Cases in Acute Inpatient Mental Health Unit

This document discusses the challenges and issues faced in acute inpatient mental health units. It covers topics such as confidentiality breach, power struggles among nurses and patients, ineffective involvement of patients in their own care, and the severe lack of development and resources within mental inpatient healthcare.

CASES IN ACUTE INPATIENT MENTAL HEALTH UNIT
ASSESSMENT TASK: CASES IN ACUTE INPATIENT MENTAL
HEALTH UNIT
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CASES IN ACUTE INPATIENT MENTAL HEALTH UNIT
Table of contents
1. Confidentiality breach.................................................................................................................3
2. Power struggles amongst nurses and patients..............................................................................4
3. Ineffective involvement of patients in their own care once they are deemed "Mentally Ill"......5
4. Severe lack of development and resources within mental inpatient healthcare..........................7
Reference list...................................................................................................................................8
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1. Confidentiality Breach
Among one of the most crucial aspects encompassing healthcare and medical ethical parameter,
the paradigm of confidentiality is considered as one prominent precursor. Patents’ wellbeing,
data securities, and societal identities fall under the governance of the medical paradigm to be
taken care of (Hassan et al. 2016). Respecting the matters of confidentiality is denoted as one of
the supreme ethical responsibilities of the nurses within the healthcare department. Subsequent
breach of confidentiality issues within healthcare takes place by the nurses who remain most
involved with patients and patient parties. With respect to mental health illness, there are
segregated legislations stipulated so that confidentiality breach is not practiced. It is expected
that treatment against their will is never actualized in case of inpatients of mental health. When a
person is affected with mental illness, a patient having depression, anxiety or paranoid symptoms
are likely to be governing legislative authorities. A professional is possible to get detained if the
mental health shall put you to risk and need to be present in the hospital. The NHS staff has to
abide by certain treatment guidance so that they are detained for their misconducts. There are
diverse sections of the Mental Health Act 2014 in Australian context adhering to inpatient
confidentiality security. Australian Mental Health Regulation 2015 secures the fact that
confidentiality resting with patient information and will shall be effectually met. It is suggested
that when a patient is unwilling to seek the treatment they cannot be forced to be intervened
under the same. The medical staffs are liable for being answerable and are likely to be detained
in case of severe confidentiality breach among the if the safety and security of the mentally ill
patients are secured (Varcarolis, 2016). However, it is following the NHS nurses breach of
ethical contract that confidential information was extended and disclosed to the patient party.
The nurse was handling the case of the teenager which is demanding utmost confidentiality. The
teenage girl being affected with psychotic symptoms of paranoia and psychosis wanted to keep
the information confidential from her family members in the fear of losing their support
(Runciman et al. 2017). It was the nurse who was found to inform the family members of the girl
about her psychotic symptomsthat were necessary to be carried out. The central theme to this
attribute necessitates that concerning matters of health and social care the professional nurses are
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required to be maintaining the code of ethics. On a later intervention, it was understood that
confidentiality was completely breached by the code of ethics. As the nurse was found to give a
call to the relatives of the girl, subsequent information and data were passed on about the teenage
girl that led to the revelation (Townsend and Morgan, 2017). The symptoms of psychosis and
paranoia were specified in her medical reports which were disclosed due to the action of the
nurse and her lack of sense of responsibility to protect the confidentiality of the healthcare
organization. It is under the Mental Health Act 1983 secures rights of the mentally affected
patients. In the case of being unprofessional and administering treatment upon the young girl
despite unwillingness can lead the professional to be held responsible.It befalls more
significantly upon the healthcare and medical professional units to actualize this practice through
their ethical code of practice (Wong et al. 2017). There are cases of repeated admission leading
to enhanced interaction between the medical nurses and the patients. This is certainly not
expected of the nurse to cross her medical professional ethics and be within the grounds. The
confidential limits through data and information shall be established. However, breach of
confidentiality was endured when the professional nurse was found to reveal the future plans of
medical intervention upon the patient towards the patient party without prior approval from the
medical authorities. Confidentiality is necessary to be critically maintained so that effectiveness
in professional conducts shall be accurately secured. In the Australian spectrum there are
government approved drafts and amendment bills created with respect to mental health
consultation.The ethical codes of conducts are necessary to be established within the psychiatric
paradigm of inpatient sections. The breach of confidentiality shall be taken place within the
organization of healthcare through effective professional sections. This confidentiality paradigm
shall be respected with the patients as well as the part of the medical professionals (Bee et al.
