Mental Health Practitioner's Assessment of Depression in a Patient

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Added on  2023/01/12

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This essay delves into the detailed rationale behind a mental health practitioner's assessment of a patient experiencing depression, focusing on a 32-year-old woman named Ellison. The essay examines how the general practitioner evaluated Ellison's current and past circumstances, utilizing the Levitt Jones clinical reasoning cycle as a framework for clinical decision-making and person-centered care planning. The essay discusses the patient's symptoms, including loss of interest, low mood, suicidal tendencies, and past experiences with depression. It also analyzes the practitioner's approach, highlighting the importance of communication, active listening, and the establishment of a therapeutic relationship. The essay outlines goals for patient care, including risk assessment, environmental hazard reduction, mood monitoring, and improvement of well-being. The nursing care plan includes building rapport, person-centered care, family involvement, physical activity, and medication. The essay concludes with a reflection on the learning experience and the importance of communication skills and ethical considerations in mental health care.
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Introduction-
The essay will provide the detailed rationale of the assessment performed by the mental health
practitioner to the person suffering from depression. I will give more focus on discussing the way
the general practitioner assessed the patient’s current and past situation and will reflect on the
same using Levitt Jones clinical reasoning cycle. It is a framework that helps in clinical decision
making and assists the health care providers to plan and evaluate the person centered care. The
information of the patient will be processed and hence the nursing goal will be established for the
same (Seo, Kang, Lee, & Chae., 2015).
Patient details-
Ellison is a 32 years old woman works in a supermarket. She recently got separated from her
partner Dave and has two kids. She has lost interest in doing anything, feels low and
unmotivated to perform her activities of daily living. She is also getting suicidal tendencies and
takes drug overdose in an attempt to self harm herself. The information obtained through the
clinical assessment mentioned that Ellison was quite depressed with signs of feeling low,
disorientation and withdrawal. She lost her appetite and reluctant to do anything that makes her
happy. In the past, she had similar symptoms when her mother passed away. The physician
doesn’t assess her vital signs. Ellison doesn’t have any signs of self harm as of now but she feels
so low that she might attempt it in the future. Only good thing about her life is her children but
she is afraid that because of her mood, she is not able to take proper care for her children.
Processing information-
The healthcare practitioners have communicated holistically with Ellison and I feel she tried her
best to collect the information on current and past health condition of Ellison. She was able to
identify the risk of suicidal and self harming tendencies. I feel, it will help the GP to gaining a
broader perspective about the patient condition. Literature suggests that “severe depression may
destroy the thought process of a person” (McElroy, 2014). I also feel that when the person failed
to cope up with the crisis or overwhelming life situation, it may lead to depression. The general
practitioner was quite composed and was asking questions relevant to the situation of Ellison.
She was also taking her due consent before asking any question that is associated with her
private life.
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Identification of issues-
Based on the video and the assessment made for Ellison, she was suffering from severe
depression. The best thing performed by the mental health provider during the assessment is by
listening to all the statements made by Ellison. Good listening skill is very important in case of
dealing with patient suffering from mental health ailment (Stuart, 2014). Secondly, after listening
to Ellison, the healthcare provider recapped and acknowledged everything she understood from
what Ellison said. It makes the patient trust on the healthcare provider and will help in
developing therapeutic relationship. As per my understanding of the situation, Ellison is quite
worried about her low mood and the future of her kids. She is unmotivated to go to her
workplace and get herself socialize with her friends. She also has the feeling of worthlessness.
According to Seo et al (2015), depression is significantly increases when there is a feeling of
worthlessness and low mood. She needs to have proper care intervention for self harming
tendencies and develop coping skills.
Establishing goals-
The major goals identified based on the problems associated with Ellison are 1) assessing the
capability of patient to minimize and accelerate risk, 2) identification of environment and reduce
the hazard at the personal level, 3) Monitor the patient for mood fluctuation on regular follow
ups, 4) Improvement of physical and emotional wellbeing of the patient (Townsend, 2014).
