CLINICAL SCENARIO AND IDENTIFICATION OF DECISION CHOSEN As part of my exploration to fulfill the requirement of the clinical decision- making analyses, I have identified a scenario in my working environment, which is Penang Hospital in Psychiatric Department. A female patient has been admitted into the female psychiatric ward, which was diagnosed to suffer bipolar mood disorder. In brief, the patient, who is 38-years old, has been further analyzed to undergo auditory hallucination and it could not be controlled due to allergic of anti-psychotic medication (Haloperidol and Clopixol Acuphase). Describing further on her condition due to bipolar mood disorder, she was irritable and restless most of the time. Therefore, she was unable perceive …show more content…
The use of heuristics in nursing reflects assessments of subjective possibility that are dependent on nurses' memory and past experience (Cioffi J, 1997). Cioffi suggested that heuristics enable nurses to develop short cuts to reduce the complexity of real practice. The main principles of heuristics consist of representativeness, availability, and anchoring and adjustment (Elstein & Schwars 2002). Representativeness can be viewed as estimating the possibility of diseases by judging how similar a case is to a diagnostic prototype (Elstein & Schwars 2002). Representativeness is the most typical type among three types of heuristics and it is more likely to take place in high-complexity cases than low ones (Cioffi & Markham 1997). Another type of heuristics is availability that refers to the estimation of probability of clinical events by the ease with which previously experienced relevant instances come to mind(Tversky & Kahneman 1973). Nurses always estimate the likelihood of the outcome based on similar events that they can recall (Buckingham & Adam 2000). However, nurses in real practice may place overemphasis on rare and salient conditions because unusual cases can be memorized more profoundly and easily than regular ones (Elstein & Schwars 2002). The third form of heuristics is anchoring, which involves the decision-making strategy that seeking for an anchor as a standard when nurses make decisions. In some cases, anchoring is valuable and even desirable in profession practice (Cioffi J, 1997). (Thompson 2003) implied that experts are commonly experts because they are proficient in employing these anchors that are led by accumulation of experience. However, he also argues that not all anchoring is desirable because anchoring sometimes may distort reasoning and it is a challenge to accumulate enough experience to establish anchors in every
A Mental Status Examination (MSE) was completed on Jadine Sawyer to evaluate her level of thinking. This examination was conducted to document how she is feeling with the life changes that are taking place in her life. Jadine’s level of thinking was recorded to provide a diagnoisis to the symptoms she is experiencing. This Mental Status Examination (MSE) also was formulated to provide a treatment plan to better assist the client.
Clive Wearing was a prolific British musical conductor and producer for BBC. He was a wildly intelligent and successful person. It came as a surprise to himself and his family when unexpectedly suffered a loss of consciousness. The type of memory loss that Clive Wearing has is retrograde and anterograde amnesia. He is unable to retain new memories; he is also unable to unearth past memories to his consciousness as well.
As nurses, we continue to gain knowledge and skills within our area of practice. We use theories to help us build concepts or ideas in gathering information, explaining relationships and demonstrating experiences of development. Theories vary in their level of abstraction and scope. Nursing theories are beneficial in helping us to understand, organize our thoughts and influence practice and research. Nursing theory has three distinct types to describe the level of abstraction:
Nursing practice requires both critical thinking and clinical reasoning. Critical thinking is the process of deliberate higher level thinking to define a patient’s problem, examine the evidence-based practice in caring for the patient’s, and make options in the delivery of optimal care. Critical thinking involves the demarcation of statements of fact, judgment, and opinion. The progression of critical thinking requires the nurse to think imaginatively, use reflection, and engage in logical thinking (Alfaro-LeFevre, 2013). Critical thinking is a vital skill needed for the recognition of patient’s problems and the execution of interventions to endorse effectual care outcomes (Bittencourt & Crossetti, 2012).
In 1898, a German psychiatrist, Emil Kraepelin, described the confusion with the side effects and named this disorder in the Latin expression, dementia praecox. Later in 1908, Bleuler, a Swiss psychiatrist and eugenicist, initially named the expression "Schizophrenia" Schizophrenia comes from the mix of the Greek words for split (skhizein) and brain (phren). Schizophrenia is a disorder which is severe and chronic and disables the brain. It is most commonly described as a psychosis which is a type of illness that causes mental disturbances that affect thoughts, emotions, and actions. In America, schizophrenia affects one percent of the population from any gender, race, and cultural group.
