ASSIGNMENT 2 – CONSUMER SCENARIO [Weight 30%]
Aim The aim of this assignment is to help you to begin to use your professional judgement and think like clinical nurses in mental health settings and/or in relation to the mental health needs of consumers. In order to achieve this aim, everyone will be assigned a case scenario involving a consumer who is experiencing issues relating to one of the various disorders commonly encountered in clinical practice.
Description this is an individual assignment of 2000 words in two parts each with several steps. Follow the steps for each part carefully.
The piece will demonstrate a sound grasp of the following as they relate to your consumer and include: • a Mental Status Examination(MSE) • a clinical formulation including biopsychosocial history and your own MSE observations leading to the clinical formulation • a nursing orientated handover • using Maslow’s hierarchy of needs to identity and prioritise consumer needs • identifying nursing interventions and goals, timeframes and evaluation criteria for their achievement • how to engage a consumer in a therapeutic relationship • the application of cultural safety • the application of the recovery model
You will need to justify your ideas with reference to relevant literature; students who plan to do well, read and use the unit’s required readings and additional items drawn from respected academic sources.
Presentation and submission • a proforma cover sheet is on BB>>>assessment. Copy and paste it into the beginning of your assessment and add your name, student ID number, name of the consumer and name of your tutor
- Please upload your assignment to the Turnitin link on blackboard under ‘assessment’ It is VERY important that you make sure you have submitted the CORRECT assignment to this link before the due date as whatever paper is in the submissions inbox at the time the link is closed, will be marked – if the wrong assignment has been submitted, then the teaching staff will not be resubmitting the correct one on your behalf
- in-text citation of all items used – there is no set number of references required • full reference list at the end of the assessment of items used within the paper properly formatted in APA style • the reference list is NOT included in the word count • word counts include everything in the body of the assessment (including headings, citations, quotes) • include a word count AFTER EACH SCTION • the paper does not need an introduction or a conclusion and is to be organised into two parts using the headings and subheadings below
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PART 1 Holistic assessment and planning: 900 words total
This part does not require full paragraphs. Use appropriate templates/ tables to set out each part: EG: MSE, 5Ps as used in tutorials and the nursing care table as in the example below
Ensure your work includes the name of the consumer and brief demographic data about them [e.g. Mary Citizen is an university educated 36 year old married woman and mother of a 14 year old girl]
1.1 The Mental Status Examination [350 words] • using the MSE format in your weekly tutorial guide provide a complete Mental Status Examination (MSE) of your consumer • use specific examples from this case study to illustrate each part of the MSE • you must use and define psychiatric terms accurately (e.g. Instead of “talks fast” use the correct term “pressure of speech“, define it properly and cite your sources)
1.2 A Clinical Formulation Table [250 words] • use information gathered from the MSE and the bio-psycho-social assessment (history of presenting complaint, family and social history, current living situation, the consumer’s strengths and coping strategies, medical history) to complete a table under the headings of presenting, precipitating, predisposing, perpetuating and protective factors (5Ps) relevant to your consumer’s clinical presentation
1.3 Plan for Nursing Care [300 words] • using Maslow’s Hierarchy of Needs, identify and prioritise the needs of your consumer • select the two (2) highest priority issues identified and clearly indicate what they are and why they are highest priority • outline your nursing care, focusing on one (1) nursing intervention for each of these needs and your rationale for each i.e. describe how the intervention assists your consumer to address or meet each need; interventions must be nursing related, detailed, practical and within your scope of practice
** NOTE: in part two you will be explaining how you would develop and use a therapeutic relationship with this consumer, and how cultural safety and the recovery model influenced your nursing care and choice of interventions
- Nursing care interventions must have a short term goal (short term = goal setting over a day or two) • for each nursing care intervention state how you will evaluate if its goal is being achieved
EXAMPLE OF NURSING CARE
Issue constipation related to medication side effects
Intervention consumer has 1 hour accompanied walk/day
Goal regular elimination established
Evaluation assess bowel elimination 1/24 hours
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Part 2: Therapeutic engagement and clinical interpretation: 1100 words total This part of the paper is to be written in properly constructed sentences and paragraphs under each subheading [not dot points] and is to provide further description and depth to the assessment and care planning identified in Part 1.
