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NURS2098 Complex Mental Health, Trauma & Recovery

29 Sep 2020 46 Views Sarah

NURS2098 Complex Mental Health, Trauma & Recovery

Q1 Part A: Identify and Describe two Key Concepts relevant to the Assessment of Suicide Risk as undertaken by MH Nurses in their practice (80 words / 2 marks).

The assessment of suicide risk by MH nurses focus on two key concepts of protective (reduce chances of suicide) and risk (increase suicide probability) factors linked with the patient. The risk factors in Derek’s case are the recurrent flashbacks of his serious motor vehicle accident, his job loss and certainly the recent trauma of his youngest son’s movement to London for employment. The protective factor in Derek’s case is very low in comparison to risk factors and increases the suicide risk. There is only the protective factor of his supportive wife and kids.

Q1 Part B: Identify and Describe three specific Mental Health Nursing Interventions essential to the MH Nursing Suicide Risk Assessment of ‘Derek’.

Your Response should describe the intervention itself and provide commentary on why and when it would be undertaken by the MH Nurse (120 words / 3 marks).

Ø  Derek needs consistent presence of a professional or a family member all the time with close monitoring and supervision to keep check over his behaviours and outcomes. Suicide is quite impetuous in majority of cases as probable in this case with no warning. It is because Derek had suicide attempt once and is presently present factors promoting suicide such as insomnia, anhedonia, energy loss, congruent effect, and low mood most of the time with poor self-care making him guilty and hopeless

Ø  On daily basis, Derek should be involved in open communication and given chances and encouragement to define his thoughts and feelings starting from surrounding environment to his personal life. This will give a look into his self-harm thoughts and intentions and can support in decreasing its intensity.

Ø  Derek should be referred to cognitive-behavioural therapy within 2 days from now to help him overcome his negative thoughts and apply effective self-management techniques.

Q2 Part A: Identify and Describe two Key Concepts relevant to ONE of the three following therapy models Motivational Interviewing (MI), Cognitive Behavioural Therapy (CBT) or Acceptance & Commitment Therapy (ACT) as undertaken by MH Nurses in their practice (80 words / 2 marks).

Motivational interviewing is most applicable in Alice’s case and this therapy model is applied with two key concepts. First, motivational interviewing (MI) is to be applied with the key motivation of changing the client, but this motivation should be evoked from client’s side only. Secondly, the client is to be involved and encouraged to identify his/her issues and then search for the best solutions. The counsellor has to put in efforts to guide the conversation and client’s thoughts, the outcome has to be articulated by client itself.

Q2 Part B: Identify and Describe three specific Mental Health Nursing Interventions (specifically linked to the Therapy Model discussed in your Part A answer), that could be utilised in the care of ‘Alice’.

Your Response should describe the intervention itself and provide commentary on why and when it would beundertaken by the MH Nurse (120 words / 3 marks).

Ø  The very first conversation with Alice should be about her family and friends. This is necessary to make her understand her family as her strength, certainly her mother and friends who have always supported Alice. This will also develop positive mental perspective in life in the beginning to encourage her on right track.

Ø  Alice feels lonely and detached from life post her father’s death. Thus, the MH nurse has to focus on using presence, verbalization, good behaviour and supportive touch with her permission to make her develop the feel that she is not alone. This will also encourage her to open up more and talk more.

Ø  The MH nurse should convey a positive and an accepting attitude towards Alice during every interaction or meeting with Alice by making frequent and brief contacts. This is also to show unconditional positive regard. This accepting nursing attitude will increase Alice’s feeling of self-worth and will also facilitate trust. This is a way to convey the belief of client being worthwhile.  

Q3 Part A: Identify and Describe two Key Concepts relevant to Mental Health Nurses in working effectively with the Carers and Families of Mental Health Consumers (80 words / 2 marks).

When MH nurse works with carers and family members of clients, the nurse has to accept the client as a whole person with his/her strengths and weaknesses through the empathetic approach and avoidance of non-judgmental behaviour. Moreover, the MH nurse also has to be consistent in nursing actions and procedures to make client feel safe and secure in every condition. Consistency needs to be in every nursing behaviour, work and client approaches.

Q3 Part B: Identify and Describe three specific Mental Health Nursing Interventions that are (specifically) informed by the principles of Family Sensitive / Carer Inclusive Practice that would be appropriate in the MH Nursing care of the Consumer ‘Sian’ and her Family.

Your Response should describe the intervention itself and provide commentary on why and when it would be undertaken by the MH Nurse (120 words / 3 marks).

Ø  Whenever Sian is approached for any nursing activity or caring behaviour, the nurse has to be neutral and firm in approach to prevent any argument, conflict or struggle in management. Such actions can be strong in triggering manic episode or escalating her negative thoughts.

