Application of the CRC to the scenario

The process of clinical reasoning cycle assists nurses and care professionals to critically respond to a clinical scenario and undertake an appropriate decision that serves the best interest of the patient.

Running head: MENTAL HEALTH NURSING
MENTAL HEALTH NURSING
Name of the Student:
Name of the University:
Author Note:

1MENTAL HEALTH NURSING
Application of the CRC to the scenario:
The process of clinical reasoning cycle assists nurses and care professionals to
critically respond to a clinical scenario and undertake an appropriate decision that serves the
best interest of the patient (Hunter and Arthur 2016). Upon critically analysing the provided
case scenario it can be mentioned that the patient Josh Wallace is an aboriginal, 20 years old
and is a University student. The patient at present stays with his mother’s sister and her three
teenage children and the brother of his grandmother uncle Bill. The patient’s past medical
and psychiatric history suggests that suicidal death has been prevalent in his family with his
uncle and cousin having committed suicide. Present life stressors for the patient include,
emotional distress, distance from girlfriend and parents. The patient appears to be depressed
and indulges in self-harm behaviour. The patient has been under medication Fluoxetine
(20mg) and has been using headspace services for his recovery.
MH assessment (MSE):
The MSE for the patient can be documented as the following:
Appearance: Unkempt and dishevelled
Speech: Monotonous and avoided eye contact
Mood/Affect: Depressed and flat
Thought Form: Tangential
Thought Content: Thoughts of self-harm and panic
Perception/Cognition: Alert and Oriented
Insight/Judgment: Intact

2MENTAL HEALTH NURSING
Risk assessment
Upon evaluating the patient’s current mental health condition, the risk factors include
self-harming behaviour and emotional distress. The immediate intervention would comprise
of referral to a psychological counsellor and psychotherapist for the administration of
mindfulness based therapies so as to promote mental health recovery.
Role of relevant MH legislation:
As per the Northern Territory Suicide Prevention Strategic Framework 2018- 2023,
the government intends to reduce the burden of grief and trauma by instilling optimism and
wellness among the Aboriginal community members. The important MH legislations that
include the NT suicide prevention strategic Action Plan (201502018), NT Mental Health
Strategic Plan (2015-2021) and NT Health Aboriginal Cultural Security Framework (2016-
2026) aim at rendering informed, inclusive and timely MH services to indigenous
Australians, implement evidence based practices to assist with the recovery practices and
build stronger communities so as prevent suicidal behaviour and reduce stigma (Australian
Indigenous HealthInfoNet 2019).
Ethical considerations of MH legislation:
Ethical considerations while treating the patient would include adapting a holistic
recovery approach where a culturally safe recovery would be devised in collaboration with
the patient that is aligned to the cultural values and preferences of the patient (Australian
Indigenous HealthInfoNet 2019).
Strengths assessment (including the application of principles of Recovery Oriented
principles):

3MENTAL HEALTH NURSING
The strengths for the patient can be identified as the patient’s awareness in relation to
the mental health disorder and his willingness to avail treatment services (Health.gov.au
2019). The level of awareness of the patient would be used for devising an intervention that
supports the individuality of the patient, is customized according to the preferences of the
patient, protects the human rights of the patient, treats the patient with dignity and respect,
effectively partners with the patient in the recovery process and helps in tracking the progress
of the implemented intervention.
Other assessments needed that would be relevant to each scenario:
The case scenario mentions that the patient has been experiencing shortness of breath
and chest pain. In order to assist the patient with these physical health symptoms, the patient
would be referred to a Pulmonologist.
Psychotropic medications
Drug group:
The medication prescribed to the patient is Fluoxetine (20 mg) which is used for
treating depression and belongs to drug group known as serotonin reuptake inhibitors. The
drug affects the neurotransmitters and elicits its action by alleviating the mood.
Side effects:
Side effects of the drug include, nausea, drowsiness, anxiety, loss of appetite,
sweating and muscular spasms (Bet et al. 2013).
Adverse effects:
Research studies suggest that adverse impact of the medication include hallucinations,
racing heartbeat, overactive reflexes, seizures and aggressive behaviour upon encountering
any of the above, immediate emergency help should be sought (Gordon and Melvin 2013).

4MENTAL HEALTH NURSING
References:
Australian Indigenous HealthInfoNet (2019). Northern Territory suicide prevention:
strategic framework 2018-2023 - Policies - Social and Emotional Wellbeing - Australian
Indigenous HealthInfoNet. [online] Australian Indigenous HealthInfoNet. Available at:
https://healthinfonet.ecu.edu.au/learn/health-topics/social-and-emotional-wellbeing/policies-
and-strategies/35470/?title=Northern%20Territory%20suicide%20prevention%3A
%20strategic%20framework%202018-2023 [Accessed 6 Jun. 2019].
Bet, P.M., Hugtenburg, J.G., Penninx, B.W. and Hoogendijk, W.J., 2013. Side effects of
antidepressants during long-term use in a naturalistic setting. European
neuropsychopharmacology, 23(11), pp.1443-1451.
Gordon, M. and Melvin, G., 2013. Selective serotonin re-uptake inhibitors: a review of the
side effects in adolescents. Australian family physician, 42(9), p.620.
Health.gov.au (2019). [online] Health.gov.au. Available at:
https://www.health.gov.au/internet/main/publishing.nsf/content/CFA833CB8C1AA178CA25
7BF0001E7520/$File/servpri.pdf [Accessed 6 Jun. 2019].
Hunter, S. and Arthur, C., 2016. Clinical reasoning of nursing students on clinical placement:
Clinical educators' perceptions. Nurse education in practice, 18, pp.73-79.