{"id":4686,"date":"2019-01-09T19:47:43","date_gmt":"2019-01-10T00:47:43","guid":{"rendered":"https:\/\/www.amyork.ca\/academic\/zz\/?p=4686"},"modified":"2019-05-25T22:54:24","modified_gmt":"2019-05-26T02:54:24","slug":"working-with-mh-service-users","status":"publish","type":"post","link":"https:\/\/www.amyork.ca\/academic\/zz\/mental-health-nursing\/working-with-mh-service-users\/","title":{"rendered":"Working with MH service users"},"content":{"rendered":"<h4>Trauma<\/h4>\n<p>\u2212 <strong>Vicarious trauma <\/strong>(also known as secondary trauma) is trauma that you experience because you hear about other peoples traumatic experiences<\/p>\n<p>\u2212 A response to witnessing the 1<sup>st<\/sup> hand trauma of another person\u00a0 \u2212 Can resemble PTSD<\/p>\n<p>&nbsp;<\/p>\n<h4>Occupational Violence<\/h4>\n<p>\u2212 Horizontal or lateral violence is a common experience in the workplace\u00a0 \u2212 A form of bullying that occurs in the health workplace<\/p>\n<p>&nbsp;<\/p>\n<h4>Roles<\/h4>\n<ul>\n<li><strong>Health professional <\/strong><\/li>\n<li><strong>Multi-disciplinary team-<\/strong> responsible for the management of a consumers plan<\/li>\n<li><strong>Social worker-<\/strong> assist with housing, finance issues<\/li>\n<li><strong>Occupational therapist-<\/strong> ensure ADLs are met, run activity groups (art, fitness etc)<\/li>\n<li><strong>Psychiatrist-<\/strong> responsible for decisions and treatments of a consumer, can prescribe medications<\/li>\n<li><strong>Psychologist-<\/strong> focus on behavioural and cognitive behaviours<\/li>\n<li><strong>Mental Health Nurse\/Nurse- <\/strong>provides primary nursing, administer medication, care for the consumers<\/li>\n<li><strong>Peer works <\/strong><\/li>\n<li><strong>NGOs- <\/strong>Non Government Organisation, charities that rely on donations and volunteers<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<p>&nbsp;<\/p>\n<h4>Least Restrictive rnvironment or Alternative<\/h4>\n<p>\u2212 A least restrictive environment- think if there&#8217;s another way of doing this and have you tried other methods that aren\u2019t invasive\/intrusive?<\/p>\n<p>\u2212 Justify that you have tried other interventions\/methods before restraints are enacted<\/p>\n<h4><\/h4>\n<h4>Social and rmotional Wellbeing of Indigenous Peoples<\/h4>\n<p>\u2212 Indigenous people have substantially higher rates of suicides then non Indigenous<\/p>\n<p>\u2212 Its important to interpret behaviours thoughts and feelings<\/p>\n<p>&nbsp;<\/p>\n<h4>Self-awareness and Reflection<\/h4>\n<p>\u2212 Personal reflection is important to re-evaluate and reassess their work practice \u2212 Reflection ensures that best practices are being met<\/p>\n<p>&nbsp;<\/p>\n<h2>Summary<\/h2>\n<p><strong>MSE-<\/strong> (PAMS GOT JIMI acronym)<\/p>\n<ul>\n<li>Perception (hallucination, illusion)<\/li>\n<li>Affect (how their mood is expressed- appropriate, restricted, blunted, flat)<\/li>\n<li>Mood (how the consumer describes how they&#8217;re feeling)<\/li>\n<li>Speech<\/li>\n<li>General appearance and behaviour<\/li>\n<li>Orientation\/Cognition (determining what their form of concept is)<\/li>\n<li>Thought content (delusional thinking, suicidal thoughts)<\/li>\n<li>Judgement<\/li>\n<li>Insight<\/li>\n<li>Memory<\/li>\n<li>Intelligence\/Form of thought (disorders- flight of ideas, tangential thinking, neologisms, echolalia)<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<h3><strong>Risk Assessments\u00a0 <\/strong><\/h3>\n<ul>\n<li>Deliberate Self Harm (DSH)- intent to harm not die<\/li>\n<li>Suicide- intent to die<\/li>\n<li>Absconding- running away<\/li>\n<li>Vulnerability (sexually, financially)<\/li>\n<li>Minors<\/li>\n<li>Violence<\/li>\n<li>Medication non-adherence<\/li>\n<\/ul>\n<h3><strong>Psychosis <\/strong><\/h3>\n<ul>\n<li>Psychosis- an acute presentation where a person loses the capacity to tell what&#8217;s real and what isn\u2019t<\/li>\n<li>Causes of psychosis?<\/li>\n<li>Hallucinations:\n<ul>\n<li>Auditory (hearing voices, sounds) \u00d8 Visual (seeing things)<\/li>\n<li>Tactile (touch)<\/li>\n<li>Olfactory (smell)<\/li>\n<li>Gustatory (taste)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><strong>Schizophrenia <\/strong><\/h3>\n<ul>\n<li>DSM- 5 criteria for assessment<\/li>\n<li>Negative symptoms- (<u>taking away<\/u> aspects from the person i.e. motivation, affect, joy, insight etc)<\/li>\n<li>Positive symptoms- (<u>adding<\/u> symptoms onto the patient i.e. delusions, depression, disorganised speech etc)<\/li>\n<li>Prodrome- what we see prior to the development of schizophrenia i.e. pre hallucinatory symptoms (subtle)<\/li>\n<li>Side effects of antipsychotics? (i.e. Olanzapine, Clozapine)<\/li>\n<li>Typical antipsychotics are 1<sup>st<\/sup> generation (i.e. Haloperidol, Promazine)<\/li>\n<li>Atypical antipsychotics are 2<sup>nd<\/sup> generation (i.e. Olanzapine, Seroquel, Clozapine, Risperidone, Paliperidone)<\/li>\n<li>Significant side effects of antipsychotics?