Below is a journal I wrote after participating in a schizophrenia simulation experience as part of my mental health nursing class. We were required to listen to voices similar to those with schizophrenia would experience through earbuds as we completed various tasks.
By the time I had made it to the community support program simulation, I had had enough. As I listened to Professor L’s condescending words*, determination welled within me. “You can choose what career you are interesting in pursuing,” she said, as she handed out our simulated job applications. “There’s nursing…but that is a demanding job,” she continued, in a doubtful tone. “You guys should consider other important jobs, like janitorial work…”
“Janitorial work? Hah! We’ll see about that,” I said to myself as I indignantly indicated that I would be pursuing the job of brain surgeon on my application sheet. Simultaneously, the voices in my head repeatedly reminded me about the supposed fact that I could do nothing but mess things up, and that I was a dumb-a**. Their deprecating words, albeit distracting, gave me all the more reason to fight them as hard as I could. I tried to perform all the assigned activities to a greater degree than I would even be able to do without the internal menaces. I would have nothing to do with bowing down to the verbal mistreatment from those who viewed my status as discriminatory. I would beat the challenge of simulated schizophrenia. Just like I learned to beat my own real-life battle of anxiety and depression.
Perhaps my past experiences occluded my perception of what I was supposed to be experiencing during this simulation. All I know is that when I shared my feelings related to the activity in class, Dr. R seemed surprised. And she reminded me that, although for me it might be a natural reaction to fight against the voices with sheer determination, most people suffering from auditory hallucinations in real life are not able to easily distinguish them from reality. People who are diagnosed with schizophrenia often do not have the mental capability or reserve to fight their symptoms, she noted. I paused for a moment, and I reflected on the gist of what Dr. Raj had just made clear to me — the inability to separate truth from a lie is powerful. Perhaps this simulation helped me to realize that how I process information is not necessarily how each one of my patients will be able to process what is happening to them.
And yet, one transferable emotion I know I experienced in this simulation was the feeling that arose within me as I faced each professor whose role seemed to be to make fun of me and my peers for our disadvantages. I felt degraded, despite the knowledge that none of them really meant what they were saying. I’ve always believed that each person on this planet is valuable and should never be looked down upon because of their abilities or lack thereof. And yet, being a high achiever, I know that I tend to innately make these judgments when I come across people who seem “mentally slow” or “delusional.” In this regard, this activity saddened me. It forced me to think of the judgments I have made in the past and it made me realize how those people would have felt if they knew what I was thinking in my mind. I pray that, as I progress through nursing school, I would truly act out my knowledge that all people are equal in value, and that these lessons will help me truly love on every patient I interact with in clinical and in my future profession.
Nobody deserves to be or wants to be disrespected. And so, I have made the conclusion that I should approach patients who hear voices with the same respect I wished I was shown during this simulation experience. I believe that true healing and recovery is best facilitated in an environment that assures the humanity of the client. As a nurse, I can and I hope I will be aware of the struggles this population deals with. I hope I remember the confusion they must be experiencing as they attempt to separate falsehood from reality. I hope I remember my desire to fight this battle, and my realization that these patients may not be able to fight their battles on their own. But through this all, I hope that I partner with my clients by meeting them where they are at and showing them respect. Because nobody should ever be made to feel worthless, regardless of their struggles. We were all created in God’s image, even when our reflection of that image has become distorted due to the nature of our fallen world.
To recognize one’s own self-worth and yet equally recognize their imperfections is a difficult task. And yet, I believe it is a crucial one for every nurse to learn, especially those who work with those who are mentally ill. We must value ourselves enough so that we can truly “love others as we love ourselves.” But we must not buy into the illusion that just because we, as nurses, may be physically or mentally healthy at a given time, we are better than any of our patients. Because, we are all imperfect.
Perhaps that is what makes all of us truly beautiful.
*none of my nursing professors are condescending at all! They are wonderful. Their attitude I described here was only for role play.