Recovery Nursing Care Plan Case Study Sample
Scenario: Ben's Mental Health Recovery Plan
Note: This is information is a continuation of Bens story from Task 1, all previous information and video still applies Ben, a 25-year-old qualified builder, was brought into the Emergency Department by the Police three days ago following an aggressive episode involving his girlfriend outside their house. Ben's behaviour raised concerns, leading the Police to believe that he was mentally unwell and posed a risk to himself and/or others. As a result, Ben was detained and taken to the local health service. Ben has a history of depression and borderline personality disorder, with known suicide attempts. His depression has been ongoing since he was 21 years old. Additionally, he has been using substances since the age of 14. His girlfriend informed the police that his substance use had become "much worse" in recent months and that he had "started acting strangely."
Upon admission to the Emergency Department, Ben was found to have a mixture of alcohol, ice (methamphetamine), and cannabis in his system. He was also experiencing a psychotic episode. The healthcare professionals managed his acute symptoms and determined that he is now stable enough to be discharged from the inpatient unit to a community setting. However, given his complex history and current mental state, a comprehensive recovery plan is necessary to support his transition and rehabilitation. Your previous MSE and risk assessment contributed to his care and after 4 days, he is to be discharged in the community.
You have just started in the community and have requested to continue working with Ben at the Community Mental Health Service. Ben has agreed to this as he is comfortable with you, having previously met you in the Inpatient Unit. He has also been taken off the Mental health act (2014) and is now not subject to any treatment orders.
Ben’s Current presentation and information:
Bens’s symptoms of psychosis seem to be resolved currently prescribed Olanzapine 10mg BD is also prescribed Diazepam 5mg TDS. These medications were also used as part of Ben’s withdrawal from his methamphetamine and cannabis whilst he was in hospital. Ben previously was on Diazepam 10mg TDS. The psychiatrist would like this to be reduced and will review these medications with a view to discontinuing when appropriate. When in hospital, Ben also started a SSRI called Escitalopram 10mg Daily. The psychiatrist would like this to be monitored[AC1] with an increase to 20 mg if tolerated, Ben was[AC2] previously on other antidepressants before admission and stated, “they did nothing for him”.
He has not had Escitalopram before.
Ben still presents as low in mood; he still states his girlfriend will leave him and will lose his job and is embarrassed about how he was brought into hospital. These statements appear to be related to his mood and do not fit delusional content. He has stated that he has no plans to take own his life, but he does on occasion think about if he could just go to sleep and not wakeup as his thoughts “don’t stop” sometimes and he just wants to get away.
Overall, Ben still has till has some mild symptoms of withdrawal, and this has generally been managed well in hospital with an Amphetamine Withdrawal Scale and his regular medication. He currently feels he cannot miss any doses of the Olanzapine and Diazepam, otherwise he may will “lose it”. Ben has discharged, back to his home with his girlfriend. She has been very supportive during his inpatient stay. His girlfriend is worried about future relapse. His mother Cathy has also been supportive to Ben during this time and has volunteered to help where she can. Ben’s workplace has organised him some sick leave. Ben’s girlfriend has discussed with you that his boss is very supportive around mental health issues and wants him back at work when he is ready.
Solution
Introduction
In the modern era, the prevalence of mental health issues in people is extremely concerning for healthcare providers which develop the need for creating recovery plans to support the victims of mental health issues and promote them towards a better quality of life. A mental health recovery plan refers to a process to help people suffering from mental health diseases enhance their interest towards life and identify their strengths. University Assignment Help, This recovery plan also has the objective of finding out the triggers that are the potential reasons for reduced mental wellness along with providing peer support for improving mental health (healthdirect., 2022). The current report focuses on a 25-year-old male named Ben who was suffering from mental health issues. Due to the severity of his condition, he received treatment from the local mental health service for a few days and currently is being shifted into the community mental health service from the inpatient unit. The current report emphasized assessing his conditions and formulating a mental health recovery plan which is both appropriate and relevant to promote his overall health condition. The recovery plan also consists of discharge planning and relapse prevention plans for enhancing the effectiveness of the journey of Ben towards the recovery process.
The Recovery Plans
The recovery plan for supporting the mental health condition of Ben is divided into several domains the conditions are identified in this report along with the recovery goals and the nursing interventions are explained which might help been to achieve his optimal health quality. The domains of the recovery plan are explained below:
Mental Health Domain
In the case of mental health, Ben was suffering from depression along with borderline personality disorder. Ben also had psychotic episodes along with several suicide attempts. In his current situation, Ben has a low mood and over-thinking habits. However, his symptoms of psychosis started diminishing after taking the medicines olanzapine and diazepam. He is still concerned about his job security and also has low self-esteem as he feels embarrassed about the need to get admitted to the mental hospital.
