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By Jackie Linton

Nurse 2001 - Family Focused

Professor Jaime Sims

Wednesday, July 23rd 2025

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Mania can be described as a period where one's mood is elevated, emotions and energy levels vary and this can all change immediately. The change in mental status will be easily noticed by friends or family. This is typically a negative symptom that comes with a diagnosis of bipolar disorder. I have chosen this topic of importance to me because gaining experience on the acute mental health units and witnessing multiple episodes of mania with different people, reminds me of a personal connection I have to someone who continues to go into manic episodes, and this topic is important to me.

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A journal represents when someone is experiencing an episode of mania, they experience racing and chaotic thoughts and typically like to write down what they are thinking so they can get it out of their head. During clinical I typically saw patients come in with a journal with lots of writing and pictures they drew.

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Specifically, a clock that's running too fast, this can relate to someone who is experiencing mania and their racing thoughts. They can be disoriented to time, have decreased amounts of sleep and have impulsive actions. The fast hands resemble speed, and this is relatable to my experience at clinical. I had conversations with people, and they were speaking quickly, loud and switching topics often, described as "word salad".

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A poem: "I felt a funeral in my brain" by Emily Dickinson

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A poem: "I felt a funeral in my brain" by Emily Dickinson

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This poem specifically captures the intensity patients feel when experiencing an altered mental status such as mania. Sometimes patients can tell they are not necessarily thinking straight but still believe their current reality to be true. Witnessing someone going through mania then coming out of it, they are confused, can feel frustrated and defeated.

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Alamy.com, 2025, c8.alamy.com/comp/2AGE05R/closeup-shot-of-a-broken-clock-with-the-shards-flown-apart-on-the-ground-2AGE05R.jpg. Accessed 23 July 2025.

Canadian Mental Health Association Ontario. (n.d.). Depression and bipolar disorder. CMHA Ontario. Retrieved July 21, 2025, from https://ontario.cmha.ca/documents/depression-and-bipolar-disorder/

Cleveland Clinic. (2021, September 14). Mania: What is it, causes, triggers, symptoms & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21603-mania

Corfman, Allisa. (4 Apr. 2016). “Analysis of I Felt a Funeral, in My Brain by Emily Dickinson.” Poem Analysis from  poemanalysis.com/emily-dickinson/i-felt-a-funeral-in-my-brain/.

Cotovio, G., & Oliveira‑Maia, A. J. (2022). Functional neuroanatomy of mania. Translational Psychiatry, 12(1), Article 29. https://doi.org/10.1038/s41398-022-01786-4

Pinimg.com, 2025, i.pinimg.com/originals/61/05/64/610564b899eca958f41212fdcdc760b8.jpg. Accessed 23 July 2025.

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Neonatal opioid withdrawal syndrome is a condition that affects newborn babies who have received addictive substances by their mother while in the womb through the placenta. During the first few days of life, they are trying to expel these substances out of their body, and it can be a dangerous process. This is a topic of importance to me that I want to showcase. I witnessed multiple women come to the floor before they had their baby because they were using drugs and needed a place to keep clean before they baby was delivered.

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This symbolizes comfort, nurturing and when swaddled, this represents being inside the womb. The frayed portion is important because it represents the blanket traveling with the baby wherever they may go. Sometimes mothers cannot care for their child and they are given to CAS. When witnessing a baby going through withdrawal in the hospital, it is emotionally upsetting.

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A hospital pacifier is something that can be used by the mother and the nurses to comfort the baby. Sometimes mothers are still on substances, are allowed to leave the unit and leave the baby with the nurses for a period. This item helps the baby stay calm and promotes the suck reflex. This is a perfect example of a baby’s first object when in the hospital. Typically, these babies are fussing and cry a lot. A pacifier resembles soothing and comfort.

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The Poem : "Welcome to Holland" by Emily Perl

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The Poem : "Welcome to Holland" by Emily Perl

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This poem can relate to parents who are raising a child that may have unexpected health challenges. The poem gently encourages acceptance, emphasizing that although the journey is different, it can still be meaningful, joyful, and beautiful in its own way.

