Mental Health Nursing - Case Study Example

? Mental Health Nursing Inserts His/Her Inserts Grade Inserts (10 12, Outline Introduction 2. Care planning 2.1. Needs 2.2. Short term goals 2.3. Long term goals 2.4. Interventions 2.5. Evaluation 3. Reflection 4. Conclusion Mental Health Nursing 1. Introduction This assignment paper conducts a case study on mental health. From the case study an assessment and a care plan will be designed and implemented. I will give an evaluation after the assessment and care plan are done to meet the patients needs. I will achieve this by identifying health problems and give interventions for the same. Confidentiality is important and therefore I will not expose the identity of my patient, I will identify her as Janet (not her real name). This is because the NMC (Nursing and Midwifery Council) code of conduct stipulates that people’s rights to confidentiality must be respected by professional nurses while giving health care. For that reason a nurses should explain to the client how and why information concerning their health is shared by healthcare professionals involved in the particular client’s health. As a result, good communication amongst healthcare professional facilitates understanding and working relation between them (Goldsmith, 2011). Janet has a problem of increasing low mood. I will implement nursing interventions such as cognitive behavior therapy, interpersonal therapy behavior therapy, mindful based cognitive therapy, medical intervention and support. In addition, I will define care planning and discuss its significance. Moreover, biopsychosocial model together with recovery framework are incorporated in the delivery of the clients health care. This paper will be informed by the use of relevant references from books and journals. 2. Care Planning 2.1. Needs The case regards Janet who is about to complete her studies in engineering. She is twenty two years and originates from Britain. Her free time is spent in the gym and cycling. She does not get along with her three roommates. The recent past shows that her mood is low; concentration is low, has no appetite and lacks sleep. Besides being unable to follow routine activities, her performance in class is dwindling after losing interest in learning. The physician prescribed antidepressants after diagnosing her with depression. The mental health nurse can use nursing intervention to assist the client recover from depression. The depression has caused the problem of low mood. A number of interventions that are useful for recovery have been identified and will be implemented in a care plan. Therefore Janet’s needs and problems are: low mood low appetite poor relationships low concentration lack of sleep no interest in studies unable to follow routine Depression is a mood disorder which manifests in different ways for different people. Depressed individuals complain of emptiness and feel sad. They become pessimistic and engage in negative thinking. A feeling of hopelessness sets in and they isolate themselves. They become restless and keep away from usual activities. Depression may cause individuals to become irritable and lead to poor relationships with others. They may end up losing interest in activities they have enjoyed doing and even abandon their hobbies. Because of many changes and engagement in thinking, individuals with depression lack concentration capabilities, forget important details and become indecisive when making choices. Their sleep patterns changes with either long episodes of sleep or lack of sleep. Lack of appetite or augmented appetite is common in depressed individuals. Consequently, depressed individuals complain of headaches, digestive problems, pain, aches and cramps. The client has symptoms such as loss of concentration, loss of appetite, lack interest at school and normal functioning is affected. According to Barrett et al (2008) a care plan is significant in providing quality care to patient. It assists the nurse treat the patient according to needs. The purpose of care plan is to identify the unique role of the nurse and clearly describe goals and outcomes. Consequently, consistent care can be given with other team members from different departments in healthcare profession. As a result, holistic treatment is given to the patient. The plan will include the social, physical, emotional needs of the client that are related to the loss of mood. It is customized according to the goals and needs of the client at different stages of care. I will involve the client when making the care plan to identify problems and solutions to the needs. It will help to make attainable and measurable goals if the client is involved. The care plan organizes, directs, individualizes and gives the intervention a meaning. Because of consistency, patients have confidence in the care plan. Time and resources are used effectively and efficiently as well. A care plan is a nursing process which begins with an assessment. Assessment entails gathering of data relevant to the client. The data should have information on the patient’s medical history with details that will help identify individual need. The information covers personal life, career and professional views. The next stage entails identification of the problems. The problems are recognized after analysis and interpretation of the information provided. Low mood that the client is showing is a disorder. It makes the client to have difficulties while doing day to day chores. Often, low mood can lead to other problems such as hopelessness, gilt and sleep disruptions. The plan is written in the next stage where goals are written and solutions found. It is important to get the input of the client when writing this plan so that the goals are achievable. The plan will be laid out step by step as a guide to recovery. The next stage is implementing the interventions. I will carry out the implementation step by engaging the client. This will be through interventions that are discussed bellow. 