Assessment of a patient in an acute phase of mental illness could arguably be one of the most important tasks that a registered mental health nurse faces in their career. The importance of gaining the correct information at this critical stage leaves little margin for error. Sullivan (1990) clearly evaluates that the consequences of a poor assessment or mis-interpretation of a patients presentation can lead to a patient not receiving the treatment they need at an important time through to the incidence of a fatality due to non admission to psychiatric services. With this knowledge in mind, it becomes crucial that the psychiatric nurse is proficient in conducting an assessment. The skill of identifying and reporting the most in depth account of the presenting facts, for continual involvement of the multi disciplinary team and initialization of the care plan and care pathway programme, remains the benchmark for a true professional.
[...] is a 39-year-old gentleman that presented himself to the accident and emergency department, after an incident of self-harming. He had informed the admitting nurse that his intention was to commit suicide. Burrow (1994) suggests that much self harming behavior has little direct relationship to suicidal intent, while Marfe (2003) argued that those who commit suicide and those who deliberately self harm are, in fact, two separate groups. Lyons, (2000), maintained that the distinction is far from clear, and there is a common thread for both of these groups, as well as highlighting the percentage of habitual deliberate self harmers who do actually go on to commit suicide. [...]
[...] Her diagnosis was supported by his confirmation of insomnia and also of his preoccupation of thoughts for a recently deceased friend He became distressed and was unable to maintain eye contact for any length of time with the doctor. These symptoms are classic of the depressed patient. Barker (1997) identified these symptoms as classic for the diagnosis of a depressive state. In order to support this diagnosis it was necessary to ask both open and closed questions. An open question requires more than a yes or no answer. [...]
[...] Although the interview room was not purpose designed for the assessment of distressed patients the doctor was quick to ensure that the chairs in the room were of the same height, within a comfortable distance between them, not too close to be overpowering and not to distant to enable a discussion at a quite mannerism. Proximity was discussed by Hall (1969) and cited in Kozier, Erb, Blais, and Wilkinson (1998), they suggested that there were in fact four different interactive zones for face to face contact and considered that a distance anything less than four feet is intrusive of interpersonal space, the doctor demonstrated her awareness of this philosophy and kept within these barriers. [...]
[...] Ley,P.(1988)Communication with patients:improving communication,satisfaction and compliance.London:Croom Press. Lyons, C. (2000). Suicide Risk Assessment. Accident and Emergency Nursing. 178-186. Martin,P (1995) Psychiatric Nursing.London :Sultari Press. Marfe, E. (2003). Assessing Risk Following Deliberate Self harm. Paediatric Nursing, 32-34 McAlaney, J. (2004). The Role of the Specialist Adolescent Self Harm Service. Nursing Standard, 18(17), [...]
[...] By completing an accurate assessment a detailed and specific care plan can be implemented and the process of returning the patient to a level of normality or to manipulate their coping strategies can begin. I have learnt that being non-judgmental and assessing the current situation at presentation is a key attribute in the skill of assessment. It becomes only to easy when interviewing known clients to simply copy their previous diagnosis or be scared by the evidence already available. If the profession is to advance then true evidence based practise need to be the standard for all. [...]
APA Style reference
For your bibliographyOnline reading
with our online readerContent validated
by our reading committee
