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B760 : Mental Health Nursing

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B760 : Mental Health Nursing

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B760 : Mental Health Nursing

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Course Code: B760
University: University Of Wolverhampton

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Country: United Kingdom

Question:

1a) Using the case study provided, identify an urgent risk area. Ensure your answer details why you have identified this risk area including specific information about the client and current literature. (2 marks)
1b) Identify one nursing / midwifery intervention you would immediately undertake with your client to address the risk area noted in question 1a and include a rationale for the intervention.
2a) Using the case study provided, identify a mental health concern. Ensure your answer details why this is an area of concern. Include specific information about the client and current literature. (2 marks)
2b) identify one nursing intervention you would undertake with your client to address the mental health concern noted in question 2a and include a rationale for the intervention.
3) Using current literature, identify and discuss (2) two legal, ethical or professional issues a nurse may need to consider when working with the client in the case study

Answer:

1a). In case of Chung, the mental health assessment helped discover a number of different factors about him, such as low mood, lack of any self-worth, and most importantly suicidality and his suicidal ideation is the main risk area for him. As mentioned by Forte et al. (2018), the suicide risk among the ethnic immigrants is higher than the native populations due to the hardships and bullying that they have to undergo. As discovered from the community nurse that came to visit his wife, he had been exhibiting some key warning signs of suicide such as low mood, slow and disinterested speech, hopelessness and helplessness, wanting to die, appearance, and sleeping and eating habits as well. Moreover, suicide risk is the most notable risk area for Chung as he had been having fleeting thoughts of suicide and is aware of the drugs that can cause him harm (Wyatt et al., 2015).
1b)  The immediate intervention for Chung will be to establish a therapeutic relationship with him, which will help in reducing the suicidal tendency of the patient by engaging in effective communication with him (Henden, 2017). The nurse will have to implement active listening, non-judgmental compassionate care approach, empathy and respectful approach while communicating with Chung to gradually help him overcome the inclination to cause harm to himself. The rationale for implementing this intervention is the fact that therapeutic communication and relation had been reported to help instil hope and will among the patients and combined with regular monitoring and 30 minutes sessions can slowly but gradually help Chung identify meaning and purpose to lifen (Gysin-Maillart et al., 2015).   
2a) The low mood can be considered as one very important mental health concern for Chung, which could have also led to deteriorating his major depressive disorders as well. Townsend and Morgan (2017), have opined low mood can be an indicator of underlying lack of the will to live and coping ability to overcome stress. It has been identified from the mental state examination that he was struggling with anxiety and insomnia, and appeared tearful, sad and restrictive, slumped in his chair, with rounded shoulders and starring at the floor for prolonged periods and avoiding eye contact which all indicate at low mood (Player et al., 2015). Hence, low mood is by far the most considerable mental health concern observed in Chung.
2b) In case low moods persist for prolonged period of time taking the most of day, it can further provoke the suicidal ideations of the patient under consideration. Hence, he will require immediate intervention (Waterworth et al., 2015). In this case, Chung will require the assistance of psycho-education from the care provider. Psycho-education is a precise, organised, instructional set of intervention that instructs and empowers the patients to achieve the predefined goals (Dueweke & Bridges, 2017). The care provider in this case will have to provide psycho-education to Chung urging him to reveal the exact issues that are provoking his suicidality and help improve the condition.
3). Chung had been an emergency department doctor, the information about his faltering medical health care lead to considerable issue regarding his professional competence. Hence, the confidentiality of the information shared by Chung can be a grave professional issue. Although, it the professional responsibility of the nurse to abide by the patient preferences regarding confidentiality, the nurse might experience moral and legal dilemma (Nursingmidwiferyboard.gov.au, 2018). The ethical issue on the other hand will be cultural appropriateness of the care, Chung being a Chinese immigrant, in case cultural and traditional aspects of care can be a possible issue (Townsend & Morgan, 2017). Along with that, regarding the legal issue the nurse will have to consider the Mental Health Act, especially the standard 5, Privacy and Confidentiality of National Standards for Mental Health Services, while providing care to Chung (Health.gov.au, 2018).
References:
Dueweke, A. R., & Bridges, A. J. (2017). The effects of brief, passive psychoeducation on suicide literacy, stigma, and attitudes toward help-seeking among Latino immigrants living in the United States. Stigma and Health, 2(1), 28.
Forte, A., Trobia, F., Gualtieri, F., Lamis, D., Cardamone, G., Giallonardo, V., … & Pompili, M. (2018). Suicide risk among immigrants and ethnic minorities: a literature overview. International journal of environmental research and public health, 15(7), 1438.
Gysin-Maillart, A., Schwab, S., Soravia, L., Megert, M., & Michel, K. (2016). A novel brief therapy for patients who attempt suicide: A 24-months follow-up randomized controlled study of the attempted suicide short intervention program (ASSIP). PLoS medicine, 13(3), e1001968.
Health.gov.au, (2018). Department of Health | Standard 5: Privacy and confidentiality. [Online]. Retrieved from https://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-servstds-toc~mental-pubs-n-servstds-2~mental-pubs-n-servstds-2-5. [Accessed on 11th Oct]
Henden, J. (2017). Preventing suicide: The solution focused approach. John Wiley & Sons.
Lawrence, R. E., Brent, D., Mann, J. J., Burke, A. K., Grunebaum, M. F., Galfalvy, H. C., & Oquendo, M. A. (2016). Religion as a risk factor for suicide attempt and suicide ideation among depressed patients. The Journal of nervous and mental disease, 204(11), 845.
Nursingmidwiferyboard.gov.au, (2018). Nursing and Midwifery Board of Australia – Professional standards. [Online] Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx. [Accessed on 8th Oct]
Player, M. J., Proudfoot, J., Fogarty, A., Whittle, E., Spurrier, M., Shand, F., … & Wilhelm, K. (2015). What interrupts suicide attempts in men: a qualitative study. PLoS One, 10(6), e0128180.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Waterworth, S., Arroll, B., Raphael, D., Parsons, J., & Gott, M. (2015). A qualitative study of nurses’ clinical experience in recognising low mood and depression in older patients with multiple long?term conditions. Journal of clinical nursing, 24(17-18), 2562-2570.
Wyatt, L. C., Ung, T., Park, R., Kwon, S. C., & Trinh-Shevrin, C. (2015). Risk factors of suicide and depression among Asian American, Native Hawaiian, and Pacific Islander youth: A systematic literature review. Journal of health care for the poor and underserved, 26(2 0), 191.

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