Mental Health –Nursing The Medical Practitioners

Question: Describe about the Mental Health Nursing for The Medical Practitioners. Answer: Effective communication is of great importance for a nurse and the medical practitioners in general. This is because effective communication helps the nurse to understand the intentions and the emotions of a patient. Communication is a two way street (Fitzpatrick, Kazer, 2012). Its not only about how you listen and convey a message but also how you listen and gain the full meaning of what is being said and make the patient feel that he is heard and understood. In this scenario, some of the best communication skills that I will use as a nurse include; becoming an engaged listener (Fitzpatrick, Kazer, 2012). Paying attention to what Thomas is saying will help him feel that he is being understood and his grievances are well heard. Being an engaged listener will greatly help in understanding emotions that Thomas is trying to communicate aside from understanding the words that he is using. Engaged listening is different from simply hearing (Capps, 2010). As an engaged listener, I will b e able to hear the subtle intonations from Thomas voice and this will help me understand how he is feeling and the information he is trying to pass. By using this method of communication, I will be able to connect with Thomas and this will result in building a connection between us and further help in reducing stress and improve his emotional well-being (Fitzpatrick, Kazer, 2012). I will achieve this by focusing on what Thomas is saying, showing interest on what he is saying and by avoiding interruption or redirecting the conversation to him. Paying attention to Thomas nonverbal communication signals is also essential while engaging with him. This is because; most of the things that affect him will be communicated through nonverbal signals. This will include his facial expressions, posture, eye contact, voice tonal variation among others. In order to achieve this, I will use body language that will convey a positive feeling towards Thomas, adjust my nonverbal signals to suit the co ntext of our conversation with Thomas and finally by using signals that matches with my words. Keeping stress in check will also boost our communication. Despite knowing that Thomas may be suffering from depression, it is important to first listen to him by staying calm until we connect and he calms down. Once he is calmed, offering him guidelines in calm and in a positive way while trying to relate to his issues will help in lowering his stress and compose his emotions (Fitzpatrick, Kazer, 2012). This is achievable by using stalling tactics, where I give myself time to think before asking or responding to Thomas, delivering my words clearly and wrapping my words with a summary. Some of the clinical signs and symptoms that Thomas has already shown include; hallucination, delusions and catatonia. Hallucination is said to be a sensory perception that emanates from the absence of the external stimuli. Hallucinations usually occur in many senses and it is commonly likely to take any form and sensations such as smell, taste and color (American Psychiatric Association, 2016). Thomas thinks that customers are negative about him. Thomas is hallucinating on this as he is not even certain if thats what the customers are thinking. At first, Thomas is described as a neatly dressed young man. Dressed in a business shirt and trouser. This indicates that Thomas is hallucinating about himself being dirty. Thomas is also suffering from delusion. In our case, when Thomas is asked how the customers are troubling him, he says that he thinks that the customer are accusing him of bad things and being dirty. Thomas immediately says that he knows the customers arent actually saying this directly to him but he knows thats what the customers are saying when he is not looking at them. This is a clinical sign for delusion. Patients suffering from psychosis suffer from delusion beliefs which are usually paranoid in nature (American Psychiatric Association, 2016).Thomas thinks that the customers are negative about him without any evidence. Changing delusions is usually very difficult as the patient already believes that it is the reality (Capps, 2010). Delusions are said to be persecutory. This makes an individual to believe that another person is out to harm them. Delusion can be categorized in to primary and secondary delusion. The primary delusion usually arises suddenly and the patient becomes unable to comprehend with the normal mental processes (American Psychiatric Association,2016).Secondary delusion is usually influenced by an individuals background of his current situation such as ethnicity, superstitions or religious beliefs. Thomas is most likely to be suffering from primary delusion as he is unable to comprehend with normal mental process. The third sign and symptom that Thomas has shown is catatonia. This is a condition where the patient gets agitated and the experience of reality is said to be impaired. Thomas is nervous and irritated. He is constantly moving and is unable to sit still. He is also unable to interact with other patients saying that he is confused and worried. These are the indications that Thomas is suffering from catatonia. There are two types in which catatonia can manifest itself. One is where the patient is unable to interact or move with the world and this usually presents itself with waxy flexibility (Freudenreich, 2008). The other catatonia is associated with outward presentation where a patient gets agitated. This involves extreme mental occupation which prevents the patient from facing the reality. Thomas is suffering from the second