stations, the lingering smell of rubbing alcohol, or the combination of both, but I seem to barely have active taste buds by the time lunch rolls around.

I can say, with confidence, that I have never had such eye-opening experiences in such a short amount of time. Who knows what the next 8 months will bring, but I certainly welcome the challenges that will no doubt come my way.

Photo Credit: loojie


L said...

And you thought it was nuts growing up at home.

Anonymous said...

hi, just wanted to thank you for writing about your msw internship experience. i'm actually applying myself and it was very cool to see a previous intern's experiences. hope you enjoyed your time there!