I have been able to establish a nurse-client therapeutic relationship through; understanding of the client’s needs (restoring self-esteem and confidence), therapeutic communication and building a rapport with the client (Townsend, (2014). ). This has helped in gaining trust, confidence and maintaining privacy. I have also developed mental health assessment skills for new and old patients.
I have experienced quite a number of frustrations. Some of which are patient centered which include: anger, hostility and physical aggression (Foster, (2013). Anger has contributed to the physical and emotional problems interfering with inter and intrapersonal relationships. Hostility (verbal aggression) on the other hand, has caused lack of cooperation and violation of norms which usually leads to physical aggression.
I have tried to counter these challenges by avoiding overcrowding of the patients for this triggers the hostile behavior. I have also been able to closely monitor them for early identification of the aggressive behavior and assist them in verbal redirection. The use of quiet time and seclusion has helped most clients to cope with these challenges by avoiding direct contact with the stimuli. Having adequate number of staff can help in time of this crisis to help me. Also the input of a psychiatrist to prescribe sedatives and antipsychotic medications may provide paramount support.
In the next one month I need to gain competence in the mental status examinations skills that determine the appropriate clients for admission and the possible management required by the individual client (Feng, (2011). Also maintain strong interpersonal skills, mental health nursing care and effective communication skills are my area of concern to improve the relationship with the patients (Hamric, . (2013)).
The manager should set objectives and goals to accomplish. This helps me in deriving motivation towards achieving them hence obtaining satisfaction after meeting them. My colleagues has helped in the orientation to the place of work, coaching me and much more being available to help when needed (Hamric, . (2013)). Team spirit offered by my coworkers has helped me realize my potentials in provision of quality of care. Clinical nurse educator, apart from teaching me on ways of patient management can also recommend me for further training on the mental health nursing programs.
Implementing evidenced based practice was my major setback. Provision of quality of care was not to the set objective. This was contributed by unavailability of the updated, reviewed and evaluated literature within the hospital settings which stipulate the guidelines for provision of quality care (Townsend, (2014). )
I have acquired the professional nursing behaviors which include collaborative approaches, teamwork and multidisciplinary team working, critical analysis and critical thinking (Hamric, . (2013)). Planning of nursing care, therapeutic nursing behavior (respect for personal space), clinical intervention and appropriate and adequate use of assessment tools are among the experts I have acquired.
Helping meet the needs of patients has been one of the main satisfying aspects of the job. Watching a previously depressed client putting a smile on the face and patients obtaining sanity is so impressing and encouraging. Also, patient’s ability to demonstrate effective copping mechanism to life stressors and achieve self-care needs.
Feng, Z. H.?S. ((2011). Use of physical restraints and antipsychotic medications in nursing homes: a cross?national study. . International journal of geriatric psychiatry.
Foster, C. B. ((2013). Aggressive behaviour on acute psychiatric wards: prevalence, severity and management. Journal of advanced nursing Routledge., 140-149 .
Hamric, A. B. (. (2013)). Advanced practice nursing: An integrative approach. Elsevier Health Sciences.
Townsend, M. C. ((2014). ). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
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