Mental Health Nursing Intervention: A Case Study of George's Recovery

This case study focuses on the mental health nursing care provided to George, a 27-year-old single male diagnosed with schizoaffective disorder and a history of sexual abuse, who is receiving treatment on an inpatient unit. The assignment explores evidence-based interventions within a recover...Read More

Running Head: RECOVERY-ORIENTED MENTAL HEALTH NURSING
RECOVERY-ORIENTED MENTAL HEALTH NURSING INTERVENTION

RECOVERY-ORIENTED MENTAL HEALTH NURSING
Background & Introduction
The domain of mental health nursing is very demanding however a rewarding choice as a
career. Mental health nursing includes a specialized nursing field that focuses on working with
consumers in order to work with recovery goals (ACMHN, 2017). The domain of mental health
nursing takes into consideration the person's psychological, social, physical and spiritual needs.
In the context of a person's lived experience along with a partnering with their family, significant
others and the broader community. The focus of mental health nurse's is to provide support to
consumer and their families at the time of crisis and also during the transition period.
Mental health nurses liaison with a range of health care providers, by providing education
for maintenance and restoration, coordination and in providing talking therapy. The domain of
mental health nurses also strives through a full range of clinical and service settings across varied
areas to provide a significant role in the health care system (Happell & Gaskin, 2013). Therefore,
mental health nurses need to possess skills, qualifications, along with experience such as to
provide high-quality mental health nursing in all context. They also need to be flexible and
responsive such that they are able to work with people across varied workplace settings and
lifespan. In the current scope of discussion includes evidence-based mental health nursing care
for George in a recovery-oriented framework, while receiving treatment on the inpatient unit and
strategies to reduce the incidence of relapse in the future.
In the current mental health nursing care based upon evidence for George within
recovery-oriented framework in receiving treatment on the inpatient unit has been undertaken.
George is a 27-year-old single male, diagnosed with schizoaffective disorder and history of
sexual abuse. George has currently lost his unemployment and has received the Disability
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Support Pension (Reed, 2009). He resides with his brother, his brother has been supportive of
him. He has been a compulsory patient in the Victorian Mental Health Act (2014). He had
recently depicted symptoms and is now in the hospital. The current scope of healthcare
management provided to him includes the usage of an antipsychotic agent, a mood stabilizer and
Electro-Convulsive Therapy (ECT).
Discussion
In the Victorian Mental Health Act 2014 places individuals with mental illness at the
center focus of decision making related to their treatment and care. The Mental Health Act
provides encouragement to nurses such that strong relationship with people can be developed
while providing them with information and support such that informed decisions can be made
(Guise, Chambers & Välimäki, 2012). This Act includes voluntary treatment as against
compulsory treatment to be able to establish robust safeguard and autonomy of people with
mental illness. It is the duty of nurse’s to be able to administer holistic care to be able to address
the patient’s mental state. Nurses have the responsibility to provide care to the mentally ill patient
and nurses need to be aware regarding the unsociable and troublesome signs that the patient
might be exhibiting. The focus of the Mental Health Act 2014 is to provide supported decision
making through the evidence-based framework and encouraging strong communication between
consumers, their families, and health practitioner (De Hert et al, 2011). It enables people
receiving mental treatment to participate in treatment decisions and to provide their views and
preferences.
Nursing assessment of a person with schizoaffective disorder and history of sexual abuse
is a complex procedure and entails the collection of data from varied sources. However, in acute
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cases as in the case of George reliable information is not easily obtainable. Nurse's in order to
provide care to George needs to adhere to steps and follow guidelines to reduce the incidence of
relapse of his symptoms again in the future (Storm & Edwards, 2013). These steps will allow
psychopathology and pharmacological and other interventions strategies.
Nursing Management
During the first stage, a nurse needs to assess the mental state of the patient. As George's
mental state is well known, the mental health nurse needs to review all aspects of treatment and
past history that the patient has faced in the past. Nurses need to go into depth to uncover reasons
for mental instability as patients with mental health are often seen to be difficult and non-
manageable (Cunningham, 2009). Significant people from George’s family, his brother and
clinical records will need to be verified along with a mental examination. The nurse will not
judge the patient due to the patient's behavior, as they need to provide care in a respectable
manner. Any trauma and chronic health conditions to George can trigger depression or anxiety.
Medication can trigger the appearance of mental distress. Undertaking a (Mental Status
Examination) MSE will enable identifying current symptomology, comprising of hallucination,
negative symptomology and hallucinations (Slade et al, 2014).
The second stage the nurse needs to establish good communication with the patient. The
nurse will need to establish good communication with the patient. As George has recently lost his
employment and has been having been admitted into the healthcare center due to his symptoms
arising again, a communicative framework needs to be established with him to understand
whether he is comfortable with the treatment that is rendered to him. Nurses have the
responsibility to provide care to the mentally ill patient and nurses need to be aware regarding the
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unsociable and troublesome signs that the patient might be exhibiting. His acceptance regarding
the treatment procedure needs to be understood. In case he has a varied point of view then such
communication needs to be noted down. His point of view regarding antipsychotic drug and
Electroconvulsive therapy (ECT) need to be known (Beebe et al, 2011). Many mental patients are
