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Mental Health Nursing Skills in Practice Essay

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Updated: May 9th, 2021

Abnormal involuntary movement scale (AIMS) examination

The skill of maintaining patient examination with the help of a 12 item AIMS is needed to determine if one suffers from tardive dyskinesia. It can be used for the first time to define the problem and then to check its severity. As a rule, the examination is included indirect observation. An unobtrusive client observation should be maintained beforehand when one is at rest (Patel & Jakopac, 2011).

Patient/Client Situation

A patient who takes antipsychotic medication came for examination because he was likely to suffer from movement disorders, including tardive dyskinesia, because of it. He needed to be monitored and assessed to indicate a problem before it became critical and could be prevented or at least minimalized.

Specific Description of Skill Used/Observed

I have taken notes seeing a nurse performing an AIMS examination. She met a patient in a waiting room and observed him for a while before the examination, noticing the way he moves and speaks. Then she started to ask questions regarding the motion of the patient’s face, upper and lower extremities, and trunk. They were taken from the guideline, which allowed us to avoid biases. Still, additional responses were added to clarify information or provide feedback and support.

Evaluation

I found the nurse’s skills to be effective, as she maintained the conversation clearly and did not emphasize the fact that it was an experiment, which allowed the client to remain calm. She asked 12 questions that are offered by a guideline and referred to the presupposed observation. She also had a printed scale with her, which reduced inaccuracy and provided an opportunity to enhance the quality of notes. She even counted the speed of tremor movements to differentiate similar conditions that require various types of treatment. What is more, the nurse later underlined that it is significant to define if the movements are involuntary because it can affect one’s conclusions.

Assessing for suicide risk

Mental health professionals must be able to determine those individuals who are at risk for suicide because they can save one’s life in this way. Thus, they need to understand this phenomenon, manage personal reactions and beliefs, develop a collaborative, therapeutic relationship with a client, maintain the appropriate environment, deepen into legal and ethical issues related to this theme, and be able to document the risk so that the information can be shared with other professionals.

Patient/Client Situation

The skill of assessing for suicide risk is mainly needed when working with depressed and unstable patients. A client with abnormal sleep and mood changes visited a healthcare facility because was not able to cope with his condition without external help.

Specific Description of Skill Used/Observed

A nurse observed his behavior for a while before starting the assessment and noticed that a patient is not willing to interact with others. Then she started a conversation, trying to ensure her involvement and willingness to help. She asked the patient about his condition and then also discussed with him a range of warning signs. What is more, she was interested in the potential risk factors and asked about job and family difficulties, chronic illnesses, etc.

Evaluation

I believe that this skill was effective, as the nurse received an opportunity to gather as much information as possible, including those things the patient knew beforehand, revealed during the examination, and left unnoticed. She noted his subconscious reactions, such as gestures and mimics to understand the situation better.

Providing client or family teaching

Patients should be able to take care of themselves because they will not receive nurse’s assistance after the discharge. In the same way, it is significant for their relatives to know how to support this person and provide everything needed to reach positive health outcomes.

Patient/Client Situation

A patient had an appendectomy and is going to be discharged from the hospital soon. Still, he is not ready to get back to his everyday routine yet. His postoperative suture requires treatment, he should not be engaged in intensive physical activities, should take medicines, and improve nutrition.

Specific Description of Skill Used/Observed

The nurse started educating the patient stimulating his interest. She explained what he should do at home and why. She asked the client about his specific concerns and discussed them also. Allocating the tasks, the nurse considered the patient’s opportunities and asked his family to join so that they can also learn what should be done and how. She showed all tools that would be used and allowed the client and his relatives to “play” with them for a while, mentioning what they do right and correcting when something is wrong. She provided them with manuals and video materials to refer to them when having problems. Also, she noticed what should be done if some problems occur.

Evaluation

I believe that the nurse had an opportunity to indicate the patient’s learning style beforehand, but I have no proves of this. Still, I find her skills effective as she provided various education materials and even allowed the patient and his family to practice. She asked questions to find out what they believe to be difficult and encouraged them to share their ideas. Finally, she educated on her example and underlined that they could find more assistance in the hospital if need. It is also critical that she promised to repeat this lesson before the discharge.

