Mrs. Cross, 65, is a patient in an acute care hospital with a diagnosis of pneumonia. The nurse tells you that Mrs. Cross has a history of schizophrenia. You are assigned to provide AM care for Mrs. Cross.
How would you approach Mrs. Cross when you enter her room? How would your knowledge about her mental health problem affect your initial contact with her?
When assigned to provide AM care to Mrs. Cross, I would approach her with understanding and compassion. My knowledge about her mental health would not affect our initial contact or the way in which I would care for her. I would be more alert to notice whether she would be exhibiting any schizophrenic tendencies in addition to the usual nursing care I would be giving her. The quality of nursing care I deliver would therefore not be compromised by my knowledge of her mental condition, in fact, I would exercise greater patience.
What would you do if Mrs. Cross told you that she saw her elephant in the room? What would you say to her?
In case Mrs. Cross told me that she had seen an elephant in her room, I would reassure her that it was not present. I would speak to her respectfully, and sit down with her and listen keenly to how she would describe seeing the elephant without dismissing her immediately. By demonstrating interest in what she has to say, I would make Ms. Cross feel respected and she would be more open to hear what I say (News Medical, 2008). I would try and explain to her that she was safe, and there was no elephant in the room.
How would you react if Mrs. Cross told you that she owned Disney World and went there free any time she wanted? How would you respond?
I would react calmly in case Mrs. Cross told me that she owned Disney World, and made visits there. I would not react by laughing incredulously or dismissing her rudely, but would demonstrate empathy by encouraging her to talk. I would make her feel that I was approachable and encourage her to speak to me about her interest in Disneyland, as this may shed more light about the meaning behind them.
How would you provide good oral hygiene if Mrs. Cross refused to cooperate because she was sure the staff was trying to poison her? What could you try that might be helpful?
I would try and convince Mrs. Cross that the staff loved her and did not wish to kill her. In addition, I would ask her to take more active role in her dental care so that she can have more confidence. To encourage her even further, I would suggest that we perform at least one step of the dental hygiene together so that she would realize that there were no intentions of poisoning her.
What would you do if Mrs. Cross curled up in a tight ball and refused to talk or cooperate during AM care? What could you do to maintain her hygiene?
In case Mrs. Cross curled up in a tight ball and refused to talk or cooperate I would try to relate to her by demonstrating care and compassion by holding her or speaking to her gently. The fetal position (tight ball) indicates sensitivity and I would make great effort to show her love, compassion, and care (Kowalsky and Bunker, 2008).
How would you feel about caring for a person with abnormal behavior? Why?
I do not have reservations about taking care of patients with abnormal behavior because they are also individuals who require respect, understanding, and empathy. In my opinion, mental disease is simply a disease like any other. Patients should not be stigmatized, mistreated, or shunned because of their conditions but should be given the best possible care.
References
Kowalski M. and Bunker C. (2008). Textbook of basic nursing care. Philadelphia: Lippincot Williams & Wilkins
News Medical (2008). Nursing care for schizophrenia patients. Available at http://www.news-medical.net/news/2008/05/06/38133.aspx
