Nursing Case Study: Treatment and Management of Paranoid Schizophrenia

This nursing case study presents a detailed analysis of a patient, Wayne, suffering from paranoid schizophrenia and the effects of past trauma, including domestic violence and family alienation. The assignment delves into the ethical considerations for mental health workers, such as truth-telling and managing risky behaviors, and explores specialist needs like community treatment and early intervention. It highlights the importance of trauma-informed care, assessing vulnerabilities, and creating a supportive environment to avoid re-traumatization. The case study also addresses the concept of re-traumatization, identifying potential triggers in healthcare settings and emphasizing the need for peer support. Finally, it discusses strategies to prevent vicarious trauma among mental health care workers through policy implementation, training, and collaborative practices.

Nursing Case Study

Contents
Answer 1....................................................................................................................................3
Answer 2....................................................................................................................................3
Answer 3....................................................................................................................................4
Answer 4....................................................................................................................................4
Answer 5....................................................................................................................................5
Answer 6....................................................................................................................................5
References..................................................................................................................................6

Answer 1
As the case study suggests, Wayne has experienced a number of instances in his life which
have led to the development of the trauma symptoms in him. The major reason for the
adverse condition of the client is the fact that he was alienated by his family a few years ago,
which hurt him tremendously on the emotional or mental level. However, the family
members of the client had to alienate him in order to prevent him from mental distress caused
due to domestic violence situation at his home. However, this reason was not good enough to
move away a person from the family as it might ruin the mental condition of a person. Due to
this action of the family, he was not able to connect with other people, specially belonging to
his own community. As a result of this, the patient also generated Paranoid Schizophrenia. In
this condition, a patient is not able to accept the reality and does not agree with it. It also
made him suspicious about the people around him and he was not able to make any friends
and connect with the people around (McKinnon & Mardon, 2017).
Answer 2
While handling the patients with Paranoid schizophrenia, the ethical measures need to be
taken by the mental health workers. The first measure is to tell the half truth to the clients
regarding their condition as they are already facing the emotional trauma and any other
information regarding their adverse condition might make their condition even worse. The
risky ambitions of the patients with the disease such as being a pilot and such others must be
controlled by the mental health workers. The family members of patients must contacted as
they will help the patient to regain the social trust and seeing, that the family still cares for the
patient, the patient might feel better. Another ethical dilemma which might rise in front of the
mental health worker is whether to initiate pharmacological treatment for the patient or not
(Pinho, Pereira, & Chaves, 2017). The mental health worker can also adopt the bio

psychosocial model of holistic care to educate the client regarding the disease and its
symptoms, and encourage the spiritual support and self management for the client (Mahone,
Maphis, & Snow, 2016).
Answer 3
There are three major types of specialist needs for the patients suffering from schizophrenia.
First, the patient can be recommended to take the services of the home treatment and crisis
resolution teams; second, assertive community treatment can be provided to patients who are
difficult to engage, and third, early intervention in psychosis services can help in reducing the
delays in treatment. For the client with Paranoid Schizophrenia, the second type of specialist
needs can be recommended. The patient must be given the community treatment in order to
reduce his dislike for the society and the people in it. The specialist services can be provided
to the client with the primary treatment (NICE, 2014). The client might also be provided the
referral services where he might be transferred to the care centres in the social setting where
the patient can be treated in presence of the society. He needs to interact with the society and
develop trust on people again including the aboriginal communities (World Health
Organization, 2019).
Answer 4
The trauma informed care can be defined as the services which “serve people with histories
of violence and trauma”. As mentioned above, the patient was suffering from domestic
violence and hence, was suffering from physical violence. The client needs to be admitted in
this program and the vulnerabilities need to be assessed so that this programme can be more
supportive and avoid re-traumatisation. The mental health worker must switch his role from a
caretaker to a collaborator and must empower the patient using a model of recovery-

orientated practice. The entire culture of the healthcare unit must be modified in order to
meet the personal, therapeutic and other needs of the client. The caretaker must try to keep a
close eye on the patient and try to eliminate substance abuse and addictions, self-harming
behaviours, and suicidality in the client. The client must be respected, connected and
informed about the treatment procedures (Mental Health Coordinating Council , 2012).
Answer 5
Re-traumatisation is the concept in which a patient suffering from trauma gets a reminder of
the actual trauma he had been facing in the past and which deteriorates the mental condition
of the patient. It can be triggered through any situation, an attitude or expression, or by
certain environment which replicate the incident or the dynamics of the original cause of
trauma. For the client, the mental health care centre can also be re-traumatizing for the
patient. For instance, the patient was also suffering from the regular drinking habits. Thus, the
lack of enough rehab beds for all the patient suffering from similar problems or indifferent
psychiatric inpatient programs can lead to re traumatisation in the patient. Also, if the patient
sees the staff members or any other patients in the hospital fighting or performing any sort of
violence, he might remember his original cause of trauma. Thus, the patient must be given
enough peer support and must be loved by the people in the staff. He must be made to
interact with the good people in the society so that his conception regarding the aboriginal
population of Australia might improve (Zgoda, Shelly, & Hitzel, 2016).
Answer 6
For preventing the workers of the mental health care unit from vicarious trauma, the
management must introduce the strict policies and protocols to support the needs of the staff
members. The management must have a good knowledge of vicarious trauma and it must be

shared with the members of the staff as well. The supervisors must identify the risks for
vicarious trauma and train the staff members in order to survive them and overcome them.
The staff members must also try to work in a collaborative manner, reflect on personal
experiences and adopt a healthy lifestyle to overcome the risk of vicarious trauma (Sexual
Violence Research Initiative, 2015).
References
Mahone, I. H., Maphis, C. F., & Snow, D. E. (2016). Effective Strategies for nurses
empowering clients with Schizophrenia: Medication use as a tool in recovery. Issues
in Mental Health Nursing, 37(5), 372–379.
McKinnon, K., & Mardon, A. (2017). The Insanity Machine: Living with Paranoid
Schizophrenia (2nd ed.). Creativia.
Mental Health Coordinating Council . (2012). Trauma Informed Care in Mental Health
Services. Retrieved from Blueknot.org.au: https://www.blueknot.org.au/Portals/2/NS-
TIC%20Lit%20Rev%20190510_F_.pdf
NICE. (2014). Psychosis and Schizophrenia in Adults. In Psychosis and Schizophrenia in
Adults: Treatment and Management (pp. 14-42). National Institute for Health and
Care Excellence.
Pinho, L. G., Pereira, A., & Chaves, C. (2017). Nursing interventions in schizophrenia: the
importance of therapeutic relationship. Nurse Care, 3(6), 331-333.
Sexual Violence Research Initiative. (2015). Guidelines for the prevention and management
of vicarious trauma among researchers of sexual and intimate partner violence.
Retrieved from Svri.org: https://www.svri.org/sites/default/files/attachments/2016-06-
02/SVRIVTguidelines.pdf

World Health Organization. (2019). Schizophrenia. Retrieved from Who.int:
https://www.who.int/mental_health/management/schizophrenia/en/
Zgoda, K., Shelly, P., & Hitzel, S. (2016). Preventing Retraumatization: A Macro Social
Work Approach to Trauma-Informed Practices & Policies. Retrieved from
Socialworker.com:
https://www.socialworker.com/feature-articles/practice/preventing-retraumatization-a-
macro-social-work-approach-to-trauma-informed-practices-policies/