Image from: https://minoritynurse.com/a-day-in-the-life-of-a-psychiatric-mental-health-nurse/

During the mental health simulation, three actors presented with borderline personality disorder, bipolar disorder, and schizophrenia. I’ve done simulations in the past with an interprofessional team, but never with such patients presented. It was fascinating to see actors perform their roles.

            I didn’t know what to expect with borderline personality disorder, but learned quickly she can present with anger, depression, and anxiety. The patient presented with relationship issues at work and didn’t find herself accountable. My problem was I tried jumping to the intervention quickly rather than doing a thorough assessment. I learned the first meeting might only be enough for an evaluation. When I asked the patient if they’ve ever thought of harming themselves, she mentioned she cuts herself. My intention of the question was if she ever thought of killing herself. I learned that sometimes you need to be direct and transparent.

            I felt prepared for the bipolar disorder patient, but the mania made it challenging to ask questions. She didn’t listen and would go on a tangent when I asked a question. I had to listen very closely to try and catch important information. In my opinion, she was the most challenging patient. I didn’t know if she ever listened to anything that was said to her.

            The last patient presented with schizophrenia. He had delusions and hallucinations. I forgot to ask about family history, whether he had guns, and whether he has a job. Overall, I felt most comfortable dealing with this patient.

            After this simulation, I learned how prepared you need to be when dealing with such patients. The most important aspect is creating trust and rapport. You may not check off all the goals you had in mind, and that’s okay. It’s essential to be patient, understanding, thorough, and present. Many patients don’t like it when we focused on writing or reading off our papers.