Promoting Collaborative and Compassionate Mental Health Care for Ruby

QUESTION

3. Describe professional therapeutic relationships with mental health consumers, carers, and significant others using empathic and compassionate language

4. Describe how to support the rights of mental health consumers to lead their treatment and recovery process, and the rights of carers and significant others with the consumer’s consent, to collaborate in the treatment and recovery process.

Aim of the Assessment

By working in a group, students will have the opportunity to develop their oral skills, learn about professional advocacy and how to work collaboratively in a team environment to obtain the best outcome for the person in your care who are experiencing mental ill-health or mental illness.

Task

Using the scenario, Ruby’s story, you will need to demonstrate your professional advocacy role as a nurse by presenting strong, coherent and evidence-based knowledge in your team discussion. You will need to produce a 10 minute video.

The aim of the 10-minute video presentation is to discuss, justify and advocate for Ruby to be seen by the Mental Health Clinical Nurse Consultant (CNC) to perform a comprehensive mental health assessment. Each member will engage the team in a discussion of approximately 2 to 2.5 minutes about why Ruby needs to be seen by the CNC. It is important that the topic you choose complements the other team members’ topics and that you are able to link this to Ruby’s current situation.

Nurses

You begin your morning shift in a busy Emergency Department (ED).  After hearing the handover from the night shift nurses, you and your team start a discussion about whether making a referral to the Mental Health Clinical Nurse Consultant (CNC) to conduct a thorough Mental Health Assessment is needed for Ruby. Team collaboration is needed to ensure that Ruby receives the best possible outcome for her mental health. Each member of your team is to choose a topic to contribute to the discussion regarding planning for Ruby’s care.

Possible topics for discussion  

1. Ruby’s recovery. You may discuss a particular recovery model and relate this to Ruby’s current situation. Strengths recovery model or CHIME recovery model are just some examples.

2. Ruby’s medications- prescribed and non-prescribed

3. Caring for a consumer with thoughts of self-harm

4. Caring for a consumer with thoughts of suicide

5. Caring for a consumer with mood disorder

6. Caring for a consumer with bipolar disorder.

7. Young people experiencing mental ill-health or illness

Ruby’s story 

Ruby is a 20-year-old woman who presented in Emergency Department (ED) due to changes in her mental health. She was brought in by her mother, Sylvia, who reported that she picked her daughter up from Melbourne and brought her back to Western Sydney after Ruby’s flatmate, Alicia, contacted her about the changes in Ruby’s mental health.

Ruby has been living in Melbourne for the past year, where she works as a shoe sale assistant on a casual basis. She planned to return to Sydney before the end of the year to start her teaching degree in 2024. This was cut short due to the changes in Ruby’s mental health. According to Sylvia, Ruby has been going out and drinking alcohol every night the past few weeks with friends she met recently. Ruby has not had much sleep the past few weeks as she comes home most mornings just sleep for 2 to 3 hours and have a shower before going to work for 9 am. The manager of the shoe shop where Ruby work has warned her that she will lose her job if she continues arriving to work late and smelling of alcohol. Ruby has admitted to her flatmate Alicia that she has been smoking marijuana and experimenting with other illicit drugs with her new friends. Ruby stated, ‘I don’t’ know what I’ve been taking, but it made me feel good.’

Lately, the two friends would get into a verbal altercation when Alicia tried to talk to Ruby about the changes in her behaviour. Ruby would become irritable and angry and would say to Alicia, ‘you’re just jealous that I have met other people and I am enjoying myself without you. I can’t help it if people love me more than they love you. I want to make the most of this before I start uni.’

A few nights ago, Ruby called Alicia at 3 am to pick her up from their local pub. Ruby explained that she felt unsafe to go home on her own because she thought that she was being watched and followed by a guy who was in love with her. When they arrived at their flat, Ruby ran to her room and locked her door. The next day, she did not go to work and did not contact her employer. The manager of the shoe store contacted Ruby and informed her that she is no longer required to work in the store. Alicia thought that she would be devastated by this news as this is her only source of income. But Ruby told Alicia that ‘I was too good for that job anyway. It’s their loss’.

