Weekly Nursing Objectives

This document discusses weekly nursing objectives including mental state examination in patients with mental disorders, learning about opioid withdrawals, enhancing communication skills with challenging patients, and observing patient behavior in an alcohol and drug withdrawal facility.

Running head: NURSING
Weekly nursing objectives
Name of the Student
Name of the University
Author Note

1NURSING
Objective 1: Mental state examination in patients suffering from mental disorders
Under the supervision of my buddy registered nurse I will be able to learn about the
importance of conducting mental state examination and its importance in patients who have
been diagnosed with mental disorder such as, depression and anxiety. MSE will act as a vital
component of psychiatric assessment and will help in determination of the psychological
functioning of mentally ill patients, at a certain point of time (Arevalo‐Rodriguez et al.,
2015). Owing to the fact that mental disorders result in significant impairment or distress in
the personal functioning of affected people, MSE will enable gaining a comprehensive
understanding of the thought content, acuity, thought process, cognition, language, and vision
of the mentally ill patients (Trzepacz, Hochstetler, Wang, Walker & Saykin, 2015).
Coalescing outcomes of the MSE with the biographical and historical information of the
psychiatric history of the patients will ease precise diagnosis and formulation of a coherent
treatment plan.
Keywords: Mental state, depression, anxiety, mental illness, examination, diagnosis
NMBA standard (s) objective links to:
1.6 maintains accurate, comprehensive and timely documentation of assessments, planning,
decision-making, actions and evaluations (NMBA, 2016)
4.2 uses a range of assessment techniques to systematically collect relevant and accurate
information and data to inform practice (NMBA, 2016)
5.1 uses assessment data and best available evidence to develop a plan
Resources:
 Instructor
 Mental state examination guidelines

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 DSM-V diagnostic criteria
 NMBA standards of practice
References
Arevalo‐Rodriguez, I., Smailagic, N., i Figuls, M. R., Ciapponi, A., Sanchez‐Perez, E.,
Giannakou, A., ... & Cullum, S. (2015). Mini‐Mental State Examination (MMSE) for
the detection of Alzheimer's disease and other dementias in people with mild
cognitive impairment (MCI). Cochrane Database of Systematic Reviews, (3).
Retrieved from
https://www.repository.cam.ac.uk/bitstream/handle/1810/283257/Mini-Mental
%20State%20Examination%20(MMSE)%20for%20the%20detection%20of
%20Alzheimer's%20disease%20and%20other%20dementias%20in%20people
%20with%20mild%20cognitive%20impairment%20(MCI).pdf?sequence=1
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice.
Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-
statements/professional-standards/registered-nurse-standards-for-practice.aspx
Trzepacz, P. T., Hochstetler, H., Wang, S., Walker, B., & Saykin, A. J. (2015). Relationship
between the Montreal Cognitive Assessment and Mini-mental State Examination for
assessment of mild cognitive impairment in older adults. BMC geriatrics, 15(1), 107.
https://doi.org/10.1186/s12877-015-0103-3

3NURSING
Objective 2: learning about opioid withdrawals
Under the supervision of my buddy registered nurse I will be able to learn about
opioid withdrawal symptoms and complications, in an alcohol and drug withdrawal facility.
Drugs and alcohol are responsible for suppressing the production of neurotransmitters in the
brain such as, adrenaline. Averting from usage of such drugs like opioid rebounds the brain
that generates a surge of adrenaline, thereby stimulating withdrawal associated symptoms
(Jesse et al., 2017). Administration of opiate drugs such as, heroin and prescription
painkillers have been found to produce a range of withdrawal symptoms after the ultimate
dosage (Singh, Müller & Vicknasingam, 2014). These symptoms usually last for one week or
more, and are characterised by indications of nausea, muscle cramping, and opiate cravings.
Opioid withdrawal also results in the onset of several emotional and mental symptoms such
as, depression, anxiety, cognitive impairment and sleep disturbances.
Keywords: learning, opioid, withdrawal, continuous, development, evidence
NMBA standard (s) objective links to:
3.3 uses a lifelong learning approach for continuing professional development of self and
others
3.7 identifies and promotes the integral role of nursing practice and the profession in
influencing better health outcomes for people (NMBA, 2016)
4.4 assesses the resources available to inform planning.
6.2 practises within their scope of practice (NMBA, 2016)
Resources:
 Feedback from mentors
 Scholarly articles

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 Access to internet and library
References
Jesse, S., Bråthen, G., Ferrara, M., Keindl, M., Ben‐Menachem, E., Tanasescu, R., ... &
Ludolph, A. C. (2017). Alcohol withdrawal syndrome: mechanisms, manifestations,
and management. Acta Neurologica Scandinavica, 135(1), 4-16.
https://doi.org/10.1111/ane.12671
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice.
Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-
statements/professional-standards/registered-nurse-standards-for-practice.aspx
Singh, D., Müller, C. P., & Vicknasingam, B. K. (2014). Kratom (Mitragyna speciosa)
dependence, withdrawal symptoms and craving in regular users. Drug and alcohol
dependence, 139, 132-137. https://doi.org/10.1016/j.drugalcdep.2014.03.017

