21FA.RNSG.2161.C31C Clinical – Mental Health Clinical – Mental Health

respond to 2 of your peers, read their post and comment on their clinical day. You responses must be substantial, at least 75 words or more, appropriate comments: thoughtful, reflective, and respectful of other’s postings.
My patient was diagnosed with Bipolar 1. In the early morning he appeared to be extremely friendly whilst in the afternoon he appeared to keep more to himself, wrapping up in a blanket and staying by a corner in the room. I came to find out that he had served 14 years in the armed forces and had recently lost his sister some months ago. The death of his sister sent him into a spiral and into a deep depression. He came to express his desire to drink bleach and stab himself in the neck to his physician. Along with these suicidal ideations, he also came to express his desire to kill one of his nurses which all led to his recent hospitalization. He denies having any plans to carry out such ideations and also denies having auditory or visual hallucinations. The most concerning aspects of this patient include: Risk for Self Harm, Alteration in mood, Disturbed Thought Processes. Interventions included: close observation every 15 minutes, pharmacological interventions, counseling, developing rapport with the patient, assess suicide plans. After 7 days in the facility, the patient remains free from self harm. I did not know that an individual on the brink of suicide and destruction could look so normal and initally raise no alarms.
I was at MCH Navigator this week. I feel like this job is mainly geared toward advocating for the patient when they leave the hospital facility. Many of the patients we followed were in need of some type of medical service after being discharged. The nurse I followed would meet the patient upon admission, and start gathering information about the patients possible needs when they were to be discharged. This included a very broad spectrum of the word “needs”. It could be anything as large as needing an in patient rehab facility, to something as minute as needing their own commode chair. As nurses we all know needing a commode chair isn’t a very small thing, and it can still be costly, depending in the patients current situation at home. The nurse would call several different agencies in order to find all the necessary resources, as possible, for the patient to make sure the patient can be discharged to their home/rehab as safely as possible. This isn’t always easy either, some patients are noncompliant to the help being presented to them. Although the nurse has gone through a lot of work in order to find these resources, it is still up to the patient to accept and obtain the help. At this point the nurse has done all she can, and must hope the patient follows through. I learned that there is a lot of work being done by nurses behind the scenes to help patients in need. We may not see them, and they are not given much credit, but they are there. The nurses on the floor are not the only nurses advocating for patients. Honestly, I don’t think many people realize/know this either.

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