2.1 Clinical handover [200words] Synthesise (consider together) the results of your MSE and clinical formulation to construct a paragraph describing the consumer and their main concerns that you could present at a clinical handover meeting.
Note: This is not merely a repetition of the case study material – it is an analysis and synthesis of the material and the MSE to produce the clinical formulation that answers why this person, why now, why with this presenting situation. This is the information your colleagues need to know so they can continue working with the consumer when you go home. Remember to keep a nursing focus.
2.2 The Therapeutic Relationship [250 words] Explain how and why a therapeutic relationship will be established with your consumer. This must not be general description of therapeutic relationships but demonstrate that you are applying it to this person. Then describe at least one (1) specific strategy appropriate for the development of a therapeutic relationship with this specific consumer and how it was applied in the nursing care interventions you described in Step 1.
2.3 Cultural Safety [250 words] Describe the first step you would take to ensure that you deliver culturally safe care to this consumer. Then identify and describe one (1) issue that working with this consumer may present for you. Describe which of the principles of cultural safety you used in applying cultural safety in the nursing care interventions you described in Step 1.
2.4 Nursing Care and Recovery Model [400 words] consider the nursing interventions you developed in Step 1. Describe how these nursing interventions take the five (5) principles of the Recovery Model into account and relate these to your specific consumer’s recovery process.
You will be assigned a case scenario involving a consumer who is experiencing issues relating to one of the various disorders commonly encountered in clinical practice.
Assignment
Luis
Luis is a 42-year-old married father of two who has been compulsorily admitted with bipolar disorder, manic episode. Luis was brought to hospital by the police. He had been out on the street running around in circles and banging his body against objects such as cars, fences and posts. Luis is a finance officer, which is a lowly position in the large accounting firm where he works. The firm is undergoing a major restructure and it is likely that a number of employees will be made redundant. Luis is 1.8m tall and weighs 90kg. On admission he was dressed in a bright multi-coloured shirt and shorts. He was wearing multiple gold and silver chains around his neck and had some wrapped around his wrists. Luis’ personal and family history is unremarkable. He finished school without problems, has a wide circle of friends and sound relationships with his wife and family. He has no particular qualifications and has been in his job for a long time. His personal interests are many and sources of frustration to his wife are the many projects he has under way. He has 4 half-finished cars in the yard and half built furniture filling the garage and tons of materials for his projects that he has collected from the side walk and garage sales.
Luis is always on the move. He speaks quite fast and his thoughts sometimes seem unconnected. He approaches the nurse and announces loudly “I am really rich. Australia would go to the dogs without me, because I advise the Treasurer how to run the country’s finances. I can make you rich too.” He also falsely claims to be the chief accountant for various Australian media magnates. Luis always speaks loudly and sometimes shouts at the nurses and other patients.
Luis tells the nurse that he feels “great. I’ve got so much energy and I don’t need any sleep at all”. He arises from bed very early and, to pass the time, sings loudly in the day room. When asked by the nurse not to disturb other patients he abuses her. He gaily shouts good morning to any other person he sees and tries to entice them into his room. When others ignore him or refuse, he becomes irritable.
He talks incessantly and makes many offensive personal remarks to the staff and patients. Any personal material other patients confide to him, he discusses loudly at the table but he doesn’t eat much and he rarely sits at the table for very long. He has insinuated that the resident doctor has a serious drinking problem and that the nurse in charge of the ward is having sexual relations with several of the female patients. He himself frequently asks the female nurses for sexual favours. His wife is very distressed by his behaviour. He has been phoning her, accusing her of “treachery” and demanding a divorce so he can marry one of the nurses. He has proposed to the nurse by letter. Luis spends much of the rest of the day phoning the taxation office and wasting their time informing them about various people he says are avoiding tax. He also phones the senior partner in his firm claiming that one of the junior partners is committing fraud. He is also in contact with a number of lawyers about this same colleague. He has been prescribed Valproic Acid; Clonazepam and Olanazapine.