5NURSING
Objective 3: Enhance communication skills with challenging patients
Under the supervision of my buddy registered nurse I will be able to learn about
different communication skills that need to be adopted while interacting with challenging
patients in the alcohol and drug withdrawal facility. Difficult interaction and communication
with patients often consume an uneven amount of resources, time, and emotional energy
(Norouzinia, Aghabarari, Shiri, Karimi & Samami, 2016). Such patients also make the
healthcare professionals feel stress, anger, anxiety, and helplessness, thereby leading to the
dislike of clients and subsequent usage of avoidance strategies (Riley, 2015). Taking into
consideration the fact that patients who experience withdrawal symptoms often become
aggressive, there is a need to use a non-confrontational and empathetic approach, while
interacting with them. The goal will also encompass avoidance of excessive stimulation,
prolonged eye contact and aggressive postures.
Keywords: Communication, patients, challenging, aggressive
NMBA standard (s) objective links to:
2.2 communicates effectively, and is respectful of a person’s dignity, culture, values, beliefs
and rights
2.5 advocates on behalf of people in a manner that respects the person’s autonomy and legal
capacity (NMBA, 2016)
3.2 provides the information and education required to enhance people’s control over health
5.2 collaboratively constructs nursing practice plans until contingencies, options priorities,
goals, actions, outcomes and timeframes are agreed with the relevant persons (NMBA, 2016)
Resources:
 Instructor

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 Open Disclosure program
 Communication tools like whiteboards, brochures and message map
References
Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., & Samami, E. (2016).
Communication barriers perceived by nurses and patients. Global journal of health
science, 8(6), 65. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4954910/pdf/GJHS-8-65.pdf
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice.
Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-
statements/professional-standards/registered-nurse-standards-for-practice.aspx
Riley, J. B. (2015). Communication in nursing. Elsevier Health Sciences. Retrieved from
https://books.google.co.in/books?
hl=en&lr=&id=SwndCwAAQBAJ&oi=fnd&pg=PP1&dq=aggressive+patients+com
munication&ots=YZri44pnAB&sig=Re9TFvI6Y-
agMm2QNUlrLI_hpSM#v=onepage&q=aggressive%20patients
%20communication&f=false

7NURSING
Objective 4: observing patient behaviour in alcohol and drug withdrawal facility and
looking for behaviour cues
Under the supervision of my buddy registered nurse I will be able to identify the
behaviour cues of patients who are currently in the alcohol and drug withdrawal facility.
Time and again it has been established that for the development and manifestation of
withdrawal symptoms, patients typically develop behaviour that is correlated with drug
dependence. This manifests in the form of psychological and physical dependence behaviour
(Renner, Ji, Pictet, Holmes & Blackwell, 2017). Hence, behaviour cues are associated with
various stages namely, feeling worse, hitting a plateau, and subsequent dissipation of
symptoms. Identification of behaviour cues will also encompass demonstration of symptoms
such as, delusions, agitation, poor social skills and formal thought disorders. Taking into
consideration the fact that withdrawal from alcohol and drugs are associated with several
altered behavioural patterns such as, pressured speech, slow speaking, word repetition,
inappropriateness to environment, bizarre clothing, strange postures, sluggish and lethargic
movements, and agitation, identification of these cues will facilitate gaining a sound
understanding of the patient’s distress (Rogers, Fox & Herlihy, 2015).
Keywords: Cues, behaviour, environment, observation, withdrawal, mental
NMBA standard (s) objective links to:
1.2 develops practice through reflection on experiences, knowledge, actions, feelings and
beliefs to identify how these shape practice (NMBA, 2016)
2.4 provides support and directs people to resources to optimise health-related decisions
3.5 seeks and responds to practice review and feedback (NMBA, 2016)

8NURSING
Resources:
 Direct interaction with patients
References
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice.
Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-
statements/professional-standards/registered-nurse-standards-for-practice.aspx
Renner, F., Ji, J. L., Pictet, A., Holmes, E. A., & Blackwell, S. E. (2017). Effects of engaging
in repeated mental imagery of future positive events on behavioural activation in
individuals with major depressive disorder. Cognitive therapy and research, 41(3),
369-380. https://doi.org/10.1007/s10608-016-9776-y
Rogers, H., Fox, S., & Herlihy, J. (2015). The importance of looking credible: The impact of
the behavioural sequelae of post-traumatic stress disorder on the credibility of asylum
seekers. Psychology, Crime & Law, 21(2), 139-155.
https://doi.org/10.1080/1068316X.2014.951643