Reflective Account of Increasing a Persons Observations on an Acute Mental Health Ward

The Mental Capacity Act (MCA) 2005 states that “an act done, or decision made, under this Act, for or on behalf of a person who lacks capacity must be done, or made, in his best interests’. The Deprivation of liberty safeguards are a legal framework introduced into the mental capacity act 2005 (MCA) by the mental health act 2007 (MHA). This legislation protects the rights of people in care homes or hospitals, where the care is imputable to the state, who lack capacity or have a mental dysfunction to make decisions regarding their care and treatment (Jones, 2008 p 383). DOLS ensures against arbitrary deprivation of liberty (dol) which was identified in the Bournewood Case ( HL v UK 45508/99 (2004) ECHR 471). The judgement in this case determined that in order to adhere to the ECtHR, lawful detention needed to meet Article 5 (1) that requires a ‘procedure prescribed by law’ and Article 5 (4) which requires a means to apply to a court to see if deprivation of liberty was unlawful (dols code of practice 2008). As such, the DOLs are designed to protect the rights of people who fall within the scope of the act.

The NSW Mental Health Act 2007 lays down the foundation in the proper provision and facilitation of care and treatment to persons with mental health disorders and promote their recovery while protecting the rights of these persons. One of the provisions of the Act uplifting this objective is in the involvement of family and nominated carers of patients. As defined by the Act, designated carers may represent from the person’s guardians; the parent

The aim of the essay is to demonstrate the process of a patient assessment and care plan formulation in accordance with the assignment instructions. It is based on a case study, which illustrates a patient who has a diagnosis of paranoid schizophrenia, the patient was admitted to a medium secure hospital unit, please see appendix for more details of the case study. The pseudonym Peter will be used to address the patient to maintain confidentiality as required by the Nursing and Midwifery Council(NMC,2008).Firstly the essay will explore the philosophies of CPA; Care Programme Approach and then demonstrate the assessment of a patient with an assessment tool and including the formulation of a care plan.A KGV assessment tool was utilized(Lancashire,1998).In addition,the essay will examine and analyse the strengths and limitations of principles and philosophies which underpin existing service models for instance biopsychosocial model which is applied in mental health care delivery.Subsuently the essay will demonstrate an in-depth analysis of holistic assessment principles within mental health care.Futhermore the essay will analyse collaborative working in relation to planning and

Emma thinks that she does not have difficulty with the supervision but she does sometimes struggle with the resistance in regards to the walk-in program. Historically, nurses have not done counselling although, it is within their scope of practice in an informal way through their college. In that instance, Emma tends to be strategic with coordinating walk-in and being mindful of which clients she assigns to each practitioner. For example, if a client presents with significant trauma symptoms or hyperarousal with trauma, nurses may not be as trauma informed as a social worker. However, a patient may present with a desire to access an assessment through psychiatry and to discuss their medication regimen where a mental health nurse may have a more advanced knowledge of medication. Nurses have addressed that ‘going in cold’ is outside of their purview and that seems to make them more resistant to being involved.

In this assignment I will be exploring the issues around communication and assessment in relation to the care given to the patient. I will look at how care was delivered and how successful it was. The NMC (2008) states that healthcare professionals must respect a person’s right to confidentiality; to ensure this I will be using pseudonyms for the service users mentioned in this assignment. I will be referring to the patient as ‘John’ and his wife as ‘Brenda’. I have gained consent from Brenda to talk about her husband’s situation in this assignment, as he did not have capacity to grant consent himself due to dementia.

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).

The aim of this reflection is to discuss patient safety in an acute setting according to the Scottish Patient Safety Programme. I will be using a model of reflection, Gibbs Reflective Cycle to structure my essay (Gibbs 1988 cited in Paterson and Chapman, 2013). In accordance with the Nursing and Midwifery Council identifiable information will not be written, maintaining confidentiality (NMC, 2010a).

