Adult Health Care Center: A Case Study

Hello Dr. Ullom, majority of the long term care facilities are under staffed. There is usually one registered nurse in charge to manage a 240 bed facility, with LPN's  and nursing assistance. I feel that these patients would benefit from having one RN to every six -eight patients with a nursing assistance. Not only would this benefit the patient but the nurse as well. Patient are placed in long term care facility with a certain problem, but ends up with additional condition such as UTI, MRSA, pressure ulcers, and etc. These issues are related to poor care they receive because of unstaffing. I'm not placing blame on the LPN or nursing assistance, but with a RN and low nurse to patient ratio, they will receive better care.

Decision making and best interests of the patient in the care for people with mental health problems are one of the main concerns in nursing practice. Healthcare professionals should be knowledgeable enough to practice the legal code regarding decision making and protection of the patient with mental health problems (NMC, 2008).

bipolar disorder at the age of 18. client has revised care as well as many different medications to

42 USCS 3002, The Public Health and Welfare, Chapter 35, lists the programs for older Americans. The Aging and Disability Resource Center is a part of the State’s system of long term care.

123). The role of a mental health counselor is critical when communicating with any prescribing professional since it "maximizes client outcomes where integrative therapies are involved" (Dickinson & Kaut, 2009 p. 218). Because the psychotherapist is in contact with the patient, he or she has the opportunity to join forces with others in the medical profession and be their eyes and ears to the appropriate professionals. As the treatment continues the mental health counselor re-assesses both the effects of treatment. Overall, the focus is on the client’s best interest (Anderson & King, 2004).

What is a nurse practitioner? Nurse practitioners are trained to diagnose and treat both physical and mental conditions through comprehensive history taking, physical exams, and ordering and interpretation of diagnostic tests (Yee, Boukous, Cross, & Samuel, 2013). The Board of Registered Nursing (BRN) states that nurse practitioners are registered nurses who are prepared by advanced education to provide primary care including medical procedures that may be required for a specialty area. The purpose of this paper is to reveal to the reader what a nurse practitioner is, providing background information of a mental health practitioner, nursing shortage, effect on the nurses and patients with the shortage of mental

Discuss any medical and psychiatric treatment concerns that you might have for this client(s). How would you address these

A psychiatric nurse practitioner focuses on treating people with psychological illnesses often with a high level of severity. Serving as an addition to the treatment team he/she can work in a variety of settings. They are commonly employed in group practices or community settings and can provide medication management, counseling, and treatment planning and management. They will work with individuals, groups and families, to provide the best treatment for those with mental health issues. Nurses also contribute to the environment of mental health care by helping implement policy, reform, improvement and evaluation of the treatment available to patients. (www.apna.org)

I chose to volunteer at Lakeview Health Center in West Salem, Wisconsin. Lakeview Health Center is a long term care facility that provides care for adults with special behavioral or mental health needs. At the beginning of the semester I listed ways that I thought Lakeview Health Center would enrich my knowledge in the field of psychology and goals that I intended to accomplish during my hours spent volunteering. I believed my knowledge would be expanded in the areas of mental health, the process of socialization and altruism. I will now reflect on this list and on the goals that I hoped to achieve.

Mental State the interdisciplinary team must ascertain if the patient is in a state of confusion, cannot answer at least simple questions or follow instruction or if he feels anger or fear towards anyone in the family (Felong, 2008). If he is confused, unable to answer even simple questions or follow instruction or harbors resentment or fear towards someone in the family, he may not be ready for placement. Housing the structure of the patient's residence is important. Is it a one-storey house or are there stairs he must climb? Issues that must be dealt with include the closeness of his bedroom to the bathroom; if he will share the bedroom with others; handle his own laundry, meals or shopping. Education it is important to know if the patient or his caregiver needs to learn diet, special diabetic diet, crutch training or other forms of therapy. The team must also determine if the patient is interested or not to capable of learning. It is also important to find out if the patient can learn the skills relevant to his condition (Felong).

Suffering from a mental illness can be debilitating and overwhelming, not only for the client, but their family members, as well. As front-line workers, mental health nurses are responsible for developing a rapport and building a foundation with this particular population. In doing so, psychiatric nurses can positively impact client care outcomes, allowing the client to experience optimal levels of holistic care. Effective therapeutic nurse-client relationships with mental health clients must be developed and maintained by nursing staff in order to provide their clients with the best care possible. In fact, The Registered Nurses Association of Ontario (RNAO) states that “the therapeutic nurse-client relationship is central to all nursing

Overall I felt my time at South Shore Elder Services as very informative and helped me gain a greater understanding of home health and geriatric health care. It also helped me see if home health is a setting that would interest me as on occupational therapist and how my interventions could help this population of clients in my future practice. Overall I think that South Shore Elder Services is a great organization and is doing great work for their clients.

There is no need in reinventing the wheel, and Iezzoni, DesRoches and Vogeli (2012) could not use a better description of what is patient center care. In essence, they describe the shift to patient care as a “movement towards collaborative care, empathic listening, shared decision making, and culturally competent care that reflect a growing understanding of the potentially therapeutic implications of patient-physician communication” (Iezzoni, DesRoches and Vogeli, 2012 pg. 384). However, hospital life does not always allow the time for this relationship to run its course for many reasons. Therefore, as a member of the hospital leadership team, I would encourage disclosure of medical errors by implementing an error disclosure training, promoting

My client initially talked about their relationship problems with their spouse. Once probing further, I was able to figure out that she had episodes for the last four years of being in slightly high moods as well as slightly low moods and her spouse was getting upset at how “moody” she has been. Immediately, I thought of Cyclothymic Disorder because of the persistent amount of time as well as the intensity of the episodes, but knew it could also be Bipolar I Disorder or Bipolar II Disorder if she met criteria for a manic or hypomanic episode. I began to probe more on her current mood, which she describes as feeling down for the past 2-3 months. I asked about other symptoms of major depressive episodes, such as diminished interest in activities, decreased or increased appetite, sleeping too much or too little, lack of energy, feeling guilty, as well as thoughts or plans of suicide. I was proud that I remembered to ask about all of those criteria and felt confidently doing so, but I did miss asking about diminished ability to concentrate or make decisions. In all of her answers to these questions, they either did not apply or were very insignificant. I discovered she felt slightly down, had a lack of energy and diminished interest in activities, but was still able to go to work and not be affected. The main issue was her husband being irritated that she would switch from feeling down and lying in bed more often to feeling more

About one-quarter of all American adults suffer from a mental health disorder in any given year, according to the National Institute of Mental Health (NIMH). Mental health is an important component of overall health and wellness. Treatment options often include medication and psychotherapy. Mental health nurses help patients who suffer from mental illness to recover their mental health so that they can live to their fullest potential. For example, mental health nurses work in a variety of settings, such as, psychiatric hospitals, substance abuse treatment programs, home healthcare services, community mental health agencies, and private practice. This paper will give a description of my clinical experience at a psychiatric hospital.