At the beginning of Lisa’s admission, performing a comprehensive and holistic psychiatric assessment is a vital role of a mental health nurse. This process will help the nurse to gather more information in response to client’s presenting condition and aspects of her life, such as living conditions, finances, support system, symptoms and overall physical health and to decide for the treatment plan (Reavley, Morgan, Jorm, 2014). The purpose of the comprehensive assessment is to communicate with the patient and establish a therapeutic relationship in order to identify the underlying concerns, to clarify the client’s mental health concerns, and to rule out any risk towards herself and others (Harder, Munro, Gaynor, 2014). Moreover, it is also a chance to assess Lisa’s history, her presenting problem and or issues, her family history, and the availability of social and family support that can help in her treatment plan (Harder, Munro, Gaynor, 2014).
Factors to consider that might contributed to Lisa’s relapse:
1. Non-adherence to medication
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Based on a study there is about 80% of patient who experienced episodes of relapse due to poor medication compliance (Frankenburg, 2015). It is likely predicted that 50% of patients with chronic illness such as schizophrenia are likely to result in poor compliance with their medication after six months due to several factors such as hectic schedule, inconvenience to their daily activities or simply perverse refusal to take medications due to contributing factors in their environment, social or personal problem that has a direct impact to self esteem and perceived role as a parent and as part of the community (Barkhof, Mejer, de Sonneville,
The term addiction can be interpreted in many ways, concering both illegal and legal substances. Not only can one become addicted to a substance, but also activities like gambling, shoplifting, and sex. Prior to considering addiction, one must first understand what constitutes a substance. Levinthal (2002) describes a drug as a chemical substance that changes the functioning of the body when ingested (4). Although illegal drugs may come to mind when hearing this definition, alcohol and tobacco fit under this criteria as well. For the purpose of this essay, controlled and regulated (licit/legal) substances will be focused upon. Alcohol is a regulated substance that can be thought of as a social drug (Levinthal, 2002, p.192) and arguably tobacco
Schizophrenia is a deteriorating progressive disease, consequently, it is resistant to treatment for the individual suffering schizophrenia. (Catts & O’Toole, 2016). In most cases the individuals suffering from schizophrenia, are resistive to treatment, in most cases, individuals suffering from schizophrenia, and are resistive in taking antipsychotics. (Catts & O’Toole, 2016). Jeremy doesn’t see himself as a “schizophrenic”, he states that “he’s happy naturally”, and often he’s observed playing the guitar and doing painting in his room. Weekly, he has an intramuscular medication to treat his disorder, crediting the support of his wife. It is indicated that the morality rate, in patients suffering from schizophrenia is higher, despite the considerable resources available, in Australia. New data show that in 20 countries, including Australia, only 13.5% meet the recovery criteria, which means that 1or 2 patients in every 100, will meet this criteria per year. (Catts & O’Toole, 2016). This means that there’s a decline in providing support and services to individuals like Jeremy suffering from a mental illness such as Schizophrenia. Many individuals become severely ill before they realise they need medical treatment, and when receiving treatment it is usually short-term. (Nielssen, McGorry, Castle & Galletly, 2017). The RANZCP guidelines highlights that
The CPA is a care management process for people with mental health and social care needs, including managing associated risks. The CPA main elements are: Assessment, Care coordinator, Care planning, Review, Transfer and Discharge. The National Standard Framework for Mental Health introduced it to supply a framework for effective mental health care (DOH, 1999; DOH, 2008; Gamble, 2005). Under CPA, John may use an Advance statement to illustrate his personal preferences and what he would like to happen in regards to his personal and home life should they come to lack capacity. These are important mechanisms for safeguarding and promoting a patient’s interests and health. The CPA is grounded in values and principles that are central to personalisation brought about when in March 2008 ‘Refocusing the Care Programme Approach’ was issued. This updated guidance highl...
Stuart, G. W. (2009). Principles and Practice of Psychiatric Nursing (9th ed. pp 561). St. Louis, MO: Elsevier Mosby.
According to Gamble and Brennan (2000), the effectiveness of medication for schizophrenia to relieve patients from psychotic symptoms is limited. Although patients have adequate medication, some received little or no benefit from it and almost half of them still experience psychotic symptoms. They are also more likely to suffer relapse (Gamble and Brennan, 2000). Furthermore, Valmaggia, et al. (2005) found that 50% of patients who fully adhere to anti-psychotic medication regimes still have ongoing positi...