not comfortable with antipsychotic medications due to their tranquilizing properties with neurotic
side behaviors. These drugs are often known as neuroleptics due to their ability to produce side
effects. Similarly, George was given ECT under general anesthesia, where the small electric
current was passed through his brain. The treatment he was undergoing was tremendously
painful, hence through open communication his reaction and feedback regarding the procedures
needed to be ascertained.
Building a relationship with the patient will enable to provide nursing care to the patient
in an appropriate manner (Happell, Davies & Scott, 2012). As the patient experiences
schizoaffective disorder, the treatment provided to him is ideal in nature. However, establishing a
relationship with George will allow him to disclose his feelings and thoughts. While devising
nursing care plans, nursing diagnosis needs to be conducted. A therapeutic relationship can be
established with hi only after appropriate discussion and contribution to curative climate and
preventing of the disease. As George might have difficulty in expressing their symptoms, it might
be difficult at first to establish a therapeutic relationship. His brother needs to be taken into
consideration while providing treatment to him. It will allow him to provide valuable insights
regarding George.
One of the best strategies that can be used is adopting language that shows consideration.
It requires great capacity for nurses to care for such patients, as a nurse needs to be empathetic
and be non-stigmatized to mental illness. A nurse needs to be able to see beyond symptoms as the
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person is already suffering terribly from despair, incomprehension, hopelessness and even might
have suicidal thoughts. The nurse will need to work with George to make him distinguished from
hallucination and delusion. Peplau’s theory of interpersonal relationships can be adopted that is
based upon the four psychobiological experiences which compel patient’s in developing a
constructive response towards needs, frustration, anxiety, and conflict. The nursing intervention
has to undertake communication and assume responsibility for it.
Provide sensitive patient-centered care is another strategy which will enable nurses to
provide adequate care to the patient. Nurses need to be aware of their communication in order to
develop a therapeutic relationship with patients. During the orientation phase, nurses need to be
extremely careful during the beginning of the relationship as they focus on the needs of the
patient. Through MSE, George's awareness regarding the problem can be easily understood and
the need for cooperation can be diagnosed. A sensitive approach for George will allow setting
targets for him which can be accomplished. Nurses can undertake possible available strategies for
recovery such as psychosocial rehabilitation programs (Muskett, 2014). The patient's
requirements will be met first prior to the establishment of completing a relationship with him.
The rehabilitation program will make him aware of his condition and enable him to live with the
disease without further deterioration of symptoms. George needs to be rehabilitated through
continuous mentoring and psychological counseling. However, establishing such a relationship is
not easy and requires special attention from the nurse on the patient. By active listening and
special attention, it is possible that nurses are able to focus on the patient experience. Through
this procedure, George will be able to distinguish between what is part of the disease and what is
not, further what is real and what is not. It is integral that patients are able to identify their
personal resources, hence the goals that are attainable for them and the ways to attain such goals.
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In addition to all strategic therapeutic nursing interventions, consultation with
knowledgeable mental health professionals needs to be undertaken (Reavley & Jorm, 2010).
Engaging with professionals with mental health professionals will help to share experiences,
knowledge, and skills regarding patient diagnosis and nursing interventions. A professional in
this field will be able to contribute effective guidelines and experiences that might add value to
the nursing interventions. Apart from therapeutic interventions and medications in controlling his
symptoms, there is a need for psychoeducation for George and his family regarding his disease,
symptoms, and importance of following routine treatment procedures. The domain of mental
health nurses also strives through a full range of clinical and service settings across varied areas
to provide a significant role in the health care system. Therefore nurses can provide education to
their patient for contributing towards improvement in their condition. Psychoeducation is a
psychotherapeutic intervention which is beyond simple knowledge transmission. It allows the
patient to develop the capability to deal with mental illness. Participating in such programs will
enable George to work upon his symptoms well and overcome his situation in a gradual manner.
The effectiveness of nursing interventions in schizoaffective disorder is not only
dependent upon patient outcome but on the entire family’s involvement. It is important in
George’s case that his brother takes participation in the recovery process such that his symptoms
do not reappear. A multidisciplinary and networked effort is considered to be crucial in the
nurse’s capability to work in the team (Tambuyzer, Pieters & Van Audenhove, 2014). Referring
to the patient to community services might allow greater engagement of the patient and help him
improvise his symptoms. It might also present relapse of his symptoms. The condition faced by
George has occurred again, hence there will need to be proactive efforts to prevent its
reoccurrence.
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Conclusion
To conclude, it can be said that the role of mental health nurses in Australia includes
varied nursing roles, functionality, responsibilities, accountabilities, creativities, activities,
innovations as well as modalities. The basis of the nursing framework is upon an ethical decision-
making process. The diverse nursing role is aimed at the promotion of optimal physical and
mental health, providing therapeutic interventions and treatment to for supporting mental and
physical health preferences, preventing of physical and mental health illnesses, and supporting
preferences in mental and physical health as per individual needs, community-based needs and
population groups.
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