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NURS683 RESPONSE1
Post‐traumatic stress disorder (PTSD) is a mental disorder resulted from sudden, threatening, or catastrophic events. The current prevalence of the disorder worldwide is approximately 8%, increasing significantly year by year. Clinical manifestations include recurrence of traumatic events, avoidance of trauma‐related cues, high arousal, and selective forgetting and emotional numbness of traumatic experiences, causing great suffering to patient (Lai et al., 2020). A comprehensive assessment of past ex-posture to traumatic events to diagnose PTSD (American Psychiatric association, 2022)
The pathogenesis of PTSD is still not fully known and brings certain limitations for the treatment and management of the condition. Stahl, 2013 explains that pharmacologic treatments for PTSD are aimed towards treating at comorbidities such as depression, insomnia, substance abuse, and pain than at core symptoms of PTSD. SSRIs and SNRIs drugs are considered first-line treatments, however they lead to residual symptoms, including insomnia. Cognitive behavioral therapy is also recommended including Exposure therapy is also effective psychotherapy for PTSD. the central symptoms concern intrusions about, and avoidance of, memories associated with the traumatic event itself, whereas in separation anxiety disorder. As an example, Sertraline, SSRI (selective serotonin reuptake inhibitor) is classified as an antidepressant, but it is also FDA approved to treat PTSD; medication is to be continued until all symptoms are gone or significantly reduced. The onset of therapeutic effects is usually delayed in about 2–4 weeks (Stahl, 2020).
Studies report that the amygdala is key in monitoring the PTSD symptoms. It has been shown that the amygdala is activated in patients with PTSD when fear is triggered and conditional fear expression. In the central nervous system, some neurotransmitters are involved in the development and maintenance of PTSD including dopamine (DA) is a crucial catecholamine neurotransmitter in the brain that has been shown to be closely associated with fear memory; Serotonin or 5‐hydroxytryptamine (5‐HT) is an important cause of anxiety, depression, and PTSD (Lai et al., 2020).
NURS683 RESPONSE1
Recurrent panic attacks largely characterize panic disorder. According to Cackovic et al. (2023), these panic attacks are intense and present episodes of discomfort and fear. It is critical to understand the neurobiology and neurotransmitters, patient presentation, and evidence-based treatment plan for panic disorders.
Neurobiology and Neurotransmitters
The neurobiology of panic disorder entails a complex interface between various brain regions and neurotransmitters. These regions include the following: the amygdala is hypersensitive during panic attacks, resulting in exaggerated fear responses; the hypothalamus is activated, leading to increased heart rate and shortness of breath (Cackovic et al., 2023). Panic attacks lead to low serotonin levels for increased amygdala sensitivity, resulting in heightened excitability. It also leads to norepinephrine dysregulation, increasing anxiety and arousal.
Patient Presentation
According to Kim (2019), patients with panic disorder may experience persistent panic attacks based on sudden, intense periods of discomfort. The physical symptoms include chest pain, trembling, sweating, and palpitations (Kim, 2019). The patients may also present behavioral changes by avoiding situations or places linked to previous panic attacks. They may also have numbed or tingly hands, experience chills, or showcase dizziness or weakness.
Evidence-based Treatment Plan
Evidence-based treatment plans for panic disorders include psychological and pharmacological treatment plans like mindfulness interventions and cognitive behavioral therapy (CBT). According to Kim (2019), CBT interventions provide exposure to feared situations to mitigate avoidance behavior. It also counteracts the challenging irrational thoughts and beliefs. The treatment plan also includes medication administration like Beta-Blockers to manage the physical symptoms, Benzodiazepines for short-term relief, and Selective Serotonin Reuptake Inhibitors (SSRIs) to regulate serotonin levels (Kim, 2019). Lifestyle medication like stress management, adequate sleep, and regular exercise can complement therapeutic interventions.
NURS682 RESPONSE1
System thinking is a holistic approach to problem-solving and decision-making that emphasizes understanding the interrelationships between different components within a system. When applied in a work environment, particularly in healthcare settings where patient care is paramount, team leaders who embrace system thinking can bring about significant improvements in care delivery and efficiency. Two key habits of such leaders include: Complexity and Collaboration and Communication.
Embracing complexity, leaders who use system thinking understand that healthcare systems are complex and multifaceted. Instead of focusing solely on isolated problems or symptoms, they look at the bigger picture and consider how different elements within the system interact with each other. They recognize that changes made in one area can have ripple effects throughout the entire system. For example, a team leader might consider how changes in staffing levels can impact patient wait times, staff morale, and overall quality of care.
System thinking leaders foster a culture of collaboration and open communication among team members. They recognize that no single individual has all the answers and that solutions often emerge through collective efforts. By encouraging interdisciplinary teamwork and regular communication channels, they facilitate the sharing of information, ideas, and insights across different departments and disciplines. This approach helps break down silos and promotes a shared understanding of the system’s complexities. In a healthcare setting, improved collaboration can lead to more coordinated care, reduced errors, and better patient outcomes.
Collaboration and communication has the power and capacity to address many challenges in the health care environment, from clinician well-being to national imperatives for better health, better care, and lower cost (McMahon, 2017). I believe that the implementation of both of complexity, collaboration and communication has improve the care that was delivered to patients and improved efficiency. Team leaders who apply system thinking principles in the healthcare environment demonstrate a deeper understanding of the complexities inherent in healthcare systems.
NURS682 RESPONSE2
The healthcare setting has always been considered a complex and ever-changing place where exploring numerous variables is necessary to achieve the best possible outcome and improve the overall practice. Therefore, applying systems thinking in a complex environment like this has been very valuable in providing better patient-centered care, fostering problem-solving and critical thinking, as well as encouraging continuous learning.
‘Systems thinking’ involves examining the features of system components (e.g., work tasks and technology) and how they are linked together to have a better understanding of how these connections influence results (McNab et al., 2020). For instance, I have observed that my team leader in my workplace would often exhibit the habits of a systems thinker. As a team leader, he would make meaningful connections within and between systems through active communication and interactions with all the team members. He would often ask for opinions and ideas and communicate them with the other healthcare professionals in the facility to influence some changes. These connections are the links and cause-and-effect interactions that keep the system running. Aside from that, he would also seek to understand the bigger picture. This allows him to broaden his insight and shift his perspective on certain issues. Given the close relationship with the team members, he was able to assess the problems more thoroughly and accurately before taking action and identify areas that required further development to ensure that the highest quality of service was provided. Hence, looking at the bigger picture can help a team create a useful strategy for moving forward and discover more long-term solutions to complex challenges (Gilissen et al., 2020).
I believe that these habits of a systems thinker helped improve the care that was delivered to patients and improved efficiency because analyzing the interactions and workflow within the system enables designing better modifications to improve related functioning (McNab et al., 2020). As such, it also highlights the shared understanding and knowledge between healthcare professionals that will aid a deeper exploration of excellent practices that will create a secure healthcare environment, not just for patients, but also for professionals.
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