NURSING

Nursing

Nursing

The aims and objectives of this interview are to identify a nursing skill observed by myself whilst I was on my practice placement. The skill which I will be focussing on is the first phase of the nursing process in the form of the initial assessment interview. The client had been referred to the mental health services by his consultant and social worker, in order to continue his care in the community, after his discharge from a psychiatric ward. I was introduced to the client, and his permission was given for me to use my nursing skill of observation and also for me to use this assessment for the purpose of my study. The client in this assignment will be referred to as 'Davey'. This is a pseudonym, in order to protect his real identity and for the purpose of confidentiality, this is also a requirement of the Nursing and Midwifery Code of Professional Practice (2002).

A patient assessment according to Basford and Slevin (1995) is 'a carefully thought out methodical approach to gathering information and making an intellectual analysis of the data' in simple terms, it is building a picture of the patient. There are a great deal of factors to be given consideration when assessing a client, the most important being that the client is the most valuable source of information. Crucial factors can be gleaned from the assessment, and there are several different techniques for doing so. Therefore, it is intrinsic to set the scene before beginning the therapeutic relationship by considering interpersonal skills (Sundeen, Stuart, Rankin & Cohen 1998). The type of assessment used here, was the semi-structured approach whereby information is gathered on a document which is designed for the specific purpose. The approach is called the Care Programme Approach.

The client Davey was referred by his consultant and social worker, to the community resource centre following his discharge into the community. The purpose of this assessment interview was to primarily determine Daveys' needs and subsequent suitability for a place at the centre, and also to establish whether the community health care team could actually meet Daveys' needs in turn. Section 117 of the Mental Health Act (1983) states that there must be provision for the discharged client until the multi-disciplinary team is satisfied that the client no longer requires its services.

Daveys' initial assessment interview was carried out by a registered mental health nurse, with myself observing. The assessment took place in an empty games room which had a relaxed theme to it, and housed several easy chairs. The chairs were placed approximately 20 inches apart diagonally, this allowed both the nurse and Davey to have personal space and also to allow him to feel non-threatened and to enable eye contact as and when he required. The room was vacant of tables. This can have a significant factor on whether the client feels at ease or not. It is also a good indicator in the nurse client relationship that there would be no barriers right from the beginning ...