Reflective on Histofy of a Depressed Patient at the Emergency Unit of a Psychiatric Hospital - Essay Example

Reflective essay on history or assessment taking on a depressed patient at the emergency unit of a psychiatric hospital using Gibbs reflective framework Reflective essay on history or assessment taking on a depressed patient at the emergency unit of a psychiatric hospital using Gibbs reflective framework Introduction Regardless of the kind of illness an individual is suffering from, one of the initial steps that a healthcare specialist ought to conduct include assessment and history taking. This is in regard to the fact that history taking informs the specialist on the root cause of the illness and the factors that could potentially exacerbate the illness. For instance, it is important for a nurse on duty to ask probing questions relating to a patient's family medical history as close family members have an array of similar factors such as similar genetic makeup and way of life (Hughes, n.d). Therefore, history taking may give a nurse or any other medical practitioner a hint on what could be ailing the patient. This paper is a reflection on history taking on a depressed patient at the emergency unit of a psychiatric hospital using Gibbs reflective framework. Gibbs reflective model Gibbs reflective model allows description of the problem, analysis of feelings, evaluation of the good and the bad of the incident, analysis, analysis of what can be concluded from the experience and articulation of an action plan (Raynor, Marshall and Sullivan, 2005). Description One afternoon, a middle aged man in his late thirties named MZ in the company of friends was brought in the emergency unit. Minutes later, his wife walked in hastily. I was the nurse on duty during this period. MZ's wife told me that he was going to kill himself and that his behaviour had been abnormal for the past one week. MZ's wife also said that his behaviour had been abnormal for the past one week. I asked MZ whether there was history of psychiatric illnesses in his family to which his family members affirmed. His grandfather had a history of schizophrenia. Secondly, I employed the use of a CAGE questionnaire (Hughes, n.d) to identify whether MZ abuses alcohol. From the questionnaire, I deduced the MZ was not abusing alcohol and other drugs. My third step was to asses MZ's mental status examination. In doing this, I assessed his interpersonal characteristics and behaviour, speech, eye contact, ability to express himself, and ability to recall. I also engaged him in a conversation to assess his alertness and subsequently asked him to recall and describe his feeling s and mood in a typical day. From my exam, I observed that MZ had a disorganised speech, was delusional and he remained speechless and motionless for an extended period of time. In regards to assessment of his feelings, MZ retorted that life was not worth living. These were characteristic signs and symptoms of depression. Feelings As a newly qualified nurse, my initial feeling was of fear. I have always feared being in close proximity with a mentally ill individual as I assumed he or she could result to violence. My fears were confirmed when MZ was brought in the emergency room. I could barely frame the right questions when taking the history of MZ as my mind often drifted to what I would do if he became violent. I was also very nervousness as MZ's case was my first case relating to mental illness and I feared I would make mistakes in assessing him. However, I was both relieved when the physician came and took over MZ's case for further review. Afterwards, the physician came to me and congratulated me for handling MZ case professionally. I was very happy for this recognition. For this reason, I presumed that I did everything right. Evaluation and analysis When someone is in the midst of a severe emotional crisis characterised by suicidal intents, he or she could be unpredictable (Schwartz, 2007). Taking the history of a patient is posited by Manton (2013) to be a fundamental step in establishing the basis of a psychiatric illness. In the same viewpoint, establishing the primary attribution of observed behaviour, delusion, and disorganised speech as in the case of MZ is considered imperative in assessing patients in the emergency setting by Manton (2013). The doctor thought I acted professionally due to my willingness to help MZ despite being a newly qualified nurse and phrasing my questions to MZ in a tone, tempo, and format he could understand. For instance, I used an audible and slow tone. Owing to the fact that MZ's case was my first practical case to deal with a depressed patient as a newly qualified nurse, I did not have time to prepare for the assessment and history taking. I translated my theoretical knowledge into practical experience to appraise the presentation of MZ's condition. My diagnosis was depression. Through my effective communication skills; listening, talking, and observing body language, I was able to formulate a trustful relationship with MZ and his wife. This encouraged them to open up and divulge all details relating to MZ's health status and in doing so, I put into practice effective and sustainable action plans. After completing the assessment of MZ, I learnt the benefit of handling emergency cases with professionalism. In this respect, I comprehended the fact that when I handle a case professionally in relation to history taking, a patient will have confidence in me and therefore divulge critical information and personal information that would aid in better understanding of the problem (Raynor, Marshall and Sullivan, 2005). I also had a chance to gain practical experience in assessing and taking the history a patient presented in the emergency unit with depression and suicidal thoughts. Conclusion Newly qualified or employed nurses are destined to possess the feelings of nervousness and fear in their initiatory experience in assessing a patient. By using effective communication skills through listening to the patient and conveying information in a succinct and understandable format, a trustful relationship with the patient is preordained. Action plan To prevent feelings of nervousness and fear when conducting assessment and history taking on a patient, I will do the following: I will ensure I improve on my confidence through a direct eye contact when inquiring about the history of a patient and ensure an experienced physician is present in the emergency room in order to overcome the fear that the patient may turn violent (Woodruff, 2007). I will also ensure I practice on history taking and assessing a patient's health status, and conduct broad research to comprehend the variety of cases that may be presented in the emergency room in order to improve my confidence. This is in attribution to the fact that "Confidence comes from having a strong theoretical foundation and reinforcing it repeatedly" (Woodruff, 2007, p. 113). References American Foundation for Suicide Prevention. (2015) Treatment. Available from https://www.afsp.org/preventing-suicide/treatment Depression and Bipolar Support Alliance. (n.d) Suicide Prevention. Available from http://www.dbsalliance.org/site/PageServer?pagename=urgent_crisis_suicide_prevent ion Hughes, S. (n.d) History Taking & Risk Assessment & Mental State Examination. University of Bristol. Available from http://www.bristol.ac.uk/media-library/sites/medical- school/migrated/documents/resourcepack.pdf Manton, A. (2013) Care of the Psychiatric Patient in the Emergency Department. Des Plaines: . Emergency Nurses Association. Available at https://www.ena.org/practice- research/research/Documents/WhitePaperCareofPsych.pdf Raynor, M.D, Marshall, J.E, and Sullivan, A. (2005) Decision Making in Midwifery Practice. London: Elsevier, 2005. Schwartz, A. (2007)What to Do In a Mental Health Emergency, Referral Solutions Group, Viewed 16 April 2015. Woodruff, D.W. (2007) 101 Tips to Improve Your Nursing Care. Eau Claire: PESI LLC. Read More