Philosophy of Mental Health Nursing - Essay Writing Assessment Answer

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Mental Health Nursing Assessment Answer

Assignment Task: 

Philosophy of Mental Health Nursing -

Explore and describe the philosophy of mental health nursing, and discuss the various theories (nursing and/or psychological) that resonate with you as a practicing mental health nurse and explain how you apply these theories in practice. Choose a (de-identified) consumer from your workplace whose case permits a detailed exploration of the theories discussed, and permits a description of how the mental health nursing theory/theories translate into practice in a real-life clinical setting. This essay has you: Explore the ways in which mental health nursing theory and the underpinning philosophy is applied in their real-life clinical setting Articulates the factors effecting the translation of mental health nursing theory to practice References: should be formatted using APA 6th edition guidelines to meet Monash University academic requirements Appendices: of additional material, such as graphs, charts, and copies of documentation, etc., should be de-identified and may be included, if appropriate. You should not include anything that is not referred to in the body of your work Real life Client detail: A 31 years old female client who was diagnosed with Borderline Personality Disorder, and she has resided in an extended secure inpatient unit for much of her adult life as a result of the significant history of interpersonal aggression. Her relevant medical issues and history are Asperger’s Syndrome, Morbid obesity, Asthma, and Type 2 Diabetes mellitus managed with oral hypoglycemic agents. She has previously received input from the cardiology team due to her ejection fraction being borderline which remains unchanged from the previous echocardiogram. The opinion is that the cause could be multifactional due to her weight, diabetes, pre-existing lung condition and obstructive sleep apnoea. In the past, she has also experienced symptoms of hyperprolactinemia secondary to her medication which has been managed with the support of the endocrine team.   She has an extensive history of verbal aggression, interpersonal violence causing significant injury, property damage, and arson. Her aggression and violence have included verbal abuse, theft, threats to kill, punching, kicking, banging another’s head against the concrete ground, slashing with broken crockery and glass, stabbing with a knife and other utensils, and strangling. Her victims have been staff, co-patients, co-residents, and the community. It has been observed that she is more likely to hurt younger women or people that she thinks are vulnerable in some way, and appears to struggle to empathies with her victims. Before she was admitted to the extended inpatient unit, she had a long admission at Thomas Embling Hospital.  After repeated assaults of staff and co-patients in the early phase of her admission to the extended inpatient unit, since 2016, when she physically assaulted a staff member by repeated punched staff member’s head and face, threw objects and was not responsive to verbal de-escalation, there had no further incidents of physical assault till 2018, when unprovoked, she punched a co-patient , threatened nursing staff and hit a security guard, she is on an adjourned undertaking with conditions of good behavior and compliance with treatment. The incident has been reported to the police. She is the oldest of three children. Her mother is a primary school teacher and father is a General Practitioner. Her parents are separated when she was 17. Ash a baby, she was described as a difficult/colicky baby/struggled to sleep and difficulty with self-soothing. She was reported as exhibiting excessive sibling jealousy and sexualized behaviour toward both brother and sister. The multidisciplinary approach to her care involves: psychiatric and medical care (with referral to appropriate specialists as necessary). Nursing care, social work, psychology (CBT, DBT). Occupational therpay, speech therapy, exercise physiology, dietetics and music therapry. Her care team meets weekly to ensure a consistent approach and to plan recovery focused activities (escorted leave to cafes, for shopping, bowling, pet therapy and the golf-driving range…).  A detailed behaviour management plan is in place. Plans have been put into place to manage issues as they arise, for example, she received a movile phone and a plan was put in place to ensure appropriate use of it. Initially agreed to used this for calls to her mother and father between the hours of 1 and 6pm. Her usage gradually increased as she managed to use it appropriately. She has paranoid thoughts of people are observing her. She also intermittently complained of auditory hallucinations of people she knows saying derogatory things about her, although she had been unable to express the content and nature of these auditory hallucinations. She is also very sensitive to any increase in sensory stimuli in her surrounding s or changes in routine which causes her significant distress and unfavorable reaction if not managed appropriately. She enjoys going out for meals, getting her hair done and reparing for festive occasions such as Christmas and her birthday. She also enjoys a number of hobbies including stringing beads, singing, playing board games and entertaining herself with her ipad. She requires ongoing administration of medication in a supportive environment that can respond assertively to fluctuations in her mental state to minimize the risk of harm to herself and others. This is currently facilitated with an MDT meeting held every week to discuss issues in her care. She is aware of this meeting and has the opportunity to record any concers or issues she would like discussed prior to the meeting. Her management plan is aimed at reinforcing positive behaviours, with a number of levels of intervention in crisis to attempt to manage and reduce her risk to others. This management plan involves consistent, standardized approaches to any inappropriate comments or behavior. Since this plan was put in place, she is beginning to identify occasions when her behaviour has been inappropriate. However, crises can be of abrupt onset with no warning and require an immediate response from trained and experienced staff. She continues to require intensive monitoring, high doses of medication and utilize PRN medications.  Goals of her admission are primarily focused on first maintaining safety, and then maximizing on her quality of life within these limits. Her management plan will progress based on her ability to demonstrate sustained alterations in how she responds to emotional triggers and challenges.

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