Ø  Within next 24hours, the nurse has to have an in-depth conversation with Sian’s family members for acknowledging their level of education about Sian’s health condition, health education and identifying their needs. This is necessary to assure effective partnership.

Ø  Daily Sian must be involved in structured and solitary activity with consistent plan and schedule. It will improve Sian’s focus and will make her feel secure.

Q4 Part A: Identify and Describe three Key Concepts relevant to Trauma Informed Care as utilised by MH Nurses in their practice (120 words / 3 marks).

First concept is focused on maintaining trust that is necessary for developing and being consistent with interpersonal boundaries and having clarity of the expectations. This assists in keeping client involve more and understand more. The second concept of trauma informed care is to focus on client’s strengths and empower him/her for building the strengths while developing improved coping skills that gives a healthy base for client to fall back on if client stops taking services. Third concept is to provide more choices and opportunities to client. With choices, client feels to have the control in the service experience and achieves a collaborative effort from the healthcare team members. It ensures more consumer participation and respect towards client rights.

Q4 Part B: Identify and Describe four specific Mental Health Nursing Interventions that are directly informed by the principles of Trauma Informed Care, and that would be appropriate in the MH Nursing care of ‘Brie’.

Your Response should describe the intervention itself and provide commentary on why and when it would be undertaken by the MH Nurse (180 words / 4.5 marks).

Ø  The foremost nursing act is to develop respect and trust in the nurse-patient relationship with key focus on applying a therapeutic approach. It should last till the treatment finishes. This is necessary as Brie has been a victim of trauma and probably Brie can misinterpret the nurse statements. The nurse must not ask questions before the development of trusting relationship.

Ø  Brie has history of traumatic events and suicidal ideation. Thus, nurse has to mandate that one nurse is present with Brie all the time and if nurse is not available, Brie’s family member has to be there with her to avoid self-harming acts and to avoid any panic attack. Physical safety is more demanded by such patients during anxious situations.

Ø  Brie should be involved in motivational interview (MI) session once a day for 3 days consistently to acknowledge her needs, strengths and issues in her life from her mouth in a calm and composed environment. MI will make Brie understand her needs and strengths and participate effectively for gaining control and better life.

Q5 Part A: Identify and Describe three Key Concepts relevant to the Recovery Model of MH Care as utilised by MH Nurses in their practice (120 words / 3 marks).

Foremost concept required is the right attitude of the nurse towards the client in all conditions and pay active listening to client and make client talk more and express more. This instils hope in client and assures that client human rights are protected. The second concept is to focus on respecting and valuing dignity of client with honest and open communication. This challenges any form of discrimination if persists and also eliminates it as soon as plausible. Third concept to follow participation and communication to acknowledge that every client is expert in one’s own life and recovery kindly involves partnership with client and carers for better support in a sensible manner. It is to involve in working in realistic and positive ways for better realisation of goals and aspirations.

Q5 Part B: Identify and Describe four specific Mental Health Nursing Interventions that are (specifically) informed by the principles of the Recovery Model of MH Care, and that would be appropriate in the MH Nursing care of ‘Heintje’.

Your Response should describe the intervention itself and provide commentary on why and when it would be undertaken by the MH Nurse (180 words / 4.5 marks).

Ø  Heintje needs daily structuring of activities on one-on-one basis with proper inclusion of Heintje in all activities. This will help him develop a sense of safety in all environments and situations. Heintje’s needs and wishes have to be structured accordingly to make him feel valued and respected.

Ø  Heintje’s delusions make him incapable in focusing on his daily activities and due to this he has lost his job and lack of finances to support his needs. Thus, he should be involved in simple but concrete activities for accomplishing better focus such as cooking, painting and dancing and the outcomes must be evaluated daily and should be discussed with him to make him reality-focused.  

Ø  Empathetic approach in all sessions with Heintje is the necessity of the condition and mental health status. This will assure that client is being understood and he is being accepted in all phases without any discrimination or stigma in any form. Empathy is also necessary as his delusions have distressing effect on him. This will also convey caring approach to him and will improve his interest in therapeutic sessions.

References

Beckett, P., Holmes, D., Phipps, M., Patton, D., & Molloy, L. (2017). Trauma-informed care and practice: Practice improvement strategies in an inpatient mental health ward. Journal of psychosocial nursing and mental health services55(10), 34-38.

Lawrence, P., Fulbrook, P., Somerset, S., & Schulz, P. (2017). Motivational interviewing to enhance treatment attendance in mental health settings: A systematic review and meta‐analysis. Journal of psychiatric and mental health nursing24(9-10), 699-718.

The Department of Health. (2010). Principles of recovery oriented mental health practice. Available at- https://www1.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-i-nongov-toc~mental-pubs-i-nongov-pri#:~:text=Recovery%20oriented%20mental%20health%20practice%3A,services%20or%20the%20broader%20community.