Question

Behavior in Overdrive”- Case study

Connie is a 35-year-old woman who is diagnosed with bipolar disorder. She is brought to the psychiatric unit after being detained in the county jail for disruptive behavior. In the present manic state, Connie is aggressive both verbally and physically. She has just removed all of her clothing in the hallway while loudly inviting male attention. She has not sat down in the 6 hours she has been on the unit nor has she eaten any food. She claims she is “Queen of the Nile in the body of a shark.” Several of the other clients appear anxious and fearful they observe her behavior.

What critical thinking is needed to begin a therapeutic relationship with Connie?

How could limit setting be used to manage Connie’s behavior?

Answer 1

Things to be kept in mind while managing  with a aggressive bipolar client in limited settings;

Deal the client with  care, judgement free and self-control method.

• Remain calm, listen to what they are saying, ask open-ended questions.
• Reassure them and acknowledge their grievances.
• Provide them with an opportunity to explain what has angered them. Understanding the source of their frustration may help you find a solution.
• Maintain eye contact, but not prolonged.
• Keep an adequate distance from the patient, but keep away from corners. It is helpful if the furniture in your room is arranged in such a way that you can easily leave, but the patient doesn't feel trapped.
• If the patient has a weapon, ask them to put it down. Don't ask them to hand it over.
• Use the panic button or call for help.
• Leave the room and call security or the police.
• If possible, move the patient to an area away from public view.

The steps of the nursing process are assessment, diagnosis, planning, implementation, evaluation. The health care is setting the priorities of the day to apply critical thinking . Each nurse seeks awareness of reasoning as he/she applies the criteria and considerations and as thinking evolves .Critical thinking in nursing is a purposeful, logical process which results in powerful patient outcomes. The critical thinking nurse has an open mind and draws heavily upon evidence-based research and past clinical experiences to solve patient problems.

The critical thinking skills that is needed to begin a therapuetic relationship with Connie are:

observation- observe Connie behaviour carefully

analysis-identify the problem and analyse how to deal with it in Connie case.

interpretation-try to co-relate and interpretated the situation .

inference- Put Connie in a enviroment friendly safe place away from public view

communication- establish communication with Connie by establishing acceptance and acknowledgement of thier grievences.

explanation-give Connie a chance to ventilate herself as to what made her angery.

self-regulation-the nurse must have self control and provide care with a non judgemental mind , keeping herself protected from Conniie .

open-mindedness- help Conne to daily ventilate herself of her emotions, desires, ambitions . fill her mind with positive vibes by listening to music , drawing and bringing out Connie's inner talent and appreciating her for the same.

problem-solving- providing her the correct treatment and therapy to come out of this situation.