Ruby did not leave the flat for the next few days. Alicia noticed changes in Ruby’s mood. She stayed in her room most of the time. She has not showered in days, ate little amounts of food, and had barely any sleep and would watch TV instead all night or watch YouTube videos on her phone. She stated to her flatmate that ‘I don’t want to sleep; I feel that something bad is about to happen’. One night, Ruby asked Alicia for help as she started to have thoughts of suicide, but with no plan of how she would hurt or kill herself. Alicia felt she had no choice but to contact Ruby’s mum, Sylvia, to ask her for help.

During the interview, Ruby sat next to her mother, slumped with her head on her hands. She would get up and pace while wringing her hands. Although she presented as well-groomed and neat, Ruby was wearing clothes that were big for her small stature. When her mother excused herself to go to the toilet, Ruby opened about her experience to the nurse. She stated that she did not want her mother to know. She told the nurse that she had been feeling unmotivated, loss interest in going to university (when all she wanted was to become a teacher) and has been having suicidal thoughts with no plan. She mentioned that her ‘heart has been beating 100 miles per hour and feels like something bad is about to happen. I don’t know why, and I will do anything to make it stop.’ She mentioned that she was commenced on 20mg of Paroxetine daily by a GP in Melbourne four weeks ago and asked if she should keep taking this medication.

ANSWER

Promoting Collaborative and Compassionate Mental Health Care for Ruby

Introduction

This essay explores the importance of professional therapeutic relationships in mental health nursing and how to support the rights of mental health consumers in their treatment and recovery process, with a focus on Ruby’s case. It emphasizes empathy, compassion, and collaborative decision-making in caring for individuals with mental health concerns.

Professional Therapeutic Relationships

Professional therapeutic relationships are built on empathy, trust, and active listening. In Ruby’s case, it is essential to establish a connection that communicates genuine care and concern. Mental health consumers like Ruby often experience vulnerability, making it crucial for healthcare professionals to provide emotional support.

Supporting Consumer Rights

Supporting mental health consumers’ rights is a fundamental ethical principle. In Ruby’s case, it means respecting her autonomy and involving her in treatment decisions. With her consent, carers and significant others should be included in the care plan, ensuring holistic support.

Video Presentation for Ruby’s Care

1. Topic 1: Ruby’s Recovery (2 minutes)
Discuss the strengths recovery model and its applicability to Ruby’s situation.
Emphasize the importance of recognizing and nurturing Ruby’s strengths and resilience.

2. Topic 2: Ruby’s Medications (2 minutes)
Address the importance of evaluating Ruby’s prescribed and non-prescribed medications.
Highlight the need for medication reconciliation and monitoring for interactions or adverse effects.

3. Topic 3: Caring for a Consumer with Thoughts of Self-Harm (2 minutes)
Discuss strategies for providing immediate support and safety for Ruby when she expresses thoughts of self-harm.
Emphasize the role of therapeutic communication and crisis intervention.

4. Topic 4: Collaborative Care for Mood Disorder (2 minutes)
Describe how a collaborative approach involving mental health professionals can assist in managing Ruby’s mood disorder.
Stress the significance of coordinated care and a multidisciplinary team.

5. Topic 5: Integrating Christian Worldview (2 minutes)
Explain how a Christian worldview can be integrated into Ruby’s care, respecting her beliefs.
Emphasize the values of compassion, empathy, and non-judgmental care.

Conclusion

The video presentation focuses on promoting compassionate and collaborative mental health care for Ruby. It highlights the importance of therapeutic relationships, respecting consumer rights, and addressing her unique needs. By embracing these principles, healthcare professionals can contribute to Ruby’s recovery and well-being, fostering hope and healing in her journey towards mental wellness.