This assessment delves into the multifaceted aspects of mental health care, focusing on the case of John, whose Mental State Examination (MSE) and clinical formulation reveal several clinical concerns. Key concerns include alcohol misuse, resulting in anger and sleep deprivation, requiring a nuanced clinical handover. The need for establishing a therapeutic relationship with John becomes apparent, emphasizing effective communication and the potential use of Cognitive Behavioral Therapy (CBT) to address his mental distress.
Cultural safety takes center stage as the cultural differences between John and his examiner are considered, highlighting the importance of providing care that respects and aligns with his cultural values. The focus is on understanding John’s culture to foster a connection and avoid negative impacts on his mental well-being.
The Nursing Care and Recovery Model propose interventions for John, aiming not only for effective care but also a purposeful life. The recovery model principles applied include uniqueness in interventions, empowering John with real choices, instigating changes in attitude through meaningful activities, fostering dignity and respect, and continuous evaluation of progress to ensure a positive impact on John’s mental health.
This assessment underscores the significance of a holistic approach to mental health, intertwining clinical, therapeutic, cultural, and nursing care aspects to promote comprehensive patient recovery.
Part 2
2.1 Clinical Handover
In part 1, the MSE and clinical formulation have been carried out for John. The results of MSE
and clinical formulation indicated that there are many clinical concerns related to John. The first
concern related to him is his habit of taking excess alcohol. The misuse of alcohol had made him
arrogant and angry. As a result, he suffered from sleep deprivation and could not sleep, followed
by poor appetite. Hence, John is under-weight. However, his physical appearance was poets like
and he had long beard. As far as his rapport towards the clinical examination, he never lost his
temper and never resisted the process. He answered all the questions politely but briefly.
However, he eventually settled down and took part in the examination anyhow. His medical
condition did not make him angry and he did not over-react. His speech was full of softness and
calmness but it sounded monotonous. He talks about his poems and becomes animated when
anything about Heather is asked. He was not spontaneous in his speech and took time to discuss
his things with the examiner. There might be a chance that he felt recalling the moments
happened in his life difficult and therefore he took time. Overall, he looks very tired and lifeless
person.
2.2 The Therapeutic Relationship
The MSE and clinical formulation of John indicates that a therapeutic relationship needs to be
established with him. This will enable the consumer to come out of his trauma easily and also
connect the examiner with him (Mental Health Commission, 2007). John is mentally disturbed
due to his break-up and he has been taking alcohol in excess. This has made him angry and
arrogant. Therefore, he needs someone who can understand his concerns and communicate with
him effectively. As per John’s condition, effective communication strategy can be helpful to
develop therapeutic relationship with him. The examiner needs to understand him and ensure
him that his situation will be fine in some days. The communication will make him reassured,
put him at ease and he will also feel empowered. He will be able to share his concerns and
feelings with the examiner in an effective way. The examiner can use effective communication
to keep him motivated to follow the medication regimen and also he can feel respected.
Therefore, effective communication is vital to deliver quality and patient centred care to John.
The use of communication for John is therapeutic. The development of relationships is critical
for nursing, especially for patents like John who feel angry and mentally disturbed. Besides this,
Cognitive Behavioral Therapy or CBT can be used to develop therapeutic relationship (Mental
Health Commission, 2007). This psychosocial intervention can help in treating mental disorders.
With CBT, the examiner can focus on the development of personal coping strategies that target
clinical problems of John and also his thoughts and beliefs.
2.3 Cultural Safety
Since the culture of John and his examiner might be different so it is essential that culturally safe
care is provided to him. Cultural sensitivity is a key concern for the healthcare providers as they
need to be very sure that their care does not impact the cultural values of the patient (Rush &
Barker, 2006). The negative impact can let the patient become hyper, which can be risky. In the
culturally safe care, examiners adopt effective nursing practices for their patients. To ensure that
I provide culturally safe care to John, I will understand his culture so that he can feel connected
to me. When working with John, there is a chance that a major issue might come up. It is related
to his angry behavior which he keeps showing. He can lose his temper during the examination
process due to which examiner can feel difficult to handle him. Therefore his angry and arrogant
nature is a concern for the examiner. The principle of cultural safety used for the case of John is
fourth, which is about focusing on the impact of the health care on the culture, history and
response of the bearers. Also, it includes this principle challenges the healthcare providers to
assess the nursing practice effectively and also providing culturally safe care so that consumer
can receive effective service.
2.4 Nursing Care and Recovery Model
The nursing care proposed for John in Step 1 after conducting MSE has focused on providing a
good life to him and also making sure he is content with himself. There have been many
concerns indentified after his clinical examination due to which these interventions have been
proposed. Considering the nursing interventions that have been developed in Step 1, the five
recovery model principles applicable to the case are as follows. First, the nursing inventions for
the John are unique. The interventions will enable John not just to get the effective care but also
leading a meaningful life. John’s life has no purpose but the interventions will provide him a
purposeful life. It will empower john to start a new life all over again which is positive and
beautiful. Second principle applicable to John’s case is having real choices. The interventions
will support John to make his own choices instead of depending on others. This will help him
lead a quality life and make most of the new opportunities that come his way. Third principle
applicable to John’s case is changes in attitude. Initially John remained angry and arrogant but
effective communication with his examiner will assure him that there is someone who can
understand him. This involves developing social and recreational activities for them. Overall,
this will instill hope in John and make him competent to lead a meaningful life. Fourth principle
applicable to John’s case is dignity and respect. The interventions for the John have been
developed in a way that he feels respectful. Also, these take into account the cultural sensitivity
of the patient. Fifth principle of recovery model applicable to John’s case is evaluating the
progress of the recovery. It is vital to track the progress of John and ensuring whether or not the
interventions are impacting the patient’s heath in a positive way. Overall, the recovery model
proposed for John as per his clinical formulation and MSE will ensure that he gets cured fast and
also become positive towards his life. His attitude towards himself and others changes and he can
stay happy for rest of his life.