Sunday, May 19, 2019
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Friday, May 17, 2019
Nurse Practitioner Philosophy
Introduction
Psychiatric
mental health nursing involves working with individuals, families, communities,
and other groups to assess the mental health needs. A PMH nurse is required to
develop a nursing diagnosis and a care plan, implement the nursing process, and
reflect upon the plan’s effectiveness.
The nurses in this concentration receive specific training on how to
administer psychological therapies, building a therapeutic alliance, handle
challenging behavior, and administer psychiatric medication. Mental health in
individuals is of paramount importance and this, among other reasons made me
major in this concentration. The mental wellness of a person determines even
his/her physical health, and so it is a great privilege to help people to live
healthy lives. In this paper, I highlight the reasons for being interested in
this concentration and then the plans I have on how to impact patients.
Interest in becoming a Nurse Practitioner
When
I was growing up, I always interacted with my uncle who was a psychiatric mental
health practitioner. I can say that he
played a great role in my life towards becoming a psychiatric mental health
nurse. This uncle always told me how to
ensure a proper mental health by ensuring that I had good personal hygiene,
sleep, and nutrition. I sometimes went
through his papers and books as well the health care plans for mentally ill
people. There are also times I accompanied him while he went to give speeches
in institutions and so began to develop more interest in this field. I started
understanding about the lifestyles for good mental health and came to know that
this field was very interesting. I found it interesting because it dealt with
things with which we encounter in our daily lives.
Additionally,
before my degree program, I did some volunteer work in health facilities,
agencies, and community programs where I encountered individuals and families
with psychiatric problems. Even though
these volunteer roles would not allow me to experience the scope of a
psychiatric nurse’s position, they provided me with a good starting point. The way I saw people suffering and creating a
burden on the caregivers, I came to develop a strong interest in becoming a
psychiatric mental health nurse practitioner.
Also, what made me take the volunteer jobs is the interest I have been
having in psychiatric mental health. I always loved to work with the families
and individuals with mental problems and to advance my interest further; I
decided that I would take a course involving mental health.
Affecting Patient Outcomes
I
want to use my education to make a positive impact on the patients in various
ways. First of all, I want to work with healthcare facilities and other senior
psychiatric mental health nurses to gain more experience on how to conduct
psychiatric assessments and create treatment plans to include medications. I
will then choose a specialization area, especially the adolescents because they
are the people I enjoy working with. I work with psychiatric patients under
supervision to acquire experience on how to care for this group of patients as
I help them out with their psychiatric mental health problems. I plan to get an understanding of the
psychiatric mental health patients and how to meet every individual patient’s
need. I also plan to emphasize in-depth
assessment of patients and the provision of treatment that will include crisis
intervention, psychotherapy, awareness training to the community, and
medication management.
As
I practice in diverse settings such as acute care settings, liaison settings,
private practice, substance abuse programs, integrated psychiatric care
centers, and community mental health centers, I want to ensure that I help my
clients live lives. I will ensure that I develop a therapeutic alliance with my
clients. I will seek to engage with patients under my care positively and
cooperatively that will empower them to draw on their resources on top of the
treatments they will be receiving. I know that the people with mental illness
require intensified presence and support. I will make sure that I offer that.
While I care for my patients, I will also demonstrate the attributes or empathy
and understanding to facilitate a positive psychological balance for the
patients.
Conclusion
This
nursing program on psychiatric mental health has given me a lot of knowledge on
how to work with mentally ill patients. I have learned how to work within the
various nursing model, use nursing care plans, and how to care for the whole
person. Because I believe that pursuing this field to me was a calling, I
intend to use all means possible to positively impact the lives of the patients
who will be under my care. The little experience I also have worming with
mentally ill patients will help me to give out the best to ensure that people’s
lives are improved. I intend to ensure that I educate people on how they can
avoid mental illnesses. My plan and impact on patients have been
comprehensively discussed in this paper, and I look forward to accomplishing
that.
Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in essay writing services. If you need a similar paper you can place your order from cheap assignment writing service services.
