1. Education is a continuous process, and every day is a chance to learn something new. Going through medicine school has significantly widened my knowledge base, as I have learned of various ways to interact with the social, economic and cultural environments around me within the healthcare system. Technology has been a crucial tool in my education since, through the internet, I can conduct researches, look up information and create online groups for inquiries and sharing information.
2. Mental illnesses can be treated by pharmacological interventions which include the provision of medicine, psychotherapeutic interventions that include counseling as well as by electromagnetic manipulation of the nerves in the brain (Milev et al., 2016). The medicine used include antidepressants, such as serotonin and norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs are venlafaxine and duloxetine. There also are anti-anxiety medications such as Benzodiazepines. Stimulants are also used in cases of Attention-deficit/hyperactivity disorder (ADHD).
3. Among the illnesses related to mental health include bipolar disorder, anxiety, depression schizophrenia, and dementia. These illnesses can sometimes be comorbid with other physical chronic diseases such as cancer, cardiovascular infections, diabetes mellitus and neurological disorders (WHO, 2003).
4. Seizures occur in different magnitudes and from different parts of the brain. While most of the causes and treatments can be conducted in healthcare facilities, seizures can occur even in public places. Therefore, the DRSABCD intervention is an ideal first aid. First, I would assess the Danger that the seizure poses to you and those around as well as the victim. Then, one should check the Response of the victim towards sound, light, and touch. In many cases, it is advisable to Send for help. The next step is to check the Airway to gauge whether the victim is conscious or unconscious. If conscious, I should prevent them from any harm, and if unconscious, the airways should be checked to any blockage by saliva. Breathing should also be monitored through chest movement, and if unresponsive, CPR should be administered. If unresponsive to CPR, a defibrillator may be employed if present to provide mechanical breathing.
5. Suicide intervention can take the shape of primary or secondary prevention. Primary prevention involves patients at risk of committing suicide. A risk assessment is hence necessary to evaluate the probability of an individual to commit suicide. It looks at the potential catalysts, the availability of means to self-harm, the frequency of suicidal thoughts and feelings and the level of self-esteem. Communication through public awareness, the provision of hotline numbers to call upon feeling suicidal and therapy also help (Bolster, Holliday, O'Neal, & Shaw, 2015). Secondary prevention aims to deter patients who had already attempted to commit suicide from repetitive habits.
6. Restraint is the use of mechanical, environmental, physical or pharmacological methods to control behavior. The least constraint policy is a law that bars the unauthorized restraining of patients (Ontario, 2001). For a restraint to be authorized, it must be conducted in a way that reduces bodily harm to the patient, follows every criterion, and with the consent of the patient or the relevant people around the patient.
7. Patient restraining is one of the most contended medical interventions, but when it is necessary, it has to be done. Patients are often susceptible to physical, mental and psychological harm. Therefore, once a patient has been constrained, it is the work of the medical practitioner to ensure a safe and injury-free outcome. Continuous and comprehensive head-to-toe assessment is required to see whether the patient is being harmed. It is also critical to assess the level of stress the patient is under, and how he/she is dealing with the stress. Documentation of the restraint should include the reason for the restraining to the patient and their family. A flow sheet can also be used to document the assessment of the patient recording the behavior, mental status, and number and type of restraints used.
8. Physical assault in the healthcare sector against nurses and other healthcare providers. As a nurse, if I were to see a colleague assaulted by a patient, the first step would be to neutralize the threat by intervening, holding the assaulter back if possible, or call security. Then I would file in a complaint on behalf of the colleague or encourage them to file a claim to have the patient dealt with according and possibly accrue a compensation.
9. I agree that sometimes patients can be a bit much. A screaming patient can agitate the healthcare provider, and this is likely to hinder effective medication. Therefore, I such a situation, I would advise my colleague to take a step back, or even take a brief leave, assess the patient's emotions, and try to view the situation in the point of view. The patient might be frightened with the possible outcome, and hence stressed out. Taking a different approach is all that matters
10. The hospital presents more than just sick people. It all presents emotions, anger issue, mental problems, physical pain, and losses. I have had to deal with lots of these issues. In one scenario, a seven-year-old boy was brought in with second-degree burns on the arm. Cleaning and dressing this wound was a challenge as the boy was screaming and unsettled. Therefore, I had to mum-up, talk to the boy as a person who cared about his wellbeing, and told him that the pain would be over before he even notices it. In short, it has been four years, and no scar can be spotted on the arm. It went well.
11. For a 55-year old widow, the stress factor could first be the pain of losing a spouse. He could also be struggling financially, socially and emotionally, and feeling lonely often. Therefore, the intervention would be therapy. Suicidal thoughts often come from depression and hence cognitive behavior therapy (Parikh et al., 2016). This will help the man re-envision the environment around him, look at death as a transition, not an end, and find new ways to live without the spouse.
12. Treating an unconscious diabetic patient relies majorly on the intravenous access. When there is no intravenous access, the patient should be treated to 1mg of glucagon subcutaneously or intramuscularly (Yale, Paty, & Senior, 2018). However, with intravenous access 10-25 mg of glucose should be administered intravenously in 1-3 minutes.
13. There are three types of restraints; physical, chemical and environmental also known as seclusion. Physical restraints include devices that hinder the mobility of the patient for example belt or vest restraints. Chemical restraints are medicine used to temporarily sedate a patient, while seclusion involves locking a patient in a room by themselves with scheduled monitoring.
14. For a patient who is restrained both hands, the assessment will be done physically by looking at the skin on the areas of restraint and evaluate any form of harm. Vital should also be monitored. Documentation will include the reason for the restraining, the expected outcome, and the welfare of the patient during restraint. Interventions might include medicine to cool them down, therapy, even though not as formal to help them manage the stress of being restrained, and the immediate release of the patient once they regain normality.
Bolster C., Holliday C., O'Neal G., & Shaw, M. (2015). Suicide Assessment and Nurses: What Does the Evidence Show? OJIN: The Online Journal of Issues in Nursing. 20(1). DOI: 10.3912/OJIN.Vol20No01Man02
Milev R. V. , Giacobbe P., Kennedy S. H., Blumberger D.M., Daskalakis Z.J., Downar J, ... & the CANMAT Depression Work Group (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 4. Neurostimulation Treatments. The Canadian Journal of Psychiatry. 61(9). Pp. 561-575. DOI: 10.1177/0706743716660033
Parikh S. V., Quilty L. C., Ravitz P., Rosenbluth M., Pavlova B., Grigoriadis S. ... Uher R. (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments. The Canadian Journal of Psychiatry, 61(9). Pp. 524-539. https://doi.org/10.1177/0706743716659418
Patient Restraints Minimization Act (2001) S.O. 2001, CHAPTER 16. Ontario. https://www.ontario.ca/laws/statute/01p16WHO (2003). Investing in mental health. Pp.1-48. https://www.who.int/mental_health/media/investing_mnh.pdf
Yale J., Paty B., & senior P. A. (2018). Hypoglycemia. Diabetes Canada. Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Retrieved from http://guidelines.diabetes.ca/cpg/chapter14
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