Psychosocial Nursing Reflection Paper

Psychosocial Nursing Reflection Paper

Introduction and Nursing Diagnoses

This reflection paper is based on the film “A Beautiful Mind” (2001), which portrays the life of John Nash, a math genius diagnosed with schizophrenia. The client is a middle-aged male who has been diagnosed with schizophrenia disorder. He also shows signs of delusions and hallucinations and has poor decision-making ability. Relevant physical conditions may include side effects of antipsychotic medications, for instance, obesity and tremors.

Priority Nursing Diagnoses

Firstly, disturbed thought processes related to schizophrenia, as evidenced by auditory and visual hallucinations, delusional thinking, and disorganized speech. Secondly, risk for self-harm related to impaired judgment and self-neglect due to schizophrenia.

Rationale

Disturbed Thought Processes – The client has auditory hallucinations and paranoid ideation; the client speaks to people who are not present. These behaviors have been reported by his family members and have been shown to cause severe impairment in his daily activities and interpersonal relationships.

Risk for Self-Harm – The client’s judgment and self-neglect are compromised, which puts him at a high risk for self-harm. Cases of aimless wandering and lack of personal hygiene have been noted and reported by the family members.

Reflection

Subsequently, to ensure that the best care is offered to the client with schizophrenia and his family, the following steps should be taken. Presently, the patient has to take antipsychotic medicines to control the symptoms and have to see a psychiatrist regularly to monitor the condition (Lähteenvuo & Tiihonen, 2021). CBT can help build coping skills, lessen the intensity of symptoms, and expand the clients’ perspective between identifying what is real and what is a delusion. Couples and family therapy are equally important because they help support and educate the family, decreasing stress and enhancing the home environment.

The main challenge to the utilization of these interventions is the stigma commonly associated with mental illness. This stigma may act as a barrier to the client and his family from seeking more help and engaging in therapeutic endeavors (Stangl et al., 2019). Another issue is medication compliance, as side effects of the drugs used in the treatment of patients with schizophrenia include a refusal to continue taking medication, which worsens the client’s situation.

Further, Varkey (2021) indicates that ethical principles are at the forefront of such considerations. Autonomy encompasses the ability to allow the client to make decisions about his treatment freely. Nevertheless, it is necessary to engage him in the decision-making process, considering that his judgment is not quite sound. This concept entails that healthcare providers should do what is best for the overall well-being of the client. Promoting a safe environment and closely monitoring the potential side effects of medicines are in line with this. Nonmaleficence affirms the principle of not inflicting evil or harm, and it avoids self-harm by close supervision and intervention.

Several resources in the community may help the client and his family. Religion and local support groups help in learning from others’ experiences and also adopting coping mechanisms (Saud et al., 2021). Family members may need ongoing psychiatric and psychological care from the community mental health center, and educational resources on schizophrenia and how to treat it can assist the family in this process.

Nursing Care Plan

Primary Nursing Diagnosis

Disturbed Thought Processes related to schizophrenia.

This diagnosis is prioritized because it directly affects the client’s insight into reality, leading to important useful impairments and increasing the risk of harm.

Goals

The client will demonstrate a reduction in hallucinations and delusions within three months. Moreover, the client will engage in one therapeutic activity per week to enhance reality orientation.

Evaluation Method

The first evaluation method includes regular assessments using standardized tools such as the Positive and Negative Syndrome Scale (PANSS). Secondly, monitoring participation and engagement in therapeutic activities.

References

Lähteenvuo, M., & Tiihonen, J. (2021). Antipsychotic Polypharmacy for the Management of Schizophrenia: Evidence and Recommendations. Drugs, 81(11), 1273–1284. https://doi.org/10.1007/s40265-021-01556-4

Saud, M., Ashfaq, A., Abbas, A., Ariadi, S., & Mahmood, Q. K. (2021). Social support through religion and psychological well-being: COVID-19 and coping strategies in Indonesia. Journal of Religion and Health, 60(5). https://doi.org/10.1007/s10943-021-01327-1

Stangl, A. L., Earnshaw, V. A., Logie, C. H., van Brakel, W., C. Simbayi, L., Barré, I., & Dovidio, J. F. (2019). The Health Stigma and Discrimination Framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC Medicine, 17(1), 1–13. https://doi.org/10.1186/s12916-019-1271-3

Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119

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Objectives

Consider future nursing opportunities about clinical findings, including current issues in mental health care and potential applications for advocacy and support related to clients with mental health diagnoses and their families. (Human Flourishing)

Psychosocial Nursing Reflection Paper

Assignment

Write a 500-word reflection paper based on the information you gathered at your mental health rotation OR with a Med/Surg, etc. patient.

Introduction and Nursing Diagnoses

Include basic client information (without identifiers) and psychiatric diagnoses/diagnoses as well as pertinent physical diagnoses.

Relay your top two priority nursing diagnoses (from your clinical observation sheet) and briefly discuss your rationale for these. Rationale should include observations, quotations, reports from staff or family, or other sources that led you to choose these diagnoses. This section should take up approximately half a page or 125 words.

Reflection

Based on the diagnoses identified, use the next page (around 250 words) to reflect on your ideas of how to provide the best care for this client and their family. Consider whether you think they are currently receiving the best possible care and what other supports and resources might better help them. Consider the following questions:

What are the barriers to implementing the nursing interventions you listed in your clinical assignment?

What ethical principles apply to these considerations?

What resources are available in your community for this patient and/or their family?

*Chapters 34-36 in your textbook provide information about group and family therapy as well as integrative treatment options that might support your discussion.