Developing a Nursing Care Plan for Auditory Hallucinations

This report presents a nursing care plan developed for Mr. Demitrie, a 22-year-old patient experiencing auditory hallucinations. The primary problem identified is the auditory hallucinations themselves, impacting his daily life. The care plan outlines three key goals: enabling the patient to function without responding to hallucinations, eliminating hallucinations by discharge, and promoting logical thought processes. Three strategies are proposed to achieve these goals: establishing a therapeutic relationship through honesty and non-judgment, conducting a thorough mental health and risk assessment to understand the underlying causes and potential dangers, and employing a reality-based approach using relaxation techniques and exercises to distract from the hallucinations. The rationale behind each strategy is discussed, emphasizing the importance of trust, accurate assessment, and distraction in managing auditory hallucinations and promoting the patient's recovery.

Running head: AUDITORY HALLUCINATIONS
AUDITORY HALLUCINATIONS
Name of the Student
Name of the University
Author’s Note:

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The purpose of this article is to develop a care plan for Mr. Demitrie who is visiting a
mental health clinic for check- up. Mr. Demitrie is a boy who looks like 22 years old and
complains to the nurse about hearing voices all the time. After the conversation with Mr.
Demitrie, a priority problem was identified by the nurse. The priority problem of Mr. Demitrie
was ‘Auditory Hallucinations’.
‘Auditory Hallucinations’ was chosen as a priority problem because, after the session
with nurse, the only major concern was the patient’s hearing voices. In all the other aspects, the
patient seems okay. The patient has the correct notion of time, day, month and year which
suggests that he is aware of his surroundings. He also admitted that he has stopped using
medication due to his trip to Japan as could not get his medication over there. However, he has
no problem with medication and he is willing to resume his medications. Another interesting
aspect is that the patient, Mr. Demitrie, is not aggressive and violent and according to him he is
not in risk of harming him or harming other. When the patient was asked about a simple math
question, the first answer was correct followed by a wrong one and again followed by denial.
From the above discussion, it can be seen that patient is not in risk of harming him or others, the
patient is willing to resume his medication and he has awareness regarding his surroundings. The
only problem was auditory hallucinations which are hindering his daily life activities need to be
treated in immediate manner to stop any further exacerbation of the problem. Therefore,
‘Auditory Hallucinations’ was chosen as a priority problem.
In order to treat the patient, Mr. Demitrie, few goals have been set up for his recovery and
the ‘Goals’ of his care plan are described below:

2AUDITORY HALLUCINATIONS
 The patient will be able to function properly without responding to his auditory
hallucinations.
 The patient will no longer experience any auditory hallucinations at the time of his
discharge.
 The patient will display appropriate and logical thought process and will not verbalise his
auditory hallucinations (Varese et al., 2016).
In order to achieve the fore mentioned goals three strategies have been provided for the
patient. The rationale of these strategies will also be discussed along with them. The three
strategies and their respective rationales are discussed below.
Strategy number 1: The first strategy that will be employed for the recovery process is to develop
a therapeutic relationship with the patient, Mr. Demitrie. The relationship will be developed by
being honest, sincere, consistent, explanatory and non- judgmental towards the patient. This
means patient will be explained every process and steps of the recovery process and why they are
being taken. The patient will be encouraged share all his thoughts and he will be assured that he
will not be judged because of it (Valente, 2017).
Rationale for strategy 1: The main reason behind the choice of therapeutic relationship is that the
trust need to be built between the patient and the nurses, otherwise it will be very difficult for
accurate assessment of the patients improvement and the state of his mental health. This is
particularly true in case of auditory hallucination if the patient does not trust the nurse and does
not open up about his true mental condition. Another reason for choosing therapeutic relationship
in this scenario is to build a rapport with the patient which will in turn help the nurse to build a
trusted relationship with the patient (O'Hanlon et al., 2016).

3AUDITORY HALLUCINATIONS
Strategy number 2: The next strategy that will be employed for the recovery of Mr. Demitrie is to
mental health and risk assessment of the patient. Any type of hallucinations, including auditory
hallucinations, can have detrimental effect on a person like self harming or the harms to the
others. Additionally, mental health assessment will be conducted to evaluate the exact condition
of the patient’s mental health condition.
Rationale for strategy 2: Generally, it has been evident that the hallucinations occur due to a
significant major illness. The altered perceptions or hallucinations occurs because of the mental
illness and it is paramount for the patient to understand the difference between real and faulty
thought process in order to fully recover from his illness. Therefore, mental health assessment is
required for the patient to determine the reasoning behind the hallucinations. Additionally,
mental health assessment provides the nurses with a baseline data on which nurses can act upon
to develop recovery care plan for the patient (Brown, 2015).
The risk factor of self harming or harm to others is always associated with the mental health
patient. This particularly true in case of auditory hallucinations as the voices the patients hear
might tell him to harm himself or others. Therefore, risk assessment should be conducted for the
patient with auditory hallucinations (Fujita et al., 2015).
Strategy number 3: The final of the three strategies that will be employed is to treat the patient
with reality based approach. In this scenario the patient will be treated with relaxation technique
and exercise (Tarrier, 2014).
Rationale for strategy 3: Distraction is one of the effective ways to treat patients with auditory
hallucinations. Distracted patients tend to be reacting less with the voices they hear in their head
(Tarrier, 2014). From the conversation with Mr. Demitrie, it is already evident that this method

4AUDITORY HALLUCINATIONS
can help the patient deal with his auditory hallucinations. Mr. Demitrie has stated that he did not
suffer any hallucinations while raveling in Japan. Therefore, relaxation technique and exercise
will be adopted for the patient’s recovery process.

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