NURSING PRACTICE



Nursing Practice

Nursing Practice

Reflection 1:

At PCH "X", a nurse was giving medication to a resident and he introduced himself. The resident did not respond to the nurse so the nurse approached him in a different manner. He crouched down to the resident's level and spoke to him again in a calm voice and lightly touched his shoulder. The resident later complied with his directions to take his medication. Non-verbal communication involves other forms of communication such as gestures, facial expressions, and touch (McDevitt 2004 pp.22-35 ). Non-verbal conversation makes up 85% of communication and is less conscious than the words spoken. It clarifies what the person is saying by the use of gestures, eye contact, touch and body language. It requires efficient interpretation to understand the correct meaning of the conversation (Reich et al. 2004 pp.28-32). One of the best indicators of interpreting what a person is trying to say is the persons' eyes and the look on their face whilst they are talking to you. This is known as eye contact and facial expression.

Most people who use verbal communication use various forms of non-verbal communication simultaneously. The nurse in the example above used non-verbal communication, when he crouched down to the resident's level and lightly touched his shoulder. This second example involves non-verbal communication: A Health Care Aide was about to assist a resident with lunch. The resident was not aware of his environment and had difficulty feeding himself. The Health Care Aide asked the resident to open his mouth but he did not respond. As a result, the Health Care Aide opened his own mouth and the resident mimicked him and they were able to continue feeding.

Reflection 2:

Mental health nurses, as key members of multidisciplinary mental health services, are well placed to conduct comprehensive assessments and to devise care plans, especially in their role as care coordinators in the care programme approach. This approach aims to ensure that coordinated care meets users' needs.

Following assessment, a care plan should be developed with clients and a copy should be sent to the primary care professional who made the referral, other agencies or services providing significant care and families or carers, if appropriate. (Reich et al. 2004 pp.28-32) Families and careers can play an important part in supporting people with schizophrenia. Clients must consent to them being involved. Mental health nurses, in their role as care coordinators, should oversee carers' assessments.

Pharmacological treatment remains the cornerstone for people with schizophrenia. This usually starts in acute care where psychiatrists and independent nurse prescribers are well placed to oversee its initiation and ongoing management.

Furthermore, nurses have an important role in giving information on medication, discussing and exploring the risk-benefit profile, and monitoring tolerance and side-effects collaboratively with clients. Such medication-management strategies are crucial in optimising the benefits of the medication regimen and adherence.

Important evidence-based treatments for schizophrenia also include specific psychological interventions, namely cognitive behavioural therapy (CBT), family intervention and arts therapies. Mental health nurses working as care coordinators for clients are ideally ...