In the case of Ben, a major goal for recovery includes the total improvement of the mental health of the patient along with enhancing the self-confidence and self-esteem in him. Moreover, the development of a coping mechanism is also a goal of this recovery plan to prevent the development of negative thoughts. Lastly, the discontinuation of the medications under the supervision of the healthcare providers is also a goal of the recovery plan.
To help Ben, several nursing interventions can be implemented including a counselling session to provide mental and emotional support to the patient by addressing his concerns and resolving them (Varcarolis & Fosbre, 2020). Another intervention can be implemented which is the use of cognitive behavioural therapy that can enhance the self-esteem of the patient and prevent the development of negative thoughts (Nakao et al., 2021). The use of group therapy activities can also be beneficial for Ben as it helps in developing a social network which helps in establishing alternative coping mechanisms in patients (Williams et al., 2018).
Family Domain
In the family of Ben including his mother Cathy and his girlfriend were always supportive towards him for promoting him through his mental health symptoms. However, his girlfriend is concerned about his future relapse.
The major recovery goal in this situation for Ben is to create a stronger relationship with his family members. Moreover, increasing the health literacy of the family members of the patient is also a part of the recovery plan as it can help in providing better support to the patient.
The major nursing intervention that can be initiated in this situation is to provide the necessary education to the family members to increase their health literacy about the condition of the patient and the future risk of relapse (Goodwin et al., 2021). This can enhance the bond between the patient and the family by providing better support.
Occupational and Social Domain
As a patient with a mental health disorder, Ben received an ample amount of support from his workplace as his higher authority has an open mindset towards mental health issues and provided him with sick leave. The organisation also one sim back after the recovery.
The major recovery goal in this case is to provide support to Ben for returning to his workplace. This support needs to be provided to him in the form of developing self-confidence and self-esteem.
The major nursing intervention that can be implemented to achieve these recovery goals is the use of behavioural therapies for enhancing his self-confidence and self-esteem. The use of cognitive behavioural therapy is again an important part of this process as this therapy helps in increasing self-esteem in the patients which increases self-confidence as well (Sønmez et al., 2020).
Physical Health Domain
The patient showed no visible symptoms of physical health issues apart from the symptoms of mental health disorders.
In this case, there is no specific recovery goal is needed. However, one holistic goal can be developed in the form of maintaining the overall physical health of the patient.
For this reason, the nursing intervention can be implemented for regularly monitoring the physical health status of the patient by checking the vital signs (Dochterman et al., 2018). The patient can also be inspired to take a balanced diet and do regular exercises which are the major nursing interventions for encouraging the patient to get involved in a healthy lifestyle (Rasmussen et al., 2020).
Medication Domain
Due to the mental health conditions of the patient, several medications were prescribed to him including the Olanzapine and diazepam. Not only that but after the administration of the hospital, Escitalopram has also been taken by the patient as an SSRI. One of the issues in this case is to identify the proper mode and time of discontinuation of these medicines.
The goal of the recovery in this case is to enhance the health literacy of the patient about the use of the medications the purpose of the medication used and the potential development of the side effects due to the medications. Moreover, proper monitoring for adjusting the doors of the medicine or the process of discontinuation is also a goal.
The nursing intervention that can be implemented in this process is the use of educational resources to enhance the health literacy of the patient about the prescribed medicine (Williams et al., 2019). A proper conversation with medical professionals like psychiatrists about the doses and discontinuation process of the medication is also a necessary responsibility of the nursing professional for supporting the mental health issues in the patient (Reid et al., 2018).
Substance Abuse Domain
Substance abuse has been a huge issue in Ben since the old days. In the current situation when Ben was admitted to the emergency department, he had traces of alcohol, methamphetamine and cannabis in his body. The habit of substance abuse was prevalent in him from the age of 14.
The major recovery goal In this case is to promote Ben towards a condition where he no longer uses substances in an abusive manner. Moreover, the second goal is to prevent the relapse of this substance abuse habit in the patient by developing alternative coping mechanisms.
Nursing interventions that can be implemented in this situation are to encourage the patient to quit the misuse of substances to reduce the mental health disorder symptoms (Finnell et al., 2019). Apart from this, the proper monitoring of the patient for identifying any sign of substance abuse is also the responsibility of the nurses to prevent the development of the relapse of the habit (Menon & Kandasamy, 2018).
Risk Assessment
The regular assessment of risks is an important part of the recovery plan of Ben as this assessment is necessary to identify any change in condition of the Ben and implement any necessary strategies. The risk assessment strategies are as follows:
• The assessment of the signs of mental distress in Ben is necessary to prevent the development of self-harm habits or relapse of the condition.
• The assessment of substance abuse habits is also important for identifying the novel development of cravings in Ben or the triggers for substance abuse.