The issues of mental illness have been around from the start of human existence. Mental illness is considered any psychiatric disorder that cause untypical behavior. Questioning happened more in the 1930’s when more problems came around and how to fix it began to arise. Mental illness included the diseases, the cures, One of the illnesses that was very common was Schizophrenia. This is a” long-term mental disease that affects how your brain works.
Abstract- Clinical Decision Support System (CDSS), with various data mining techniques being applied to assist physicians in diagnosing patient disease with similar symptoms, has received a great attention recently. The advantages of clinical decision support system include not only improving diagnosis accuracy but also reducing diagnosis time. In this paper, we have given the CDSS with some advance technologies like Support Vector Machine (SVM) classifier has offered many advantages over the traditional healthcare systems and opens a new way for clinicians to predict patient’s diseases. As healthcare is the field in which Security of data related to patient diseases are needs to be more secure, for that in this paper, we have use RSA
A patient’s decision-making capacity is variable as their medications or underlying disease processes ebb and flow. You should do what you can to catch a patient in a lucid state - even lightening up on the medications if necessary and safe - in order to include her in the decision making process. Delirious patients have waxing and waning abilities to understand information. However, if a careful assessment is done and documented at each contact, and during lucid periods the patient consistently and persistently makes the same decision over time, this may constitute adequate decisional capacity for the question at
Limitations recognised throughout the SDM process were related to risk of further deterioration in the Consumer’s mental state. As the Consumer was slowly taken off his medications, in a safe clinical manner, his presentation deteriorated. The Consumer’s sleep pattern worsened due to the elevation in his mood, there was a noted increase in impulsivity and poor boundaries with others on the inpatient unit, leading to the Consumer becoming vulnerable. There was a prominent increase in erratic and aggressive towards others, leading to the assault of a staff member on the inpatient unit and subsequently required the use of restrictive interventions. The decline in mental state resulted in the Consumer’s father, case manager and treating team coming together for a family meeting with the Consumer present in which the previous medications the Consumer had been previously prescribed were recommenced in an attempt to re-stabilise his presentation, unfortunately this was a substituted decision made by the consumer’s father and treating tream.
Ways of Knowing Related to Nursing Theory Emily Amstutz University of Missouri Kansas City MSN FNP Program Abstract Carper (1978) presents four fundamental ways of knowing that have been developed from emerging patterns in the discipline of nursing: (a) empirical way of knowing, (b) esthetic way of knowing, (c) personal knowledge, and (d) ethics. As a registered nurse, I primary utilize the empirical way of knowing in my practice because it is science based and encourages logical decision-making skills. The four fundamental ways of knowing apply to nursing theory by: Keywords: empirical, esthetics, personal knowledge, ethics, ways of knowing, Ways of Knowing Related to Nursing Theory
It involves the health professional to gather cues and information, process the information, establish goals, take action and evaluate the outcomes (Levett-Jones 2018, p. 5). This can be used as part of the information processing theory where information and cues are gathered and processed. The clinical
Through this initial assessment, the nurse can obtain information that is crucial in providing the client with effective holistic care. Nursing assessment framework tools are used to help the nurse obtain accurate information about the patient’s wants and needs. This initial assessment based on subjective and objective data, helps to determine the patient’s actual problems and potential problems (Weber & Kelley, 2013). An assessment is carried out to obtain objective data and a physical baseline of the patient on admission.
Psychoanalytic Sigmund Freud (1856-1939) is reflected as the forefathers of psychology and founder of psychoanalysis. Based on Freud’s theories, psychoanalytic therapy is a type of treatment that tends to observe at the background from early childhood to perceive if these situations have affected the individual’s life, or to current issues. (Counselling Directory, 2014) This therapy discovers how the unconscious mind empowers thoughts and behaviors, with the purpose of offering insight and resolution to the person seeking therapy. This form of therapy is a long-term treatment whereby it can take duration up to weeks, months or even years depending on the complexity of the patient being explored.
Giving care to a patient is not a straightforward process because a patient is made up of advanced systems. Symptoms and the severity of a disease process are dependent on a particular patient, and it may not always be uniform from patient to patient. Because of this, nurses must be able to use their knowledge appropriately to help a patient. Nurses use techniques, such as Evidence Based Practice, in order to integrate new and advanced knowledge into their patient care (Canada, 2016). By exercising evidence based practice, nurses effectively seek knowledge, take experience from past situations, and apply this intelligence to best give patient care (Canada, 2016).