Reflective Practice Portfolio: Nursing Leadership And Management

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Reflective Nursing Practice Portfolio
Question 2: Reflecting My Clinical Experience as a Nurse
There are various circumstances where you as a clinician you are supposed to make an ethical decision when you are dealing with a given situation. In my clinical experience, I also faced challenges, and I was therefore forced to think and make an ethical decision. There was a 43-year-old woman who had lived with disturbing hallucinations which were filled with persecutory delusions for the past 20 years. The hallucinations had interfered with her daily living, and therefore she had been admitted and discharged from various psychiatric hospitals for at least 20 times.
It was discovered that the woman had a mental disorder and she completely refused treatment. The health care providers determined that the woman was not only a danger to herself but also the other people that she stayed with. After being discharged from the health facility, it was agreed that the community mental health clinic would be given the responsibility of treating the health condition of the woman. She was therefore supposed to make regular visits to the hospital for a checkup. During the time of her visit, her diagnosis varied during his rare visits since the healthcare workers who were dealing with her kept changing given the regular transfers that happened at the clinic. She was diagnosed with having disorganized schizophrenia, schizoaffective disorder, borderline personality disorder traits and bipolar disorders.
The woman again came back to the local community psychiatric clinic to seek for assistance. She was admitted to the hospital, and she was later released on only one condition if she agreed to see a therapist. The woman had seen all the other clinicians at the hospital. It was my first week at the facility, and therefore I received the referral. So many questions lingered up in my mind, "Should I accept the referral given that I have the least amount of clinical experience?" Given the deteriorating health condition of the woman, I made a decision to accept the referral.
At the time of the referral, she was on an injectable medication that would help her to control her psychotic symptoms. On most of the occasions, she would refuse the medication altogether and run away from the clinic screaming. On another occasion, she told me that she would only accept the injection if it was given while lying outside naked, with her hands raised up and her legs together. She then began to yell at the hospital "So that God can see what you are doing to me." She sure enough went and did it. I asked myself, Should I go ahead and administer this injection to her? At times she would phone me almost 30 times in a day saying that she was in a dangerous health condition. My colleagues advised me to avoid receiving the calls since it was becoming too much. I asked myself, "Should I avoid receiving her calls?"
As a way of answering the questions that were lingering up in my mind and making a decision, I began by recognizing that the woman is a human being like me with an identity. I used the Relational Ethic Framework in handling the situation. Relational Ethic Framework provides that there are ...