Within the assessment parts of the clients life that should be addressed are as followed: mental, physical, and emotional health of the client. Through asking a series of questions to the client the professional will access the background information of the client such as their history with suicide, employment, education, drinking or drug history, family history or the religion they practice (McNeece & DiNitto, 2012). Professionals use the CCA to establish and provide the needs of the
The physician will question the patient about any stressors she may be contending with at home or work prior to her entering the hospital. The physician will order lab tests and speak with the patient to understand the psychological factors; a referral will be made for making a final diagnosis. After the physician reviews both lab tests and the psychological factors, a referral will be made for the patient to see a clinician. The referral will focus on obtaining support and stabilization. The clinical assessment will gather information using written forms as a first step, including releases to speak with family members. The second step would be to invite the family along with the client in an effort to obtain a better understanding of existing medical conditions along with any past mental disorders. Abuse as a child or abuse as an adult will be determined. The clinician will evaluate if the client is portraying any signs due to alcoholism or a drug addictions. An example of one question her clin...
...umbers don’t seem to be out there. If anyone happens to find any rates of relapse for Schizoaffective Disorder please send us an email! However, it seems to be agreed that a relapse can happen and is more likely to happen if no medication is taken. This is one reason that it is extremely important to be sure the patient continues any prescribed medications. No medication should ever be stopped without speaking to your doctor. Remember, your doctor has your best interests at heart so it is important to keep him or her up to date on your situation.
Classical antipsychotic treatments are commonly used to treat schizophrenic patients with major positive symptoms of schizophrenia, such as Thorazine, Haldol, and Stelazine (Gleitman et al., 2011). Antipsychotic treatments are usually administered with a variety of psychosocial treatments including social skills training, vocational rehabilitation, supported employment, family therapy, or individual therapy (Barlow & Durand, 2014). This is to reduce relapse and help the patient improve their skills in deficits and comply in consuming the
Rather than preparing graduates in education or consulting as previous graduate nursing programs had done, this program educated psychiatric-mental health nurses as therapists with the ability to assess and diagnose mental health issues as well as psychiatric disorders and treat them via individual, group, and family therapy (ANA, 2014). Thus, the Psychiatric Mental Health Clinical Nurse Specialist (PMH-CNS), one of the initial advanced practice nursing roles (Schmidt, 2013), was born. After Community Mental Health Centers Act of 1963 led to deinstitutionalization of individuals with mental illness, PMH-CNSs played a crucial role in reintegrating formerly institutionalized individuals back into community life (ANA, 2014). PMH-CNSs have been providing care in a wide range of setting and obtaining third-party reimbursement since the late 1960’s. In 1974 a national certification for PMH-CNSs was created (APNA, 2010). Subsequently, PMH-CNSs began to be granted prescriptive privileges in the Pacific Northwest in the late 1970s, that practice has now spread to 37 states and the District of Columbia (APNA,
Greg is an individual who has experienced a traumatic event while being intoxicated while being on the job. Greg was a paramedic and had come to a bad accident where a five-year-old boy was injured. The young boy had several injuries and Greg was responsible for providing him with the proper care. The unfortunate part is that Greg was intoxicated while on the job and he was not thinking clearly while making decisions involving the boys care; as a result, the boy’s death could have been prevented. This event turned Greg’s life upside down, this never would have happened if Greg would not have been intoxicated while being on the job.
The sample generalist assessment used focuses on the client’s: living skills; health and disability; educationemployment; legal issues; housing; significant relationships; understanding of the issue; demographics; and crisis management (National Council of Social Service, 2006). The social worker has the opportunity to delve further into those areas if deemed necessary by their agency (National Council of Social Services, 2006). The competency-based assessment is a complex assessment tool developed for use in mental health settings. Gray and Zide (2007) wrote the book to foster and build on the human focus of social workers and to provide a counterbalance to the deficit focused Diagnostic and Statistical Manual of Mental Disorder (DSM) when working in mental health settings. Several theoretical frameworks are evident in the competency-based assessment and clearly articulated in the provided excerpt from Gray and Zide (2007).
My experience in mental health clinical was very different from any other clinical I had before. In a mental health clinical setting, I am not only treating client’s mental illnesses, I am also treating their medical problems such as COPD, diabetes, chronic renal failure, etc. Therefore, it is important to prepare for the unexpected events. In this mental health clinical, I learned that the importance of checking on my clients and making sure that they are doing fine by performing a quick head-to toes assessment at the beginning of my shift. I had also learned that client’s mental health illness had a huge impact on their current medical illness.
Varcarolis, E. M., Carson, V. B., & Shoemaker, N. C. (2006). In Foundations of Psychiatric Mental Health Nursing (p. 283). St. Louis: Elsevier Inc.
Walsh, A & Clarke, V. (2009) Fundamentals of Mental health Nursing New York: Oxford University Press.