Psychiatric Mental Health Nurse Practitioner (PMHPN) Treatment to Schizophrenia

This is a class discussion post . Please respond to the discussion post. Thank you
What is the most appropriate response by the PMHNP? How can the PMHNP support adherence?
The most important response that the PMHNP can provide Mark with is understanding and compassion. The American Psychiatric Association (2021) guidelines recommends that persons with schizophrenia be treated in a person-centered approach that includes both pharmacological and nonpharmacological therapies. If a person’s symptoms improved with antipsychotic medications, it is recommended that treatment with an antipsychotic is continued. Psychosocial interventions including CBT, psychoeducation, family interventions, self-management skills, and for those that have a poor history of service utilization and frequent relapses assertive community treatment. Including adherence therapy in the clinician’s approach provides education to the client regarding their disease characteristics, and the prognosis of further functional decline, especially when not adhering to medications. The PMHNP needs to investigate the side effects that are concerning to Mark and see if there is an effective alternative that may have fewer side effects or an intervention that may be utilized to offset the more troublesome ones. Finally, including the patient in treatment decisions, removing obstacles to care, such as arranging transportation, and including family when appropriate are all interventions utilized in adherence therapy (Yildiz, 2021). The PMHNP can advocate for community resources for the Mark. Assertive community treatment may also benefit this individual. This would include a team of providers, a nurse, psychiatrist or PMHNP, and a social worker that would make regular visits to Mark in the community, where he lives and works. Their medical, psychiatric and personal needs such as food and shelter are provided. Efforts are made for job placement as well. If Mark should experience a crisis, onsite, immediate interventions can be implemented. This modality can decrease relapse, homelessness, and rehospitalization (Yildiz, 2021).
What are the ethical and legal obligations for the PMHNP in this situation?
The principles of ethics include beneficence, nonmaleficence, autonomy, and justice. It is the moral code that as practitioners we must follow. Autonomy is the patient’s right to make decisions for him/herself, beneficence is to do good, nonmaleficence is do no harm, and justice is fairness in all settings despite financial abilities, race, religion, gender. It is the PMHNP responsibility to respect the autonomy of the patient. If Mark is oriented and not posing a risk of harm to self or others, his autonomy cannot be violated. If Mark expresses intent to harm others, himself, or is having severe hallucinations or delusions and cannot separate reality from his psychoses, then having him involuntarily hospitalized honors the codes of nonmaleficence (no harm to others or self) and beneficence, do good, by providing care (American Nurses Association, 2015).
Mutually shared goals. What steps can the PMHNP take to promote their personal emotional and mental health when working with clients whole health choices are likely to lead to adverse outcomes?
It is always important to take time to recharge our own batteries. If your mental health is ignored you cannot adequately care for your patients. Having a peer group that understands the situation and can help provide insight into the case and provide suggestions, or even just an “I get it…It sucks and it’s not your fault” can prove valuable to one’s ability to leave work at work. Taking time to be with family and friends and participating in hobbies, exercising, massages are all activities that can help recharge and revitalize your body, mind, and soul.
References
American Nurses Association (ANA). (2015). Code of ethics for nurses with interpretive
Statements. Silver Spring, Md.
American Psychiatric Association. (2020). The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia (3 rd ed.). American Psychiatric Association. https://doi(dot)org/10.1176/appi.books.9780890424841Links to an external site.
Yildiz, M. (2021). Psychosocial rehabilitation interventions in the treatment of schizophrenia
And bipolar disorder. Archives of Neuropsychiatry, 58(1), S77-S82. https://doi(dot)org/10.29399/npa.27430Links to an external site.