Respond to the colleagues by offering additional insights or alternative perspectives on their diagnosis or provide alternate next questions and why you selected those.
What the Practitioner Did Well?
In the YMH Boston vignette 4 video, the practitioner started well by letting the patient know his right and explain confidentiality rules. Confidentiality and protection of patient information must be maintained. (American Nurses Association, 2014). Maintaining patient confidentiality will help promote an environment conducive to providing quality care, building trust, and contributing to solving ethical issues in mental care settings. (American Nurses Association, 2014). The practitioner was professional throughout the evaluation. The practitioner begins well by asking the patient open-ended questions such as what brought the patient to the clinic. The patient was tense and angry with his conduct, but the practitioner was able to engage in their conversation by saying, “I would like to know you more.” Open-ended questions are beneficial to use during the evaluation to facilitate communication.
In what areas can the practitioner improve?
The practitioner did not introduce himself to the patient and did not obtain informed consent from the patient before proceeding with the evaluation. Informed consent is one of the ethical principles of autonomy. The patient has the right to consent to participate and make decisions regarding his treatment. (Muir et al.,2019). The practitioner should have introduced himself to the patient to help develop rapport. The practitioner should interview the patient’s parents to gather more information and complete the evaluation.
At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
Compelling concerns are not incorporating the patient’s mother. The initial interview was done by the patient only, which will hinder the patient treatment plan. Having the patient’s mother present will help the practitioner to know the presenting symptoms and appropriate treatment plan. It is the responsibility of the practitioner to evaluate data appropriately to determine an accurate treatment plan for their patients. (American Nurses Association, 2014). The patient displays anger in his conduct, and it may be a strain in the parent-child relationship. Adolescent anger that happens at home might mean that the parent-child relationship may need improving. (Swanepoel, 2019). I believe that the practitioner should get the patient’s mother involved to know the root of the problem.
What would be your next question, and why?
The next the question that would involve asking the patient is to know his communication and relationship with his mother. I will ask him that I would like to interview him and his mother. I will also ask the patient if he is a willingness to work on his anger issues. It seems like his relationship with his mother is not conducive; I will ask the patient strategies he has tried in improving communication with his mother, and the areas he feels can make a difference in their relationship. Involving the patient’s mother will enhance communication, provide a healthy relationship, and promote change in patient behavior.
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
Muir, H. J., Coyne, A. E., Morrison, N. R., Boswell, J. F., & Constantino, M. J. (2019). Ethical implications of routine outcomes monitoring for patients, psychotherapists, and mental health care systems. Psychotherapy, 56(4), 459–469. doi-10.1037/pst0000246“
Swanepoel, A. (2019). Fifteen-minute consultation: The angry child. Archives of Disease in Childhood. Education and Practice Edition, 104(1), 11. doi-10.1136/archdischild-2017-314020
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