Late Adulthood Paper
Introduction Summary
The
examination of the paper allows us to establish the fact that one of the
highlights of the fact that there has been an improvement in the quality of
life especially in the western nations is based on the growing number of
individuals who are living in advanced old age. The prevailing demographic
component is thus the main attribute that makes it imperative that there is an
implementation of medical as well as psychological interventions that exhibit
the ability to assure adequate standards of wellbeing for this elderly
population.
Through
the examination of the accessible research, it is evident that in most of the
western nations, the issue of advanced age is considered to be a period whereby
there is a loss of cognitive efficiency as well as a reduction in anatomy among
people falling in this population. It is additionally evident that less
research has been conducted on issues revolving around the age-related
improvements that could include wisdom, life experience as well as warmth.
From
the consideration of these issues, it has become evident that the implication
of the negative expectations as well as ideas leading to late adulthood can
have an adverse impact on the beliefs relating to the aged population on
attributes of their cognitive as well as memory abilities. When compared to the
young adults, the older population is believed their memory is more fallacious,
deteriorating with time and is less controllable. Research on the impact of the
age-related attributes on self-referent wellbeing as well as cognitive
efficiency has revealed that elderly individuals who have a higher perceived
sense of control over their cognitive, as well as mnestic efficiency, were more
satisfied with their lives and more optimistic about their life. Further, these
individuals were more inclined to employ effective strategies in compensating
for the mnestic losses, were less depressed, less anxious, less depressed and
even less health vulnerable.
Methodology Summary
The
present study used a sample of 139 healthy 139 healthy adults between the age
of 20 and 99 years old, which has voluntarily agreed to take part in the study
and were consequently assigned to three age groups. These groups comprised the
young who included participants between the age 20 and 30 years, the old who
were between 65 and 74 years old and the very old who were taken to be the
participants that were above the age of 75 years old. Recruitment of
participants was conducted via local social services for the aged as well as
via city councils.
For
these participants to be included in the study, it was imperative that they are
native-born, permanent residents in Ogliastra. Further, the participants had to
be descendants of the people who are originally from the area for a minimum of
two past generations and that they had to show indications of cognitive
impairment. For the exclusion criteria, was a cut-off score of <24/30 on the
mini-mental state examination, used to exclude the cognitively impaired
participants.
Social
demographic attributes and lifestyle were collected via the use of a
preliminary interview for each of the participants. Each of the participants
received a packet of questionnaires that included the cognitive failures
questionnaire that was meant to investigate an individual’s capacity to resist
irrelevant stimuli as they try to remember something, with the question being
the participants being asked to self-rate how frequently motor or memory
functions failed in the course of their daily functions. There was the
sensitivity to memory questionnaire that had 34 items evaluating an
individual’s propensity to recall, especially on the issue of frequency and
intensity of recall. They were additionally evaluated on their tendencies to
store personal memories in addition to the use of external aids as the dairy.
The third questionnaire includes the psychological well-being and aging
questionnaire that evaluated psychological wellness.
Results
Overall,
there were three main outcomes from this study.
One of these outcomes is that individuals living in Sardinia exhibited
greater levels of wellbeing and less depressive signs that psychological
distress compared to the control population that was from northern Italy. It
was additionally evident that age-related factors had an impact on the
psychological wellness, with the participants classified as very old referring
to coping strategies more than the younger groups.
Further,
it is evident that psychological distress is more evident in the old as well as
the very old groups. There was a case of a clear manifestation of clinical
depression as well as psychological distress that was found among the
participants under the classification of very old from northern Italy while
young participants from Italy did do not differ significantly from the old as
well as the very old participants. It is further established that signs of
depression were more common among the female participants than the male
counterparts.
It
is clear that most of the older adults are on most occasions perceived as
lacking competence related traits that include independence, confidence as well
as mental and physical abilities, albeit the fact they are known to be kind,
trustworthy as well as well nurtured. These types of view on most occasions operate
without awareness or intention, and their reinforcement follows a series of
additional negative stereotypes that take the assumption memory processes
deteriorate progressively in late adulthood. These stereotypes further assume
that the deterioration of the cognitive abilities of this aged population is
inevitable, pervasive and uncontrollable. It is a relation to this issue that
cases of memory failures among in the young population is associated with the
lack of effort or attention while mnestic failures among the aged population
are associated with incompetence.
