Nursing Interventions for Schizophrenia

Nursing Interventions for Schizophrenia Schizophrenia is a severe mental illness in which individuals loose the ability to discriminate between reality and imagination, characterized by disturbances to their thoughts, behavior and feelings. About 1% of the population is predicted to suffer from schizophrenia at some point in their life (www.rethink.org), with experience of psychotic episodes such as those of schizophrenia ranging in their duration of a single crisis, to the chronic experience of schizophrenia over a life time. During episodes of schizophrenia, patients will experience a range of what is know as positive and negative symptoms associated with the condition. Positive symptoms include delusions and hallucinations and unusual or irrational behavior (often as a result of the hallucinations and delusions). Delusions can be defined as strange thoughts or beliefs which are not founded in reality, some examples include delusions of grandeur (such as believing oneself to be the next messiah) and delusions of persecution (as in being secretly watched / followed by the police or secret service). Hallucinations are when you see (visual) hear (auditory) or smell (olfactory) things that others cannot. One of the most well known symptoms of schizophrenia is that of hearing voices. People may also experience thought disturbances such as thought jumping (going from one line of thought to another in rapid succession) poor concentration and attention abilities (www.mind.org.uk). Negative symptoms are those which in some way take away from the individual such as anhedonia (not getting pleasure out of activities which were previously pleasurable) and social withdrawal from social situations and a lack of interest in personal hygiene (such as not washing or changing clothes). Treatment of individuals with schizophrenia can be in hospital (forced through section or voluntarily in some cases) and in community settings, and should involve a mixture of pharmacological treatment (typical and atypical antipsychotic medications) and psychological therapies such as cognitive behavioral therapy (CBT) in order to manage current symptoms, and in preventing and minimizing future relapse and crises. Nursing of individuals with a severe mental illness such as schizophrenia within a community setting (e.g. after discharge from hospital or when patients not under section and do not want to go to hospital) will be conducted by a community psychiatric nurse (CPN) who will often be working within a community mental health team (CMHT) from a care programme approach. The role of the CPN has diversified over recent years, and is now often nominated within the CMHT to act as the individuals key worker (i.e. who the patient will have most contact with in the CMHT). CPNs can be seen to be involved in patient care interventions in a number of capacities. The most predominant (and traditional) intervention role of the CPN may be seen in the medication management of people with schizophrenia. Typical (haloperidol) and atypical (aripiprazole, olanzapine etc) antipsychotic medication use now mean that around 70% of patients will experience some degree of relief to their psychotic symptoms (McCann, 2001). However relief is most often not absolute and the majority of patients will experience some form of side effects. In typical (older generation drugs) this is often in terms of extrapyramidal symptoms (EPS) such as movement disorders like Tardive Dyskinsia, and although newer atypical drugs are renowned for less EPS, side effects can include weight gain, sexual dysfunction and sedation. CPNs are therefore an important contact with the patient in ensuring that they are taking their medication correctly, and in identifying patients who may be experiencing high levels of side effects who as a result are at a high risk of discontinuing their medications. By identifying such individuals, relapse can be minimized by helping the patient to engage with clinical services to investigate other medication options of which there are a good number. Switching is a term used by professionals to define this process and it is not unusual for patients to have to switch between medications a number of times, before finding the most appropriate drug / combination. Dosage required is also a very individual factor, and therefore an important aspect of medication management is to check to signs that dosage is high enough to enable clinical relief, but also low enough to minimize side effects. CPNs are thus often in a position to recognize if their patients are not on high enough dosages. The way in which medication is administered will also differ between patients some may be able to take their drugs orally, but a number of patients with schizophrenia are on a form of drug administration called depots. These are long-lasting injections of the antipsychotic, and are often used for patients who suffer severe episodes and those who have a history of non-compliance in taking their medication (Jackson-Koku, 2001). CPNs may also act in helping people come to terms with the fact that they are suffering from an illness, as denial is common in those mental illnesses such as schizophrenia (Fung Fry, 1999), often referred to as lacking insight into illness, and so discuss the need for taking their medications. Providing medication related information is therefore an important part of the medication interventions that nurses are involved with, and will often include discussions about side effects, recognizing early signs of illness and other concerns the person may have. Nurses are however becoming increasingly involved in psycho-educational (Fung Fry, 1999) and psychological therapy (McCann, 2001) based interventions in their patient care within community settings for sufferers and their families. Such approaches have in the literature, been described as aiming at increasing social functioning, decreasing distress, and reducing hospital admission rates (Tarrier Birchwood, 1995) These educational interventions are so targeted on helping to reduce distress in more drug-resistant cases, to help both sufferers and their family (Leff et al, 2001) deal with the illness and learn the signs of relapse and symptom return, and as mentioned above, in increasing medication compliance through better understanding and information. (McCann, 2001) Psychological therapies such as CBT and cognitive therapy (CT) have found recognized success in treating many mental illnesses including schizophrenia including when used within community settings (Morrison et al, 2004), as are aimed at helping people deal emotionally with their illness and its associated distress, but also to help on a practical level through promoting relapse prevention strategies and reducing social disability (Fowler, Garety Kuipers, 1995) Coping techniques and strategies can also be discussed when CPNs become aware and gain knowledge into what particular symptoms are causing people most distress. One example of this could be distraction techniques discussed with those who are having problems with auditory hallucinations; one method that is known for helping many people with this is to listen to music. CPNs often also play an important counseling role to those they support (royal college of psychiatrists,1997). Acting as key workers for people with schizophrenia gives many CPNs the opportunity to get to know the person, and so are in a position to use the discussions they have with their patients in an intervention capacity. Counseling may help in anxiety and distress reduction, but also will provide invaluable insight for the CPN into what the person is going through, how much they understand and whether they are doing well or becoming ill. All this information will play a crucial role in the assessment capacity that the CPN also performs within the care programme. CPNs are thus seen to be involved in many aspects of peoples outpatient care in community settings. Especially involved in medication, information and more recently psychosocial and psychological interventions, nurses looking after people with schizophrenia within the community are central to the patients care programme, and act as an invaluable access into mental health services (McCann Clark, 2003) for community patients.

