Nurses engage in clinical reasoning in order to provide effective and consistent care. According to Kozier et al (2014) clinical reasoning is “the thought process used to assess a clients evolving situation and health concerns, gather data and make decisions to solve problems within a particular clinical context to achieve better client outcomes” (p. 408). Elstein and Bordage (as cited in Jones, et al, 2009) stated that “clinical reasoning as the way clinicians think about the problems they deal with in clinical practice” (p. 516). When the nurse assess, gathers data and provides interventions to the client, they are using clinical reasoning. This framework is important when caring for patients with ASPD because these patients can act impulsively leading to an unstable hospital unit. According to Jackson (2014), assessment of the ASPD patient needs to be accomplished quickly and decisions regarding care must be decided promptly because the behavioural situation can change rapidly.
Antisocial Personality Disorder
According to the DSM-V, ASPD diagnosis is made when “individuals have a history of symptoms of conduct...
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... The nurse should not view the inability to permanently change the behaviour as a failure of the care plan. Instead the nurse can reflect on the situation and apply what was successful to next patient.
In conclusion, the nurse must have clinical reasoning skills when caring for an ASPD patient in order to keep the hospital unit safe from the effects of the manipulative behaviour. Once the nurse is able to assess the type of manipulation that is occurring, it is important to address it promptly. This can be done by providing structure that will deter the behaviour. Maintaining rules on the hospital unit are done through setting limits, and consistently addressing the manipulative behaviour. Although his behaviour can be difficult to change, the nurse can measure his or her success of the care through how safety was maintained on the hospital unit.
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