Conclusion
From
the assessment of the study findings, cases of lower cognitive abilities,
reliance on external assistance promoting memory and greater use of coping
strategies was more common among the aged and very aged than the case was among
the young participants. One of the prevailing explanation for these attributes
is the fact that socio-cultural attributes that emphasize on the positive
social roles played by the elderly as the state in Sardinia promote tend to
support psychological well-being in late adulthood. Further, it is evident that
in such a community, the elderly are considered helpful which makes them more
respectable and are involved in their social work. In the case of the northern
Italy, the region is characterized by dominance with the older people failing
to be enhanced in their social communities.
While
the current studies have tried to explain the issues and attitudes that are
associated with the aged, it is imperative future research addresses the issue
the impact that dietary dissimilarities have on the Sardinian and other Italian
regions. In my opinion, the current study has been integral in providing
additional information on the issue of respecting the aged especially in the
Sardinia region as well as the role played by genetics in aging. The article
has effectively enumerated the significance of involving the elderly in the
society as a strategy of improving their wellbeing and the consequent quality
of life.
The
language that the authors have used in this article has additionally been
effective in ensuring there is easy comprehension of the issues addressed. The
authors have indicated balance in their examination of the different regions,
allowing the reader to get a clear picture of the issues addressed. It,
however, follows that the authors should have used more subheadings, especially
in the analysis to make it easier for the readers to follow the case
analyzed. On the issue of future
research, it is imperative that studies assess the effects of cross-cultural
attributes on the self-rated psychological wellbeing in other regions in
western cultures where there is an indication of collectivistic viewpoints.
References
Fastame, M. C., Penna,
M. P., & Rossetti, E. S. (2014). Perceived cognitive efficiency and subjective well-being in late adulthood:
the impact of developmental factors. Journal
of Adult Development, 21(3), 173-180.
Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in essay writing services. If you need a similar paper you can place your order from cheap assignment writing service services.
Risk Prediction Presentation
Introduction
• The use of violence risk assessment tools
within criminal justice and forensic psychiatry has been on the rise in the
recent past.
• However, there is limited data that is
relevant, reliable, and unbiased inaccurate prediction of risk.
• There are several structured tools for the
assessment of the risk of violence in criminal justice.
• The tools help to inform decisions on
detention, discharge, client management, and general psychiatry about violence.
• This presentation is based on a review of
case studies of Colleen M. and Xander L. using selected risk assessment
devices.
Brief
review of cases
Case 1: Colleen
• She is a 15-year old girl whose parents are
irresponsible of taking care of her opting to live with an auntie.
• She had a dispute a neighbor about her dog
that resulted in her death and charged with involuntary manslaughter.
• Colleen also tested positive for opiates,
but she denied it.
Case 2: Xander l.
• Is a 17-year old male known as a gang
member and with a history of purse snatching, breaking, and drug possession?
• He was arrested with a concealed weapon and
has been in custody once and placed on probation twice.
• Xander lives with his supportive mother
who is not happy with his conduct.
Summary
of the risk assessment
• The choice of tools used in risk assessment
is the Hare Psychopathy Checklist-Revised (PCL-R) and the Statistical
Information on Recidivism Scale (SIR).
• SIR tool combined 15 items in a scoring
system and generated the probability estimates of re-offending within three
years of release.
• Each item measures the demographic/criminal
history aspect
• It uses positive and negative scores for
individual items
• The summation item score gives a total
ranging from -30 (poor risk) to +27 (very good risk). The scores are then
clustered in groups ranging from very good (4/5) to the poor (1/3 prediction of
succeeding).
Continuation
of risk assessment
• The PCL-R is a diagnostic tool used for
rating individual psychopathic/antisocial tendencies.
• It was originally used to assess persons
accused or convicted of crimes.
• It uses a 20-item symptom rating scale that
allows examiners to compare the level of psychopathy with a prototype.
• The maximum score in a PCL-R tool is 40,
and any score above 30 implies a diagnosis for psychopathy.
Comparison
of results for each
• For, Colleen, the score from the PCL-R tool
was obtained as 21.