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Cleveland clinic. (2022, June 12). Neonatal Abstinence Syndrome: Symptoms & Causes. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23226-neonatal-abstinence-syndrome

Kain, S., & Newby, B. (2023). Neonatal Abstinence Syndrome: A Review of Treatment in the Neonatal Intensive Care Unit. Canadian Journal of Hospital Pharmacy, 76(3), 234–238.

Kingsley, Emily Perl. “Welcome to Holland — Emily Perl Kingsley.” Emily Perl Kingsley, 1987, www.emilyperlkingsley.com/welcome-to-holland.

Graylinemedical.com, 2025, www.graylinemedical.com/cdn/shop/products/aaaa_d2cb3d99-143a-4ffa-815b-3f9421236d72_400x400.jpg?v=1602243623. Accessed 23 July 2025. “Https://I.redd.it/7zv8ne8lfq8a1.Jpg.” Reddit, 2025, www.reddit.com/media?url=https%3A%2F%2Fi.redd.it%2F7zv8ne8lfq8a1.jpg. Accessed 23 July 2025.

LOGAN, B. A., BROWN, M. S., & HAYES, M. J. (2013). Neonatal Abstinence Syndrome. Clinical Obstetrics and Gynecology, 56(1), 186–192. https://doi.org/10.1097/grf.0b013e31827feea4

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Smudging is traditionally a ceremony for purifying or cleansing the soul of negative thoughts for a person. Four specific elements are involved including, the container, the sacred plant, the fire to light the plant and the smoke that the plant produces. This is a topic of importance to me because I have been on the mental health unit, where people of indigenous culture have requested to smudge. This is very endearing activity to be a part of.

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This is a very direct representation of smudging. This is the two may items you need. Many different items such as Sage, sweetgrass, cedar and tobacco can be used. Sage represents a cleansing for negativity. During clinical, indigenous peoples who come to the mental health unit frequently ask for these items. I always appreciate that we can do this for them. It is a ceremony that is deeply rooted in their culture. Especially when they are mentally ill, they rely on traditional ceremonies for support and grounding.

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A medicine wheel and/or a drum represents this circle. Both represents holistic healing of the mental, emotions, physical and spiritual self. This can be represented in a smudging ceremony where Indigenous culture is very holistic and looks at all parts of the human. For real life context, when someone who is indigenous is in a psychosis or a mania episode they have stated to me that they need to be treated in a way more than pills and being locked up. It makes me think how better we can support them moving forward and allowing them to smudge on the unit is a great start.

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Etsystatic.com, 2025, i.etsystatic.com/23364696/r/il/4f8922/3694349467/il_fullxfull.3694349467_e7oc.jpg. Accessed 23 July 2025.

Joseph, B. (2017, February 16). A Definition of Smudging. Ictinc.ca. https://www.ictinc.ca/blog/a-definition-of-smudging

Manitoba Education and Early Childhood Learning, Indigenous Education Directorate. (2019). Smudging protocol and guidelines for school divisions. Government of Manitoba. https://www.edu.gov.mb.ca/iee/publications/pdf/smudging_guidelines.pdf

Marsh, T. N., Coholic, D., Cote‑Meek, S., & Najavits, L. M. (2015). Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in Northeastern Ontario, Canada. Harm Reduction Journal, 12, Article 14. https://doi.org/10.1186/s12954-015-0046-1

Pinimg.com, 2025, i.pinimg.com/originals/e4/fa/85/e4fa85060cb3ab256fc509ebe8f0cf92.jpg. Accessed 23 July 2025.

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PPH is severe or excessive bleeding after child birth. This can range from mild to severe depending on how quick it can get under control. Nurses and the patient need to be aware of symptoms such as dizziness, increased heart rate and increased bleeding with or without clots. This topic is of importance to me because a situation happened with a mother when I was at clinical and the fast reactions of the nurses are what stop the situation from becoming life threatening.

