Fascinated by the Mind, She Forged a Path in Psych Nursing
Kim Larrier
When Kim Larrier started her rotation at the VA Central Western Massachusetts Healthcare System in Leeds as a student in the nursing program at American International College, she had a pretty good idea what path her career might take.
By the time it was over, the die was cast.
“I was quite intrigued with how the mind works, and how medical issues can impact someone’s health,” she recalled. “On that rotation … to see people get better with their symptoms — I was quite fascinated with how medications impact and how they can help someone’s mental health.”
So, when it came time for her senior management rotation, instead of a medical floor, which most students prefer, Larrier chose the psych unit at Holyoke Medical Center (HMC). And more than 30 years later, she is still there, now serving as clinical coordinator of the M5 Adult Behavioral Health Unit.
When asked what she likes about work in this realm, she quickly replied, “everything.”
And what she likes most is seeing people get well.
“When they come in at their worst, and they feel like they have nothing to live for, and then, through groups, meeting with them, medication … it’s nice to see people get better,” she said, adding that the unit has a strong track record for success, one that drew the attention of a brigadier general at the VA hospital she worked with on her rotation, who sought insight from the team at HCC on how it might be more helpful to veterans, especially with regard to suicide prevention.
“When they come in at their worst, and they feel like they have nothing to live for, and then, through groups, meeting with them, medication … it’s nice to see people get better.”
“Suicidal feelings are sometimes just a temporary feeling,” she went on. “And my goal as a psychiatric nurse is to get them the treatment so they don’t feel that way.”
There have been some difficult times on M5 — COVID was a stern challenge, to say the least — and some very scary moments, including the time several years ago when a brain-injured and deaf patient threatened her with a large piece of glass from the door he shattered with a chair in his room.
“I’m trying to write on a piece of paper, ‘please stop doing that,’” Larrier recalled. “He’s yelling at me, and he’s got blood all over the glass … he’s pointing the glass at me and saying, ‘I’m a grown man, and I don’t need to be here; let me out of here.’
“That was very scary,” she went on, adding that the situation was resolved with the help of 11 staff members.
Meanwhile, she has treated patients who would later be charged with murder, but were just another patient when they arrived.
But these moments have been far outweighed by those opportunities to see patients get better — and to play a significant role in helping them get better.
HMC has 54 inpatient psychiatric beds across three units, one for seniors and two for younger individuals, noted Larrier, adding that M5 has 20 beds for those ages 16 and up. Individuals assigned to these beds arrive with issues and conditions ranging from homelessness to substance abuse problems; suicidal tendencies to unmanageable anxiety and depression. And, due to a statewide shortage of beds, patients come from across the Commonwealth.
The average length of stay is seven to 10 days, she went on, adding that most patients arrive first at the emergency room, where they are evaluated by the crisis team.
Those who are assigned to these floors work with a psychiatrist and a social worker, while group therapy focuses on coping skills, how to manage feelings, manage a panic attack or anxiety, and more.
But nurses play a critical role in these broader collaborative efforts; in addition to administering medication, they conduct mental health assessments each shift where they grade depression and anxiety.
“The mind can be tricky … it can trick people into feeling that it’s not worth living. When they’re so focused on killing themselves, their mind will play a trick on them and make them believe their kids would be better off without them, their spouse would be better off without them, or they’re not needed at work, that they don’t fit in this world,” said Larrier, adding that nurses play a lead role in collaborative efforts to help patients fight through such feelings.
Many of these patients return to the unit several times, she went on, noting that she and the other members of the team build a rapport with them and, more importantly, earn their trust.
“Many times, we’re asked to come down to the emergency room to help with a difficult patient that we know,” she told BusinessWest. “They may not take a medication from a nurse in the ER that they don’t know; however, if they call me and want me to talk with her, we’re more than happy to work with them.”
As she noted earlier, many of those who come to this unit do get better and go on to lead productive lives, and such success stories are among the many rewards from working in this realm. She cited the case of a woman who had become so depressed, she became catatonic.
“That means she sits, she stares, she doesn’t eat, she doesn’t talk,” she said, adding that, through shock treatments and other interventions, she was pulled out of this catatonic state.
That was one small victory among many for a nurse who has always been intrigued by the mind and decided long ago that this wouldn’t just be a fascination; it would become a career.