2.2. Short term goals The short term goals will be for Janet to: become involved in cycling every day for three months develop and maintain relationship with the roommate and go jogging for three months attend all class regularly as required perform in her class work 2.3. Long term goal Nursing requires time to give full assistance in the case of depression. The loge term goals are as follows: I will assist Janet reduce episodes of low mood so that the client is able to function normally by enrolling her in a peer support group for three months. I will help her make and maintain a friend every week for three months. Therefore, her performance will not be affected by depression. I will encourage her to engage in sports, attend class regularly and develop interest in studies and attempt to support her begin functioning normally. I will help her deal avoid negative thinking 2.4. Interventions Janet’s depression can be treated different approaches and recovery framework. I will supervise Janet’s case to ensure that she learns to adjust with the treatment given. This corresponds with the NMC code of conduct that nurses endorse the well being of patients under their care. The treatment will cover biopsychosocial model, psychological treatment for depression, medical treatment and support mechanism. This intervention can be used because it will give a holistic approach to depression when treating depression. The causes of her depression maybe physical and social; hence, neglecting them would not be solving the problem (Rowe, 2003, p. 101). I will apply biopsychosocial model in the implementation stage to help the client recover. Frankel et al (2003, p. 8) reveals that, biopsychosocial model was propounded by George Engels. Engels believed that the interaction between biological, psychological and social factors give understanding of health and ill health. The mind, body and environment contribute to the development of disease. Cohen and Brown (2010, p. 89) add that, biopsychosocial model can be used in the treatment of mood disorder. Biopsychosocial call for interrogation of biological, psychological and social challenges that the client is encountering when there is a health problem. Then after identifying the different challenges, I will identify therapeutic tools and use self awareness to make a diagnosis. This means that Janet will have to share a lot of information about their life circumstances that may have led to the low mood. The narration about life circumstances will assist the healthcare provider identify the most challenging aspect of the patients situation is most significant in supporting the patient to heal. This will call for a multidimensional treatment for the patient. The client use of biopsychosocial model as an intervention will facilitate healing and long term well being when implemented appropriately. Biopsychosocial model has been chosen as an intervention because it provides a holistic approach to the treatment of low mood. I will also use psychological treatments or therapies as an intervention for the low mood. Psychosocial intervention and framework will give the patient relief from psychological bondage. Psychological health is as important as physical health and can be treated to prevent further suffering. Cognitive behavior therapy will be used to treat low mood. It assumes that people’s behavior and thinking affects their mood. Cognitive behavior theory can be applied in Janet’s case because they need to change their thinking. I will ask the client to identify how she thinks and behaves so that she is affected. Such patterns of behavior and thinking can be eliminated to improve the client’s mood. Dealing with issues rationally will be helpful. This intervention is useful because Janet can learn to think react realistically, positively and use problem solving skills to handle challenges. Interpersonal therapy is an intervention best suited to deal with relationships. Janet’s poor relations with the roommates can be mended to improve her low frame of mind. This intervention assumes that poor personal relations contribute to worsening of low mood and should be discouraged. This therapy helps people identify poor relationship activities that leave the patient exposed to low mood. By identifying patterns leading to negative relations the client can avoid them. Then they can improve relations by dealing with people in a different way and coping with issues that arise. This