Stacy Smith is a 28 year-old, single, black female who comes to the Employee Health Clinic
complaining of a migraine headache and fatigue. She has been an employee in the Information Technology Department for the past 6 years, having started immediately after graduating with honors from college. She is currently working as an interim department manager while her supervisor is out on medical leave. She lives alone in her own apartment, she often spends time by herself and stopped going to the gym saying “ I used to go to the gym 4 times a week but I don’t have any interest or motivation togo anymore”. She used to eat healthy foods but is eating a lot of fast food and has gained 10 pounds in the last month. Although she has experienced migraines on occasion in the past, they are now having more frequently (1-2 per week) and are becoming more severe (7/10 on a self-report of pain accompanied by nausea and light sensitivity). She has been feeling extremely stressed and fears being unable to cope with the responsibilities of her job. She has had several recent conflicts with the employees under her supervision. She is having increasing trouble sleeping and has recently begun to have 2 or 3 glasses of wine before going to bed every night. She feels edgy and destressed and wants to be given “something like Ativan” to help calm her nerves and get her through the day. She has no other medical problems and no known allergies.
Objectives
How would you communicate with a distraught client like Stacey? What communication techniques would be effective and why?
Stacey is diagnosed with a Major Depressive Disorder? Enumerate the signs and symptoms to support this diagnosis.
Complete the substance abuse assessment on the “hypothetical client” using the CAGE Questionnaire. (See questionnaire next page).
Complete the Zung Self-Rating Depression on a “hypothetical client” (See questionnaire next page).
What are the non-pharmacological interventions would you use to reduce the clients level of stress and why?
What are the psycho-pharmacological interventions for Stacey’s diagnosis (major depression), write the indication, side effects, adverse effects and nursing consideration.
Clients like Stacey can be communicated with simple communication techniques. A calm and warm approach will help a lot. Allowing her to ventilate her feelings and all the emotions she carries which is troubling her during work and causing mental stress. Following are few communication techniques which will be effective in this case:
1) Active Listening– Being attentive to what the client is saying, verbally and non-verbally can help the nurse as well as the client in communication.
2) Empathy– The ability to understand and accept another person’s reality, to accurately perceive feelings, and to communicate understanding. Example here the nurse can start this way “It must be very frustrating to know about the level of stress you are facing these days and how you are unable to cope with the office responsibilities."
3) Sharing Feelings– Nurses can help clients express emotions by making observations, acknowledging feelings, and encouraging communication, giving permission to express “negative” feelings and modeling healthy anger.
4) Silence- Not all shared feelings need reply. Some circumstances render silence more appropriate than the most carefully crafted set of words for a response. This slows down the conversation and provides client some time for contemplation and reflection for what he just shared. This may provoke anxiety on the nurse’s part, but this proves to be beneficial as this allow clients to collect their thoughts. They can refocus clients by helping them to the part where they left off or to ask them what they are thinking. This is also the perfect time to assess non-verbal gestures.
5) Reflecting- Patients often ask nurses for advice about what they should do about particular problems or in specific situations. Nurses can ask patients what they think they should do, which encourages patients to be accountable for their own actions and helps them come up with solutions themselves.
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Signs and symptoms of major depressive disorders are :
Trouble thinking, concentrating, making decisions
Sleep disturbances
Anger outbursts
Irritability or frustration, even over small matters
Unexplained physical problems, such as back pain or headaches etc.
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no questionaire is provided here, provide questionaire.
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Sadness is a natural part of the human experience. People may feel sad or depressed when a loved one passes away or when they’re going through a life challenge, such as a divorce or serious illness. However, these feelings are normally short-lived. When someone experiences persistent and intense feelings of sadness for extended periods of time, then they may have major depressive disorder (MDD).
Stacy Smith is a 28 year-old, single, black female who comes to the Employee Health Clinic...
Stacy Smith is a 28-year-old, single, black female who comes to the Employee Health Clinic complaining of a migraine headache and fatigue. She has been an employee in the Information Technology Department for the past 6 years, having started immediately after graduating with honors from college. She is currently working as an interim department manager while her supervisor is out on medical leave. She lives alone in her own apartment, she often spends time by herself and stopped going to...
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