CASE STUDY QUESTION 4 The three major problems or potential risks are: Intoxication: A close association has been observed among people suffering from mental health and their addiction to alcohol or other drug (AOD). Treatment of such patients becomes very difficult if AOD and mental health occurs simultaneously. Such people are more likely to face many “chronic medical conditions” (Sterling, Chi & Hinman, 2010, p.338-339) Self harm: The occurrence of self harm can be attributed to an action which is a result of severe “emotional distress”. In order to cope up with the situation such actions are taken (Maureen & Maureen, 2011, p. 28-29). Dependence: People suffering from mental illness like “depression” or “anxiety” tend to develop a dependence on smoking or alcohol. The dependence arises as a means of self medication or as a coping strategy. (Pederson & Soest, 2009, p.130) QUESTION 5 The nurses who are in charge of treating mental patients need to have a thorough idea about how to treat the patients because the process is very “complex” and “demanding”. (Ford et.al, 2009, p.113). The following interventions can be suggested. Intoxication: One has to monitor the physical and mental condition f Carol constantly. Any change in them can be crucial for her treatment. Documentation of the observations is necessary for future referencing and consultations. Self harm: an important element in therapeutic supervision is to focus in assisting the victim to develop self awareness and goal setting
(Buck & Lysaker, 2010 p.1). Carol’s mental condition can be attributed to her past and her lack of security in life. So here she needs to be motivated. As Carol has done this before so it’s important to supervise how much she intends to harm herself at present. Further a part of the treatment should be maintenance of a safe environment which is very crucial. Any sign of conflict or tension should be kept away from her else improvement would be negligible. Dependence: According to DSM, the problem of dependence is very severe (Hathaway et.al, 2009, p. 992). If dependence continues then the problem becomes more acute. In case of Carol one has to supervise to check signs of withdrawal. When Carol was brought in the hospital she was irritable, restless, and very anxious. She even complained of headaches. All these were there as she was dependent on alcohol and cannabis. If the above symptoms reduce overtime then they are the signs of withdrawal. Maintenance of hydration level is very important for the smooth working of the body. At this time it’s crucial that she doesn’t develop any physical illness. So a thorough monitoring of all vital signs is important. Question 6 The rationale for the above nursing interventions is as follows. Mental patients cannot be made treated by simple intake of pills. They need constant supervision and care of those in charge of them. Reasons for mental disorder can vary from person to person but the method hardly differs. Intoxication: Documentation is very vital in case of mental patients. It’s very important to record down the observations since the admission of the patient. The records reflect the care that was given and the accuracy of the patient’s condition. Documentation is also required also for legal purposes.(Importance of good record keeping for nurses, 2003). Such documentations are also vital for teaching medical students (Siegler, 2010, p.1). Self harm: Mental care patients are often not aware of their surroundings and end up doing something wrong. So supervision is very vital over here. The changes in the patient’s behavior and attitude over time can be very useful in its treatment progress. Through therapeutic supervision there is an enhancement in the quality of care for the patients (Rice, 2007 p.1). The environment around us is very important for our development. Hence it is very important for the nurses to keep the environment around such vulnerable patients as good as possible. The built-in setting has a direct and indirect consequence on psychological health (Evans, 2003 p. 536). Dependence: Treatment resistance, addiction to alcohol or drugs, etc. is few of the vital signs in mental patients. Their progress to a certain extent depends on the improvements in these signs. So there is a need to supervise it. Maintenance of hydration level is required so that no other complications arise. As dependence is a very crucial problem so to check the progress of the patient monitoring of withdrawal signs are very important. BIBLIOGRAPHY 1. Sterling, S., Chi, F. & Hinman, A. (2010) Integrating Care for People With Co-occurring Alcohol and other Drug Medical, and Mental Health Conditions. Alcohol Research and Mental Health, 33 (4), pp. 338-349. 2. Maureen, B. & Maureen, D. (2011) Helping people who self harm to care for their wounds. Mental Health Practice, 14 (6), pp.28-31. 3. Pedersen, W & Soest, V.T. (2009) Smoking, nicotine dependence, and mental health among young adults: a 13 year population based longitudinal study. Addiction, 104 (1), pp.129-137. 4. Ford, R., Bammer, G. & Becker, N. (2009) Improving nurses’ therapeutic attitude to patients who use drugs: Workplace drug and alcohol education is not enough. International Journal of Nursing Practice, 15 (2), pp. 112-118. 5. Buck, D.K & Lysaker, H.P. (2010) Clinical Supervision for the Treatment of Adults With Severe Mental Illness: Pertinent Issues when assisting Graduate Nursing. Perspective in Psychiatric Care, 46 (3), pp.234-243. 6. Hathaway, A.D., Callaghen, R.C., Macdonald, S. & Ericksion, P.G. (2009) Cannabis Dependence as a Primary Drug Use- Related Problem: The case for Harm Reduction- Oriented Treatment Options. Substance Use and Misuse, 44 (7), pp.990-1008) 7. Siegler, E.L. (2010) The Evolving Medical Record, Annals of Internal Medicine, 153 (10), pp. 671-w223. 8. Rice, F., Cullen, P., McKenna, H., Kelly, B., Keeney, S. & Richey, R. (2007) Clinical Supervision for mental health nurses in Northern Ireland: formulating best practice guidelines. Journal of Psychiatric and Mental Health Nursing, 14 (5), pp. 516-521. 9. Evans, W.G. (2003) The Built Environment and Mental Health. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 80 (4), pp.536-555.