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Mental health is the state for an individual of well-being where he realizes his abilities, can work in a productive manner, cope-up with the normal stresses of life as well as communicate towards his community. There are certain aspects or reasons due to which, there can be caused some serious mental issues with an individual. It is an essential expectation from all the nurses working within the healthcare settings that they should provide the patients with compassionate and effective care. This essay is based on applying the three-phase conversational model on the case of Christine who had been facing plenty of troubles in relation to her mind as well as physical health and wellbeing. Christine, at the age of 2 was taken to foster care due to her parents not being able to take care of her as they were a drug addict and used to live on the streets. Christine had a miserable time in her teenage due to being sexually harassed as well as indulging in illegal activities such as selling cannabis. She needs compassionate and effective care in a healthcare setting to be able to mentally and physically fit. This essay will help in formulating the case for her using biopsychosocial theories and a three-phase conversational model.
A brief overview of Christine's case and critical evaluation
Christine from her childhood has been a troubled individual. She was taken into a foster home at the age of two and hence has never had real parenting. The only supporting individual she had in her life was Angel who was also a foster child. When she left Christine lost that emotional support and got into buying, selling, and using cannabis. She has had huge physical traumas as she was sexually assaulted at the age of 16 which she never spoke about to anyone. When she was out of her foster home she got into hardcore drugs and her connection with the people around started to break loose (Trimboli, et al., 2018). At such a young age she has seen the worst of the world and her mind is shaped in accordance with that. She is 25 now and she has been admitted to acute mental health in the patient ward where she will be given an appropriate mental and physical health environment to try to cope up with whatever she has been to up till now. The three-phase conversational model consists of the phases of Connecting, Sharing information, and Finding agreement. These will be explained in detail under various heads which will cover Christine's journey. These are as follows:
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Christine's current condition is horrible and in the realm of psychopathology. She has been a drug addict for many years now. She has not been eating and sleeping right, her basic biological cycles which are needed to give a person a healthy life are not at all in any order or form. She has been physically torturing herself by excessive use of drugs and not sleeping at all, let alone not eating right. Her mental state is not in its right place as well. She has become paranoid about people and always tends to think that they are trying to steal her ideas and things. Christine has been through so much that in her mind all the trauma she suffered is irrecoverable now. There were two instances when she was happy and up to something in her life. Once when she was with Angel in the foster home and went to school and baked cakes with the angel at home and second for a brief interval of time when she was with her acquaintance at Holloway and was indulged in painting and writing and even sold art while engrossed in it (Briggs, et al., 2017). These might be the things that can pull her back into the civilized world because what she has been through has been too much for her. The major risk which lies in her case is that when a substance abuser has suddenly pulled away from drugs it can cause serious mental and physical problems to the particular person in question, so plans have to be well devised on how to pull Christine away from all the abuse without causing her any more harm. When a person has suffered things like sexual abuse, parental abuse, homelessness, and substance abuse the person becomes suicidal in nature and skeptical of everything and everyone as we see in Christine's case that she has become paranoid of people around her. Christine's eating habits with substance abuse were very volatile (Hopwood, et al., 2019). Sometimes she used to overeat and eat in huge amounts at once and sometimes used to just starve intentionally. These things might look like a side-effect of drug abuse but unintentionally or indirectly these are suicidal because one is not taking basic care of their physical conditions. The trauma causes one to lose their mind because there is no rational way out which one can think of and it seems like the world around makes no sense. Christine used to talk with herself and laugh hysterically which showed signs of mental illness within her. Plans need to be devised by the mental nurses in order to bring respite to the trauma caused to the patient. Safety measures like providing an environment where someone is directly or indirectly watching the patient all the time has to be provided so that whenever the patient tries to do something harmful to herself appropriate measures can be taken. It is taking a huge risk leaving a patient like this alone in a room because their mental state is as such that they can flip out at any point in time. The assessment of the accurate physical and mental condition of the patient is of utmost importance for a mental nurse (Virili, et al., 2018). If there is an inaccurate representation of the patient's mental health then no matter what steps are taken they won't be beneficial because the treatment of such patients is very subjective as every step in the treatment will bring in something new in the patient and then the course of action will depend according to the present state of the patients. Hence there has to be a comprehensive plan according to the various situation the assessment can lead to so that the nurse has at least the slightest idea of what needs to be done in that particular scenario (Edwards, et al., 2019).
