Discuss about the Mental Health for Interpersonal Skills in Interviewing Patient.
Nursing is a profession that heavily relies on the communication with the patient and other health care providers. For a meaningful diagnosis of an illnesses in a patient, excellent interpersonal skills among the nurses is pivotal. According to Bach & Grant, (2015), the interaction between a nurse and a patient can only be fruitful when approached carefully to build a rapport and the rest will run smoothly.
Communication is the heart of any nurse patient interaction. Information ought to smoothly flow to influence the participation of either parties. The basics of communication incorporates a five component circuit; sender, message, means, recipient and a feedback (Arnold & Boggs, 2015). Communication involves the passing of messages from a sender to the recipient using an appropriate means. All the participants must take part for it to be said to have happened. To facilitate communication, I would first create a rapport that would enable us to proceed smoothly. By first asking the patient some questions unrelated to their disease and assuring him of your commitment to his wellbeing. By addressing them by his name, Mr. Barry would feel that I am making an effort to identify myself with him. It helps build some confidence. I would ensure that we communicate in a language that both of us understand or seek the help of an interpreter if need be.
Listening is an essential trait in any interaction with a patient (Bramhall, 2014). A good listener allows for time for the other person to put across their input without interruption. A nurse should make use of open ended questions and allow the patient express themselves freely. Listening should be an active process, in the sense that, the person talking should be able see that you are listening to them. In some instances, I would node with agreement and maintain an eye contact. In some instances, take notes where necessary. This will make Mr. Barry see that I am concerned about his condition. This will be a way of encouraging him to give more information about his condition. He needs reassurances that something will be done despite the fact that he already feels he is a wreck
Patience cannot be overlooked especially in patients who seem nervous and mentally disturbed. They may tend to make some incomprehensible statements (Blais, 2015). Some may talk so fast. From the case scenario, Mr. Barry has been described as restless and stressed up. He has a lot racing in his mind. An initial attempt to interview him would be to calm him down. It may take some time and that emphasizes the need to be patient with him.
Signs and symptoms of mental disorder.
They can be broadly classified into emotional and physical signs and symptoms (Barkley, 2014). Emotional signs revolve around the personality and the behavioral disorders. Physical signs are elicited from the body changes that occur as consequence of the mental disturbance. An example is weight loss.
Mr. Barry shows signs of anxiety. He was observed to be looking around anxiously and seemed to be more restless than other patients. By this particular behavior one can conclude that he has some concerns that are not necessarily physical illness (Taylor, 2014). He seems to be so much concerned about his family and children. He feels that there are some problems that need to be addressed but feels helpless. His emotional outburst is likely a consequence of being retrenched from the local telephone company. He seems unable to predict the future and uncertain of what may ensue with the current state of affairs. He has worries even for his adult children and feels he can’t cope with their problems
He presents with some disruptions in the daily routine that he cannot control. His eating and sleeping patterns have been disrupted. His normal routine disruption may result from psychological stresses. An individual is unable to sleep due to anxiety, stress, pain and discomfort. Mr. Barry is stressed of the thing he cannot control. He cannot have proper sleep worrying about his health and money problems. In stressful situation, the brain releases neurotransmitters that are involved in suppressing the sleep and hunger centers in the brain. The consciousness centers are stimulated and there is an increased sympathetic tone. This translate to sleep disruptions and a raised level of consciousness.
Physical signs such as an increased blood pressure and a decrease in the body weight per age may also be an indicator especially when accompanying other emotional symptoms (McGee, 2016). Mr. Barry shows presents with an increased heart rate and episodic shortness of breath. These signs show an increased in sympathetic tome and an inhibition of parasympathetic system. He also presents with a decreased weight per age. This may be attributed to the digestive upsets and the increased sympathetic outflow which increases metabolism and breakdown of fats in the body. These signs, though presented physically are an indicator of existing mental health issues. The relationship may be missed if behavioral symptoms are not clearly identified
Psychosocial therapy will address his emotional, social and mental dimensions in order to address anxiety disorder. This intervention includes a complex interaction between the past events and their interpretation with regards to their effect on the present ones (Ross, 2017). In mental health one may try to convince him that there are still other opportunities to explore in life beyond unemployment. All his problems seem to be centered around the fact that he is jobless and fears that he may not be in a position to support his family effectively. An attempt should be made to make him view the circumstance as just a challenge that will enable him be more constructive in life problems. He still within the working age and can secure a job. It might be an opportunity to think of he can start his own business. He can also be encouraged to create social bonds to help him cope and avert depression that may soon ensue without social help.
