How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 33

This book is in B&W, not color - Print page in Grayscale for Correct view! 5. Nursing a patient with a severe psychotic illness About these Guidelines For general nurses and healthcare officers Nurses play a central role in the assessment and treatment of patients with severe, psychotic mental illnesses. Nursing such patients is a skilled job that requires special training. Sometimes, general nurses or healthcare officers without mental-health training may augment the care provided by mental-health nurses. This section provides information to help them to do that. It covers two topics. • Information about psychotic illness. • What a generalist nurse can do to contribute to assessment and treatment. It does not cover specialist topics such as how to assess hallucinations and delusions. Information about psychosis What is psychosis? The word psychosis is used to describe a broad range of mental disorders that affect the mind, where there has been some loss of contact with reality. These types of disorders can vary greatly, though certain types of symptoms are characteristic. They include unusual and often extremely distressing experiences such as the following. • Disturbances of thinking: thoughts become confused and may seem to speed up or slow down. Sentences are unclear or do not make sense. Patients may feel as if their thoughts are being put into their head and are not their own thoughts. They may have difficulty concentrating, following a conversation or remembering things. They may then appear to be unresponsive or uncooperative. • Delusions: false beliefs that seem real to the patient and are not amenable to logical argument. They are often very frightening. For example, a person may believe that their food is being poisoned. Common themes for delusional beliefs are persecution, punishment, grandiosity and religiosity. For example, someone acutely ill may believe that he is Jesus. • Hallucinations: patient sees, hears, feels, smells or tastes something that is not actually there. For example, they may hear voices that no one else can hear. Food may taste or smell as if it is bad or poisoned. Hearing voices is a very common symptom of schizophrenia. The hallucinations can range from occasional voices through to an almost constant barrage of derogatory comments from a large number of different voices. • Changed feelings: patients may feel strange and cut off from the world. Mood swings are common and patients may feel unusually excited or depressed. Their emotions may seem dampened — they feel less than they used to or show less emotion to those around them. Different types of psychotic disorder There are different types of psychotic illness. These include the following. • Substance-induced psychosis: use of, or withdrawal from, alcohol or drugs may be associated with the appearance of psychotic symptoms. Sometimes the symptoms remit as the effects of the substances wear off. Sometimes the illness lasts longer. It is possible for a patient to both have a more long-term psychotic illness and to misuse substances. It is not possible to tell from the symptoms alone whether someone has a substance-induced psychosis or whether they have another psychotic disorder. It is a mistake to think that because a prisoner is a drug user they cannot also have a severe psychotic illness such as schizophrenia. For [email protected] Property of Bookemon, do NOT distribute 35