Question

Nate is a student nurse assigned to shadow Juanita, an RN working in the psychiatric unit of a local hospital. As they start their shift, Juanita gives Nate a brief history of their first patient. Darlene Fultz has been diagnosed with dissociative amnesia. Ms. Fultz was brought to the hospital by a police officer who had responded to a complaint that she was loitering in a local shop. When the officer questioned her, Ms. Fultz seemed very confused and could not identify herself. According to the officer, she “didn’t seem to know who she was, where she was, or why.” Ms. Fultz was identified by a driver’s license in the purse she was carrying, but she denied any knowledge of being Darlene Fultz.

         In the few days since the patient was admitted, she has been positively identified as Darlene Fultz by her sister, Julianne Berg. According to the sister, Ms. Fultz was married, but she and her husband divorced about a year ago, not long after the couple’s only child, a 6-year-old son, was killed when the car Ms. Fultz was driving collided head-on with another vehicle. Ms. Fultz’s husband told the sister that his wife had taken an overdose of sleeping pills a few months after their son’s death. After that, he tried to help her, but it was too difficult for both of them. Apparently, the two sisters are not close, although Ms. Berg says she has tried to stay in touch. Since the divorce, however, Ms. Fultz had become depressed, anxious, and increasingly distant, and the sisters had rarely communicated.

         Nate, who has been listening in stunned silence, says, “What a sad story. Has she remembered her family or the accident or anything else about her life?”

         “Not yet,” replies Juanita. “She has daily sessions with a therapist, but they haven’t delved into her repressed memories yet.”

         “Why not?” asks Nate. “It seems like someone should tell this patient what’s happened to her as soon as possible before she’s too far gone to ever remember. Shouldn’t they already be working on recovering her memories and integrating her identity?”

         “Whoa, slow down,” Juanita says gently. “First, think through the nursing process for this condition. Based on what I’ve told you, are we at the ‘integration’ phase yet? And second, remember that dissociative amnesia isn’t all bad. Right?”

1.      What is your opinion of the conversation between Juanita and Nate? Is Nate’s idea about disclosing all known information to Ms. Fultz appropriate? Why or why not? If not, what would be more appropriate? Do you think Juanita was just kidding when she said that “dissociative amnesia isn’t all bad”? If not, what do you think she meant by that?

2.      Juanita said that Ms. Fultz was not in the integrative phase yet. How does she know that? (Remember to base your answers on your knowledge of the nursing process for this condition.)

Answer 1

1, sharing appropriate and particular information about the patient when taking care of the patient is safe and provide effective care. multidisciplinary teamwork and information sharing make nurse staff provide emphasis on integrated care. dissociative amnesia is the loss of all memory of patient events and information. she meant that it is not all bad is that we can prevent and resolve these issues by preventing further trauma in the future. due to stressful or traumatic events that make the person to unable to remember their personal information.
2, Integrative phase is a character that person can able to manage their psychological illness by their own control with regaining memory, perception, consciousness, an emotion that bound to stress and events. ms.fultz was out of control her ability she is very confused and can not identify her self to bound to stress. her ability to integrative phase is not yet met.