a nurse is caring for a client who has schizophrenia and is threatening to harm others on the unit This is a topic that many people are looking for. star-trek-voyager.net is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, star-trek-voyager.net would like to introduce to you Do This, Not That! Providing Care for Medical Patients with Psychiatric Issues: Hallucinations. Following along are instructions in the video below:
Welcome to do this not that im sooo self licensed clinical social worker and and behavioral health liaison manager for bjc healthcare. Today. Were trying to understand and competent and confident when providing care for patients who experience hallucinations they say theyre gonna hurt my family okay the voices that youre hearing.
I cant hear these voices what i need you to do is tell me what theyre saying so i can help you it makes sense to me. And its perfectly okay to be uncomfortable. When someone is behaving oddly or out of the norm.
The key is to push through that discomfort to provide good care. I know the first patient. I had who was hallucinating scared me to death the truth is its more grandma than grad school.
You dont need to be a masters level licensed professional who works on the psych unit to help a person through a difficult time you just need to know what to do so. Lets talk about hallucinations. First hallucinations are present in many medical disorders and every patient with hallucinations does not have a psychiatric illness.
They can occur in any sensory domain. Most commonly auditory and visual. A patient experiencing hallucinations is reacting to sensory experiences.
Without the presence of stimulus. The visual auditory hallucinations can be interactive or more like a movie you could see psychomotor agitation like pacing or rocking. An inappropriate effort you laughing and smiling or crying in the absence of an appropriate cause.
The patient looking over her shoulder are somewhere else in the room or a lot of eye movement. They may seem distracted unfocused unable to carry on a conversation. Ask you to repeat yourself or appear confused their lips could be moving or they could be speaking to someone other than you they may be talking to you.
But think youre someone else are saying things that dont make sense potato tornado. You could see latent speech. A delay in answering questions as if the patient is seeking advice from someone who isnt there and how old are you 103 psychotic hallucination address accuse seduce humiliate and jeer the patient interacts with them its these types of hallucinations that pose the greatest risk because the voices and apparitions often instruct the patient to hurt themselves or others.
And sometimes the patient will engage in risky behaviors. In an effort to make the voices stop. So.
Whats going on here. What causes this hallucinations can be caused by a lot of things more common ones are a medical condition glucose. Nutritional.
Or electrolyte abnormalities carbon. Monoxide poisoning or lead poisoning post anesthesia brain masses injuries or disorders. Adrenal and thyroid conditions.
Fever. Infection. Or serious illnesses.
A sensory problems such as blindness or deafness being drunk or high or coming down from drugs or alcohol ptsd a physiological brain abnormality affecting perception and thinking so what actions should a healthcare worker. Take first begin ruling out possible medical causes. Even if theres a known psychiatric disorder.
Next. We need to remind ourselves that hallucinations dont necessarily mean that theres a safety risk not all of these patients need to be on the psych floor. If a patient appears to be hallucinating ask directly about what you observe for example are you seeing things are you hearing voices are they speaking to you or about you what are the voices.
Telling you do you think that youre in danger has this happened to you before ask if the patient is considering behaviors. That would result in negative outcomes. Then use their answers to assess risks like harm to themselves or others.
Or elopement. If the risk is not manageable. Follow your organizations protocol and document.
The specific hallucinations.
Dont argue about what is real and not real dont challenge the patient or try to dispel the hallucination with logic. Dont touch the patient at least not without asking permission. And explaining what youre doing do take a respectful instead of condescending tone.
Regulate your voice to a lower volume tone and slower rate as permission to do things to the patient ground them in reality by talking about items in the room. Convey that you believe the patient is hearing or seeing things because they are hi. Melissa.
Im jennifer your nurse. How are you doing today. What are you okay im sorry i couldnt hear you those people are talking you can hear someone talking where i dont know close.
Theyre saying. I shouldnt be here. Melissa look at me someones talking to you i cant hear them talking theyre talking about you what else are they saying that im stupid that i shouldnt have let the police bring me here.
I shouldnt be here do you know where you are not exactly i just they dont want me here. I shouldnt be here can you see these people melissa can you see people no are they talking to you at all. I dont think they know im listening they hate me thats terrible are you seeing anything that i might not be able to see no one sir do the voices ever tell you to do things listen pay attention.
Okay. Lets just see if we can have you straighten up this trade table you get ready for your breakfast. While youre talking to me okay do the voices ever tell you to hurt yourself or anyone not these people.
But some do those people went away. I dont talk to them. Anymore.
That must have been awful for you before you said you werent sure where you are youre in the hospital and im your nurse. Do you think its safe here no its not safe anywhere. It must be frightening for you what are you most worried about that theyre gonna come and get me.
I dont want to go with them. Well do everything we can to keep you safe here. Melissa.
I need to take your blood pressure can i do that they say i shouldnt let you do that stupid. I know those people you hear dont want me to take care of you but im worried about you and i just want to help you get well will you let me help you i want to go home. Its better there well until youre ready to go home are there things that we can do to make you feel safe maybe.
Things that we can do to help with the voice maybe what do you do at home to help with those voices. I watch tv. But my tv only works on channel 113 at night the light has to be on sometimes i listen to the radio.
It helps drown out the voices well lets do that ill turn on the tv. And you see which channels work here. Ill make a note for the night nurse to make sure you have your light on at night.
Maybe she can check with you about which lights can quiet the voices. When you find the right channel. Maybe then i can take your blood pressure.
Im gonna go find a radio for you okay. Thank you welcome. Some important points to remember are that the patient is often frightened by these experiences.
Theyre afraid theyll be seen as crazy or insane. Often friends and family ignore the hallucinations not every patient hallucinates is dangerous nor do all of them need to be in a psychiatric unit. See him or her as a real person.
Not as a disorder. Patients need reassurance compassion and grounding remember. What we said.
Earlier. You dont need to be a psychiatric professional to help a person through a difficult time you just need to know what to do thanks for watching you .
Thank you for watching all the articles on the topic Do This, Not That! Providing Care for Medical Patients with Psychiatric Issues: Hallucinations. All shares of star-trek-voyager.net are very good. We hope you are satisfied with the article. For any questions, please leave a comment below. Hopefully you guys support our website even more.