Nursing care plan-
Develop therapeutic relationship with Ellison- Iseler & Adam (2014), suggested that building
strong rapport and trust with the patient can help gaining more detailed insight about the patient.
I feel that through a holistic communication and respecting the thoughts of the patient, the
healthcare practitioner was able to develop that with Ellison (Happel & Gaskin, 2013).
Person centered care- Watt & Forbes (2015) mentioned that when the patient gets empathy and
someone to understand their situation, it helps in developing connectedness and fosters positivity
within the patient.
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Family involvement- As Ellison was quite comfortable with her sister and kids, they can be
involved in developing coping skills. Her sister can look after to provide safe environments
where Ellison may not able to attempt self harm (Kutney & Aiken, 2015).
Physical activity- Ellison will be advised to perform physical activities to uplift her mood and
work life balance.
Proving medication- She will be provided with medication that can reduce the depressive
symptoms and develop coping mechanism (Adam & Isler, 2014).
Reflection on the process-
Through this episode with Ellison, one of the most important things that I have learnt is to
develop communication skill. The way mental health care provider was communicating with
Ellison was allowing her to share things freely even after she was feeling low and depressive
symptoms. The major aspect of the mental health care is to assess the patient thoroughly and
establish an interpersonal relation between the patient and the healthcare providers. The case also
helped me in understanding the importance to practice within the scope of ANMC and ethical
codes (Klainin-Yobas, Cho, & Creedy, 2012). The best thing performed by the mental health
provider during the assessment is by listening to all the statements made by Ellison. Good
listening skill is very important in case of dealing with patient suffering from mental health
ailment. Secondly, after listening to Ellison, the healthcare provider recapped and acknowledged
everything she understood from what Ellison said. It makes the patient trust on the healthcare
provider and will help in developing therapeutic relationship. I level of confidence while
assessing the patient was quite remarkable and helped in developing a therapeutic relationship
with the patient (Robson Haddad, Gray, & Gournay,. 2013).
Conclusion-
Reflecting on the nursing practice may help in developing various skills and gaining knowledge
from the previous experiences. The video case study of Ellison helped me in understanding the
importance of communication skills and body language during assessing a patient with mental
health issues.
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References-
Adams, K. L., & Iseler, J. I. (2014). The relationship of bedside nurses' emotional intelligence
with quality of care. Journal of nursing care quality,29(2), 174-181.
Seo, M., Kang, H. S., Lee, Y. J., & Chae, S. M. (2015). Narrative therapy with an emotional
approach for people with depression: Improved symptom and cognitive‐emotional
outcomes. Journal of psychiatric and mental health nursing, 22(6), 379-389.
Storm, M., & Edwards, A. (2013). Models of user involvement in the mental health context:
intentions and implementation challenges. Psychiatric Quarterly, 84(3), 313-327.
Stuart, G. W. (2014). Principles and practice of psychiatric nursing. Elsevier Health Sciences.
USA
Townsend, M. C. (2014). Psychiatric mental health nursing: Concepts of care in evidence-based
practice. FA Davis. Philadelphia
Happell, B., & Gaskin, C. J. (2013). The attitudes of undergraduate nursing students towards
mental health nursing: A systematic review. Journal of Clinical Nursing, 22(1-2), 148-158.
Klainin-Yobas, P., Cho, M. A. A., & Creedy, D. (2012). Efficacy of mindfulness-based
interventions on depressive symptoms among people with mental disorders: a meta-
analysis. International journal of nursing studies, 49(1), 109-121.
Kutney-Lee, A., & Aiken, L. H. (2015). Effect of nurse staffing and education on the outcomes
of surgical patients with comorbid serious mental illness.Psychiatric Services.
McElroy, S. L. (2014). Prescribing antidepressants for bipolar depression: what does the
evidence say?. The Journal of clinical psychiatry, 75(9), 24-24.
Robson, D., Haddad, M., Gray, R., & Gournay, K. (2013). Mental health nursing and physical
health care: A cross‐sectional study of nurses' attitudes, practice, and perceived training needs for
the physical health care of people with severe mental illness. International Journal of Mental
Health Nursing, 22(5), 409-417.
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