This essay will evaluate the nursing practice and the improvements implemented to the patient’s situation while establishing a therapeutic consideration to a client being cared for by the Assertive Outreach Team where I’m undertaking my semester 5 placement. …
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In this critique, my client will be confidentially referred to as Ms. B. Her identity will be protected in accordance with the code of professional conduct as specified by the Nursing and Midwifery Council (NMC, 2008) which basically requires health professionals to respect the confidentiality of patients and prevent patient information from being improperly disclosed to other people.
I would be establishing Ms. B’s background, as well as her medical history to date. Using therapeutic approaches, I will also describe her psychological, physical, and social needs; and I would also be describing how these approaches have helped in the assessment of needs, in the identification of goals, and in the identification of applicable nursing interventions.
Describe the chosen individual’s background and history to date.
Ms. B has been diagnosed with major depressive disorder and has already attempted suicide twice in the last six months. As described and defined by the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) major depressive disorder is characterized by the following symptoms for a continuous period of atleast two weeks: having depressed mood most of the day, every day as observed by others; markedly reduced interest in daily activities nearly every day; significant loss of weight or significant weight gain; insomnia or hypersomnia almost every day; psychomotor agitation or retardation almost every day; fatigue or loss of energy; feelings of worthlessness or excessive guilt almost every day; reduced ability to concentrate almost every day; and recurrent suicidal ideation (Sammons, n.d, p. 1). Rottenberg, et.al., (2002, p. 135) also discuss that one of the characteristic symptoms of depression is anhedonia which basically refers to a person’s inability to feel pleasure. In effect, those with major depressive disorder are often unresponsive to repeated attempts to stimulate pleasure. Individuals suffering from major depression seem to have a diminished experience in terms of positive feelings in relation to non-depressed individuals, more often than not these individuals experience a lesser feeling of joy or pleasure from some of their activities (Allen, et.al., 1999). This reduced response to pleasure has been attributed to feelings of depression from their anxious states and their related forms of psychopathology. Those with major depressive disorder also seem to display a general affective flattening where they would have a standard emotional response to all emotional stimuli (Rottenberg, et.al., 2002, p. 136). In effect, these individuals show less electromyographic response during affective memory stimulation; less facial reactivity to facial stimulus; and a lack of autonomic response to various stimuli (Dawson, et.al., 1977). In most emotional stimuli, they seem to manifest a monotone and an unenthusiastic response. Ms. B is a White Caucasian female, 34 years old, who recently miscarried her child and then was left by her husband for another woman. She came from a broken family with her parents divorcing when she was barely 5 years old. Her mother was an alcoholic and abandoned her when she was 11 years old. She was then sent to live with her father, who was physically abusive. She was severely beaten by her father when she was 14 years old and was removed from his custody. She was then raised in an orphanage until the age of 17 when she run away and started living in the streets as a prostitute. She hustled the streets for 10 years until she was arrested for sexual solicitation. By that time, she was already addicted to cocaine and heroin. She was sent to rehabilitation and successfully recovered from her drug addiction. At the age of 30, she
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