• The score from the SIR tool was obtained as
3 for the group cluster.
• For, Xander, the score from the PCL-R too;
was obtained to be 25.
• The score from the SIR tool was determined
as four on the group cluster results.
• A score of 21 on the PCL-R tool and three
on the SIR tool shows that Colleen has not transited to a fully violent
criminal, but her behavior seems to deteriorate with time.
Continuation
of results comparison
• The score of 25 on the PCL-R tool and four
on the SIR tool results indicate that Xander is a repeat offender and has criminals’
traits that need to be reassessed.
• The two assessments help to predict the
level of violence demonstrated in the case studies.
• Xander seems to be a more violent and
repeat criminal in comparison to Colleen who finds herself in violent
situations.
• However, taking opiates complicates the
matter, and it's easy to conclude that she is being oriented to criminal
behavior.
Additional
Information
• The SIR tool predicts only recidivism for
the released offenders and categorizes results from very good to poor.
• On its part, PCL-R tool reviews an
individual record and history of crime.
• However, the two have limitations in
assessing the risk of violence on particular individuals.
• It would be appropriate to have additional
information on the effect of relationship to criminal behavior, other
underlying factors other than the physical criminal behavior, and the level of
threat of risk to criminal behavior.
Continuation
on additional information
• The relationships between the offenders and
their families play a critical role in predicting criminal behavior and the
risk of violence, hence necessary to assess.
• Other factors that I liked to have included
the influence of the state of mind in engaging in criminal behavior which could
not be comprehensively assessed through PCL-R tool.
• It would be necessary to have details on
the level of risk to criminal behavior from the two case studies which does not
come out from the assessment tools.
Recommendation
on correctional strategy for each
Colleen
• She needs counseling on how she can accept
the status of her dysfunctional family and strategies of moving on.
• She should be taken to a rehabilitation
center where she can be guided on how to deal with emotional challenges other
than the use of opiates.
• Colleen requires understanding how to deal
with misunderstandings and conflicts without the use of violence and risky
reactions.
Continuation of
recommendation
Xander
• He needs support and counseling on how he
can avoid drug abuse that probably has largely influenced his conduct.
• He should be taken to a rehabilitation
center to learn on how to live in peace with others, especially her mother.
• Due to the possession of a concealed
weapon, Xander ought to be punished legally to understand the consequences of
his conduct.
Conclusion
• Violence and criminal behavior risk
assessment are crucial considerations in criminal justice.
• The discussed assessment tools are PCL-R
and SIR tools which have been found to be effective in risk assessment.
• However, some limitations cannot be fully
accounted for when using the tools.
• Colleen is at lower risk of engaging in
criminal activity and violence in comparison to Xander who is a serial offender
with a history of criminal activities.
• The two requires counseling,
rehabilitation, and should understand the consequences of their behavior.
References
• Bonta, J. (2002). Offender risk assessment:
Guidelines for selection and use. Criminal
Justice and Behavior, 29(4), 355-379.
• Desmarais, S., & Singh, J. (2013). Risk
assessment instruments validated and implemented in correctional settings in
the United States.
• Douglas, T., Pugh, J., Singh, I.,
Savulescu, J., & Fazel, S. (2017). Risk assessment tools in criminal
justice and forensic psychiatry: the need for better data. European Psychiatry, 42, 134-137.
• Hare, R. D. (2003). The psychopathy
checklist–Revised. Toronto, ON.
• James, N. (2015). Risk and Needs Assessment
in the Criminal Justice System. Congressional Research Service.
Therapeutic Mediations for Clients with Severe Anxiety or Panic
Describe a client from your clinical setting or work
who experienced severe anxiety or panic.
Anxiety
is a vague feeling of uneasiness or dread; it entails the activation of the
nervous system in response to internal/external stimuli that may have physical,
emotional, cognitive, or behavioral symptoms. The patient to whom I attended
presented the signs of abrupt panic that could last even up to 10 minutes.
After a panic attack, she experienced a fast heartbeat, shortness of breath,
sweating, and trembling.
Include a brief history and three most pertinent
medications.
