Assignment 1: Practicum Journal: Voluntary and Involuntary Commitment

PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice.

In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.

Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?

Learning Objectives

Students will:

• Evaluate clients for voluntary commitment
• Evaluate clients for involuntary commitment based on state laws
• Recommend actions for supporting parents of clients not eligible for involuntary commitment
• Recommend actions for treating clients not eligible for involuntary commitment

To Prepare for this Practicum:

• Review the Learning Resources concerning voluntary and involuntary commitment.
• Read the Week 7 Scenario in your Learning Resources.
• Research your state’s laws concerning voluntary and involuntary commitment.

The Assignment (2–3 pages):

• Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?
• Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.
• Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.
• If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.
• If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.

Assignment-2 slides of power point only

1. U tube video link on power point

2. 2 Slides  power point. only.

3. Pictures and be creative

4. Please use pathophysiology

5. Add pictures of diseases.

6. Samples of power point attached

1. Keep it simple and make sure that the content that your are covering demonstrates to me that you understand the impact of the pathophysiological process that you are trying to educate your ‘patient about”. As a Nurse Practitioner you will on a daily basis be explaining complex diseases for your patients and it is imperative that you educate the patient with the underlying cause, outcomes and impact on their lives using the foundation pathophysiology as your guide.

BEFORE SUBMITTING the make absolutely certain that your that your work contains:

1. Some information of interest about the disorder could historical facts
2. A description of the manifestations of the disorder with an explanation as to the cause of these manifestations (MAKE SURE THAT YOUR EXPLANATION OF THE CAUSE OF THE MANIFESTATIONS IS PRESENTED USING PATHO TO EXPLAIN WHY!!!).
3. A description of the abnormal diagnostic testing with a discussion of the causes of the abnormal test results (MAKE SURE THAT THE CAUSES OF THE ABNORMAL DIAGNOSTIC TESTING IS PRESENTED USING PATHO TO EXPLAIN WHY!!!)

A discussion of the treatment plan and/alternative therapies with potential expectations of the treatment plan etc.

1. A discussion of the specific information patients who have the selected disorder need to know (make sure this is evidence-based information where applicable)

Reflective Journal

Learners are required to maintain a reflective journal integrating leadership and inquiry into current practice.

In your journal, reflect on the personal knowledge and skills gained in the this course and address a variable combination of the following: new practice approaches, intraprofessional collaboration, health care delivery and clinical systems, ethical considerations in health care, population health concerns, the role of technology in improving health care outcomes, health policy, leadership and economic models, and/or health disparities. Outline what you have discovered about your professional practice, personal strengths and weaknesses that have surfaced, what additional resources and abilities could be introduced to a given situation to influence optimal outcomes, and finally how you met the competencies aligned to this course.

Using the schoo website ……. or the Internet, research about power sources for a nurse leader. Based on your understanding, answer the following questions:

1. In your opinion, what are the three most important power sources for a nurse leader? Why?
2. How are they best used in a leadership role? Describe.
3. What sources of power do you see most often displayed in your work environment? Why?

4 postsRe: Topic 2 DQ 1

There are many factors that influence the heath of an individual or the population. In a broad term one of this factor is termed Social Determinants of Health (SDOH). SDOH are the complex circumstances where people are born, live, grow, play learn, worship, work and age (heathy people. Gov, 2018a; World Health Organization, n.d.). In order words, these are broad range of personal, social, economic and environmental factors. The determinants are about individual place in society, this includes income level, educational level and type of employment. Over the years group of people have experienced racism, discrimination and historical events such as the black people. These experiences have detrimental effects on the health care needs of these group of people. SDOH is the main factor responsible for today’s major health problems in society including depression, hearth disease, diabetes and obesity (What are the Social Determinants of Health? 2018).

There are complex interactions between the SDOH. For example, low income will have direct impact on the individual or community accessibility to proper health care, lack of good food and thus increasing the burden on the individual or family. This burden is often translated into poor coping mechanism in the form of drug use and sometimes comfort eating of unhealthy food. Poor health can reduce the individual opportunities to have meaningful employment which in turn impact on the individual’s income. These factors interplay with each other and have a positive or negative effect on the overall health of the individual or population.

A communicable disease chain is the process by which pathogen of infectious agent is transmitted to another organism (Green, 2018). This model of communicable disease chain is presented by six links, infectious agent, susceptible host, reservoir, portal of entry, mode of transmission and portal of exist (Break the Chain of Infection, n.d.). All these elements most be presence for the spread of communicable disease in a population. To stop the spread of disease is by breaking the chain at any link.

Nurses are in better position in breaking the chain of infection because they are involved at all levels of prevention (Institute for Work and Health, 2015) The nurse can use preventive measures or health education that are aimed at breaking the chain and reducing the risks of infections in other people. These measures include adhering to proper hygiene measures (WHO, 2018). For example, in the case of contact precautions, nurses should always use the appropriate personal protective equipment disposed of immediately after attending the patient to protect the nurse and other patients from getting infection.