After the patient has been assessed as accurately as it can get, appropriate planning for the treatment is very vital. Christine has had a great deal of trauma and mental illness but first and foremost their physical condition of Christine needs to be improved and informed care is necessary. Because if a patient is physically not fit and feeling well, stabilizing them mentally is a task that will be very difficult. A patient who has been a substance abuser needs proper planning first of all for physical betterment and then mental stabilization will fall into place. The authorities and mental nurses devise strategies to create an environment beneficial for behavioral health (Eidelman, et al., 2019). The environment promotes the patients to be resilient. Christine has been a heroin addict and she duly needs that environment where a healthy resistance to all of this is there. The promotional strategies are adopted for such patients. These strategies help them to reinforce the entire continuity of the behavioural health services wherein they are endeavoured to put into a habit of not using or using little harmless substance. The plans are devised so that the prevention of illicit drug use can be done (Herber, et al., 2020). Many times there is a misuse of prescriptive drugs so that the doctors try to eradicate through appropriate planning. Christine will have to go through a treatment to eradicate this substance abuse behaviour else any other plan would not work if this problem still persists. The effect drugs had on their mind of Christine was horrible. As discussed above she used to talk with herself, she became aggressively loud and hugely paranoid. All these things come under planning the treatment of psychopharmacology patients. Nursing care plans are of various types and stages. In Christine's case, one problem identified is Imbalanced nutrition due to excessive drug abuse and plans are made under nursing care to correct that. Christine has had insufficient dietary intake. Nursing assignment care makes plans in order to first of all monitor the nutrition intake of the patient so that adequate nutrition can be generated inside the patient's body (Cappelli, et al., 2020). Along with dietary plans the Nursing care has various other things as well. Christine's mental status will be assessed and it will be seen that whether there is a presence of psychiatric disorders or not. This is done because many patients intake drugs in order to get respite from depression or anxiety. It is a scientifically proven fact that almost 60% of drug addicts or substance-dependent patients have underlying psychological problems (Komasi and Saeidi, 2019). This is very much true in the case of Christine as she has lived without proper parenting and was also sexually assaulted. The Nursing care people sit and have conversations with the patients about their substance abuse without judging them even a bit. This helps the patients in overcoming that professional barrier and speaking their minds out. One of the major things that the Nursing care nurse do is that they ask patients to list their past accomplishments and all the positive things that have happened to them, this helps in lifting the patient's self-esteem and mental state so that they do not have that craving for drugs. This will be hugely useful in Christine's case as she has had some time in her foster home with Angel and she used to paint, write and sell art which can come rushing back if she tries. She has shown that she has enough potential to break through even in tough times. These are some plans which will be applied in Christine's case taking into consideration all her past experiences (Aggarwal, et al., 2020).