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This is a very real example of what you look for when a woman is hemorrhaging. One of the initial things you tell someone who has just given birth is to monitor how fast and how much they are bleeding into a pad. It is represented when a nurse needs to push on the women's fundus and blood gushes out or blood clots, or the fundus is boggy. These are all early signs of hemorrhage and need immediate action. Unfortunately, while I was at clinical, someone was passing huge clots, and I witnessed the nurse determine whether they were blood or placenta and that was a surreal experience.

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This relates to the immediate reaction needed to save a woman who is not clotting and bleeding out. This will gather the team and get the women the care she needs to stop the bleeding as soon as possible. Typically, if you must use the code blue button, the hemorrhage is very far along, and some simple assessments might have been missed. Luckily, I never experienced this happen while I was at clinical, but being at the hospital sometimes you can hear "code blood transfusion" called over head in the labour and delivery unit and you know, something bad has happened

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Apsf.org, 2025, www.apsf.org/wp-content/uploads/newsletters/online-only/2021/staff-assist-code-buttons-in-ct-suite.jpg. Accessed 23 July 2025.

Cleveland Clinic. (2024, November 12). Postpartum Hemorrhage: Causes, Risks, Diagnosis & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22228-postpartum-hemorrhage

Instyle.com, 2025, www.instyle.com/thmb/PIK-GKwMWxrDm3uP3LD1CYducxo=/1500x0/filters:no_upscale():max_bytes(150000):strip_icc()/102017-period-pad-ad-lead-2000-fad1102f292647eba445cb9122ee5f89.jpg. Accessed 23 July 2025.

Public Health Agency of Canada. (2024, August 1). Chapter 5: Postpartum care. In Family‑centred maternity and newborn care: National guidelines. Government of Canada. Retrieved July 21, 2025, from https://www.canada.ca/en/public-health/services/publications/healthy-living/maternity-newborn-care-guidelines-chapter-5.html#a4.2

Wang, M. J., & Oyelese, Y. (2025). Postpartum hemorrhage. Maternal–Fetal Medicine, 7(1), 38–48. https://doi.org/10.1097/FM9.0000000000000261

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Psychosis is a term used for a collection of symptoms that can happen when the brain has a hard time deciphering what's real and what's not. It causes a disconnection from reality and there are several reasons why it can happen, sometimes resulting from mental health. This topic is of importance to be because many people of all ages, come into the crisis unit and need to be admitted of a diagnosis of psychosis. It is interesting because anything can trigger it.

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For myself, this relates to psychosis because they can often have disorganized thinking. They can have difficulty connecting what is real and what is fake. When I cared for someone during clinical trials in a psychosis, I was told "this isn't them" and it made me think of the one puzzle piece that's missing but can always be found.

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This can relate, while being in a psychosis, patients are often confused, lose their sense of self and distinguish what's real and what's fake. The fog resembles reality versus delusions. In clinical I watched a patient stand for a long period of time staring into the wall, it reminded me they aren't looking at themselves.

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Alamy.com, 2025, c8.alamy.com/comp/AE5DDN/closeup-of-jigsaw-puzzle-pieces-connected-with-three-pieces-missing-AE5DDN.jpg. Accessed 23 July 2025.

Canadian Mental Health Association Ontario. (n.d.). Understanding psychosis and finding help early. CMHA Ontario. Retrieved July 21, 2025, from https://ontario.cmha.ca/documents/understanding-psychosis-and-finding-help-early/

Cleveland Clinic. (2022). Psychosis: What It Is, Symptoms, Causes, Types & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/23012-psychosis

Commonsensewithmoney.com, 2025, www.commonsensewithmoney.com/wp-content/uploads/2015/08/foggy-mirrors.jpg. Accessed 23 July 2025.

Mehta, U. M. (2020). The social neuroscience of psychosis: From neurobiology to neurotherapeutics. Indian Journal of Psychiatry, 62(5), 470–480. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_550_20