THE JOB IS TO REPLY WITH A COMMENT TO EACH POST, POST 1 AND POST 2. WITH 2 COMPLETED (EDUCATIONAL  REFERENCE) includidig retrival or doi, IN APA WITH CITATION ABOVE 2013 PER COMMENT.

  POST 1

 

Comprehensive Integrated Psychiatric Assessment

Following recent research, the level of mental health problems among children and adolescents has risen dramatically (American Psychiatric Association, 2013). The present-day life and current associations within the society contribute greatly to these adversities. Culture, environmental exposure, social and economic status are frequent predisposing factors to mental and behavioral disorders. For example, domestic violence, sexual assault and the rising prevalence of divorces are the most common causes of mental health problems among the youth (American Psychiatric Association, 2013. Nonetheless, assessing and treating children and adolescents is very challenging. Psychiatric mental health nursing practitioners (PMHNPs) ought to be patient and diligent when practicing mental assessments to this type of clients.

Based on the YMH Boston Vignette 4 Video

What did the practitioner do well?

At the beginning of the session, the nursing practitioner expresses his respect for the nursing code of ethics, conduct and autonomy. This is a good approach since it assures the client of his protection and the nondisclosure of his/her health information. Additionally, the nursing practitioner was keen to establish a sense of rapport between himself and his client. This was necessary to necessitate voluntary and ease of information sharing.

In what areas can the practitioner improve?

The nursing practitioner fails to warm-up the client at the start of the interview. It is advisable to start with a casual conversation before jumping into the main point (Kaplan, 2016). Failure to this (as evident in the Boston Vignette 4 Video) the patient keeps his guard up and even suggest that his mother should answer some of the PMHNP’s question. Also, it is imperative to

apply cognitive testing to help determine the client’s mental status at the time of visit (Kaplan, 2016). Contrary to this aspect, the PMHNP appears more interested in the patient’s history than his current status. Ideally, the PMHNP should improve on the areas noted above.

At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

 The nursing practitioner in the YMH Boston Vignette 4 Video seats causally and speaks rather sparingly. In comparison to the PMHNP in the YMH Boston vignette 1 video the practitioner seats and speaks directly to the client to capture his attention and cognitive status. This makes his client attentive unlike the patient in video 4. As a matter of facts, the practitioner shares a little enthusiasm in the client’s interests (basketball) to help improve the mood of the interview and consequently, derive more information (Merrell, 2013).

What would be your next question and why?

Question: Do you often lose temper on people other than your mum?

This question is necessary to help determine the specific triggers of the client’s anger. If the answer is ‘NO’, then it’s true that the mum triggers his anger through excessive pressure and nagging. However, if the answer is ‘YES’, then the frequent loss of temper would qualify as one of the symptom for mental health conditions such as intermittent explosive disorder (Kulper, Kleiman, McCloskey, Berman & Coccaro 2015).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Kaplan, B. J. (2016). Kaplan and Sadock’s Synopsis of Psychiatry. Behavioral Sciences/Clinical Psychiatry. Tijdschrift voor Psychiatrie, 58(1), 78-79.

Kulper, D. A., Kleiman, E. M., McCloskey, M. S., Berman, M. E., & Coccaro, E. F. (2015). The experience of aggressive outbursts in intermittent explosive disorder. Psychiatry research, 225(3), 710-715.

Merrell, K. (2013). Behavioral, social, and emotional assessment of children and adolescents. Routledge.

POST 2

 

Comprehensive Integrated Psychiatric Assessment of an adolescent

What did the practitioner do well?

In the YMH Boston Vignette 4 YouTube Video, the therapist was professional by telling the teenager at the beginning of the session of the right of confidentiality and privacy unless he has suicidal or homicidal thoughts. This information built a good rapport and trust with the client which then enabled him to share his feelings. The adolescent may be worried about confidentiality, and clinicians can reassure them that approval will be requested from them before any detailed information is shared with parents, except situations involving danger to self or others (Price, 2017). The practitioner built a good rapport with the client by making good eye contact, trying to focus more on the client and not the parents, as well as asking him about his hobbies. Rapport is built by enabling patients to feel easiness during stressful situations. The practitioner also does a good job as he allows the client to explore his feelings. “When adolescents become able to cope with the controversial and problematic situations, anger affects self-perception because it is displayed in a situation where individuals are restrained or challenged” (Lok & Bademli, 2018). Moreover, the practitioner asked about his school and by asking him about what he liked doing after school.

In what areas can the practitioner improve?

The therapist needs improvement is communication because he did not introduce himself to the patient at the beginning of the video. In addition, the therapist was not firm with his statements as he agreed mostly with the client putting faults oh his mother. The client just wants someone to listen to him which explains why he praised his girlfriend because she listens to him. The practitioner failed to find out why the client thinks his mom is irritating. Moreover, the practitioner needs to improve on listening skills as a lot of time was spent taking notes during the interview which can be distracting for both the therapist and the patients. The practitioner could have politely asked the patient if it is okay for him to take notes during the session and explain the reason for that.

At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

A very important compelling concern is to inquire if the client feels safe at home with his mother. In addition, medications being taken by the client and psychiatric history and, lastly coping skills.

