Tag Archives: Nurse

N – #AtoZChallenge on Mental Health

Welcome to the #AtoZChallenge on mental health, day 14. Today’s letter is N. Another late post, because I slept through the day yesterday so wasn’t able to schedule it. Here goes.

Neuropsychiatry

Neuropsychiatry is the branch of psychiatry specializing in the effects recognized brain diseases have on people’s mental health and behavior. Of course, mental illnesses have a biological component too, but neuropsychiatry is particularly interested in conditions like epilepsy, Parkinson’s Disease and brain injury. Some psychiatric institutions have specialized neuropsychiatric units or outpatient clinics. Mine has both. The inpatient unit is mostly for people with brain injury. In my institution, a neurologist is in charge of directing the care on this unit.

Neurotransmitters

Neurotransmitters are chemicals that the brain cells use to communicate. They commonly have multiple functions, hence the side effects of psychiatric medications affecting neurotransmission. Well-known neurotransmitters are serotonin and dopamine.

Serotonin is thought to play an important role in mood. A deficiency in it can cause mood disorders, such as depression or bipolar disorder. Unfortunately, an excess of serotonin caused by antidepressant use can cause serotonin syndrome, which is a potentially life-threatening condition. Serotonin syndrome is particularly associated with a type of old-school antidepressants called MAOIs.

Dopamine plays a role in different physical and mental functions. Dopamine is necessary for movement. Parkinson’s Disease is caused by a degeneration in the dopamine-producing cells in the brain. On the other hand, an excess of dopamine is linked to psychotic symptoms. First-generation antipsychotics (such as Haldol) block the brain receptors for dopamine. Like I said however, dopamine is necessary in movement. Hence, peoople on first-generation antipsychotics commonly experience tremors and muscle stiffness similar to Parkinson’s patients. This movement disorder associated with antipsychotic use is called Parkinsonism.

Nicotine

Many people with mental illness smoke. Among people with schizophrenia, as many as 90% do. It is well-known among smokers that cigarette-smoking relieves stress. This coul be psychological dependence though. However, research shows that nicotine actually helps decrease psychotic symptoms specifically. It is not just a matter of psychological dependence on nicotine that causes people with schizophrenia to experience fewer symptoms after smoking. As such, schizophrenics might unknowingly use nicotine as self-medication.

Nurse

Obviously, mental hospitals employ nurses as support staff. Their primary tasks are to observe and facilitate the patients’ day-to-day functioning. Obviously, administering medications is a common task. However, nurses also use psychosocial interventions.

Community psychiatric nurses (CPNs) are employed by outpatient clinics to help support patients in the community. They often do some form of psychosocial counseling and are also often employed as case managers. As such, they do some tasks formerly done by social workers.

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Medical #WotW

It’s been a tough week, so I haven’t written much. I’ve had countless plans and ideas in my mind, among which restarting my Dutch blog (yes, again!), but my brain and body won’t fully cooperate. I did restart the Dutch blog, but I only republished an old post. Because I can’t really get my mind to work towards creating an original blog post, I’m just going with #WotW and share my word for the week. I’m a bit late, but I checked and the linky is still open.

My word of the week, not quite surprisingly, is: medical. I’ve had quite the week with medical visits, after all. On Monday, I had to be screened by an endoscopy nurse in preparation for the upper GI endoscopy, which was Friday. The screening was relatively easy-going. The only hurdle was that the nurse hadn’t gotten a referral letter, so he had no idea why I was supposed to get an endoscopy. I explained that i had heartburn and pain up my esophagus. “Ah, you have reflux.” I happen to know the term in English but had hardly heard of it in Dutch and thought it’s the same as heartburn. I got the idea that the nurse felt the endoscopy wasn’t necessary, but he didn’t say so. Not that it’s his job to decide on such matters anyway. The nurse did say that my being short of breath while lying down but not (too badly) during slight exertion could be due to the reflux.

On Friday I got the actual procedure. It was a breeze too. A nurse from the institution came with me since my husband was at work. She wasn’t allowed in the room when I got the endoscopy but that wasn’t a big problem. I was sedated under twilight anesthesia, where you’re conscious but not quite aware of what happens. I can’t remember a thing about the procedure itself, though I do remember being brought to recovery. In the bed next to me was a man who got the news that he might have cancer. That gave me a bit of anxiety, because I still wasn’t so sure nothing would be found on my endoscopy. As it turned out, the doctor was finished telling me the results within less than half a minute. Nothing was found and he’d send a letter to my GP. I’m glad that nothing was found, although it would’ve been better if something with an easy, targeted treatment had been found.

On Tuesday, I went to my GP again because I’ve been having terrible fatigue and what I have gotten to believe is some sort of brain fog. I didn’t mention the term brain fog but did describe what it’s like. The doctor sent me for bloodwork and is going to give me a physical examination next week. Even though I’ve been a little less exhausted over the past few days, I do hope something easily treatable will be found. As the doctor explained, fatigue usually has more than one cause. It could be I’m having some case of the winter blues, because I’ve been feeling more depressed lately too. Fatigue for me gets better and then worse but it’s never fully gone though. I have had vitamin and iron deficiencies in the past, so we’lll see whether these are acting up again.

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