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NURS1066: Context of Mental Health Nursing: Recovery Nursing Plan

    Discipline of Nursing

     

    Written Assessment Task

    Recovery Focused Nursing Care Plan

    DUE: Due Sunday 29th March, 2020 by 23:59 .

    Title: Recovery Focused Nursing Care Plan 2000 Word Assignment

    Assignment Number 1: 40%

     Developing a Recovery Focused Nursing Care Plan [RFCP].
    - A Recovery Focused Nursing Care Plan based on the care of a consumer described in one of scenarios. Please see the assessment information package for more information on this assignment.

    Instructions:

    1. Choose 1 of the scenarios to use as the basis for your assignment [you will base your entire assignment on one of the case scenarios only]
    2. Read the Case Study and identify 4 Goals drawn from both the case study information and the HONOs scale for the consumer in the scenario. Consider and adopt a Recovery Model perspective in doing this.
    3. Having read the following case study, and familiarised yourself with the layout of the nursing care plan, you are to complete the Recovery Focused Nursing Care Plan for this client.
    4. Each RFNCP must include 4 full Goals/Issues with each section fully completed.
    5. In keeping with the Recovery Model principles [as conveniently discussed in the Week 1 lecture and reading] remember to:
      1. Rank the goal priority in the order in which the consumer would like to address the issues listed [there are going to be different ways to do this depending on what you see as being the highest priority]; this will require some critical consideration on your behalf.
      2. Make sure that language used on the RFNCP is clear, encouraging and agreed by consumer and clinician.
        NURS1066: Context of Mental Health Nursing 1

       

    Discipline of Nursing

      

    c. Keep in your mind at all times the importance of this being a ‘shared document’ that aims to maximise the consumer’s strengths, capacity, abilities and resources.

    1. You are allowed to ‘fill in’ details in the case study where you feel that it is important for the completion of the RFCP. If you do this you must include all additional information in an Appendix which should be cited in text wherever this information is relevant.
    2. You must support your work with references. In particular this means that you will need to locate references that support nursing and consumer interventions as wells as in identifying potential strengths [especially through the literature on the Recovery Model] as well as when identifying supports and resources and determining timeframes for review.
    3. Please post all questions up on the Course Canvas Discussion Boards as this will allow all students to benefit from the answers.
    4. In keeping with RMIT policy all assignments are to be submitted through the Turnitin Portal available via the course Canvas webpage:

    a. The assignment is due by 23:59 on Sunday night: the portal will remain open for two weeks past the due date to allow students with Extensions to submit however the time you submitted your work is recorded on the system so please make sure that it is submitted by 23:59.

    The Turnitin portal will open 2 weeks prior to the assignment due date to allow you to submit your assignment. You are allowed to submit it as many times as you would like up until 23:59; the assignment I will receive to mark will be the LAST one you submitted.

    1. You are not required include an Introduction or Conclusion section for this assignment though you may include Appendices as required.
    2. You need to submit your Assignment as a single uploaded file with your name and student number on it. So you need to collate your assignment into one document which includes your [1] Title page, [2] Table of Contents page, [3] the actual Assignment and [4] the Reference List in APA format. There is no need for a University cover sheet or making guide with electronic submissions as I will mark it off the screen and your mark will be released to you with the paper and feedback.
    3. Finally, you must make sure your assignment is written in 3rd person past tense and uses headings. No use of I, me, my etc. This is a Care Plan but it is also a critical assignment that requires that you use the literature effectively and think about how the literature informs your practice in the given scenario.

      

    NURS1066: Context of Mental Health Nursing 2

    Discipline of Nursing

      

    Constructing the Recovery Focused Nursing Care Plan:

    When constructing the RFCP you are required to submit he document using the following format:

    Consumers Priority
    		Identified Goals/Issues
    		The consumer’s strengths to address these issues.
    		Consumer and Nursing Interventions
    		Person/s Responsible
    		Timeframe
    - Include a succinct statement describing the issue.
    - Rank according to the consumers priorities.
    		- Can be done using HONOS or based upon the information provided in the case study.
    		- This section is critical to ensuring the plan has a genuine recovery focus.
    - You need to ask questions such as:
    - ‘What can they do?’
    - How
    can they help themselves?
    		- Include agreed actions and expected outcomes.
    - Consider what needs to be done for each Goal / issue and identify what things the consumer can do and what things the nurse needs to do.
    		- Who is responsible for this intervention occurring?
    - Who will be assisting in this intervention.
    - What sort of assistance are they going to give.
    		- This needs to be realistic and developed with the consumer.
    - It also needs to reflect the time taken for interventions to effect change in the consumer’s symptoms.