2017). The nurses of the professional boundaries shall be established so that effectiveness is
ensured within the psychiatric inpatient sector. This healthcare dimension shall be effectually
practiced with proper codes of conducts so that the data and privacy of the patients shall be
restored in an appropriate manner.
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2. Power struggles amongst nurses and patients
In the case of serving within the acute care psychiatry settings, there are frequent experiences
undergone by nurses in terms of patient violence. It is the aggressive and outrageous outburst of
the nurse which is likely to immensely influence the resultant outcomes f the nurses and
caregivers working within the organization (Adler-Milstein et al. 2015). There are significant
qualitative studies which intervene and explore the psychiatric cases concerning nursing
experiences. The patients who are needed to be kept under acute care are ones who manifest
fierce outcomes as the inpatients. The psychiatric settings demand the patients be obeying
maximum discipline within the boundaries of intensive care. There are empirical pieces of
evidence prominently stating the fact that constant state of analysis is made to resolve the issues
encountered within the healthcare settings especially within the psychiatric unit. There were
empirical pieces of evidence where 12 Canadians were found to be registered nurses who were
self-reporting patient violence (Hockenberry and Wilson, 2018). In the case of inpatient acute
care psychiatry department, the thematic analysis and qualitative data revealed that problems and
practices needed to be interpreted accurately. There is found to be a constant state of comparison
undertaken with the use of analysis, where problems, needs, and the practices are used for overall
data interpretation. It is necessary for the clinical attendants to pay heed to the ethical boundaries
while displaying the services. Issues like power, control, and stigma are attached so that nurses
are able to create impactful influences. The patients who exert extra energies to retaliate the
clinical treatment administered upon them are found to be pressurized with the nurse attitudes
and behavior (Fitzpatrick et al. 2017). They often have to face the harsh service provision from
the clinical department towards the patients. In order to maintain the minimal decorum of the
psychiatric unit filled with inpatients, the violent outbursts of the patients have to be effectually
managed through the imposition of power. There are usually diverse strategies that professional
caregivers are entitled to extend towards the patients. Maintaining personal safety and prevent
them from managing patient violence shall be restored through professional conducts. Nurses are
found to endorse the educational enhancement and following the incidents so that effective care
is provided towards the patients. However, there are experiences encountered where
unprofessional care conducts are necessary to be prevented and advised with proper feedbacks
and suggestions. The power struggle between patients and healthcare nurses are most prominent
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in the case of contradictory and dilemma arising situations. There are often instances where
patients ask for better and improved intervention and other alternatives for gaining mental care
appropriateness (Grisctiet al. 2016. However, it is based upon the clinical emergence and the
patient satisfaction that person-centered approaches are taken into consideration. The patients
look forward to better scopes for intervention provided for themselves and their families. Being
denied to offer through any compromised approach can result in a power struggle between the
two parties regarding the medical intervention stipulated.