I
learned that this problem had begun in young adulthood and continued occurring
throughout her life. She would occasionally experience distress over time
leading to the impairment of her daily routines, social life, and occupational
functioning. The treatment of this condition a three-pronged approached that
help the patient to overcome this disorder. They include education, medication,
and psychotherapy.
Describe the assessment process for this patient
There
was a physical examination followed by a medical and personal history of the patient. Because extreme anxiety or panic accompanies
many medical conditions, I had to uncover any medical issues that might
underlie the anxiety attacks. I then let the patient describe any occurrence of
panic disorders in her family and asked her to mention other contributing
factors if any, such as stressful events, caffeine use, or recent life changes.
Identify at least one effective and one
non-effective nursing intervention. Why did they work? What didn't work?
One
effective nursing intervention is one suggested by Mennin (2006) involving the
implementation of relaxation skills to reduce anxiety and manage anxiety
symptoms. I thought her about progressive muscle relaxation, biofeedback,
cue-controlled relaxation, and mindful breathing, and how to apply these skills
in her daily lives. I assigned the client homework after each session, and this
intervention seemed to work well. I also
applied Jongsma Jr’s (2016) strategy of limiting the relation between different
settings and worry, postponing the worry until some designated “worry time.”
The latter failed to work.
Name and describe two stress reduction techniques
you have used and whether they were helpful or not in reducing stress
The
two stress reduction techniques include positive reframing and
decatastrophizing. Positive reframing involves helping the client to turn the
negative messages into positive ones whereas decatastrophizing entails using
questions (what if) to realistically appraise the situation.
References
Jongsma Jr, A. E.
(2016). Adult psychotherapy homework planner. John Wiley & Sons.
Mennin, D. S. (2006).
Emotion regulation therapy: An integrative approach to treatment-resistant
anxiety disorders. Journal of Contemporary Psychotherapy, 36(2),
95-105.
Clostridium difficile
Clostridium
difficile or C.diff and Clostridium difficile infection (CDI) are terms used to
describe a condition which results from a bacterium found in the intestines and
stool some people and animals. According to Kassam and colleagues (2013),
C.diff is the major cause of health care related infectious diarrhea. Even
though bacteria are good for our bodies, some bacteria in our bodies may
sometimes cause illnesses such as C.diff. The most common cause of C.diff is
the use of antibiotics. The antibiotics work by killing bacteria. Because they
cannot differentiate between good and bad bacteria, they may kill good bacteria
thereby opening an opportunity for C.diff to thrive and cause illness (Dubberke
et al., 2014). C.diff can be spread via the failure to wash hands properly
after using washrooms and touching that comes into contact with another
person’s mouth. Health care workers can also spread C.diff if they fail to wash
their hands in between caring for patients properly.
There
are various precautions a health worker should take protect oneself and the
patients. As a health worker, one of the precautions is to wash my hands after
caring for a patient thoroughly. This will prevent C.diff from spreading from
one patient to another. The other thing I will do is to put on gloves and a
gown over my clothing when handling a patient with C.diff. I will also ensure
that I remove the gloves and gown as I wash my hands before leaving the room
where I have been caring for the patient.
The other precaution to take is to ensure that the medical equipment and
the patient rooms are thoroughly cleaned using an effective product once they
have been used by other patients (Burnham & Carroll, 2013). I will also
make sure only to use once or use disposable towels for drying my hands.
References
Burnham, C. A. D.,
& Carroll, K. C. (2013). Diagnosis of Clostridium difficile infection: an
ongoing conundrum for clinicians and for clinical laboratories. Clinical
Microbiology Reviews, 26(3), 604-630.
Dubberke, E. R.,
Carling, P., Carrico, R., Donskey, C. J., Loo, V. G., McDonald, L. C., ...
& Gerding, D. N. (2014). Strategies to prevent Clostridium difficile
infections in acute care hospitals: 2014 update. Infection Control &
Hospital Epidemiology, 35(S2), S48-S65.
Kassam, Z., Lee, C. H.,
Yuan, Y., & Hunt, R. H. (2013). Fecal microbiota transplantation for
Clostridium difficile infection: systematic review and meta-analysis. The
American Journal of Gastroenterology, 108(4), 500-508
Thursday, May 16, 2019
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