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Throughout this summative assessment, I will be studying a service user, who I will address as Patient A throughout this essay to maintain their confidentiality, to whom I have had the experience of working with their care whilst being on placement throughout my course. The patient has a diagnosis of chronic schizophrenia with predominantly negative symptoms and Autism Spectrum Disorder living in the community with their parents have been active in mental health services for over 20 years and have become more isolated and quieter throughout this time.
Within this assessment, I shall be dealing with topics such as the delivery of care, the important care and compassion in healthcare, empowerment, person and family-centered care, and managing self when working in a team while maintaining this service user’s dignity and confidentiality. According to the Royal College of Nursing RCN (2016), confidentiality does not just include the client’s diagnosis or their name but everything in their care and they have the right to decide who is aware of their treatments and what is disclosed withtohelpingcentered from other professionals who are not involved in their care.
Caring for someone who lives with Schizophrenia in community settings can become difficult to nurse as it is one of the most disabling and disruptive psychiatric illnesses, according to McLynn (1996).
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McFadyen, Ford, and Rigby (2014) state that an increased amount of assertive care is essential when providing care and support for those with a long-term serve illness. Patient A’s diagnosis was not known until they were around 20 years old and mental health services only became aware of this individual as they were brought to the hospital by police from a ‘Place of Safety’ Assessment on several occasions and brought on to the ward to which he absconded a few times.
Patient A’s diagnosis of Autism Spectrum Disorder had been queried for many years however was confirmed in January of 2019. Living in the community with a learning disability and needing nursing care can be daunting for anyone but having a mental illness too can overwhelm anyone.
One way of improving and delivering quality nursing care to someone in Patient A’s case is to go to adequate, appropriate training, communicate effectively and work together with other services as acknowledged by Black (2013).
Delivery of care could theoretically be an issue when providing care and treatment for a service user who has a mental health illness, a learning disability, or both. From my experiences, on the first occasion of meeting Patient A, I immediately got to the realization that there were plenty of barriers in our way to help Person-centeredfrom individuals such as the patient does not speak much and limits themselves to ‘yes’ or ‘no’, their mother is very involved and gives valuable information however I was uncertain that we were able to get an accurate indication of this service user’s day as we were not receiving the information directly. Chaplin et al (2009) indicate that inequalities are often experienced by those with an intellectual disability.
When seeing this patient, it is vital to show compassion and deliver person or family-centered care. In the essence of my patient, do not say a lot of words, mainly ‘yes’ or ‘no’, and prefer to have their parents in the room with them. Also, this person allows their parents to disclose information to help with their treatment. Miller et al (2018) convey that having a “collaborative person-centered approach to care is instrumental to supporting attainment to personal recovery.” To me, this is evident in my patient as those involved in their care all have a goal which is to make this person be a well as they can be by working together and having Patient A’s own goals and wishes respected. Person-centred care is also vital when delivering a quality standard of nursing care and Parrish (2013) states that the role of the nurse when supporting someone living in the community who suffers with a learning disability is to support them with overwhelming changes, assist with overcoming barriers and focus on aiding the individual with day-to-day living.
Furthermore, care and compassion could be seen as a vital component when building a relationship with someone, especially if they have a Learning Disability or a mental health condition. Compassion, as a concept, has received limited in mental health nurses, and component as mental health nurses, we struggle to define this concept. However Community Mental Health nurses bring more clarification as stated by Barron, Deery, and Sloan (2017). In my experience working with the community mental health nurse on Patient A, I could say this is the case as this nurse displays so much compassion towards Patient A, his family,family-centered, and his thoughts on particular subjects he may interact with.
Following on, family-centred care is very important if the family is well involved. Patient A’s mother and family are very involved in this person’s care, making sure they take their medication at appropriate times, making sure they are looking after themselves by eating, drinking and washing properly and,family-centered being very open to trying new techniques to help improve their child’s quality of living. For example, their mother asked the Community Mental Health Nurse if a dog would help with speech and friendship after seeing someone similar to her child on television. Doerschlen (2013) highlights that family-centred care is cripatientsthe optical soothetoatient as they can help sooth them if going through a difficult time, translate for their relatives if there is a barrier (for example, if English isn’t that person’s first language or if the person struggles to convey their emotions.)