Discharge planning
The discharge planning is a crucial part of the recovery plan which refers to the process of safe transition of the patient from the impatient health service to the community service. The discharge plan also involves several strategies which are as follows:
• The initial activity for developing the discharge planning of a patient is to assess the readiness of the patient for discharge (Kaya et al., 2018). It is also necessary to assess in the case of Ben for identifying his current status of mental health along with the progress of the recovery plan.
• The second part is to establish a collaboration between the support network of the patient which includes the family members of the patient along with the treatment team (Shalaby & Agyapong, 2020). In the case of Ben, this collaboration is also important for ensuring the safe transition of his treatment procedure.
• The following part is to develop a follow-up care plan for regularly monitoring and reviewing the condition of the patient after the shift in the treatment (Stanley et al., 2018). In the case of Ben, the follow-up plan will include the use of proper monitoring of regular medication administration and avoidance of substance abuse habits.
• The last part of the discharge plan is to ensure continuous contact between the healthcare providers and family members of Ben to ensure a continuous implementation of effective communication that would help in tracking mental health status of Ben (Varcarolis & Fosbre, 2020).
Relapse prevention plan
For the prevention of the relapse of the substance abuse habit and mental health problem symptoms in Ben, several important strategies can be implemented in the recovery planning which is as follows:
• The Initial strategy for preventing the relapse should be the integration of the healthcare team where different entities of the treatment team can help in providing expert opinions for supporting Ben (Leach et al., 2020).
• The following strategy is the accurate assessment of the triggers of issues in Ben which can worsen the symptoms of Ben (Menon & Kandasamy, 2018).
• The next strategy is to develop personalised coping habits in Ben which might help him to change the status of his mental health condition by managing his emotions (Buckworth, 2018).
• The implementation of the support network and enhancement of health literacy is another important strategy for the prevention of relapse which also needed to be implemented in the case of Ben.
• Lastly a regular monitoring process is necessary for reviewing the overall scenario of mental health status in Ben along with developing emergency plans in the case of a sudden increase in the distress situations.
Conclusion
On a concluding note, it can be said that the report generated a compact recovery plan for supporting the mental health status of Ben to provide him stability. Therefore, the recovery plan acted as a guiding path for Ben to achieve the goal towards living a quality life. The report identified the mental health challenges which were the major hindrances in the life of Ben as the recognition of these mental health issues was important for initiating the journey towards recovery. Moreover, the report also identified the substance misuse history of Ben which was a reason for the development of his mental health issues. The report integrated the involvement of the support network in the establishment of the recovery plan for Ben in the form of the support of his family including his parents and his partner along with the health care providers which was one of the major aspects of this recovery journey. The main objective of the recovery plan was to ensure empowerment of Ben which might increase self-confidence and self-esteem in him for promoting him towards a better life. Therefore, it can be said that the recovery plan highlights the need for systematic initiative for effectively managing problems and challenges regarding mental health issues of Ben and achieving a better quality of life.
References
Buckworth, J. (2018). Identifying and managing relapse risk. ACSM's Health & Fitness Journal, 22(2), 34-35. DOI: 10.1249/FIT.0000000000000367
Dochterman, J. M., Wagner, C. M., Butcher, H. K., & Bulechek, G. M. (2018). Nursing interventions classification (NIC)-E-Book. Elsevier Health Sciences. ISBN: 9780323497688
Finnell, D. S., Tierney, M., & Mitchell, A. M. (2019). Article Commentary: Nursing: Addressing Substance Use in the 21St Century. Substance Abuse, 40(4), 412-420. https://doi.org/10.1080/08897077.2019.1674240
Goodwin, J., Saab, M. M., Dillon, C. B., Kilty, C., McCarthy, A., O'Brien, M., & Philpott, L. F. (2021). The use of film-based interventions in adolescent mental health education: a systematic review. Journal of psychiatric research, 137, 158-172. https://doi.org/10.1016/j.jpsychires.2021.02.055
healthdirect. (2022). Recovery and mental health. Trusted Health Advice | healthdirect. https://www.healthdirect.gov.au/mental-health-recovery
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Leach, M. J., Jones, M., Bressington, D., Jones, A., Nolan, F., Muyambi, K., ... & Gray, R. (2020). The association between community mental health nursing and hospital admissions for people with serious mental illness: a systematic review. Systematic reviews, 9(1), 1-8. https://doi.org/10.1186/s13643-020-01292-y
Menon, J., & Kandasamy, A. (2018). Relapse prevention. Indian journal of psychiatry, 60(Suppl 4), S473. https://doi.org/10.4103%2Fpsychiatry.IndianJPsychiatry_36_18
Nakao, M., Shirotsuki, K. and Sugaya, N., (2021). Cognitive–behavioural therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial medicine, 15(1), pp.1-4. https://doi.org/10.1186/s13030-021-00219-w
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Shalaby, R. A. H., & Agyapong, V. I. (2020). Peer support in mental health: literature review. JMIR mental health, 7(6), e15572. https://doi.org/10.2196/15572
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