Case Description
JJ is a twenty-seven-year-old homeless man with schizophrenia who has experienced repeated hospital treatment and interactions with healthcare professionals. The patient came to the clinic from a local shelter and is also known to lack reliable access to housing, food, water, and hygiene. JJ takes antipsychotics, but due to the lack of regular access to medicines, he violates the regimen, which leads to an aggravation of his mental state. Given the circumstances, the patient has been given an additional drug to relieve symptoms, but this will not have a significant effect.
Case Analysis
Homeless patients with mental illness often face adverse conditions and circumstances that require significant medical and ethical attention. JJ has considerable experience in inpatient care and other interactions with healthcare professionals. Unfortunately, this pattern is typical for the most vulnerable groups of patients in psychiatric hospitals, clinics, and emergency departments (Duke & Searby, 2019). Each patient has a history of events, problems, and social relationships that led them to their current position.
Schizophrenia is a severe illness that often requires significant efforts to improve the patient’s quality of life. In most cases, the cause of the disorder is a complex combination of different reasons, ranging from molecular to social (Lysaker et al., 2018). In this case, the situation is complicated by the irregular intake of medicines due to the complex life situation of the patient.
The ethical issue is that the medical staff need to build informal relationships with JJ to help him. They should find out what events could cause his current condition. Such relationships with patients may be perceived as unprofessional or unethical. The efforts of medical personnel in treating mental illness are usually directed, among other things, to solving the patient’s problems, which will improve their quality of life and reduce the manifestation of symptoms, and not only to provide medications. JJ’s case requires a similar approach, as without addressing his social problems, drug therapy will be ineffective, and his condition will worsen without addressing his social issues.
Whatever chain of events and decisions has brought JJ to his current position, he is a man in need, and it is ethically correct to help him. The situation demonstrates that the irregular use of antipsychotics is not the patient’s fault, and his systematic entry into specialized medical institutions indicates the presence of problems that need to be addressed. In this case, the patient’s awareness of these problems and the desire to solve them are essential.
If such a desire is present, it would be ethically correct from the point of view of the medical staff to find a way for JJ to obtain constant access to the necessary medical substances. Medical personnel have no legal prohibitions against having private conversations with patients. The provision of voluntary assistance to socially vulnerable groups of the population is in the state’s interests since social inequality in medicine leads to high financial costs on the part of the state and the waste of human potential.
Solutions
Private communication about personal problems will allow you to transfer meetings with the patient beyond just working communication. Such a dialogue contributes to building trusting relationships, which is essential for treating mental disorders and solving this problem in particular. To begin with, the medical staff should show empathy, find common ground with JJ, and learn more about his situation.
Important questions are whether he has an education, has relatives, maintains relations with them, and what circumstances led to his becoming homeless. It is necessary to discuss how the patient assesses his current situation, what psychological ailments his schizophrenia is burdened with, and whether he feels the need to change anything. If JJ is aware of the problem and willing to address it, or if the medical staff convinced him of this during the conversations, there are two approaches.
The patient cannot get out of his position, as schizophrenia interferes with his normal functioning. First, he needs to stop negative symptoms with the help of antipsychotics. The first way to solve this problem is to search for charitable foundations and volunteer programs that provide the necessary medicines to vulnerable groups of people. The case description mentions that JJ was in a shelter before being admitted. When the patient goes into remission after the hospital stay, he can return to the shelter and take antipsychotics provided by such a fund. This will allow him to return to everyday life gradually.
The second approach is to find a way for JJ to get money for medicines while he is still in the clinic. Since the symptoms of schizophrenia can be relieved during inpatient treatment, this is a possible option. The medical facility may have jobs that JJ could do, such as cleaning. Some medical staff could lend a computer to a patient to look for remote work that does not require special skills. The availability of financial resources would allow JJ to provide himself with the necessary medicines, even while living in a shelter.
This scenario may hurt me as a nurse practitioner. Such assistance conflicts with the professional code, as it goes beyond the authority of the medical officer (Fowler & American Nurses Association, 2023). Showing compassion for patients like this can lead to nurse practitioner burnout and can also be negatively perceived by hospital management. However, this human approach is the key to improving the patient’s condition. Only the joint activities of the medical staff and the patient, as well as a trusting relationship between them, will enable JJ to escape his difficult situation.
References
Duke, A., & Searby, A. (2019). Mental ill health in homeless women: A review. Issues in Mental Health Nursing, 40(7), 605–612. Web.
Fowler, M. & American Nurses Association. (2023). Essentials of Nursing Practice Package (Guide to the Code of Ethics for Nurses, Nursing Scope and Standards of Practice, Guide to Nursing’s Social Policy Statement). American Nurses Association.
Lysaker, P. H., Pattison, M. L., Leonhardt, B. L., Phelps, S., & Vohs, J. L. (2018). Insight in schizophrenia spectrum disorders: Relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. World Psychiatry, 17(1), 12–23. Web.