The author will also discuss the principles of the Mental Capacity Act (2005) and the Mental Health Act (1983) and how it protect an adult who is vulnerable and lacks capacity. Likewise, the author will discuss ranges of nursing interventions, person-centred care, and ethical dilemmas.

This assignment will critically analyse and justify the decisions based around a fictitious patient using a clinical decision making framework highlighting its importance to nursing practice. The chosen model will demonstrate clinical decision making skills in the care planning process. The patient’s condition will be discussed in-depth explaining the pathophysiology, social, cultural and ethical issues where appropriate in the care planning and decision making process. Any vulnerability that the patient may experience will be discussed and dealt with in the care planning and decision making process. The supporting evidence based literature will be analysed and

Patient’s decisions may sometimes be affected by various factors i.e. Their surroundings, they are often vulnerable and out of their normal environment. A conventional health care setting may be in a hospital environment where patients are most likely feel sensitive and insecure. Matiti and Trorey (2008:17) conducted interviews involving 102 patients in 3 different hospitals across the United Kingdom, over a period of 18 months. The purpose of these encounters was to annotate what was being said and also the fundamental meaning of how patients believed that their dignity was being put in jeopardy. One of the key aspects of patient dignity is making choices. Whilst conducting these interviews Matiti and Trorey (2008:17) discovered that despite the fact that patients accepted the loss of a little independence within the hospital surroundings, they wanted the freedom to participate in the decisions about their healthcare. Patients’ understanding in terms of choice, authority or participation in care and autonomy varied extensively. A number of patients were grateful that they were given the option to make decisions and that these were acted upon. On the contrary others considered that their right to making choices was contradicted and often their

My experience in mental health clinical was very different from any other clinical I had before. In a mental health clinical setting, I am not only treating client’s mental illnesses, I am also treating their medical problems such as COPD, diabetes, chronic renal failure, etc. Therefore, it is important to prepare for the unexpected events. In this mental health clinical, I learned that the importance of checking on my clients and making sure that they are doing fine by performing a quick head-to toes assessment at the beginning of my shift. I had also learned that client’s mental health illness had a huge impact on their current medical illness.

It is important to be aware of the changing world, changes in the law and how people perceive those who are vulnerable and dependent. At the heart of all of this, the patient’s needs and wishes still have to be at the center of any decision making and effective communication between professionals and patients is inherent in our moral duty to ensure that patients have access to the care they are entitled

During my work placement I noticed that nurses work in a variety of services and are in an ideal position to promote patients’ mental health and wellbeing by helping and empowering them to realise their abilities rather than focusing on their disability or illness (Ruddick,2013).

In this case study, one day of care for a 28 year old, male patient on a low secure psychiatric unit will be examined and discussed. The main focus will be on implementation and evaluation of the nursing process. These areas will be covered under; physiological, psycho-sociological and pharmacological aspects of the patient’s care. Although, the case study is discussed using third person expression, the care discussed is what was implemented and evaluated by myself, a second year student nurse, under supervision from a qualified member of staff.

In Mental Health practice, the assessment of a patient is a vital part of their treatment as it is required to be aware of their ailment before a treatment plan/course is made. Therefore, risk management is a practice that involves the assessment and engagement of an individual through standard assessment tools and approaches so as to devise a means to manage an individual’s risk behaviour(s). Assessment is essential when it comes to nursing practice, as it is a major key element of knowing what care is required as well as knowing if the right form of care is delivered successfully (Combst et al., 2013). The questions that usually come to mind will be how the assessment is carried out and how will the practitioners and clients react to the outcome of this assessment. The aim of this assignment is to critically analyse the assessment tools, models and approaches utilised in mental health practice. Furthermore, a consideration will be given to the limitations of the assessment practice such as the reliability of the assessment tools. To carry out this task, a fictitious individual will be used in this report. A number of possible ailment and presenting risk behaviours are listed then an eventual analytical procedure for the individual’s assessment will be explained.