The Lamb and The Tiger by William Blake Essay -- Poet Poems William Bl

'The Lamb' and 'The Tiger' by William Blake Write about The Lamb and The Tiger by William Blake. Explain how the poet portrays these creatures and comment on what you consider to be the main ideas and attitudes of the poet. 'All things bright and beautiful, All creatures great and small, All things wise and wonderful, The Lord God made them all.' Cecil Frances Alexander Indeed, God created all creatures great and small, and he could not have created two creatures more different from each other than the lamb and the tiger. The question arises in one's mind therefore: - 'Could one creator design and give life to two exhibits of such a vast contrast?' ====================================================================== William Blake certainly poses this question in a somewhat clever manner in the two examples of his work that I've analysed and compared, namely 'The Lamb' and 'The Tiger'. In the two collections of his work, namely Songs of Innocence and Songs of Experience, he has several contrasting poems that bring the two states of being described by both collections under the microscope. As one of the early Romance poets, Blake was writing in opposition to the rapidly changing, revolutionary eighteenth-century. Essentially, that opposition developed into an appreciation of the emotions, as opposed to reason ant intellect, and a recognition of the purity and innocence which childhood represents in contrast with the corruptions and in-authenticity of adulthood, with its learning and experience of life. The English Industrial Revolution played a very influential role in William Blake's work. Songs of Innocence includes a reversal of the expected 'hierarchies'. The poems reject t... ...ecessary self-knowledge. The Lamb develops into the Tiger - innocence is the price that must me paid to attain an identity in 'grown-up land'. It has to sacrifice its meek, mild, gentile innocence to become the Tiger of Experience prowling the 'dark forests' of life. In conclusion, I feel William Blake is attempting to transmit an important message: never mind how innocent we are during our naÃÆ'Â ¯ve, happy playground days, the big bad world is awaiting us all, and we have to stop resisting and accept that we're all going to develop into Tigers at some point - gaining our own unique symmetry in place of our soft, delightful, tender selves. Life past, present and future poses many questions - it's up to us to answer them, to discover our true identities, and to decide where exactly our faith lies. Innocence is the foundation upon which experience is built.

