- Clinical Scenario
You are a new graduate nurse and part of a small multidisciplinary team in a large 24-hour medical clinic. A young man has just presented. He is neatly dressed in a business shirt and trousers. However, he appears nervous, constantly moving seemingly unable to sit still. He does not interact with other patients who also seem to want to avoid him. When you get the opportunity, he responds to your request to fill out the admission form so he can see the duty doctor. When it comes to his appointment time, the duty doctor asks you to sit in and assist him with the interview.
- Describe the key communication skills you will use in order to engage with Thomas. (400 words)
The young man gives his name as Thomas. He has a slight accent that you are unable to place. In response to asking why he has attended, he tells the doctor about becoming increasingly nervous and irritable at his place of work – which is at a nearby bank where he is working as a bank teller. He is calm, but appears troubled. He describes experiencing increasing difficulty responding to questions from customers and says that the manager has told him to take sick leave and “see someone”. When you ask how the customers are troubling him, he states that he thinks they are accusing him of “bad things” and being “dirty”. He immediately says that he knows customers aren’t actually saying this to him directly, but he feels very confused and “worried” because he knows that this is what they are saying about him when he is not looking. He states he hasn’t used drugs and then asks if he has a mental illness?
- There are a number of potential clinical signs and symptoms in the scenario so far. Identify three significant signs or symptoms and support this with evidence from the scenario. (400 words)
Following a basic physical check-up and questions about his general health the doctor acknowledged the confusion and distress, explaining to Thomas that it is possible that he could be experiencing psychotic symptoms. He is provided with a script for 5mg olanzapine nocte and an appointment for the next day.
- Discuss the education you will need to provide to Thomas about his medication before he leaves the clinic. (400 words)
Following your education, Thomas briefly acknowledges the information you mentioned. You conclude that his brief response shows that he needs support. You therefore ask if there is someone who is able to support him. He tells you that he has a partner who could come and get him.
- Discuss your strategy to address medication compliance issues that might arise. (400 words)
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