Write a Discussion of main issues in relation to the MSE.
Write a Discussion of main issues in relation to the MSE.
With reference to the case presentation, discuss the approaches you
would apply to enable you to engage with, and undertake a Mental State
Examination for Annabelle. 1. Discussion of main issues in relation to
recovery- demonstrated exceptional knowledge and understanding of the
recovery approach. Drew upon excellent examples in its application. This
refers to the issues you would consider to enable you to undertake the
MSE 2. Discussion of main issues in relation to the MSE. Demonstrated
exceptional knowledge and understanding of assessment using relevant
components of the MSE. Draw upon excellent relevant examples in an
integrative manner. This refers to a discussion on the main aspect of
the MSE pertinent to the case presented. 3. Analysis of issues relating
to mental health. Extensive integration of credible and relevant
literature and evidence from a variety of sources to support discussions
and substantiate key points and ideas. What is referred to, include the
broader issues such as psychosocial, etc., that maybe of significance
in relation to mental health care. They may be embedded within the
discussions above, or separately if more appropriate. Introduction- case
study You are working on a busy Emergency Department (ED) as a newly
registered nurse. A young woman in her early adulthood presents at 0800
hours in the company of an older woman. The young woman is dressed in
dirty jeans and a T-shirt and is barefoot. Her hair is dyed blue and
pink but is unkempt and matted. She has a number of piercings in her
nose, eyebrow and lip. She is very tense and paces up and down the ED
corridor wringing her hands from time to time. She responds instantly to
any sounds or movements in the ED that alert her attention and her eyes
stare intensely either into the ceiling above or at staff members. Her
gaze and manner alternates between being intrigued to afraid to hostile.
She seems unable to sit still for any time at all and ignores the older
womans pleas to relax and sit by her side. She does however, follow the
ED bed coordinator to the bed/cubicle she has been allotted but insists
upon as much distance as she can get from any physical contact. The
young woman hesitates before entering the cubicle like she is about to
enter a trap. The older woman nurtures her carefully into the cubicle.
The bed coordinator leaves them and approaches you with a concerned
smile on her face Shes yours until the psych team gets around to her get
as many details as you can from the mother Interview preparation You
are given her medical record file. From this record you read that her
name is Annabelle and she is 22 years old. She lives in a nearby suburb
with her parents and her occupation is listed as being between studying.
She has no religion listed and she has never been married. You note
that the older woman accompanying her is indeed her mother. With her
file in hand you approach their cubicle Initial Interview As soon as you
enter the cubicle Annabelle looks intensely at the ceiling and then
suddenly glares at you. Her mother reassures her Annabelle Its all right
theyre here to help you You notice Annabelle wrings her hands and
begins to sweat. Her pupils are extremely dilated. After you introduce
yourself, the mother asks if she can talk to you alone. You agree. She
tells you Annabelle hasnt been herself since dropping out of university
where she studied nursing 12 months ago. She has lost contact gradually
with nearly all of her friends and become increasingly isolated
listening to loud music in her bedroom and refusing to discuss her
situation with either of her parents. Over the last three months her
behavior has become increasingly odd and erratic. She spends increasing
periods in her room alone but also goes out, sometimes for days at a
time. She never lets her parents know where she goes, with whom or what
she does. She comes home disheveled and dirty. She has lost a lot of
weight over the past few months and often doesnt eat for a day or two.
Recently, she has been heard talking loudly to herself in her room and
over the past week she has been shouting as if at someone but she is
alone. On one occasion when she returned from one of her walkabouts she
was accompanied by a strange young man who had dreadlocks but refused to
come inside when invited. He hung around the house for a few hours but
left when he was approached by Annabelles father. The past week has been
especially difficult. Annabelle has not slept nor has eaten or taken
fluids enough to sustain her. Over the past two days she has started
pacing and wringing her hands and behaving as if she is constantly in
danger. Last night she burst out of her bedroom and screamed
incomprehensibly at her father then stopped suddenly and went back into
her room. It took her mother until this morning to coax Annabelle into
visiting the hospital with her. Her mother begs you for some help. You
decide to approach Annabelle to ask her some questions and decide to
interview her alone. You show her mother to where she can have a cup of
tea while you do this. When you return to Annabelles cubicle, she is
smiling at you. Then looks up to the ceiling terrified. She mutters to
herself and then smiles again, this time to herself, before she says to
you: Why am I here???!!! You wont tell her anything will you? You begin
to tell her that her treatment here is confidential but she interrupts:
You know dont you? You know its in my veins! Annabelle stares intensely
up and down her arms. Her arms are covered in sores that she is
constantly picking at. Before you can answer she adds, Theyre
everywhere. Everywhereunder my skin! Everyone of us is falling the
whole planet is falling! She begins to giggle to herself. Then she looks
up at the ceiling once more Shut up, shut up, shut up!!!!!!! then
distressed, proceeds to scream and hold her ears as if to block a loud
noise Suddenly there is a security guard and two nurse colleagues by
your side. Annabelle stops screaming and slides down the wall saying to
you: Forgive me! Forgive me! I never meant to hurt anybody please
forgive me? You ask her: Forgive you for what, Annabelle? What have you
done? She looks up at the ceiling intensely and then back at you: Cant
you hear what theyre saying?! All the children have been hurt She slumps
to the floor and begins to sob in both distress and despair
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