    NURS1066: Context of Mental Health Nursing 3

    Discipline of Nursing

    The HONOs and the Recovery Focused Nursing Care Plan:

    The HONOs scale is completed as part of the assessment data and can be used to identify the key Goals and Issues and then rank them according to consumer preference. It is included as part of the case study information.

     

    Domain
    		Results

    1. Overactive, aggressive, disruptive behaviour. 2. Non-accidental self-injury.
    3. Substance use and misuse.
    4. Cognitive problems.

    5. Physical illness or disability problems. 6. Hallucinations or delusions.
    7. Depressed mood.
    8. Other mental health issues.

    9. Relationships.
    10. Activities of daily living.
    11. Problems with living conditions.
    12. Problems with occupation and activities.

    Answer

    Recovery Nursing Plan


    Case Study: Kate

    Kate is a 27-year-old single female, a single woman referred to the local inpatient Unit by her GP.

    As a case manager, the Recovery Care Plan is-:

    HONO Case Score:

    The diagnostic assessment of the patient is done through the mental health evaluations which would show the sign or symptoms of patient describing the risk factors, issues and correction method, for example, any sudden mood disturbance, experiencing a dysfunctional grieving, or showing the signs of the risk for self-directed violence, any symptoms in the self-esteem disturbance, any sort of self-care deficit, any signs of withdrawal or a social isolation and showing the altered nutrition (Burgess, 2020). As per Kate’s HONOs scores, it shows key pointers depicting her present health conditions. From this, the scores projected from the highest care priorities show that the patient often experiences a depressed mood (score 4), shows the problems with the daily activities or the daily living (4), along with experiencing the problems with occupation and handling of the activities (4). As per the DSM assessment along with the HONOs scoring shows the disorder of the patient having the Major Depressive Disorder (Moderate) and reflecting the single episode with peri-natal onset.

    RFNP Table:


    Consumers
    Priority
    Identified
    Goals/Issues
    The consumer’s    strengths to
    address these
    issues.
    		Consumer and Nursing Interventions
    Person/s
    Responsible
    		Timeframe
    Kate   had been suffering and shows the signs of the onset extremely mood swings,   withdrawals and also shows the constant suffering especially the morning   anxiety, crying inconsolably, feeling withdrawn and experiencing sadness   whole day
    Consumer priority #4
    Issue:   Signs and risks for ineffective coping is shown in the patient causing the   signs of depression and having the limited patient response to the different   stressors which is attached to the childbirth and parenting issues during the   first few weeks or months after the childbirth 
    (Davidson, 2020).
    Goal:   It is important to implement recovery focussed care planning and having the   patient care to show the signs of verbalizing and stressful care that   indicate the issues and feelings related to the signs of the overall   improvement and help the patient overcome the care.
     
    HONOs score 4 
    From   the coordination and collaboration with the case manager along with the   patient care that is part of the consideration often the sign of the patient should   be discovered to show the following strengths:
    -The   patients need to develop the goal-directed
    –There   is a sign of recognizing a need and often it comes from the depression along   with the care for her sister's daughter.
    -The   patient does not show any signs or evidence of any hallucinations or   delusions (Jones, 2020).
    -The   patient shows the suicidal tendency and to end the emotional turmoil, but as   per the history has not shown any significant want or any major tendency to   attempt in trying. 
    -Kate   is just in a situation that is limited to the time, place and person.
    -Kate   shows visible signs of good memory while recalling, relating and presenting   an intact judgment that is not unsound or impaired in any manner.
    -Kate   shows no insight within her illness even though there are episodes of feeling   angry, feels resentment, feeling withdrawn but as such she has not sunk into   the stage of the unrecoverable mode.
     Kate’s   present perception of the situation is to sit down, sleep and actively involved   in listening to correct the situation. She needs to identify the perception   related to the patient and how there can be stages that can help to earn   respect, be socially valued and start keeping well by motivating herself in   the active engagement to the situation. Through constantly listening, she can   get a better frame of mind and develop a nursing intervention. Nursing   intervention can be deemed as the past and the present situation showing the   patient's condition. It even represents how the past and present conditions can   play a major role in earning better treatment and health outcomes.
    Kate   should be motivated to find out a true self, through the mode of empowerment   and engaging herself in the positive activities along with the relationships   which can create a life that would redefine the change along with correcting   the hopeless feeling and setting herself into the optimistic feelings.
     
