Explore the personal and social implications of mental illness, as well as, ethical, legal and clinical practice implications related to a mental health patient being admitted to a medical ward
Assignment Task
You are a newly registered nurse working in a large metropolitan hospital on an early shift in a busy medical ward. You have been allocated Veronica to care for her as a 1:1 special in a single bed side-room. You are given the following hand-over by the night duty RN.
Veronica is a 25 year old woman admitted yesterday post overdose of Sodium Valproate and Seroquel, and multiple self inflicted lacerations to her abdomen. Veronica has a diagnosis of Schizophrenia and is currently on an ITO-L1 which requires review today. Overnight Veronica has had a fluctuating sensorium – has been occasionally drowsy, but at other times very restless and agitated. Her conversation has had a paranoid and delusional flavour at times. Veronica is confused and likely has a delirium related to the ingestion of prescribed medications.
Veronica has an intravenous line of normal saline 1 litre over 8 hours – started 4 hours ago. Urinary catheter insitu which is draining well. The last ECG showed lengthening of Q-T interval and a repeat ECG is booked for 10:00 AM. TPR & BP are within normal limits – for checking 4 hourly along with neurological observations until reviewed by treating medical team.
Veronica’s behaviour has not presented any significant management problems overnight in the ward. However she did present to the Emergency Department in a severely agitated state when a Code Black (Aggressive incident) was initiated. Because of her fluctuating sensorium she is to be considered at risk.
The self inflicted wounds to her abdomen were sutured in ED, all wound sites are intact but there is some ooze noted at the suture sites; the dressings will need to be changed during the day. Veronica is not to be given any medication unless severely agitated. The Consultation-Liaison psychiatry team are aware of her admission to the medical ward and will review her later this morning. Over the next few hours it is likely that Veronica will become more alert and likely more distressed and agitated. You are advised to call for assistance if you have any concerns.
In a parting comment the night duty RN states that – “I do not know why we are wasting time on looking after people who want to kill themselves, there are plenty of sick people out there who need hospital beds”.
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