intervention has been chosen because it will assist Janet learn how to maintain good relations. This intervention is relevant because it creates an avenue for dealing with issues that may be causes of the low mood. Behavior therapy is another intervention that lays emphasis on increasing activities and enjoyment in one’s life to deal with low mood. As this theory suggests, I will encourage the client to change the beliefs or attitudes, and alternatively, they engage in activities that are rewarding, enjoyable and satisfying. Doing so negates negative feeling and thoughts (Creek and Lougher, 2008, p. 27). Hence, this intervention is chosen to help mend Janet’s conduct. Mindfulness based cognitive therapy intervenes in a low mood situation by encouraging the patient to mediate in own situation by connecting to a group. Fawcett and Karban (2005, p. 7) mentions that, the group consists of people with similar issues. I will suggest to the client that they should join a group. While in the group the members will be taught on dealing with present and only notice experiences in the past whether good or bad. I will teach the client to avoid changing past or future and accept the present. Brown and Stoffel (2010) say that, mindfulness based cognitive therapy assists patients stop dwelling on negative thoughts. As a result, mindfulness based cognitive therapy can be used in the prevention of low mood which causes depression. In case the therapies are unsuccessful, I will suggest medical intervention on the client. Antidepressants are medications used in the treatment of depression. Antidepressants are given when the treatment and other interventions prove in futile. Antidepressants can be given alongside the psychological treatment. When any other form of treatment is unsuccessful antidepressants are given, under the supervision as Shelton (2009, p. 34) suggests. Patients with severe cases of depression and where any other form of treatment cannot be given are treated with antidepressants. The treatment will be mood stabilizers. In line with Watkins (2000), medications can be used in the case of the client if the physician does so. This may be as a result of failed treatment in therapy. She may be required to go for review when she recovers and receive advice to overcome the challenge. Another way of intervening in the client’s case is by providing support as framework as Powell (2009) discusses. Although depressed people like staying alone, recovery can be easier if the client interacts with family and friends. Recovery is difficult when a patient is in isolation. Therefore, the client should accept social invitation because they will aid in the healing process. I will encourage the client to engaging in exercise in the plan to maintaining good mental health. Exercise assists in the moderation of mood because exercising changes the level of stress hormones in the brain. Moreover, exercising keeps an individual away from negative thinking by engaging them. Exercise improves sleep, distracts people from thinking, opens opportunities for socializing and improves the well being of an individual. The client can engage in sports like cycling and the gym which she is enthusiastic about. This will help her focus on different ideas from what causes depression and help her keep fit. I will assist the client join a support group. Watkins (2000, p.77) says that, mutual groups help to give depressed a place to connect and form social network. Together they share experiences and come up with ways of dealing with the problems. Health communities and mental health centers may have mutual groups where people can enroll and benefit. Support is a framework that complements any other intervention. Support can be a preventive measure as well as a long term treatment. 2.5. Evaluation Janet was able to relate well with the roommate. They attended jogging together where they related without disagreements and shared their experiences in their past. Janet began cycling every day in the evening an activity that enabled them get sleep and refresh their mind. They learnt to manage their negative thoughts and were in good mind to engage in studies. Janet has been able to attend classes and performs well academically. While giving these interventions, levels of confidentiality should be maintained. The medical professional does not share information about the health of an individual with third parties. The interventions require one on one interaction between the health professional and patient; thus, health professionals should build trust and maintain professionalism throughout the treatment period. I will establish if the client has developed positive thinking, has enrolled for sports ad is able to solve problem. The success of the care plan is realized if the client is able to function normally after recovering. 