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Description of the Client
The client I have worked with is a 62-year-old man. He is a White American with Hispanic roots (his grandmother was Hispanic, and grandfather was White). He was born in Loss Angeles and has been living here all his life. He is married to a woman who is eight years younger than him. He belongs to the middle class. They are a Catholic family. They live in a house in a well-developed community. At present, he owns a small plumber company which he started at the age of 19. He does not work himself now due to his health problems. His wife works as a teacher of literature at high school. His hobby is repairing retro cars. He has a big family with many cousins, aunts, and uncles. His mother is still alive and lives with his family. His relationships with neighbors are friendly. The client and his wife have two sons who live in other states. They both are married, and the elder brother already has a daughter and a son. The grandchildren love visiting grandfather’s house.
Until the age of 40, he did not experience any significant health problems. When he was 40, he was diagnosed with type 2 diabetes. Also, he was obese. However, careful following of the doctors’ prescriptions and change of lifestyle to healthy improved his quality of life. his healthy died helped him both to prevent diabetes complications and lose weight. At present, his blood glucose is within normal limits due to the diet and supportive therapy. He was hospitalized a month after a car accident in which he has broken both arms. Both fractures are almost set and his overall physical condition is good for his age. However, he has developed some mental problems that have to be addressed. Thus, the client has typical symptoms of posttraumatic stress disorder and related depression. Moreover, he is getting addicted to alcohol. Nowadays, the client regrets deciding to drive a car despite the rain on the day of the accident. He dreams of buying and restoring a Ford Shelby Mustang. Finally, he hopes to get back home and complete a rehabilitation program to return to his hobby.
Type of Practice Setting
The practice setting under analysis is the White Memorial Hospital where I did my internship. My duty was to provide care and administer the prescribed medicine to elderly patients. The hospital cooperates with the community mental health program, so I had to work with patients with mental health problems in addition to those with different physical conditions such as diseases or traumas.
Number of Contacts with Client
I had eleven contacts with the client. These were nine face-to-face contacts and two phone calls. We contacted every time I had to work with patients. I received two phone calls after the patient’s discharge to consult about the rehabilitation process and diet changes not to gain weight while he is not as active as he used to be.
The evident problem of the client is his inability to accept the current situation and make efforts for its improvement. The client suffers from the loss of ability to operate his hands that used to be his instrument both for work and hobby. Thus, already at the hospital, he was diagnosed with posttraumatic stress disorder. His woman referred the client to the hospital because of two major reasons. First of all, she was disturbed by his depression and other PTSD symptoms. Secondly, she was afraid that he would become an alcohol addict. Moreover, having both hands in plaster, he could not perform any self-care activities and needed help while his wife was at work.
Nature of Dissatisfaction or How I Was Stuck
During my internship which I consider successful, I still faced some problems that made me feel dissatisfied. First of all, I experienced countertransference to the client. He looked despaired and depressed because of his trauma. In fact, he reminded me of my grandfather who once broke his leg and could not ride his favorite bicycle on weekends in the country. During the practice, I felt stuck at first. My major limitation was the lack of skills since my background is work with children aged 5-15. Consequently, I was confused by the necessity to work with elderly clients. However, administering drugs was not a problem, because it is an integral task of any nurse. Moreover, all prescriptions are made by the doctor and my duty is only to deliver them on time. I believe I coped well with this part of practice because I feel confident about my pharmacological knowledge.
Another significant problem was that the majority of patients had some mental conditions in addition to their primary diagnoses and age-related changes. I did not have any experience of work with mental disorders. Thus, I was afraid I would not cope with this part of care. Clients with mental disorders need special care and more attention while these were the components that I lacked. Nevertheless, I managed to resolve the issue with the help of my senior colleague who advised me on the peculiarities of care for older adults with mental conditions. The first objective that I remember is that they need more attention than young adults. Moreover, it is essential to learn as much as possible about the patient’s mental conditions to be ready to react to their behavior that may not be always common. Finally, I came to realize that elderly patients in general and those with mental disorders in particular need attention and communication. They are eager to share their memories in case there is a listener. I suppose I looked interested in their stories. In fact, listening to the clients was an exciting experiment. After sharing their life stories, patients become attached to you and are more eager to take the necessary treatment and follow the doctor’s instructions than before which is likely to have a positive impact on patient outcomes.
The last problem I faced was related to my personal feelings and principles. I am against alcohol consumption, and the fact that the client was likely to develop an addiction made me feel negative about the client. However, I managed to control my emotions, and the client did not notice my attitude. Moreover, I decided that I can help him get rid of the harmful habit and switch his attention to something positive. On the whole, I believe I have managed to succeed. I was attentive and patient in explaining the principles of self-care and the order of rehabilitation to allow the client to return to his hobby.