What brings you in today? How can I assist? 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)
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