Building a Therapeutic Psychiatric Nurse-Patient Relationship

Approaching Jane During Her First Days on the Unit

Case Study (Psychiatric Nursing) Jane is a 17 years old girl who lives at home with her parents. She is the oldest of three girl siblings. Her father is a judge in the supreme court and her mother is a school teacher. She and all of her sisters are conscientious students who maintain high GPAs throughout their schooling. Jane spends a large portion of her free time studying and reading books. She is considered a "very bright" individual by all of her teachers. Jane also participates in community events in her local neighbourhood. Jane is admitted to the assessment and treatment unit after she is picked up by the police at a friend’s house. Jane’s friend’s parents called the police after finding Jane in their daughter’s room, half naked and apparently confused as to where she was. She shouted at her friend’s parents as if they were strangers to her and accused them of trying to hurt her. She told them that they should leave the house as she would not allow them to stay there. Her friend’s parents believed she might become violent and that she might have taken drugs. On admission, through Jane and her parents, it is discovered that Jane had gone through some sort of low mood and withdrawal two years ago. Jane relates that, at the time, she felt very low in her mood, but did not consider suicide. She also struggled to keep up with her studies at that time. However, this situation seemed to resolve itself and she went back to her usual patterns and mood level. Information also presented at admission, and later, confirmed through urine and blood tests, was that Jane has never taken any drugs, has not smoked and does not drink alcohol. In fact, she is described by her best friend as the model teenager! She befriends many boys, but has not had a relationship with a boyfriend. Jane was preparing to go to university and study law. She has aspirations to follow in her father’s footsteps. During the admission assessment, Jane’s concentration waxes and wains. Sometimes she seems distracted and it is not clear if she is listening to a voice or not. She denies doing so. Jane also denies any current suicidal ideation and says that she is glad to be here, as she did not feel safe in the community. Questions Outline how you might approach Jane during her first days on the unit, in order to establish a therapeutic psychiatric nurse-patient relationship. Create and provide a segment of a conversation (about ten to fifteen lines) you have with Jane on the first day. Identify the skills used in this section of the conversation and state their intent versus outcomes. Develop a recovery care plan for Jane which will guide her care over the first 72 hours. Assuming that Jane is more settled after the first 72 hours, redevelop the care plan to address her longer-term needs.