<\/li>\n<\/ul>\n<p>\u2212 Weight gain \u00e0 metabolic syndrome \u00e0 abdominal obesity, hypertension, diabetes, cholesterol<\/p>\n<ul>\n<li>Clozapine side effects?<\/li>\n<\/ul>\n<p>\u2212 Agranulocytosis- can occur within the 1<sup>st<\/sup> 18 weeks of Tx (weekly blood tests required)<\/p>\n<p>\u2212 Weight gain<\/p>\n<p>\u2212 Constipation<\/p>\n<p>\u2212 Sedation<\/p>\n<p>\u2212 Headache<\/p>\n<h3><strong>Affective (Mood) Disorders\u00a0 <\/strong><\/h3>\n<ul>\n<li>Symptoms of depression?<\/li>\n<\/ul>\n<p>\u2212 Avolition (lack of motivation)<\/p>\n<p>\u2212 Persistently low mood<\/p>\n<p>\u2212 Insomnia\/hypersomnia<\/p>\n<p>\u2212 Weight gain\/loss of 5%<\/p>\n<p>\u2212 Anhedonia (no pleasure)<\/p>\n<ul>\n<li>Depression- DSM 5 criteria for assessment<\/li>\n<li>Types of depression:<\/li>\n<\/ul>\n<p>\u2212 Major depressive episodes<\/p>\n<p>\u2212 Psychotic depression (symptoms of depression but may also feature psychotic symptoms)<\/p>\n<p>\u2212 Bipolar disorder I<\/p>\n<ul>\n<li>Treatments include: Cognitive Behaviour Therapy (CBT), antidepressants, rCT<\/li>\n<li>Treatments- Antidepressants<\/li>\n<\/ul>\n<p>\u2212 SSRI<\/p>\n<p>\u2212 SNRI<\/p>\n<p>\u2212 MAOI<\/p>\n<p>\u2212 TCA<\/p>\n<p>\u2212 Tetracyclic<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Side effects of antidepressants? \u2212 Anticholinergic<\/li>\n<\/ul>\n<p>\u2212 Sexual dysfunction<\/p>\n<p>\u2212 Dry mouth<\/p>\n<p>\u2212 Nausea<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Bipolar disorder is associated with mania<\/li>\n<li>Mania = persistently elevated, expansive or irritable mood<\/li>\n<li>Hypomania = &#8220;mini&#8221; mania, no psychotic features or delusional thoughts<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Treatments- Mood stabilisers \u2212 Lithium<\/li>\n<\/ul>\n<p>\u2212 Sodium valproate<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Dual Diagnosis <\/strong><\/h3>\n<ul>\n<li>Dual diagnosis= the addition of a mental health condition AND a drug\/alcohol addiction<\/li>\n<li>Delirium tremens (DTs)- is associated with alcohol withdrawal<\/li>\n<\/ul>\n<p>\u2212 Treated with high does of Valium and Thiamine<\/p>\n<h3><\/h3>\n<h3><strong>Personality Disorders\u00a0 <\/strong><\/h3>\n<ul>\n<li>Borderline Personality Disorder (BPD) criteria:<\/li>\n<\/ul>\n<p>\u2212 Aggression<\/p>\n<p>\u2212 Intense fear of abandonment<\/p>\n<p>\u2212 rxtremes of moods (unstable\/stable)<\/p>\n<p>\u2212 History of self harm<\/p>\n<p>\u2212 Chronic feelings of emptiness<\/p>\n<p>\u2212 Increase in risk taking behaviours (i.e. lots of sexual relationships, unprotected sex, drug use) \u2022\u00a0 No specific treatment for BPD<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Eating Disorders\u00a0 <\/strong><\/h3>\n<ul>\n<li>Anorexia Nervosa = low BMI, excessive exercise and diet, poor self image<\/li>\n<li>Bulimia Nervosa = binging eating or purging behaviours, excessive exercising<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3><strong>Older Adults <\/strong><\/h3>\n<ul>\n<li>Know the differences b\/w: Depression, Delirium and Dementia<\/li>\n<\/ul>\n<p>\u2212 Causes<\/p>\n<p>\u2212 Signs and symptoms<\/p>\n<p>\u2212 Treatment<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Trauma \u2212 Vicarious trauma (also known as secondary trauma) is trauma that you experience because you hear about other peoples traumatic experiences \u2212 A response to witnessing the 1st&hellip; <a class=\"continue\" href=\"https:\/\/www.amyork.ca\/academic\/zz\/mental-health-nursing\/working-with-mh-service-users\/\">Continue Reading<span> Working with MH service users<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[121],"tags":[],"_links":{"self":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4686"}],"collection":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/comments?post=4686"}],"version-history":[{"count":2,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4686\/revisions"}],"predecessor-version":[{"id":4803,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4686\/revisions\/4803"}],"wp:attachment":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/media?parent=4686"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/categories?post=4686"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/tags?post=4686"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}