GENERAL MANAGEMENT OF A PSYCHATRIC PATIENT
GENERAL MANAGEMENT OF A PSYCHATRIC PATIENT
Introduce yourself to the patient so that the patient can know you.
Explain your roles and responsibilities in order for the patient to understand your presence in the ward
Ask the patient to introduce her/himself and tell you the preferred name so that you can address him/her by that.
Avoid making promises you cannot fulfil to the patient to prevent patient losing confidence in you.
CREATING A SAFE ENVIRONMENT
Remove all dangerous items such as ropes, bars/rods from the patient unit to prevent the patient from harming him/herself.
Ensure that the windows in the patient unit are very high and with bars to prevent the patient from jumping out of the room.
Ensure enough lighting in the room to prevent patient from hiding and harm anyone who comes in the unit.
Ensure that the door of the patient unit or ward is kept locked all the time to prevent patient from running away.
COUNSELLING
Encourage the patient to express his/her emotions , concerns and worries in order to identify what could have caused the mental problem.
Answer the patient’s questions honestly in simple terms to help him/her understand the condition.
Allow the patient to talk freely without being interfered so that they can express their feelings at their own pace freely.
Encourage the family to visit the patient to reduce on anxiety and feeling of loss of independence.
ORIENTATION TO REALITY
Have the watch and calendar in the patient unit to orient the patient to time and date on a daily basis.
Ask the questions to the patient such as name and location atleast twice a day to assess orientation to reality.
Politely refuse hallucinatory statements of the patient and explain real situation to make the patient aware that what he is talking about are just hallucination.
Take the patient around the ward to show him/her of the geography of the ward to orient to reality.
SKILLS TRAINING
Teach social skills to help patient integrate well with others.
Teach anger management skill to help patient manage anger and prevent harm.
Teach assertiveness skills to help patient stand for what is right without violating anyone’s rights.
Teach behaviour modification skills to help patient change unacceptable behaviours to acceptable one.
Teach patient communication skills to empower them with good communication with others.
Do group therapy on a daily basis to assess the social skills acquisition by the patient.
HYGIENE
Encourage patient to take a bath to promote body hygiene.
Encourage patient to change clothes, comb hair and clean the teeth to promote self-esteem.
Encourage the patient to make his/her own bed to promote comfort.
Encourage patient to clean all his/her utensils to promote hygiene and prevent diarrhoea.
PROMOTION OF NUTRITION
Serve a well-balanced diet containing essential nutrients eg carbohydrates, proteins and vitamins to promote nutrition and energy atleast in 3 main meals of the day.
Give snacks rich in Vitamin B to help in the generation of brain cells.
Encourage meals rich in roughage to prevent constipation.
Encourage enough oral fluids on a daily basis to prevent dehydration.
Serve meals in a palatable manner on a tray if possible put flowers and fruits to promote appetite.
PATIENT OBSERVATION
Observe for signs of improvement on a patient on a daily basis by finding out about their current location.
Observe for improvement in terms of major signs of the condition such as hallucinations, illusions and delusion to assess prognosis.
Check routine vital signs of temperature, pulse, respirations and Blood pressure to identify any infection early, assess the cardiopulmonary system and identify hypertension early respectively and intervene accordingly.
Observe for adherence to learnt social skills in order to assess patient’s prognosis.
DISCHARGE PLANNING
Discharge planning should start as early as the patient stabilizes to let him/her aware that one day he/she will be out of the hospital to prevent institutionalism.
Remind him/her on the daily basis that he/she needs to adhere to social skills to make him/her integrate well in the community once discharged.
PROMOTION OF QUICK RECOVERY
Ensure that all ordered drugs are given to the patient at the right time and in the correct dosage to promote quick recovery.
Explain to the patient the importance of taking drugs as a way to promote quick recovery in order to have the patient motivated to take the drug.
Congratulate the patient upon taking the drugs in order to get him/her motivated to take the drugs.
Involve the family and significant others in giving drugs to the patient so that they can learn for continuity of drug administration after discharge from the hospital.
Explain to side effects of the drugs to the patient and family and how they are managed to ensure that they can continue giving drugs and managing side effects without stopping therapy.
LINKAGE TO COMMUNITY MENTAL HEALTH STRUCTURES
Communicate to the patient and family the available community mental health nurses in their community and how to contact them when face a problem with the patient in the community.
Tell the community the names of Psychosocial counsellors in their community where the patient can go for continued counselling to ensure continuity of care while in the community.
Tell the family and patients where to access the social welfare department for support in terms of housing and clothing for those patients who lose their houses while admitted in the hospital in order to prevent relapse of mental condition due to stress.
Explain to the patient and family the role of traditional leaders in ensuring that mental patients are not stigmatized in the community for stigma can cause relapse of mental condition.
DAY OF DISCHARGE
Get drugs from the pharmacy for the patient.
Give the drugs to the patient and family while giving instructions on how to take them to ensure continuity of care.
Ask the patient and family to re-explain the instructions and side effects of the drugs to ensure that they understood your explanation.
Assure the patient and family that the health facility is always open for them whenever a problem arises at home to ensure that the patient is attended to early before complications.
Bid farewell to the patient and family with a smile to gain their trust and confidence in your care.
Comments
Post a Comment