Nursing Assignment: Application of Mental Health Act in Patient Care

This nursing assignment presents a case study of a 64-year-old patient, Mr. Stephen, admitted to a psychiatry ward with symptoms of PTSD, delirium, and suicidal tendencies. The essay details the nursing assessment, diagnosis, and the implementation of a holistic care plan based on the bio-psychological model, incorporating cognitive behavioral therapy and collaboration with a multidisciplinary team. The assignment emphasizes the application of the Mental Health Act 2014, focusing on patient-centered care, rights, and advocacy. It explores the patient's symptoms, including hallucinations, delusions, and self-harm behaviors, linking them to the underlying trauma and neurocognitive impacts. The care plan includes medication administration, psychotherapy, and psychosocial interventions to manage risks and promote the patient's recovery. The essay also highlights the importance of collaboration with other healthcare professionals and the patient's family to strengthen the social framework. The assignment demonstrates the EN's role in providing informed care and promoting the patient's dignity and autonomy, as guided by the Mental Health Act.

Running head: NURSING
ASSIGNMENT 2
NURSING ESSAY
Name of Student
Name of University
Author note

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I am currently attending Mr. Stephen, admitted in the psychiatry ward of the
hospital, bed no. 39. Adhering to my practices as a EN under the policies laid down by the
Mental Health Act, 2014 - The Mental health act 2014 empowers the persons (in Australia)
affected with the mental health conditions at the very center taking their own decisions
related to their health and mental well-being (Parry, Lloyd and Simpson 2018). As an EN, I
focus to deliver a patient centered care and patient empowered care under the policies of Act.
Under the Mental health Act of 2014, I intend to assist and collaborate with other mental
health care professionals such as psychiatrists, psychologists, social workers, the health
therapists and the nursing professionals to deliver an effective recovery service to the Mr.
Stephen. The Mental health act promotes rights and advocacies of the patient through a
rightful, informed care. The Mental health Act of 2014 promotes diversity in the services of
mental health by collaborating with multi-disciplinary professionals in order to deliver an
informed mental health care. Hence, as an EN under the supervision of my guide and nursing
supervisor – I will use an effective communication with the other service providers, the
clients, the consumers, the facilitators and the health care professionals in Australia as
supported and guided by the Mental Health Act, 2014. The act promotes decision making in
the mental health subject by promoting a meaningful patient centered intervention experience
and I would apply the same in treatment and care of Mr. Stephen. The Act supports and
directs a holistic care to the mental health patients in Australia through the BPS model. I
would deliver a holistic care to Mr. Stephen. According to Act, the individuals’ dignity,
autonomy and rights should be protected, promoted during assessment, recovery and
treatment of the mental health patients.
Mr. Stephen, 64 years was admitted last night at 2000 hours, following disruptive
behavior at home, cuts at wrist and violent outburst at home. He was in acute confusion when
he was bought in and was not been able to talk or recollect the events at home. His wife Mrs.

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Carla bought him to the facility and while I took the patient history – she communicated
history of post-traumatic stress disorder in Stephen since a war event that occurred 30 years
back. He had diagnosed history of depression. After a complete nursing assessment of the
patient – several signs and symptoms such as delusions, hallucinations (he complained
hearing voices that told him to cut his hands and he was seeing insects on the ceiling which
was actually empty), disorganized (rambling speech) and thinking, extremely abnormal
psychomotor behavior, apathy. Mr. Stephen also exhibited lack of eye contact, bizarre
posture and episodes of stillness. My nursing diagnosis was that he had a personality disorder
plus he was in a state of delirium. He was afraid of the hallucinations (auditory and visual)
and he held a strong delusion that he is still in a war and the whole world has turned in a
battle field. I performed a risk assessment of the patient and found out he had suicidal
tendencies. I immediately reported back the assessment to my supervisor and she asked to
plan a holistic care for the patient.
I incorporated the holistic bio-psychological model of care into my care plan for Mr.
Stephen. In the psychological aspect of the BPS mediated care – I incorporated
psychotherapeutic modalities such as cognitive behavioral therapy and individual therapy to
treat and care for his delusions. I planned to collaborate with the hospital clinical
psychologist for the same. The patient needed speech therapy as he had sensory aphasia.
Therefore, I planned to collaborate with the speech therapist to better the subject’s
psychomotor ability. I administered the medications (the anti-depressants and the anti -
psychotic drugs that were prescribed the psychiatrists) on time and in times of critical
assessments, I along with RN referred the patient to the clinical psychologist, the attending
psychologists and the speech therapist to plan the further care. I collaborated effectively with
my RN and the multidisciplinary team (MDT) and Mr. Stephen’s family network to
strengthen the social framework of the patient. The psychosocial aspects were focused on to

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teach and reeducate positive coping mechanisms to the patient. He had self-care deficits and
hence the ADL re-education was an important nursing intervention.
In delirium and personality problems, several areas in the hippocampus, limbic
system and several parts of cerebral cortex especially parietal lobe is affected (Moshfegh et
al. 2017). The past trauma during the time of its incident affects the memory system very
deeply thus distorting the neuro cognitive patterns of the mind and brain (Henderson et al.
2016). When a person is rethinking about the traumatic situation consciously or
subconsciously – it re-traumatizes the person’s being, physically, mentally and
psychosocially as well. In this case, in the acute confusion state when the patient was
admitted, his past memories of fear and sights in the jail where he was imprisoned by the
foreign army took form of hallucinations and delusions thus affecting areas of his prefrontal
cortex which turn affected motor planning and execution. The sensory and motor cortex
relating to receptive and expressive speech was also affected which lead to speech problems
(and the triggers were memories of past trauma, fear and negative emotions associated with
the same.). An intense fear and distorted logical reasoning led to his self-harm behaviors
which can be attributed aggression mediating neurochemicals which are released overly.
The potential complicated encountered in treatment and care of Mr. Stephen was self
harm behavior. He was biting his hands and scratching his finger on this skin and we had to
administer sedative to calm him down. PTSD was the main root concern which lead to his
depersonalization, delirium and detachment from reality (Weisenhorn et al. 2017).
To manage the risks impended, I along with my supervisor RN consulted with the
attending psychiatrist and the clinical psychologist whether to put on restraints but finally as
the patient responded well to the medications and the psychotherapy – his aggressive and self
harm behaviors were bought under control. When his delirium was managed and he stopped
having hallucinations – I taught him self-monitoring and self-management skills to manage

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his triggers by himself in a positive way. Over the course of week, his initially impaired
cognitive parameters showed betterment and he gained on functional scale.

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References
Henderson, S.N., Van Hasselt, V.B., LeDuc, T.J. and Couwels, J., 2016. Firefighter suicide:
Understanding cultural challenges for mental health professionals. Professional Psychology:
Research and Practice, 47(3), p.224.
Moshfegh, C., Swiercz, A.P., Hopkins, L., Hurr, C., Young, C.N. and Marvar, P.J., 2017.
Effects of Essential Oil on Fear Memory and the Immune Response: A Potential Alternative
Therapy for Post Traumatic Stress Disorder (PSTD). The FASEB Journal, 31(1_supplement),
pp.882-5.
Parry, S., Lloyd, M. and Simpson, J. 2018. “It's not like you have PSTD with a touch of
dissociation”: Understanding dissociative identity disorder through first person
accounts. European Journal of Trauma & Dissociation, 2(1), 31-38.
Weisenhorn, D.A., Frey, L.M., van de Venne, J. and Cerel, J., 2017. Suicide exposure and
posttraumatic stress disorder: is marriage a protective factor for veterans?. Journal of child
and family studies, 26(1), pp.161-167.