    From   the patient perspective, it is important to encourage Kate to open up and   communicate her feelings, her sudden bolt of fears, showing the signs of the   anxiety such as unable to take care of the baby, of household or her sister.   Ability to communicate and being able to overcome the challenge of self-harm   or facing the issue of worthlessness.  The patient also has shown signs   of feeling fear, anxiety and has taken remarkable steps to feel overburden   due to the effect of anxiety. There is also a sign of higher levels of   anxiety that has resulted in depression. But in the long run, the negative   impact of health is limited to the patient. The patient feeling secluded, sad   and pressurized can be corrected through the push and ensuring the patient is   not harming oneself or not undergoing any suicidal attempts.
    Kate   should be motivated to participate and develop care planning to regain   control of her life again. Kate should also be given additional   responsibility to cure one own care. It often infuses and results from a   sense of responsibility along with having self-awareness and attaining a   self-improvement image to gain control (Llewellyn-Beardsley, 2020). The patient's mind   should be corrected and guided with the encouragement to take self-improvement   plans along with control over the self increase solution of own life.
     
    Kate   should be given  antidepressant therapy   and include the counseling 
     
     
    Kate   should be given active care and also engage in the responsibility that can   help to develop a sense of worthlessness along with gaining positive   empowering activities to correct her daily life (Fibbins, 2020).
     
    Kate   mother and sister should be given guidance and direction to keep her more   engaged and provide her optimizing responsibility to  activities along with finding  strengths to correct the normal happy life   again
     
    The nursing case manager   will take the responsibility of communicating with patient effectively,   discovering depressing triggers and overcome it (Kerr, 2020)
     
    A   psychotherapeutic practitioner will take the responsibility of managing her   antidepressant and counseling therapies. The psychotherapist practitioner's   counseling therapies are one of the best ways to cope up with the depression   because sometimes medications are unable to reduce depression in a patient.   for such patients, customized counseling therapy plays a key role.
     (Llewellyn-Beardsley, 2020)
    Kate   has shown the suicidal tendency and also shows the risk factors about the   patient having the measured that shows every 12-24 hours.
     
    The   shift showing the signs of the depressing mood along with the protruding disturbed   thought process needs to be rectified and analyzed twice or to thrice a week.
     
    Kate   has to also ensure she is shifting herself and restoring the back of her life   along with gaining and rejoining her job or working on her family life to progress   that can be tracked daily (Jones, 2020).


    Consumers
    Priority
    Identified
    Goals/Issues
    The consumer’s strengths to
    address these issues.
    Consumer and Nursing
    Interventions
    		Person’s ResponsibleTimeframe






    Shows the sign of the nutrition- weight   loss (8kg and also shows the unhealthy eating habit often snacking.
     

    Issue
    The issue of nursing is to diagnose the   focused altered nutrition
    Goal
    To have a healthy maintained diet and   there should be proper nutrients, that help to cope with difficulty in   experiencing the emotional ways to strengthen it.
    Honos   score 4
    -Kate   often shows a sign of diminished appetite, but there is also a recognized way   of understanding the problem is not to eat her favorite snack but to get   adequate calories.
    -To get support from mother, sister, and   friends by getting food when not cooking.
    -Kate   knows she is unwell, feeling sad and depressed, but she needs to correct her situation   by staying engaged and active.
    Kate   needs to make a positive change (Jones, 2020).
    Kate    along with the baby needs to get a   well-balanced diet  
    -To get the medical evaluation and also   understand the investigation based on the potential health problem that can   diagnose weight loss (Foster, 2020).
    -BMI needs to be monitored and checked   weekly
    -To have the full nutritional counseling   along with seeking help from the nutritionist
    -To have the constant assessment and consultation   done by the psychologist to test her triggers and keep a check on her habits.
    -Kate needs to follow a healthy diet and   attain a balanced daily intake which involves every 2 hours eating and keep   herself engaged.
    - Kate should understand her  nutrition counseling and understand her   weight loss issues
    -The nurse needs to maintain a record   and the balance chart
    -To have the small frequent meals than   to have the three big meals leading to a loss in appetite.
    -Kate should eat alongside with others   in her family or close ones. 
    -To get full nutritional and   psychological counseling, to judge week 1.
    -To get the meal frequency to be   substantially be increased during the 4 weeks (Foster, 2020).
    -Kate needs to engage and have healthy snacking.
    -Weekly   weight checks.


    Consumers   PriorityIdentified Goals/IssuesThe consumer’s strengths to address these issues.Consumer and Nursing InterventionsPerson/s ResponsibleTimeframe

    Issue: Violence and shows   self-destructive behavior.

    Goal: Kate shows the safety signs   to be maintained and there should be a reason to live to be strengthened.

    HONOS   Score: 4
    With   case manager following issues was found-:



    -Kate needs to understand support [system   and constant monitoring of the changes with the high intensity to the   frequency of any sort of self-harm ideation.



    - Kate's Case



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