type of catatonia. There are notable educational remedies that can be given to psychotic patients that help in treating emotional disorders that are common. The cognitive behavioral approach is one of the methods that focus on the theoretical models which help in offering treatment to patients like Thomas. The best education that I will give Thomas for his medication is the cognitive therapy (Swerdlow, 2010). Through this educational therapy, Thomas will be able to talk about his experiences and thus develop strategies that will help in collaborative discussion. Offering the cognitive behavioral therapy which is commonly known as CBT has proved to be effective and efficient especially when administered alongside the standard care (Capps, 2010). This type of medication therapy helps in treating delusions and hallucinations something that Thomas is suffering from (Swerdlow, 2010). The main aim for offering Thomas a CBT medication is to help him identify thinking patterns that are not helpful and the emot ions that may make him get unwanted feelings. This will help Thomas in replacing the thoughts he has with a more realistic and balanced thoughts and behavior. Family therapy is also one of the best medication educations that I will give to Thomas .After the episode of psychosis that Thomas has experienced, he will require more support from his family. After discussing with Thomas, he informs us that he has a partner who can come get him. We will educate the partner and Thomas on the importance of having a family therapy apart from taking his medication dosage appropriately (Freudenreich, 2008). The 5mg of olanzapine administered to Thomas by the doctor is used in treating depressive episode such as the one Thomas is suffering from. The dosage should be taken daily and it is important for Thomas not to miss the appointment given to him. The above dosage can be combined with fluoxetine but when instructed by the doctor. Group psycho education will also be important to Thomas and his p artner (Freudenreich, 2008). This helps in familiarizing Thomas with the major cause of the disorder and teach the partner on the signs that Thomas is likely to exhibit to indicate relapse and finally to train Thomas on the social skills that will help him in recuperating .This will ensure that we also inform Thomas that failure to take his medication may have effects on his treatment and it is more appropriate if he adheres to the dosage and information that is given to him by the doctor (Swerdlow, 2010). Non medical compliance remains the greatest challenge that psychiatrists are facing. Between 20-50% of psychotic patients do not comply (Brunner, Smeltzer, 2010). One of the most suitable ways of ensuring that Thomas adheres to his medication and appointment is by using the cognitive adaptation training and environmental support. This is one of the most effective way of making a psychotic patient to adhere to his medication and appointment; it includes the use of technology in the development of more sophisticated pill storage containers such as the med-emonitor which is capable of storing medicine for a patient for over a month and also store more than 5 different types of medication. This device will help Thomas take his medicine at the appropriate time (Brunner, Smeltzer, 2010). It will also remind Thomas on the importance of taking his medicine and the goal he is aiming to achieve at the end. The device will also alert Thomas that he is taking the wrong medicine or if he is tak ing the medicine at the wrong time. Thomas will also be able to update us on the side effects he may experience as a result of taking his medication as the device is directly connected to the doctors web. Through the use of this device, the doctor will be able to know if Thomas is not adhering to his medication as the device will send signal when he fails to take the medicine (Swerdlow, 2010). The other suitable method that we will use on Thomas is the cognitive behavioral therapy. One of the major reasons that can make Thomas not to comply on taking his medication is his attitude towards his medication and the degree to which he is willing to accept that he is suffering from psychosis and that he needs the treatment. This will help us understand the likelihood of Thomas adhering to his medication and appointments. If we realize that Thomas does not accept that he is suffering from schizophrenia we will consider giving him the cognitive behavioral therapy so as to influence his feel ings (Brunner, Smeltzer, 2010). This will help in treating the irrational thoughts that Thomas is suffering from and challenge his thoughts by developing a plan that will help in replacing the irrational thoughts with a more helpful thought. As a result of this, Thomas will be able to accept his condition and see the importance of adhering to the appointments given to him by the doctor and also taking his medications as prescribed (Capps, 2010). Reference American Psychiatric Association,. (2016). Schizophrenia spectrum and other psychotic disorders: DSM-5 selections. Brunner, L. S., Smeltzer, S. C. O. C. (2010). Brunner Suddarth's textbook of medical-surgical nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams Wilkins. Capps, D. (2010). Understanding psychosis: Issues and challenges for sufferers, families, and friends. Lanham, Md: Rowman Littlefield. Fitzpatrick, J. J., Kazer, M. W. (2012). Encyclopedia of nursing research. New York: Springer Pub. Freudenreich, O. (2008). Psychotic disorders: A practical guide. Philadelphia: Wolters Kluwer Health/Lippincott Williams Wilkins. Swerdlow, N. R. (2010). Behavioral neurobiology of schizophrenia and its treatment. (Springer eBooks.) Heidelberg: Springer.