Empowerment is one of the most indispensable subjects in nursing. Nurses must empower their patients in order to build strong relationships and therapeutic relationships relationships and which could be imperative for a service user who has a mental condition or any disabilities. The Nursing and Midwifery Council, or NMC, states in their code that “nurses shall encourage and empower people to share in decisions, resect the level the person’s involvement in their care and recognize when people are anxious or distress and respond politely” In terms of my experiences with Patient A, empowerment has been sown to me by those involved in this patient’s care as if decisions were to be made, the patient is well informed and asked for their input, involving them in their care and improving the repertoire between patient and nurse. In terms of Patient A, they enjoy going on holiday with their parents as they enjoy the sun and vitamin D. A randomized controlled study conducted by Krivoy et al (2017) suggests that Vitamin D improves cognition and the risk of having schizophrenia but does not affect psychosis or mood status. I think that the Vitamin D does help my service user as seeing them before and after their holidays to either Thailand or Australia has a slight change in their personality and the conversation becomes more fluid so as a team, we encourage the family to have a holiday if that can.
Independence is one of the key goals that Patient A and their parents agreed upon with the Community Mental Health Nurse that I worked alongside. Parrott (2015) emphasizes,are that nurses should promote independence which in turn prevents dependency particularly with someone like Patient A who has a degree of learning disabilities.
As a student nurse, I have learned that dignity and respect is key to having an efficient patient-nurse relationship and after working with a person with a possible learning disability and a diagnosis of a mental health condition, Patient A must have respect and dignity in all aspects of their life. The World Health Organisation, otherwise known as the WHO, (2015) define dignity as “the inherent and inalienable worth of all human beings irrespective of all social status”. This includes race, sexuality, and gender andand highlights the importance of, physical or mental state. Patient A deserves the respect to maintain his dignity and respect by maintaining his ability to make decisions about his care.
In addition to, communication goes hand in hand with dignity as by having effective communication, you increase the probability of the patient trusting you as a nurse and opening up about how they feel, what their thoughts are highlightsimportanceofthe from conditions, and how they are feeling about their care and treatment. Sheehy and Nind (2005) highlights that a better way to achieve productive and beneficial pathway of communication with a service user who has a diagnosis of both a learning disability and a mental health illness is to initiate research to decrease the lack of understanding, bring the significant people in their lives together to create a better comprehension to this individuals case and pinpoint when their mental health deteriorates and could potentially be problematic when offering support and care.
Multi-disciplinary teams are insightful when creating the best care plan for someone in need of treatment physically, mentally or cognitively. Outram et al (2014) suggest, suggestion that using a multi-disciplinary approach can be advantageous topic as healthcare can be seen from a larger viewpoint from other professional backgrounds which can help decrease the service user’s anxieties and stresses.
As mentioned previously and throughout this assessment, Patient A has a possible diagnosis of Autism Spectrum Disorder which is classified as a learning disability. One legislation to assist a service user who has a learning disability is The Human Rights act (1998) which displays all human rights and with including relation to learning disabilities include the areas of Article 2, Article 3, , and Article 14. Article 2 which is the right to life, according to About Learning Disabilities (2019) expresses that this right is a ‘universal and limitless right’ and that those with a profound learning disability maintain their right to receive medicinal treatment or pro-longing treatment.
The right to not be tortured is the prospect of article 3. Article 3 states that those who have a learning disability are legally protected tofrom,the of abuse (mentally, physically or emotionally), poor living cond itions, and any possible neglect as written by the Human Rights Act (1998). This legislation also declares that public authorities hypothetically be prosecuted if they fail to protect those with learning disabilities from harm highlighted in this article.
Finally, as stated in Article 14, or the right not to be discriminated against, About Learning Disabilities (2019) ensures an individual with learning disability has equal opportunities as those without, such as a job or having the right to live independently. One ethical principle that is highlighted throughout the legislation is beneficence as their key ethical principle as it focuses on doing well for all and focusing the on patient’s best interests. Kennedy (2004) defines beneficence as “a positive act of helping others and ensuring the action is good.”
Assessing a person’s health needs who have a service, or learning disability can be a struggle. Callan ET at (1995) acknowledges that as nurses, we should have a methodical approach of assessments of observation, examination and reflection to produce an overall picture of this individual and their needs to ensure that they are the center focus of all plans which have to be put in place. Autonomy is displayed throughout this qualitative research as it suggests that patients haste their own opinions and are entitled to make their own decisions about their care and treatment. Kennedy (2004) implies that to use autonomy effectively in nursing, we must make sure a patient has all the information required to make an educated decision.
To conclude, Patient A is a service user who I have had the experience of working with who has had an official diagnosis of chronic Schizophrenia with negative symptoms alongside Autism Spectrum Disorder who can be difficult to maintain a reciprocation with. With the knowledge of what I have learned through meeting this individual and what I have gained understanding which in learning disabilities, I now feel more confident in the skills that I can use to convey professionalism and my ability to understand the patient’s communication, whether being verbal or non-verbal. In the future, I plan to maintain my skills, build upon them and become more self-assured.
Navigating Complex Care for Patient: A Holistic Approach. (2022, May 22). Retrieved from https://studymoose.com/quality-nursing-care-essay
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