inPractice - Fall 2019 - 10

PA COLLEGE / FEATURE

O

Perhaps the most important transformation of all, though, is the slow
but steady dismantling of the stigma that has been part of mental
illness for centuries.

Over her 30-year career, Barbara Keener Reed, RN '55, witnessed
a lot of changes in the field of mental health nursing. Given her
introduction to the field in the mid-1950s, however, it's something
of a surprise that she ended up working as a mental health nurse at
WellSpan Philhaven, an inpatient facility in Mt. Gretna.
During Reed's student nurse psych rotation in the early 1950s at
Philadelphia State Hospital at Byberry, she recalls holding down
patients while doctors administered shock therapy without anesthesia
or muscle relaxants to soften involuntary muscle spasms. Her other
Byberry experiences-seeing patients neglected in highly visible
isolation rooms and being submerged in cold water as a treatment
modality-also made a lasting impression. "I thought the conditions
were atrocious and that I would never work in the field," she says.
So, after graduating from Pennsylvania
College of Health Sciences, then known
as the Lancaster General Hospital School
of Nursing, Reed became a medical and
surgical nurse. Then, she moved with her
husband and children to Somalia to do
missionary work. When she returned to
central Pennsylvania and to nursing, she
was inspired by a newfound passion: "I was
developing an interest in listening to other
people's problems and decided that working
at Philhaven would be good."
She joined the Philhaven staff in 1983 and
expanded her education to include family
therapy, teaching classes to patients and
their families on healthy relationships
and communication skills-a therapeutic
modality that didn't exist when she was
a student nurse at Byberry. Today, retired
nearly six years, Reed has fond memories
of her career as a mental health nurse.
"When you see a glimmer of hope shine from your patient's eyes,
that was the most rewarding," she says.

Marie Kline, RN '71, also has witnessed the change in how people with
mental illnesses are treated by the public
and the medical profession: "There's
definitely an increase of attention to
personal dignity and to the integration
of mental health services into the local
community in a variety of ways,"
she says.
The Mind/Body Connection
One such program is the crisis
stabilization unit in Harrisonburg,
Virginia, where Kline works part time,
a job that tempted her out of retirement
from hospice nursing. Her unit, which
prepares residents for transition into
the community or to detox centers
or other medical care, provides a
homelike, secure, step-down
environment from the hospital or prison.
"We see people with a lot of substance
abuse, suicidal ideologies, post-traumatic
stress disorder and childhood trauma,"
says Kline, who recently registered as a Qualified Mental Health
Professional-Adult with the Virginia Board of Counseling.

"

And medications have improved greatly. During her psych rotation,
also at Byberry, Marilyn Wolgemuth, RN '53, recalls the introduction of
Thorazine, an antipsychotic medication. "Medications have made such a
difference and worked wonders," says Wolgemuth, who worked at psychiatric
hospitals in Texas and the midwest throughout her career.

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Ann Glick Derrick, '69, who worked for 23 years at Philhaven's adult
inpatient program and now works part time in its day program,
acknowledges that some stigma is still there, but she's seen a change.
"People are much more willing to talk and are much more open," she says.

"

The gains in mental health care since the mid-20th century are substantial.
Shock therapy has evolved into electroconvulsive therapy, now administered
under anesthesia in a safer and more controlled and effective manner. The
restraints and isolation treatment techniques of yesteryear are no longer
a part of modern-day treatment for mental illness. Instead, mental health
practitioners use de-escalation techniques or therapeutic physical holds.
Today's mental health nurses work in a variety of settings: inpatient
facilities at state-run or community hospitals, outpatient programs,
or community-based programs designed to increase access to care.

10

"Over the course of my career, I saw that patients were valued people
and not looked down on because of their mental illness," Reed says.
"We still have a way to go, but there's been progress."

She job-shares nursing duties-taking vitals, providing
medication-and teaches classes using dialectical behavior
therapy, a type of cognitive behavioral therapy, for the residents.
"When I went to nursing school, you just didn't have counseling,"
Kline says. "Now you have counselors and peer support in mental
health. People have opportunities for increased potential now."
Helping people become who they were meant to be
was what Wolgemuth yearned to do during her 1950s
psych rotation. "Sometimes I feel so useless here," she
wrote in her journal of her student nursing stint at Byberry.
"We play games with patients and supervise meals, all part
of the mental therapy, but it's in contrast to rushing
my legs off on the general surgical floor."
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