Intervening to reduce agitation and/or anxiety

Those patients who are agitated or anxious do not just prevent nurses and other healthcare professionals from providing appropriate services but also are likely to hurt themselves or the people around them. Thus, nurses must be able to calm them.

Patient/Client Situation

A patient with the symptoms of anxiety came to the hospital because he thought that he had the flu. He was not able to sit at his place calmly and was constantly trying to attract attention.

Specific Description of Skill Used/Observed

The nurse asked him to come down and tell her what was wrong. She noted the peculiarities of his behavior also. The professional spoke to him in a low, calm voice. She reassured him and provided feedback. She tried to establish eye contact with a patient and hold his hand while speaking. Then she turned on calm music and asked if the patient is fine with it. Then she referred to calmative.

Evaluation

This skill was effective as the nurse tried to cope with anxiety without medical treatment from the very beginning, which was likely to have a positive influence on one’s condition and allow the nurse to deepen in the situation. She observed the patient’s behavior and tried to build trust-based relations with him so that her influence increased. As a result, he found out how to compose himself, became calmer, and the dose of calmative was reduced.

Using self-disclosure

This skill allows a nurse to enhance a patient’s emotional and mental state by sharing personal ideas and experiences. It is critical to use this skill when a client requires help but not when a physician has a desire to share (Dexter & Wash, 2013).

Patient/Client Situation

A patient who has divorced just recently came to the hospital. She was upset over this situation and could not pull herself together. As a result, she had a headache and insomnia in addition to a depressed condition.

Specific Description of Skill Used/Observed

Seeing that a patient has a problem, a nurse started a conversation with her, asking about her general condition. She encouraged the patient to share her ideas of why she feels bad so that the situation with divorce was revealed without any interference into one’s personal life. The nurse did not evaluate the event but said that she could understand the client as she had experienced a similar situation. She disclosed the fact that she had a divorce and mentioned how she survived it.

Evaluation

I believe this skill to be effective, as it allowed the nurse to make the customer feel better. She got a better understanding of the patient’s situation and provided some insight in this way. Still, the nurse did not provide a lot of information about herself, which allowed her to avoid negative consequences. In addition to that, this skill allowed the nurse to build trust-based relations with her client, which was likely to enhance their further interaction and have positive influences on the quality of care provided and achieved health outcomes.

Assisting with discharge planning

This skill is needed when a patient is going to be discharged soon. A nurse needs to consider various alternatives based on the patient’s condition and determine whether the goals of the treatment were met.

Patient/Client Situation

A patient who suffered from depression and spent several weeks in an inpatient facility is going to be discharged in three days. A nurse was going to help with discharge planning so that the very procedure was clearly described and it was stated what and should be done by the patient after the discharge (Centers for Medicare & Medicaid Services, 2014).

Specific Description of Skill Used/Observed

The professional assessed community resources and support systems to find out how the patient would get home, and who will assist him, etc. She checked medications availability for one to continue treatment. The nurse prepared a summary of the client’s stay and his condition on discharge. She also mentioned recommendations for aftercare. She also prepared a list of services that are likely to be interesting to the patient and beneficial for his condition.

Evaluation

This skill was effective as it allowed the nurse to assist in discharge planning and make it easier for the patient and other professionals involved in his treatment to maintain this procedure. The nurse did not interfere with the patient’s private life but prepared a list of options that can be rather beneficial during the follow-up and aftercare processes. What is more, she prepared a lot of documentation that is likely to be required by other professionals who will treat this patient in the future. In this way, they also will have an opportunity to find out his previous health and history, which is critical for the allocation of appropriate care.

References

Centers for Medicare & Medicaid Services. (2014). Discharge planning. Web.

Dexter, C., & Wash, M. (2013). Psychiatric nursing skills: A patient-centered approach. San Diego, CA: Springer.

Patel, C., & Jakopac, K. (2011). Manual of psychiatric nursing skills. Sudbury, MA: Jones & Bartlett Publishers.

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IvyPanda. 2021. "Mental Health Nursing Skills in Practice." May 9, 2021. https://ivypanda.com/essays/mental-health-nursing-skills-in-practice/.

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IvyPanda. (2021) 'Mental Health Nursing Skills in Practice'. 9 May.

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