Create a recovery focused nursing care plan for the mental health patient

Create a recovery focused nursing care plan for the mental health patient from case study 2 Create a recovery focused nursing care plan for the mental health patient from case study 2
Create a recovery focused nursing care plan for the mental health patient from case study 2
Order Description
no introduction and conclusion are required and that the word count is 1500 works with 20% over or under allowed
create a Recovery based nursing care plan for the patient in case study 2.
the assignment is to be completed in the format provided in the attached document including completion of HONOs
One goal per page
Requiring 22 Referances, UK english
Discipline of Nursing
Complex Mental Health & Recovery 1
Recovery Focused Nursing Care Plan
DUE: Sunday 19th April 2015 by 23:59 [End of Week 6].
Title: Recovery Focused Nursing Care Plan
1500 [approx.] Word Assignment
25 %
Please see the Recovery Focused Nursing Care Plan Information Package
for full details of the Assignment.
This document provides all of the necessary details for Case Study 2.
Case Study 2: The Client with Schizophrenia
Clinician Role: Case Manager (Nurse): Community Case Management
Identifying Information: Bernard is a 25-year-old single male currently
residing as an inpatient mother in the local Mental Health Unit where he has
been a patient for the past 14/7. Prior to this admission you had been casemanaging
Bernard in the community for the past 9 months. He was admitted
with worsening psychotic symptoms over a 4/52 period in the context of
poor compliance with his oral medication that he puts down to due to
increased stress at home and work. He has been re-established on his
medication with good effect and you are seeing him today to review him and
discuss his discharge plan before he is discharged home in 2/7 time. Bernard
is not religious, works part-time as a labourer for his uncle (who is a brick
layer). Bernard lives with his parents and his younger sister in the family
Presenting Complaint: Bernard reports increased paranoid ideation in the
preceding 4/52 stating ‘they’ are watching him, following him and talking
about him. When asked who ‘they’ are he refuses to identify them, stating
that if he does “they’ will come after you too”.
History of Present Problem: Bernard reports first being diagnosed with first
onset psychosis at the age of 22. He was studying Engineering at University
and was half-way through his final year leading up to mid-year exams when
he first became unwell. At this time he experience paranoid ideation and
Discipline of Nursing
Complex Mental Health & Recovery 2
heard voices of a commentary nature. He was treated by the local First Onset
Psychosis Team and made a good recovery over time in the community.
Eventually he was discharged to ongoing treatment via a private psychiatrist
and his GP and everything had been going well until 11/12 ago when he
experienced a full relapse of symptoms whilst on a family holiday overseas.
He had returned to Australia and had been an inpatient in the local Public
Adult inpatient Unit for almost 2/12 at that time and had subsequently been
assigned a Case Manager to oversee his progress following this episode. He
had initially made slow but steady progress in the community and had
started to work for his uncle as a labourer to earn some extra money. This
had initially gone well however some of the other workers on the building
site had started to make fun of him leading to his becoming increasingly
stressed and subsequently more disorganised in his thoughts and actions. He
also reported beginning to feel quite paranoid about his co-workers, and
began to suspect that they were planning to harm him or his family. He
reports that his poor compliance with medication was accidental and he did
not mean to not take them. Bernard states that although his paranoia has
receded over the past fortnight he has experienced increasing anxiety,
feelings of helplessness and worthlessness, as well as feeling overwhelmed
by his situation, saying “I did my best last time and it all just fell to pieces;
what’s the point in trying now if that’s what’s going to happen?”.
Bernard sleeps 6-8 hours per night, experiencing some difficulty getting to
sleep as he tends to lie in bed worrying about his life and future. He denies
any middle-of-the-night or early-morning awakening. His appetite has
increased since recommencing medication and he report a weight gain of 4
kilograms in the past fortnight. He eats large meals and usually snacks on
top of this. Meals at home are usually prepared by his mother. Bernard had
been contributing to the running of the household prior to his relapse
however at present does not feel up to doing household chores. He has
become increasingly insular and has avoided social contact, tending to avoid
friends and family who have come to call: he states this is for fear of them
becoming targeted by the same people who were targeting him. Bernard
describes few interests or activities outside the home; he had been heavily
involved in the Drama and Soccer clubs whilst at University however he lost
contact with most of the people he knew from them once he became unwell.
He has been unable to establish a new social circle since then.
The evenings are most difficult for Bernard — he feels increased anxiety,
restlessness and finds that his pattern of negative rumination is markedly
worse during the evening. He describes feeling disconnected from his life
and unsure of what he is doing. He says he had a clear plan of what he
wanted to do with his life but “that is all gone now” and he is struggling to
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Complex Mental Health & Recovery 3
come to terms with the loss. He admits to occasional suicidal ideation in the
form of a passive wish to be dead “because it would just be easier” however
he denies a history of suicide attempts or current suicidal plan, stating he
“could never do that to my Mum and Dad or Sister”. He denies any alcohol
or drug abuse; he reports some experimentation with Cannabis and Ecstasy
at parties in first year Uni but did not like the feeling and has not tried
anything since.