Supporting Medication Adherence and Boundaries in Mental Health Nursing: A Case Study

QUESTION

Aaron Livet is an 18-year-old male, who was admitted a few weeks ago to a
mental health unit for stabilization after suffering his first psychotic
episode.
From his clinical chart you learn that Aaron had recently enrolled in a
Journalism program at the local community college. It is noted in his
records that Aaron’s friends recounted they had noticed him become more
socially withdrawn over the last semester with increased demonstrations of
‘odd’ behavior. Prior to this admission, Aaron had been telling his friends
that he was the son of God and his role in life was to “fight the Devil”.
Aaron was brought to the emergency department for psychiatric
assessment by city police after he was found running through the streets
without clothes at 2AM in the middle of February.
You are the pre-graduate PN student working on the

where Aaron is admitted. Over the course of a few weeks, you work with
Aaron in his recovery and notice significant improvements in his insight and
mental status. A few days prior to this discharge, Aaron verbally requests
to add you to his Facebook friends list so you both can keep in touch after
he is discharged. Similarly, he confides in you that he plans to discontinue
his medications as soon as he is discharged from hospital because “pills are
not effective for the son of God”.

ANSWER

Supporting Medication Adherence and Boundaries in Mental Health Nursing: A Case Study

Introduction

This case study focuses on Aaron Livet, an 18-year-old male who was admitted to a mental health unit following his first psychotic episode. As a pre-graduate PN student, the nurse’s role is crucial in supporting Aaron’s recovery, promoting medication adherence, and maintaining professional boundaries. This essay will explore strategies to address medication non-adherence while respecting Aaron’s beliefs and ensuring appropriate nurse-patient boundaries.

Importance of Medication Adherence

Medication adherence plays a vital role in managing mental health conditions. It helps stabilize symptoms, prevent relapses, and enhance overall well-being (Naslund et al., 2019). For Aaron, continuing his medication regimen after discharge is crucial for maintaining stability and preventing further psychotic episodes.

 Understanding Aaron’s Perspective

To address Aaron’s belief that “pills are not effective for the son of God,” it is essential to approach the situation with empathy and respect for his personal beliefs and values. Nurses should engage in active listening and open dialogue to understand Aaron’s perspective fully.

Psychoeducation and Collaborative Decision-making

The nurse can provide psychoeducation about the benefits of medication in managing mental health conditions. By explaining how medication helps stabilize brain chemistry and control symptoms, the nurse can foster a collaborative decision-making process with Aaron. This approach empowers him to take an active role in his treatment while considering evidence-based practices.

Cultivating Therapeutic Relationships

Establishing a therapeutic relationship based on trust, respect, and empathy is fundamental in mental health nursing. The nurse should continue to develop a therapeutic rapport with Aaron, reinforcing the importance of medication adherence while validating his beliefs and experiences.

Discussing Potential Consequences

In a non-confrontational manner, the nurse can discuss potential consequences of discontinuing medication. This can include explaining the risk of symptom recurrence, the impact on daily functioning, and the importance of maintaining stability for achieving personal goals such as academic success.

Encouraging Ongoing Support

Assure Aaron that he will continue to receive support after discharge. Emphasize the availability of outpatient services, such as counseling, therapy, and community resources. Discuss the benefits of a holistic approach to mental health, including therapy, self-care, and healthy coping strategies.

Establishing Professional Boundaries

While maintaining a therapeutic relationship, it is essential for the nurse to establish professional boundaries. Accepting friend requests on social media platforms can blur these boundaries and potentially compromise the nurse’s objectivity and professionalism. Instead, offer alternative means of communication, such as providing contact information for appropriate follow-up.

Conclusion

Supporting medication adherence and maintaining professional boundaries are essential aspects of mental health nursing. In the case of Aaron Livet, the nurse can promote medication adherence by engaging in psychoeducation, collaborative decision-making, and discussions about potential consequences. By cultivating a therapeutic relationship and providing ongoing support, the nurse can help Aaron understand the importance of medication while respecting his beliefs. Additionally, establishing clear professional boundaries ensures the nurse-patient relationship remains focused on Aaron’s well-being and recovery.