Psychiatric Nursing Reflective journals Psychiatric Nursing Reflective journals Psychiatric Nursing Reflective journals Day 1 An experience with Paranoid schizophrenia Mrs. Jones, 33 years old, had been admitted for paranoid schizophrenia. Recently she had been hearing “voices which were controlling her”…
She appeared inattentive to my instructions and needed three repetitions of what I had said for her to understand me. When she had obeyed my instructions, I admired volubly her pretty appearance and hugged her. To my queries, she had just stared at me as if she was scared but today she called me up. Seizing the opportunity, I moved up. Nervously pulling me to her side and looking around to ensure that nobody was within hearing distance, she whispered in my ear. Her neighbor was plotting to kill her and her husband, it seemed. She had heard noises from her backyard which sounded like gunshots when she had been in the kitchen at home. Her movements appeared jerky and speech was not incoherent but appeared monotonous. Realizing that her suspicious and guarded nature was characteristic of her condition, paranoid schizophrenia, I pretended to be a good listener to gain her confidence. She claimed that the neighbor of around her age was attracted to her and was eyeing her sexually. Several times he had approached her for sexual favors. She had told her husband about this but he did not believe her. At times the neighbor had thrown stones at her house when she was alone and had rung the doorbell several times. Each time she went to the door, there would be no one. Saying all of this at one go, she quickly pushed me aside when she noticed the nursing supervisor arriving. When the supervisor had left, Mrs. Jones again strode up to me and caught my attention. She told me that her husband was a good man but he did not believe her stories and told me to keep what she told a secret. Half an hour later, Mrs. Jones did not appear to want to talk with me. When I smiled at her, she seemed to have no recognition. I was a little taken back by the stony look on her face. Her husband had told me that she was a receptionist in a hotel and very much appreciated by the others and customers. Believing that she was then well, she had stopped her treatment. He had not noticed the medicines not being taken. This had triggered this episode. She had also not kept her appointments with the psychotherapist. Anyone would have believed this lady the way she told the stories. They would have been credible had they come from a normal person. The fact that she was admitted for paranoid schizophrenia reminded me that the stories could be delusions. Though I had studied about schizophrenia and its various forms and symptoms, this was the first time that I was in close contact with a person with schizophrenia. Having no physical deficiencies, Mrs. Jones could easily pass on the road without anyone realizing the depth of mental illness that she had, the extent of trouble that she could create and the magnitude of suffering that she went through. What she needed was sympathetic people around her and proper pharmacological and psychological treatment. A person who did not know her to be a patient could even irritate her unknowingly. This was the situation for most psychiatric disorders. When we were taught psychiatry, we never realized that most psychiatric patients became ill only occasionally and that most of their lives; they were presumably fine and able to work like Mrs. Jones. Treatment allowed them to be a part of normal society. However the treatment schedules should never be missed. I also noted that psychiatric patients should never be allowed to consume drugs without supervision. A family member had to take responsibility. This was another of my new learning. It would serve ...
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