3. Ineffective involvement of patients in their own care once they are deemed "Mentally
Ill"
Mental health unit comprising core psychiatry patients are encompassed with the usual level of
severe incapability in their problem solving, self-care and decision-making abilities. There are
varied dimensions of psychiatric disorders which include Neuro-developmental symptoms, the
patients with the bipolar-related disorder, schizophrenia spectrum and psychotic disorders
(Stevenson et al. 2015). The people affected with the severe cases of depression, anxiety or
obsessive-compulsive disorder as well as traumatic stress disorders are usually admitted as in-
patient unit. It can be understood that such patients are undergoing a certain level of criticality in
their mental abilities to justify their action and think rationally. In such a case the perception of
the patients' regarding the clinical administration upon them are not seriously taken into
consideration. It can be understood that such patients are having a different mental orientation
which is incapable of taking significant decisions. Hence when admitted in the care units of
psychiatry they are supervised and monitored with special decision-making authorities. If the
family is not able to take responsibility of the affected persons which is a normal phenomenon in
mental health situations, the medical board has to take charge of the intervention carried out
upon them (Vandewalleet al. 2016). It is typically following the grounds of incapability, lack of
complex mental functioning, difficulty in rationalizing, problem-solving that decision-making
skills are not imposed upon them. Hence following this precursor if the mental configurations are
understood to be incapacitated, they shall not be able to take account of involvement in the
subsequent clinical intervention plan. It is with respect to such unfavorable conditions addressing
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to psychiatry department that patients being admitted in such a condition are not involved within
the self acre attributes. There are significant observations created within the clinical paradigm
emerging from tested and tried empirical studies that stated such instances of ineffective
involvement for dementia affected patients. The old aged individuals suffering from dementia or
Alzheimer's symptoms are found to gradually be driven towards a worse state of mental and
physical ability. The physical, as well as the mental deterioration, begins to take place within
them, which leads to compromised self-care, negligence towards self-hygiene and managing
medical needs for themselves. Such cases of ineffective involvement among patients directed
towards self are likely to be evidenced more vividly in terms of mentally affected individuals
rather than the physiological ailments (Mugisha et al. 2016). The patients suffering from bipolar
disorder might contribute their opinions in an exaggerated manner. However, those opinions and
suggestions shall not be put to implementation in an effective manner. Severe questions upon
rationality and justice that shall be incorporated within the medical intervention plans.
4. Severe lack of development and resources within mental inpatient healthcare
The psychiatric healthcare organizations are recognized for the complexities they face in the
process of dealing with mentally ill-conditioned patients. There is a wide paradigm of
disturbances and disorders that the patients in the ward affected. However, keeping in
comparison with the intensity of patient incidence rates and the severity of their health outcomes,
the availability of the resources are minimum in nature (Gostin and Wiley, 2016). There is a
sheer sense of lack encountered with appropriate development and resource utilization. The
nurses operating 24/7 within these inpatient units of psychiatric wards are encountering with
such complex difficulties. It is becoming increasingly challenging for the nurses to take charge
of each case demanding individual care requirements to be catered with independent and equal
effectiveness. The quality of care and services are hence encompassed to be compromised. If the
resources in the forms of workforces, equipment, medical technological advancements and the
professional means of interventions are deteriorated in nature, psychiatric units shall suffer
incessantly. The massive number of patients shall be suffering as a result of mismatched patient
and service disproportion. The healthcare sector with special emphasis upon psychiatric
department is identified as one of the most sensitive aspects of business sectors where the supply
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of adequate services and care is a matter of emergency (Hoeftet al. 2018). The level of efficiency
and professionalism that this sector demand is not necessarily required in any other department.
Hence in such service providers if there are evidence of lack of appropriate equipment and
medical advise the patients are likely to suffer from a deteriorated health condition. Rather than
experiencing better-recovering rates within this sector the number of complaints and
deteriorations shall become vivid in nature. There are empirical studies reflecting upon the
London Boroughs which are found to be severely suffering from a deficiency in technologies,
medical types of equipment inadequate and unprofessional staffs. The lack of training and
development programs within the organization are also evident within the psychiatric units
(Landeweeret al. 2017). The mental inpatient health and wellbeing is necessary to be taken into
consideration so that lack of development in the resource levels shall not impact the patient’s
life.
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