Care of the Psychiatric Patient in the Emergency Department

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Table of Contents

Overview of Presenting Issues and Management----------------------------------------------2

Janet’s Mental State Examination----------------------------------------------------------------3

Three Potential Risks------------------------------------------------------------------------------5

Formulation and Hypothesis----------------------------------------------------------------------6

Significant Presenting Issues and their Intervention------------------------------------------7

Nursing care Plan----------------------------------------------------------------------------------10

References------------------------------------------------------------------------------------------12

Overview of Presenting Issues and Management

In the given case study, the patient has arrived at the emergency department in disturbed and agitated condition. She was silent however her expressions were reflecting as she was depressed. The bloody clothes were representing that she may have attempted suicide. Janet’s parents informed that they have noticed change in her behaviour from few months. She has lost her focus on work and studies and as a result left school. She becomes angry, agitated and violent when her family members try to ask questions or try to discuss with her regarding her health, hygiene or dressing. According to her parent she does not take meals which affected her health. Most importantly, she had broken a mirror by smashing with her hands and locked herself in her room before she came to the emergency department which shows her anger, violence and agitation that may be harmful for her and for others as well.

As far as management is concerned in regards to Janet and staff safety, it is very important to make the patient calm and relax first by focusing on the patient’s emotions instead of frightening them if patient still continues to be violent in the hospital. It is crucial to approach the patient with confidence that being a nurse I have acquired adequate knowledge and skills which are necessary for the identification, assessment and management of patients with mental illness. It is suggested that if nurses are confident about their role and support which they can provide then it results in better relationship formation with the patient (Clark, Parker & Gould, 2005). Initially, it is important to try to communicate with the patient clearly and directly however compassion is important. In order to avoid any mishap or accident due to patient’s agitated and disturbed situation, clinical environment surrounding patient’s bed should be free from things or instruments that can be broken or can be used as weapons. Safe surrounding environment can reduce the possibility of violence and would increase patient’s and staff’s safety. Together with that effective communication is required so that patient’s aggression can be minimized through empathetic and respectful communication (Judge & Bolton, 2013). Try to calm Janet with continuous talking so that her mind remains busy.

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