3. Reflection As a mental health nurse student, this module has increased existing knowledge in providing health care. Cases of mental health cannot go unnoticed after a wide range of information has been used and analyzed to understand mental health. Mental health is part of the overall well being and requires a lot of attention. Mental ill health may not be quick to diagnose and require patience and a lot of investigation in the diagnosis. The topic on mental health has been informative on how to assist patients with mental ill health, and focus to encourage mental health well being. It has also provided insight on how to prevent mental ill health. Significantly, information has been useful in proving knowledge that will assist in diagnosis of mental ill health. Different intervention methods have also been learnt. Additionally, information on NMC code of conduct has been learnt. The code of conduct provides nurses with methods of assisting patients without breeching ethics and showing misconduct. The code of conduct is applied by all nurses and informs on the best practice when it comes to handling patients. Mental health patients have rights that should be honored (Goldsmith 2011). Each patient is unique and so is mental health as Shelton (2009, p. 34) points out. The symptoms reveal differently for different people. Similarly patients react differently to different kinds of intervention. There are different interventions that have been coined from research. This is because the topic of mental health has been researched on comprehensively. There are opportunities for research in the mental health topic that a scholar can engage in. After the completion of this module, it will possible to analyze mental health situations. Given a case it is possible to identify and diagnose symptoms of mental health problems and offer appropriate intervention. It is possible to follow up and assist an individual with mental health problem overcome mental problem and help them recover while using the best quality care. What is more is that with the NMC code of conduct, patient’s confidentiality can be guaranteed throughout and after treatment. It will be possible to discern issues concerning mental health care when given a patient to give care. 4. Conclusion This case scenario is an example of how patients suffering from low mood can be assisted by the nurse using a care plan. I have observed the NMC code of conduct when giving care throughout the treatment by respecting confidentiality of the client. This has been achieved by keeping the details of medical history confidential. No information was shared without explanation and consent from the client. Confidentiality should be kept and no information about the client can be shared with others. Cognitive behavior therapy application will help her respond realistically, positively and resolve problems with predicament solving skills. Interpersonal therapy will cause learn with people well and maintain good relations. Behavior therapy promotes the idea of the client do activities that will make her feel rewarded. Mindful based cognitive theory supports the idea of participating in a group that people with similar problems can meet and deal with issues together. The psychological approaches diverts thoughts that lead to depression and help patients deal with own behavior. Support from family and friends help in recovery. Depressed individuals need to engage in exercise which will keep their physical health fit. Poor eating habits are discouraged. Individuals can engage in support groups to facilitate recovery. The use of antidepressants is considered when other interventions are not successful. Antidepressants are prescribed and can be used while the patient is undergoing therapy treatment. Though depression is a mental health problem it requires the individual to be physically fit, psychologically healthy and deal with social problems for the patient to recover. Recovery will require the participation of the patient. The depressed will be required to identify own triggers and learn skills of dealing with the issues. This module has provided a platform for learning mental health. Moreover, it has brought enlightenment on the emphasis of NMC code of conduct while giving health care. Bibliography Barrett, D., Wilson, B., and Woollands, A. 2008. Care Planning: A Guide for Nurses. Upper Saddle River: Pearson Education. Brown, C. and Stoffel, V. C. 2010. Occupational Therapy in Mental Health: A vision for participation. Philadelphia, PA: F.A. Davis Company. Cohen, J., & Brown C. S. 2010. John Romano and George Engel: Their Lives and Work. Suffolk UK: Boydell and Brewer Limited. Creek, J. and Lougher, L. 2008. Occupational Therapy and Mental Health. London: Churchill Livingstone. Fawcett, B., and Karban, K. 2005. Contemporary Mental health, Theory, Policy and Practice. New York, NY: Routledge. Frankel, R.M., Quill, T. E., & McDaniel, S. H. 2003. The Biopsychosocial Approach: Past, Present, Future. Rochester: University of Rochester Press. Goldsmith, J. 2011. ‘The NMC code: conduct, performance and ethics’. Nursing Times,107, 37. Powell, T. J. 2009.The Mental Health Handbook: A Cognitive Behavioural Approach. Milton Keynes: Speechmark Publishing Ltd. Rowe, D. 2003. Depression: The Way Out Of Your Prison. London: Routledge. Shelton, R. C.2009. ‘Long-term management of depression: tips for adjusting the treatment plan as the patient's needs change’. Journal of Clinical Psychiatry, 6, 32-37. Watkins, P. N. 2000. Mental Health Nursing: The Art of Compassionate Care. 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