Cultural factors can affect people with mental illness. Ms Jones believes she is a Tahitian Princess and is refusing food and fluids that are not part of her traditional diet. Ms Jones is speaking rapidly, often in her “native tongue. This is a delusional belief.
Despite the delusional belief, responding respectfully and sensitively to cultural beliefs, identify two (2) negotiation skills that could be used to resolve this conflict.
You are an enrolled nurse working in an acute inpatient mental health facility. You have been allocated a new client who has just been admitted into the ward. Mr Paul Brown has been admitted via the community team. He has not been taking his medications as ordered and has therefore is experiencing an increase in his psychotic symptoms. Mr Brown has Paranoid Schizophrenia. He had been prescribed Olanzapine 20mg Nocte, but dislikes taking it as he has gained over 10 kgs, but also admits he often forgets to take it and can’t recall the last times he has. He also expressed a concern of looking like a zombie whilst on it, and doesn’t like how this makes people look at him. He is now experiencing auditory hallucinations. He hears voices telling him not to trust people. He is also paranoid and believes he is being watched. He has called the police to report unfamiliar cars in his street. He has not checked his mail box for the last few weeks and subsequently has had his electricity cut off for not paying his bill. He has a Mental health community case manager but has refused to open the door when she visits as he thinks she wants his money. The community staff have attended the Multi-Disciplinary Team (MDT) meeting to participate in a review of Mr Brown. You are requested to attend as you are his primary nurse for the shift. The community team have provided his care plan with his identified goal of symptoms management. You advise them on a “coping with voices’ group being run on the ward, and after a collaborative discussion including Mr Brown, everyone is in agreement for him to attend. At this meeting a discussion is held with Mr Brown regarding medications, and the treating team decide to start him on a depot injection – despite his desire to keep taking oral medications.
Case study 4
4.1 The EN, will report any relevant information to the RN. Being a part of the MDT, and liaising with the Community Nursing staff, from the information in the case study, identify two (2) pieces of information you would hand over to the case manager.
4.2 An outcome of the MDT is for Mr Brown to attend a group program on managing voices. This program explores psychosocial stressors as well as triggers for voices and develops skills to reduce the distress of voices. A secondary benefit to the group is socialising and normalising of behaviours. This has been identified, by Mr Brown and the treating team as part of his rehabilitation and recovery goals. Identify four (4) therapeutic outcomes of group therapy.
4.3 Acting as an advocate for Mr Brown identify two (2) examples from the case study, which could support him having a trial of oral medications.
4.4 As an enrolled Nurse, utilising non – discriminatory practices identify one (1) action you would undertake to minimise stigma and advocate on behalf of Mr Brown to respect and support his decision for oral medications.