Case Study: Urgent Risk And Mental Health Concern In A Nursing/Midwifery Setting

Identifying an urgent risk area

1a) An urgent risk area in the case study is the suicidal thoughts that Chung has been experiencing for the past week. The patient is even aware of a highly lethal medication which he could take to overdose and eventually die. Depressed patients experience fleeting thoughts of death due to stressful occurrences in their lives (van Spijker et al., 2015). Mr. Chung feels that he has disappointed his wife, daughter, and the accident and emergency department. His wife gives through caesarean section due to complication; hence making her undergoes extreme pain. The patient also feels that the medical error committed was entirely his fault.

1b) The ideal nursing intervention for suicidal thoughts is to maintain a therapeutic relationship with Mr. Chung. The therapeutic interaction enables the nurse to explain the severe effects of committing suicide (Forkmann et al., 2014). The caregiver builds the relationship by encouraging the patients to share their experiences openly. Furthermore, the nurse should discourage the patient from taking his life and urge the family members to keep him company. The nurse on duty is the person charged with the responsibility of maintaining a therapeutic alliance with the patient. The caregiver should meet the client for forty-five minutes daily. The family of Harriett should allow Chung to spend time with his daughter.  

2a) One critical mental health concern in the case study is a low mood that Chung has been experiencing for the past six weeks. The patient has been feeling worthless, hopeless, helpless, and wants to die. Patients with clinical depression experience a tearful and a flat mood that lasts for over a month (Geraghty et al., 2017). Several factors such as long working hours, shift hours, and the pressure at the hospital are the causes of the low mood. Additionally, Chung gets very little time and space to spend with his new daughter. The fact that his wedding lacked a Chinese reference is another cause of flat mood.

2b) The intervention for the low mood requires the nurse to partner with the family members to cheer up the patient. The caregiver should convince Mr. Chung that the condition of the wife and the daughter are not his fault. The patient should realize that a caesarean section is a conventional method of birth in the Australian hospitals. The nurse should urge Harriett’s parents to allow the patient spent quality time with Charlotte after work. The process of raising the mood of a depressed patient eradicates suicidal thoughts from their minds (Turecki, & Brent, 2016). The nurse should meet the patient and his family for twenty minutes daily.

3) Two ethical issues that arise from the case study are beneficence and confidentiality. Beneficence dictates that the consequences of an action should benefit the people that the activity affects (Doody, & Noonan, 2016). Directing a lot of questions to Mr. Chung can stress him and increase the severity of the depressive symptoms. Therefore the nurse should ask few questions and direct other concerns to the family members. Confidentiality is keeping secrets of an individual from the third party. The caregiver should not avail the information from Chung to anybody without the patient’s permission. Therefore, the nurse should observe the ethical principle of beneficence and confidentiality when attending to Chung.

References

Doody, O., & Noonan, M. (2016). Nursing research ethics, guidance, and application in practice. British Journal of Nursing, 25(14), 803-807.

Forkmann, T., Wichers, M., Geschwind, N., Peeters, F., van Os, J., Mainz, V., & Collip, D. (2014). Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: results from a randomized controlled trial in patients with residual depressive symptoms. Comprehensive Psychiatry, 55(8), 1883-1890.

Geraghty, A. W., Santer, M., Williams, S., Mc Sharry, J., Little, P., Muñoz, R. F., … & Moore, M. (2017). ‘You feel like your whole world is caving in’: A qualitative study of primary care patients’ conceptualizations of emotional distress. Health: 21(3), 295-315.

Turecki, G., & Brent, D. A. (2016). Suicide and suicidal behavior. The Lancet, 387(10024), 1227-1239.

van Spijker, B. A., Calear, A. L., Batterham, P. J., Mackinnon, A. J., Gosling, J. A., Kerkhof, A. J., … & Christensen, H. (2015). Reducing suicidal thoughts in the Australian general population through web-based self-help: study protocol for a randomized controlled trial. Trials, 16(1), 62.