Psychiatric Nursing Multimedia Scenario One - Student Reflection
PATIENT PRIORITY:
1. Sherry
2. Paul
3. Susannah
4. Bill
Rationale:
I chose to speak with Sherry first because she appears to be the biggest threat to herself. Safety being my priority, I organized the rest according to the threat of safety to themselves or others.
Paul was my second choice because he was the second highest danger to himself and others based on his recent behavior with the bat. Sticking with the priority of safety threat, I chose
Susannah to evaluate third. She is at risk for not meeting basic needs like food and fluid. Next I chose Bill because he was the least likely to harm himself or others, although he may be at risk of being harmed because of his disruptive behavior.
PATIENTS:
Sherry
Answer: A
Rationale: Sherry appears to be actively suicidal. Initially, I would ask if she had a plan to carry out suicide or if she had access to medications or firearms to assist her to carry out her plan.
Next, I would attempt to see if she had a history of suicide attempts. This would be useful information because she may be more likely to be successful if she attempts suicide again.
Evaluating her level of depression is essential as well. Speaking with her family about history of suicide attempts and depression will also be useful in treating Sherry.
Paul
Answer: A
Rationale: He appears to be a threat to others in this scenario. He easily escalates on interactions with disruptive patients. I think alone time is okay, but if he is a potential threat maybe the courtyard isn't the best place for him to calm down as others may be there. If he is already escalating and runs into another person he finds annoying or disruptive it may incite a physically violent response. I think letting him have alone time in his room would be the best option in retrospect. Decreasing stimulus and likelihood of other triggers would be the safest