Listen. Let Mark express his
concerns and reasoning for not taking the medication. Be empathetic in
listening and nonjudgemental. Patient adherence is key to medication
compliance and outcomes. Negotiating a plan is necessary for the client to
invest themselves. We need to be concerned if he has basic needs like
housing and food. Socioeconomic status and access the healthcare seem to
play a pivotal role in his current compliance. Hopefully he was discharged
with a case manager that can help navigate basic needs. Identify his support
systems. Educate Mark on the positive effects of compliance with the
medication such as improved symptoms, improved quality of life and
reduced hospital stays. Explain that antipsychotic medications are
associated with metabolic disturbances (Pillinger et al., 2019). Together,
help him create a plan to manage/minimize weight gain. Provide him with a
crisis hotline number.
What are the ethical and legal obligations for the PMHNP in the
above situation?
The American Nurse Association (ANA) code of ethics provides ethical
guidelines to provide safe patient centered care (American Nurses
Association, n.d.). Patients with mental health diagnosis typically can have
poor insight and poor judgement. It is the PMHNP’s job to provide respectful
compassionate care with confidentiality. We must assess suicidal and/or
homicidal ideations (Berardelli et al., 2021). We are mandated reporters.
Mark is at greater risk for suicidal/homicidal since he is Caucasian, male,
younger age and being unmarried (Berardelli et al, 2021).
Goals that are not mutually shared between providers and patients
can be very challenging, both clinically and emotionally. What steps
can the PMHNP take to promote their personal emotional and
mental health when working with clients whose health choices are
likely to lead to adverse health outcomes?
First, as a nurse and then a provider, caring for our patients has always been
mentally, emotionally, and physically demanding. Burnout in healthcare
workers includes insomnia, depression, anxiety, PTSD, and/or other mental
health challenges (Murthy 2022). Promoting self-care in your professional
career and personal life will help reduce mental and emotional burnout (Mott
& Martin, 2019). Acknowledging personal feelings and biases with different
clients and his/her goals and outcomes can promote self-care. Yoga
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