This is the phase in Christine's treatment where the actual treatment will begin. The mental nurse and the Nursing care have had their assessments and now implementation has to be done. The team will actually intervene in the space in which Christine is right now and try to bring her back to the normalized world through appropriate physical and mental treatment. This is a stage where the three-phase conversational model will come in very handy. First of all the model has three stages which help the treating team to bifurcate the patient's states and work accordingly step by step to tap into the hidden civilized personality of the patient. The first stage is about connecting with the patient, understanding the patient's mental state, and to what extent the patient will cooperate (Persia, 2019). This engagement between the mental nurse and the patient will have a significant impact on the treatment. The second stage is about the exchange of facts and all the required information. If the patient starts sharing information that means that there is some progress. The sharing does not have to be just one way, the nurse can also share the required amount of information. The third stage is about finding an agreement. There won't be many topics on which the patient and the nurse will agree but there has to be a middle ground where both the parties have to meet and find an agreement to take the treatment at the next stage. In Christine's case, the mental nurse in its entirety needs to have a therapeutic relationship with her (Lambert, et al., 2020). She has been through many disappointing things. She never had the comfort of parenting, never really was happy for prolonged periods in her, was sexually assaulted, and had a long history of drug abuse. The Nurse is definitely going to listen to her without any judgments else she will be too skeptical to even enter in a conversation with her. The connection should be enough, it is important that the nurse connects with Christine on a deeper level; it is just that she should have a decent connection with her so that she opens up about her experiences. There has to be an exchange of facts between the nurse and Christine as well as because the patient also wants to connect to the person with whom the conversation is being done. The Nursing care will try to tap on Christine's artistic side because it will however her mind away from the mental instability of suicidal and lunatic thoughts and bring in a realm of art. They will try to connect with her on the artistic points and not go deep down into her childhood. This will help Christine in forming a relationship where she might be able to have a free willing conversation with the mental nurse because there will be something on which they can have an agreement. Coming to a stage of the agreement is of prime importance in Christine's treatment (Baird, et al., 2017). The abusive side of Christine's life is of prime importance as that's where she needs respite but it is not important for the mental nurse to agree on those things to generate a level of trust and light up a conversation. These things will be subtly subdued by the Nursing care as they do not want to give Christine's instant denial of these things yet lessen her thoughts and usage of them. These are the things which in the treatment will be aptly listened to but not agreed to blatantly rather it will be tried to gradually subdue these things by using her subconscious thoughts. Still agreeing upon certain things is of prime importance because on the basis of that itself Christine will properly coordinate the treatment (Patankar, et al., 2020).
This is an ongoing step. This comes in at the later stage of the treatment and goes on for quite sometime after the treatment as well. This evaluator step not only evaluates the patient during and after treatment but also the mental nurse and the importance of a mental nurse in a multi-disciplinary team. Christine will be under scrutiny eve after the treatment. She will have regular checks performed on her to see if the trauma or her addiction is well gone or not. The major part though is the importance of a psychiatric nurse. Diagnosing disorders is of prime importance for mental health patients. Psychiatric nurses are trained to do so. They are trained to listen to the patients aptly and ask appropriate questions at appropriate intervals. Unlike physical ailments, psychiatric treatment relies on the information which is provided by the patient himself. The mental nurses focus on the actual need of the patients and devise their plans hovering around those needs, unlike the physical treatment where the patient has to turn paths in accordance with the medications given. Counseling and mental health evaluations are also one of the major plus points which mental nurses provide. Medicines can cure a person physically but overcoming mental ailments is a different deal altogether. When a patient comes in with serious mental health issues it is the mental nurses who will calm the patient down and develop an environment wherein the patient will agree to cooperate fully with the doctors. The mental nurses generally connect with the patients at a personal level and hence are of prime importance in helping a person to adopt a healthy lifestyle and assist with a lot of self-care activities (Ruckmani, 2018). To administer the psychobiological treatment cycles of a patient is the main job of a mental nurse, this includes psychoeducation, counseling, and crisis intervention, and case management. The mental nurses within a hospital provide the facilities and functionalities of a psychotherapist to the patients. The primary mental health care facilities which are of prime importance to a mental health patient care being provided by a mental nurse. In the above-discussed case of Christine as well, the nursing care people were the individuals who helped her overcome her trauma which she had accumulated in her past by developing appropriate care plans and implementing them properly. The evaluation of Christine will go on by these mental nurses on a personal and a professional level as well even after the treatment because of the connection they've made with each other. It can be stated that the importance and role of mental nurses have been growing in the modern age as they are connected to the patients in such a way in which doctors can never be and patients do open up about their traumas to them, so it is very important in a multi-disciplinary team.
Conclusion and Recommendations
The above report was about Christine and her substance abuse problem and how she was treated in the mental health aspect by the psychiatric nurses. It was discussed how the steps of treating a mental health patient by psychiatric nurses should go on. It was discussed that before any treatment a proper understanding of the patient should be done and then only the intervention part and the treatment part should come into the picture. A couple of steps that the Nursing care people should've taken with Christine should be like involving her in group therapy so that she can get a glimpse of how others are reacting and behaving in the therapy. Administration of antipsychotic medications should also be done by the team. The team if not able to find out appropriate solutions should focus on fully restructuring the treatment plan if necessary. Exploring support in the peer group is also one step that can be taken in order to move the treatment to another step.
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