Marriage and How It Has Changed Essay

Marriage has gone through profound changes over the last five decades, but we continue to speak about it as though it’s the same old familiar pattern. To see how much has changed; I am going to look at the shift from the forties, to the sixties, to today. In 1968, less than a year after the famous Summer of Love, as they used to say out in the country, â€Å"The times they were a-changing.† The sexual revolution, Viet Nam, drugs–the youth of the day were convinced the world would never be the same again. Yet they didn’t think about how such changes would affect marriage. It seemed as if they thought it would be about the same as it had been for their parents, except better because they (like most youth of most times) thought they were better than their gray and jaded parents that represented the â€Å"American Gothic† portrayed that day. No matter how you describe it, it was a powerfully attractive vision. The average age at which Americans got married dropped drastically, to just 19 for women. The number of children soared higher than it had for decades, to a peak of 3.7 children per woman in 1957. The goal back then was domesticity, and both partners worked for it–one to earn the pay, the other to make the home. If a man was a good provider, if he didn’t drink or beat his wife, if he was a â€Å"good father† to his children, he was a good husband. A good wife had to be a decent cook and housekeeper, take care of the children and provide emotional support to her husband. Polls taken during that time show that more than 90 percent of people could not imagine an unmarried person being happy. When asked what they thought they had given up for marriage and family, most women said, â€Å"Nothing.† Since the fifties, we’ve chased personal happiness, career and self-fulfillment and assumed that marriage and family would somehow fit in. One sign of this shift is the percentage of couples who say they would stay together â€Å"for the sake of the children,† which sank from about 50 to 20 between 1962 and 1977. We’ve lost something else, something far more surprising: the pure sexual drama of marriage. In Goin’ to the Chapel: Dreams of Love, Realities of Marriage, Charlotte Mayerson describes some startling discoveries about the Ozzie and Harriet generation. While talking in-depth to 100 middle-class women of all ages about their marriages, she  found that those who enjoyed a passionate sexual relationship with their husbands were almost certain to have come of age in the fifties. In contrast, sex just wasn’t that important for younger women. â€Å"Time and time again, the younger women say, ‘On a scale of one to ten, sex, I would say, gets a three,'† Mayerson writes. â€Å"These younger women had plenty of sexual relationships before they married, and the thrill was gone before the wedding day. For many older women, however, the excitement of sex had been a reason to marry, and the passion remained.† Those â€Å"Ozzie and Harriet† marriages, Mayerson suggests, could be considerably more passionate than those that have come since the Sexual Revolution. Baby boomers didn’t rebel against domesticity, they just took it for granted. Marriage wasn’t a treasure for which they worked and sacrificed, they thought of it as an adventure that happened because you fell in love; and it competed with other adventures–sex, travel, success, saving the planet. Today, the fifties serve as an ideological battleground. For conservatives who regret the changes that have come, those years are a reminder of the good old days. For liberals who push society to escape oppressive patriarchal arrangements, they are a dreaded Dark Ages. Their constant cry is, â€Å"We can’t go back to the fifties!† Indeed, we can’t. But we would do well to recognize what we’ve lost and might regain. We’ve lost the emphasis on marriage and children that provided so much stability. Back then, a man’s career was to provide for the family, not his ego; a woman’s ambitions were put on the shelf if they conflicted with the children’s needs. That was certainly restrictive to some, but it created a strong social fabric. Since the fifties, we’ve chased personal happiness, career and self-fulfillment and assumed that marriage and family would somehow fit in. The situation is hardly hopeless. After all, if something like half of all marriages ends in divorce, that means the other half don’t. We can’t guarantee that our children will succeed, but we can certainly prepare them and support them to be numbered among the successful. For previous generations, marriage was an inevitable destination. It didn’t take any special intention; it was a stage in life. For the ’00 generation, marriage  will have to be a much more intentional act. They need encouragement, they need mentors, and most of all they need straight talk. We must ask them: â€Å"Do you know what you’re doing? Are you prepared to make this a success?† We often hear that if we do not learn from the past, we are bound to relive it. In my opinion, it is certainly something that wouldn’t hurt us a single bit in this particular situation. Works Cited Mayerson, Charlotte. Goin’ To the Chapel; Dreams of Love, Realities of Marriage. 1996. Basic Press

Evaluating The Theories Of Learning Essay - 1704 Words

This paper was chosen because it is significant to evaluate the theories of learning taught by very important psychologist, and the different ways they can be applied to life. It is also noteworthy to state that the techniques of these theories differ from one psychologist to another. Correspondingly, this author believes there are several ways that people can be reinforced in the process of learning. This lesson covers the definition of learning, different types of learning, and, also, discusses learning styles. Furthermore, the author will similarly focus on illustrating and describing how individuals can apply the latter in a biblical aspect. Ultimately, after reading this paper, the reader should have a better insight into the process of learning in which an individual experiences permanent, lasting changes in knowledge, behaviors, and ways of processing the world. Significant Theories of Learning Fact: Jessica was the receptionist at Unity Nursing Home. She is a very joyful and friendly person and an immense asset to the facility. Recently, she was promoted to the Admission Assistant position. She felt very excited and eager, but at the same time, she was apprehensive. Despite her worries, Jessica decided to embrace the opportunity given to her and transitioned into her new role. After just two months in her new position, her supervisor unexpectedly resigned, leaving Jessica with an incomplete training and a lot more responsibility that she bargained for. AlthoughShow MoreRelatedOnline Learning : Online Learners And Evaluating Their Learning Characteristics From The Perspective Of The Adult Learning Theory Essay1384 Words   |  6 PagesIntroduction: Online learning, as a newly emerged platform to access to higher education, has become prevalent in China in the past years. Some scholars think highly of this form of education and believe that it will finally lead to a revolution of education. 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