Roles of a Mental Health Nurse

Running head: ROLES OF A MENTAL HEALTH NURSE
ROLES OF A MENTAL HEALTH NURSE
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1ROLES OF A MENTAL HEALTH NURSE
Lisa is visited by an alcohol and other drugs community counsellor who finds her in
an agitated and restless state. Having left her parent’s home, Lisa has been staying with her
partner since last two weeks where she had found herself hearing voices and sleeping in the
night on the garden chair with a knife. She also thinks her partner has inserted a transmitter in
her stomach and all of her feelings and thoughts are getting transmitted out. She talks about
cameras in the rooms and terrace that is always watching her. The ‘voice’ that she hears are
referred by ‘Lisa’ as being horrible which alerts her continuously about her partner who
would hurt her bad one day. She is also afraid if she may hurt her partner in order to protect
herself. Throughout the conversation, she had been responding to invisible stimulus in the
room with erratic gazing. She is on cannabis and speed currently and Lisa could not
remember if she has taken her medications in last two weeks which has worsened her
symptoms to great extent. Her parents were angry with her for leaving them and she had not
spoken to them as well. Substance abuse has led to hallucinations in a stage of psychosis
(Clark et al., 2017).Lisa had been hallucinating about the cameras (visual hallucinations) and
hearing voices (auditory hallucinations) along with commands (command hallucinations)
which is a key issue. Memory is another problem for Lisa because it caused a forgetfulness
about medications, presenting her agitation and hallucinatory symptoms due to non-
adherence to prescribed drugs. Risk of self-harm or to others (her partner) is another potential
issue with Lisa for the paranoid delusionary voices has made her conscious about the danger
posed by her partner and in turn, she keeps a knife while sleeping at night.
While Lisa’s case portrays certain covert borderlines of a complex childhood trauma
which she still attempts to cope with through the use of drugs. There had been trauma
survivors who shows exquisite resilience towards their own recovery (Ben-David & Jonson-
Reid, 2017) while others struggles with day to day self and worldly conflict with contrasting
emotions, dubious relationships, and loss of self-identity (Matheson et al., 2015). Any sort of

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complex trauma affects just not its victims who were involved directly but with their near
relations too and future children as well (Woolf et al., 2016). Trauma of any kind – mental or
physical is a big health problem of major concern. But to the horrors of our currently
established medical systems – the etiology or the pathophysiology is not properly identified
or acknowledged and hence the insidious course of these events goes unaddressed. Subjects
who are affected are again somehow re-traumatized within healthcare systems with
practitioners who lack the requisite knowledge about the trauma. These practitioners with the
ad hoc trauma care training can easily trigger the sensations of depression and discomfort
back in the patient. Trauma Informed Care and Practice is an agile strengths-based medical
framework founded on five exclusive core principles – trustworthiness, safety, choice,
empowerment and collaboration along with the respect for population diversity. Trauma
informed services aims at not re-traumatizing or blaming victims for their own traumatic
reactions. The trauma care experts embrace optimism and hope to a point from where
recovery becomes possible (Schiff et al., 2018). Trauma-informed services allow survivors to
be like ‘special’ individuals who had been through extremely unpleasant situations but have
actually managed to drive through. Identifying core principles for each of the issue is
extremely important (Raja et al., 2015). Perceived distress along with lack of self-control
triggers hallucinations in traumatic or developmental schizophrenia (Hugdahl & Sommer,
2017), has common etiological processes that needs a specific treatment. A complete 5 year
follow-up is advised for non-psychotic adults between 40 to 70 with recurrent auditory verbal
hallucinations(Daalman et al., 2016). Ensuring safety and collaboration is important for a
nurse led care of Lisa. In trauma treatment settings, there is a great distinction between: 1)
treating trauma symptoms, 2) treating experience of the trauma. The difference is understood
which doing trauma-processing therapy (Varkovitzky, Gilbert & Chard, 2018). An eclectic
counseling of the trauma experience help stabilize the memory induced agony which treating

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the responsive symptoms can better the present recovery (Spiers, 2018). There exists a
potential treatment gap between trained trauma care practitioners and number of patients with
severe trauma histories. Though every practitioner or health care provider is not trained on
trauma care but it is recommended for every health care setup to train their practitioners on
trauma care and practice. A structured approach must be followed by institutions for
providing Trauma Informed Care (Isobel & Edwards, 2017) .Hallucination is a de-realization
disorder which can be have an extreme complex origin and sometimes, the underlying causes
can be extremely diffused. Although securing safety at home (Cockerham, 2016), change of
environment and behavioral therapies (Goldbeck et al., 2016), can be intervened by a nurse
along with help of a multi-disciplinary team including psychiatrists, community health
workers, occupational and physical therapists. Memory loss and registration problems leads
to loss of identity, detachment with the reality and many cognitive distortions (Bortolotti &
Sullivan‐Bissett, 2018) – collaboration with the patient, developing trust worthiness with the
subject are the main principles of informed trauma care to be practiced by a mental health
nurse. Risk assessment and risk management is crucial to informed trauma care and practice
which involves assessing the life risks of the subject by a nurse. An effective communication
with the patient while cutting down her fears and paranoid behaviors through counselling is
important and a mental health care nurse should be able to ‘empower’ Lisa to charge of her
own life for the nurse must many roles of many practitioners in Lisa’s recovery. As a
practitioner of informed trauma care, a mental health nurse must be able to ‘choose’ what is
right for the patient and situational with reflective judgment becomes an important trait in this
vital decision making process. With further qualitative conversations, the nurse must be able
to decipher any past traumas associated with current present substance abuse issue and the
nurse must also be able to analyze any such findings in development of her paranoid and