What would be your next question, and why?

I would ask the client about the possibility of having a family session which could be beneficial by making the people involved understand themselves more. It is important for the therapist to remain neutral and validate each family member`s feeling with the goal to improve communication among them and enable the therapist to develop an appropriate care plan for the client (Renee, & Ballas, 2018). Lastly, the next question would have been the practitioner to find out if the client is using drugs or having any suicidal or homicidal thoughts.

References

Lok, N., Bademli, K. (2018). The effects of anger management education on adolescents’ manner of displaying anger and self-esteem: A randomized controlled trial. Archives of Psychiatric Nursing. 32(1), p. 75-81.

Price, B. (2017). Developing patient rapport, trust, and therapeutic relationships. Nursing Standard. 31(50), p. 52-65.

Renee, W., & Ballas, P. (2018). Comprehensive Psychiatric Evaluation for Children. N.p.: University of Rochester Medical Center. Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02564

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

[T]he way to create a culture of retention is, in fact, to create a culture of engagement and contribution.
—Jo Manion (2004, p. 30)

When employees feel engaged and motivated, they are often more committed to an organization. Organizational commitment is broadly defined as an employee’s intent to stay with the organization. Nurse managers can have significant influence on an organization’s culture and thereby on employee engagement and commitment.

To prepare

• Select one of the following perspectives and complete the corresponding survey for this Discussion. Do not look at the scoring directions until after you have completed the evaluation.
  • If you hold or have held a management position in your recent or present workplace, access the document, “Creating a Culture of Engagement: Manager Survey,” found in this week’s Learning Resources.
  • If you have yet to hold a management position, or would prefer to answer the survey from the perspective of an employee, access the document, “Creating a Culture of Engagement: Employee Survey,” found in this week’s Learning Resources.
• After you have completed the survey, reflect on the results. Based on score breakdown, select the culture cluster you consider the most critical to address in this workplace. Then, review this week’s media, “Recruitment, Retention, and Employee Development.” What strategies could you, as a nurse manager, employ to address this cluster?
• Consider how this culture facilitates or negates your feelings of organizational commitment.

By Day 3

Post an evaluation of a recent or past workplace by sharing the total score of your survey. Explain whether this score accurately captures the culture of this workplace. Identify the culture cluster that you consider the most critical to address, and suggest at least one intervention you could initiate to effectively change this aspect of the workplace’s culture. Explain how this culture encouraged or diminished your feelings of organizational commitment.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Find a colleague whose critical culture cluster is one of your stronger ones. Share a strategy for strengthening this aspect of his or her culture.
• Use authentic experiences and this week’s Learning Resources to evaluate a colleague’s intervention, offering suggestions and insights.
• Assess a colleague’s workplace. Applying what you know about your own intrinsic motivators, explain why this workplace would or would not be a good fit for you.

 

Required Readings

Manion, J. (2011). From management to leadership: Strategies for transforming health care (3rd ed.). San Francisco, CA: Jossey-Bass.
Chapter 3, “Building Commitment: Inspiring Others to Follow” (pp. 69–114)This chapter focuses on inspiring commitment in the workplace. The author differentiates between commitment and compliance and lists the different kinds of organizational commitment.

Fasoli, D. R. (2010). The culture of nursing engagement: A historical perspective. Nursing Administration Quarterly, 34(1), 18–29.  Retrieved from the Walden Library databases.

Fasoli’s article evaluates the history of work engagement and its effect on nurse retention. The author analyzes the history and modern use of work engagement and explores how these are used as a framework for creating a culture of nursing engagement.

Shantz, A., & Latham, G. (2011). The effect of primed goals on employee performance: Implications for human resource management. Human Resource Management, 50(2), 289–299.  Retrieved from the Walden Library databases.

This study analyzes the effects of subconscious motivation on job performance. The results reveal that someone’s subconscious can be primed to accomplish job-related goals and that HR professionals can use this to their benefit.

Vlachoutsicos, C. A. (2011). How to cultivate engaged employees. Harvard Business Review, 89(9), 123–126.  Retrieved from the Walden Library databases.

This article tells the reader how to make the most out of engaged employees in the workplace. The author provides and supports with real-life examples six steps that readers can use to help them achieve their goals.

Wisotzkey, S., Bell, T. D., & Grim, R. (2011). Connect and engage for better nurse retention. Nursing Management, 42(10), 14–18.  Retrieved from the Walden Library databases.
 

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

 

• please critique your peers’ works, such as purpose, concepts, assumptions, and theory’s implications for nursing practice, nursing education, and nursing research.  Does each group use concepts and the conceptual framework/theoretical framework/model of the theory to guide the nursing implications?
• Discuss theory applications from their selected articles.
• Please provide suggestions or opportunities for improvement.
• Ask a challenge question to encourage your peers’ participations and critical thinking, for example a question about a unique situation and theory’s application, such as infection prevention.
• Critique the packet of materials and APA format.

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

  

Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.

For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology.

                                            To Prepare

· Review this week’s interactive media pieces and select one to focus on for this Discussion.

· Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.

Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. 

Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. 

How might these potential impacts inform how you would suggest treatment plans for this patient? 

Be specific and provide examples.

.

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"