The anxiety can also be addressed using body mind techniques. Relaxation can be very helpful to help reduce the heartrate to normal. It involves a deliberate effort to concentrate one’s energy into addressing the issue that is stressful. Mr. Barry can benefit from a session where he is advised to practice meditation when he feels stressed up.
His disturbed sleeping pattern and digestive upsets may be offset medically. These symptoms have occurred secondary to anxiety disorder. Treating the primary cause will solve the secondary presentations (Morey, 2015). Pharmacotherapy is usually a second line approach in dealing with anxiety after other non-medical ones. Anxiolytic agents can be administered by the psychiatrist to alleviate these symptoms. Selective serotonin reuptake inhibitors are the first line drugs. Mr. Barry may benefit from this approach. TCA may be used as the second line if the SSRI fail to work.
Venlafaxine is a Serotonin and norepinephrine reuptake inhibitors (Procyshyn, Bezchlibnyk-Butler, & Jeffries, 2017). They increase the amount and time which free serotonin is available on its receptor. This leads to downregulation of the receptor. Serotonin regulates the mood and behavior such as appetite and sleep in an individual. this drug is prescribed as a remedy for anxiety. The drugs effect takes some time to set in. therefore the patient should wait for some time to allow for it to take effect and reduce the anxiety.
For a slow release capsule, Mr. Barry should swallow it whole. He should not try to crash them or chew them. The drug is taken with food. Sometimes, to make it easily consumable, one may opt to open it up and sprinkle it in food in order to take it in small duration intervals (Winner, 2015). This is okay as long as they don’t chew it and all the medicine is taken at ago. Nothing should be preserved for later consumption. He should try to consume the drug at approximately the same time to ensure that therapeutic concentrations are maintained throughout.
The drug should be stored at room temperature away from heat and moisture. He should continue taking the medicine even though sometimes it may seem as if it is not working. He should allow for some time for its effects to set in. if he feels that it is not working, he should not discontinue unless he is advised so by the doctor. Unpleasant side effects may be observed if the medication is stopped abruptly (Aftab, 2015). Mr. Barry rarely takes alcohol. Under this circumstances, he should not take any alcohol to avoid some side effects associated with its consumption while taking the medication. He should also avoid activities that require him to be alert such a driving. Venlafaxine impairs thinking and reaction. This may pose a threat to his safety if he is involved in dangerous activities.
Mr. Barry should be well aware of the side effects that are likely to ensue once he starts taking the medication. He should not be allergic to the drug thus he should be vigilant to catch any signs of allergy. It may result into a swollen tongue, rash, hives and difficulty in breathing. If such signs are noted, one should avoid using these drugs and seek medical attention.
He should be aware of probable drug interactions that may be dangerous (Spina, Pisani, & de Leon, 2016). In case they want to take NSAIDs, they should consult their doctor on the one they should take. There is an increased antiplatelet effect by using it with these drugs. This poses a great danger if they are injured since they may lose a lot of blood in the process. Other drugs that he should consult before taking are: any other anti-depressants, anticoagulants and drugs to treat migraine
According to Lader (2015), common side effects associated with venlafaxine include: changes in vision, dizziness, headaches, dry mouth, nausea, vomiting, diarrhea, insomnia, increased sex drive, sweating and fast heartbeats. He should be aware of these effects for him to be psychologically prepared. If they persist or increase he can always consult a doctor for further assistance. Immediately consult a doctor if seizures occurred.
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