401013 Mental Health Nursing

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30-03-2021

Question:

a) Using the case study provided, identify an urgent risk area. Ensure your answer details why you have identified this risk area including specific information about the client and current literature. (2 marks).

b) Identify one nursing / midwifery intervention you would immediately undertake with your client to address the risk area noted in question 1a and include a rationale for the intervention. (2 marks for the intervention and 2 marks for the rationale)

Identify the most urgent concern first in terms of immediate safety concerns.

We want to see your understanding of the client’s issue, so avoid writing brief details about the client such as: ‘the client has self-harm thoughts’. Expand on the detail of the concern ie. the client has presented with daily self-harm thoughts for 3 months, with intermittent / regular thoughts to cut his wrists using a razor blade. The client reports family contact as a possible cause of distress triggering self-harm thoughts which last for one hour daily immediately after seeing his family.

You should then add in some literature about self-harm which has relevance to the case study ie. males and self-harm, incidence of self-harm. Remember 1a is only 2 marks, so the literature here doesn’t need to be expansive, but do make sure you provide some literature and provide details of the client’s main concern ie. safety concern.

You should include a rationale with your intervention using literature and making reference back to the case study. Ie. why would you use recovery-based language when building a relationship with your client? Why would you undertake a risk assessment with your client?

Questions 2a and 2b - 200 words in total

2a) Using the case study provided, identify a mental health concern. Ensure your answer details why this is an area of concern. Include specific information about the client and current literature. (2 marks)

2b) Identify one nursing / midwifery intervention you would undertake with your client to address the mental health concern noted in question 2a and include a rationale for the intervention. (2 marks for the intervention and 2 marks for the rationale)

Ensure the interventions includes how, who and when you would actually carry out the intervention. Your rationale should state how and why you would carry out the particular intervention.

Ensure literature is included when you discuss the rationale.

Question 2 a and b helps us to assess that you understand the difference between an urgent client concern ie. safety and a mental health concern. Question one was concerned with safety identification whereas question 2 is about mental health concerns ie. possibly low mood or anxiety.

You should include a rationale for the intervention you have offered in 2b. ie. why have you decided to carry out the intervention making reference to literature and your client?

Question 3 - 100 words in total

3) Using current literature, identify and discuss (2) two legal, ethical or professional issues a nurse / midwife may need to consider when working with the client in the case study (4 marks).

Question 3 helps us to determine your understanding of some of the wider issues in relation to a person’s presentation and care.

Answer:

Question 1 (a)

The given case study represents Chung a 35-year old person working as a doctor in the Accident and Emergency department in a busy inner-city hospital. The person represents a number of health problems, which affects his state of wellbeing and wellness. Chung’s problems were identified past six weeks that defines about his poor health condition. Health refers to the state of complete physical, mental, and social wellbeing. Symptoms identified included lack of confidence, sleeplessness, as Chung started waking up at 3 am. He became a passive towards life and developed negative thoughts of committing suicide. Therefore, the urgent risk area identified in his case was the safety concerns that need to be addressed (Bruce et al., 2015).

Question 1 (b)

Nursing interventions in context to the health problems of Chung may include number of ways, which would help a nurse or health practitioner to understand his behaviour, and respond appropriately. Approach of establishing a therapeutic alliance and using a recovery-based language may help in this case. Involving him in a daily 30-minute exercise and other activities would help improve his health. Moreover, undertaking the suicide risk assessment of such patient will be beneficial, as it will help him develop a positive attitude towards life. The rationale based on such interventions taken by nurses states that using a recovery-based language for Chung will serve the purpose of that intervention. It will help in understanding the patients’ perspective towards life and such health problems (Rickwood et al., 2015).

Question 2 (a)

Chung’s poor health condition raised some mental health concerns that need to be resolved. Mental health issues such as suicide ideation, feelings of hopelessness, low-mood, anxiety, and low-esteem were the symptoms identified. In addition, he felt worthless to undertake the responsibility of his wife and child. It has been found that anxiety or mild depression is common to men and women both, but nature of problem differs. Low mood or anxiety is males tend to develop aggressive behaviour leading to loss of interest in work and family life. Hence, it has been a major issue in the health of males that should be treated well on time (McClay et al., 2015).

Question 2 (b)

Mental health problems in men affect their state of wellbeing, which must be treated timely. Necessary interventions in this case can be counselling of such patients by nurses in healthcare. Counselling helps in understanding the cause and drawbacks of such issues and the behavioural patterns of the patients. It also helps in directing his thoughts towards living a positive and happy life. As untreated depression for a longer time may lead to the risk of suicides, therefore counselling Chung will help in improving his attitude towards life. Rationale for using these interventions by nurses is that it will provide them an analytical approach to assess and treat him properly (Clement et al., 2015).

Question 3

Nurses/midwives in their role of mental health nursing require considering some ethical, legal, and professional concerns in the healthcare. One ethical concern in maintaining effective therapeutic relationship with Chung and other patients is the confidentiality of their information. Respecting the patient’s autonomy, acting in the beneficence and justice are some other issues. Chung was detained under the Mental Health Act, therefore he must be treated be urgently by the healthcare professionals. Two ethical concerns include managing the confidentiality of patient’s information and following ethical rules and guidelines for treating patients. Hence, these issues must be taken into consideration in the healthcare with due diligence (Urden, Stacy & Lough, 2017).

References

Bruce, M. L., Raue, P. J., Reilly, C. F., Greenberg, R. L., Meyers, B. S., Banerjee, S. & Rosas, V. H. (2015). Clinical effectiveness of integrating depression care management into medicare home health: the Depression CAREPATH Randomized trial. JAMA internal medicine, 175(1), 55-64.

Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N. & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help seeking? A systematic review of quantitative and qualitative studies. Psychological medicine, 45(1), 11-27.

McClay, C. A., Collins, K., Matthews, L., Haig, C., McConnachie, A., Morrison, J. & Williams, C. (2015). A community-based pilot randomised controlled study of life skills classes for individuals with low mood and depression. BMC psychiatry, 15(1), 17.

Rickwood, D. J., Mazzer, K. R., Telford, N. R., Parker, A. G., Tanti, C. J. & McGorry, P. D. (2015). Changes in psychological distress and psychosocial functioning in young people visiting headspace centres for mental health problems. The Medical Journal of Australia, 202(10), 537-542.

Urden, L. D., Stacy, K. M., & Lough, M. E. (2017). Critical Care Nursing-E-Book: Diagnosis and Management. United Kingdom: Elsevier Health Sciences