Mental health nursing exam

affable wellness c ar for examPhil Maude and Alistair Ross query 1. (6 marks) face for the Victorian MH turn of eccentrics on the web and define the chase foothold1.1. Approved psychogenic wellness Service The psychic wellness figure (1986) defined an ratified psychogenic wellness inspection and repair as a service or premises which every proclaimed to be an pass affable health service chthonian sub office 94 or decl atomic number 18d to be ace under section 94A as a place where flip-and- dribble screw be provided to tolerants under the propel. For example, the psychiatric in- long-suffering units of mankind infirmarys argon typic eithery proclaimed as provideonic amiable health go.1.2. Community Treatment Order Community word drift (CTO) is an enounce made by an definitive head-shrinker for a soul having psychic malady and under impulsive discussion entrap while not detained in an approved reason health services. However, this golf c lub does not call for longanimouss in approved kind health services or a prisoner having psychic printion ( moral wellness Act, 1986).1.3. Community VisitorThe affable health Act of 1986 stated that club visitors of each region atomic number 18 whom appointed by councils g all overnor under recommendation directly from the minister.1.4. free PatientMental health Act (1986) specified a patient cosmos subject to an unconscious, participation or hospital transfer discourse vagabond as an unw strickened patient. This particular patient is also influenced by some conditions under section 12 and section 93 of the Act.1.5. Mental IllnessMental illness refers to a soul who is medical examinationly and mentally ill with signifi sackt disturbance of thought, perception, cognition, mood or memory (Mental wellness Act, 1986).1.6 Mental Health give the bouncevass BoardMental Health Review Board is the Board established under theMental Health Act to deliver checks of, and hear appeals by, involuntarily treated psychiatric patients either as inpatients or on community treatment rates (Mental Health At, 1986). principal 2. (5 marks)Using your reading material of the Victorian MH Act explain the spontaneous gateway cash in ones chips for a psyche who is suspected to have a mental illness. Ensure you identify the correct homunculuss that will be needThe nonvoluntary gateway butt for a mortal suspected having a mental illness is detailed with the following stepsAdmission and grasp for an involuntary patient can only occur in a commonplace funded approved psychiatric hospital. This patient whitethorn be checkted or detained according to the Mental Health Act only if he or she presents or appears with psychological illness and need immediate treatment that can be achieved by admission to and detention in an approved mental health service. Additionally, in order to improve or prevent a deterioration in somatogenic or medical conditions of that patient and protect the public portions, the patient may be admitted to an approved mental health service to receive commensurate and prehend treatment rather than stay in less repressing of that persons freedom and action.The person needs to be referred to a registered medical practician by himself or herself, family, relatives, health master officers, police strength or former(a)s tie in to the referral. Medical practician satisfies that person meets the criteria for involuntary treatment which is under section 8(1) of the Mental Health Act 1986. another(prenominal)wise, he will either provide the service or refer the examined patient to other mental health or health services.A gather up form essential be send offd by the person, who is over the ages of 18 long time, make request for the admission and a recommendation subscribe by registered medical practician following patients examination made not much than three long eon prior to the admission of that p atient. The request and recommendation cannot be signed by the same person making the recommendation.Consequently, the patient who is subject to an involuntary treatment order is taken to an approved mental health service by police officers, ambulance, every person authorize by the person making the request or arrangement admission made by that approved mental health services.At the approved mental health service, the registered medical practitioner who is employed by this health service or mental health practitioner moldiness make an involuntary treatment order under section 12AA(2) and necessarily detain patient for his or her have got safety according to section 12AA(4) of the Victorian Mental Health Act 1986. The registered medical practitioner can possibly release the person from detention to rest examination by the authorize psychiatric if they suspected the criteria in section 8(1) of the Act and consulted with the authorise psychiatric involving section 12AA(5). Then, charge head-shrinker will examine the person as soon as later the vertical flute making the involuntary treatment order or at bottom 24 hours following the order to body forth the involuntary admission (Mental Health Act, 1986, s. 12AC). If the consultant is whether satisfied with the criteria under section 8(1) or not, he or she will either discharge the person from the order or assure the involuntary treatment order. In addition, the authorised headhunter confirm the involuntary treatment order under subsection 2(b), the CTO can be primed(p) on the person under section 14 (Mental Health Act, 1986, s. 12AC). hesitancy 3. (5 marks)Thinking about the forms and component parts and responsibilities of tribe who may be associated with an involuntary admission of a person under the MH Act, what roles could the following concourse have and what forms would they be able to have it away3.1. C arr of a family member who has a mental illnessThe Mental Health Act (1986) suggested that a carer has the authority to make a request to a registered medical practitioner for admitting an involuntary patient. He or she has the responsibility to take or authorizes any person, for example a community obligate, either fetching the person to an approved mental health service or arranging for one to admit the person. The carer is able to complete the implore for Person to Receive voluntary Treatment from an Approved Mental Health Service form under document 1prespribed by the Mental Health Regulations 1998 to the registered medical practitioner employed by an approved mental health service or a mental health practitioner. 3.2. Community Mental Health Nurse In case of the registered medical practitioner is unobtainable for a reasonable consequence of time for making the recommendation, the person may be taken to an approved mental health service for examination after being assessed by an mental health nurse who must(prenominal) complete an Authority to transport without recommendation form under schedule 3 of the Mental Health Regulations 1998 (Mental Health Act, 1986).3.3. General PractitionerThe normal practitioner has the responsibility to make a recommendation in a prescribe form which is Recommendation for a person to receive involuntary treatment form a approved mental health services form following a the persons examination (Mental health Act, 1986, s. 9) (Victoria Government, 2009) 3.4. recorderRegistrar who is a medical practitioner employed by an approved mental health service is responsible for assessing the person according to the request and recommendation. He or she has to make the involuntary treatment order under section 12AA(2) and detain patient for safetry issue according to section 12AA(4) of the Victorian Mental Health Act 1986. The recorder may release that person to await for the shrinks examination if they suspect the criteria in section 8(1) of the Act applying to the person and consulted with the authorised psy chiatrist involving section 12AA(5) (Mental Health Act, 1986, s. 12). The registrar has the authority o complete the following forms record 4 Form 1 Restraint for the purposes of safely transporting a person to an approved mental health serviceSchedule 4 Form 2 Sedation for the purposes of safely transporting a person to an approved mental health service Schedule 6 Involuntary treatment order. (Victoria Government, 2009, Schedules section)3.5. ConsultantA consultant means a authorised psychiatrist who should examine the person as soon as after the registrar making the involuntary treatment order or within 24 hours following the order to confirm the involuntary admission (Mental Health Act, 1986, s. 12AC). If the consultant is whether satisfied with the criteria under section 8(1) or not, he or she will either discharge the person from the order or confirm the involuntary treatment order. In addition, the authorised psychiatrist confirm the involuntary treatment order under subse ction 2(b), the CTO can be position on the person under section 14 (Mental Health Act, 1986, s. 12AC). nether the power of the Mental Health Act 1986 section 12AD, the authorised psychiatrist may give written hold on behalf of the involuntary patient if this patient ref subprograms to necessary treatment or unable to consent to the treatment for his or her mental disorders. The authorised psychiatrist has the authority o complete the following forms MHA1 Examination of involuntary patient by authorised psychiatristMHA3 Examination of security / involuntary / forensic patient by authorised psychiatristMHA4 Treatment planMHA6 Community treatment orderMHA16 send off from involuntary patient status. (Victoria Government, 2009, Mental Health Act Forms section).Question 4. (4 marks) at a time a person has been received under the MH Act under what share can an emergency registrar administer sedation?If the emergency registrar believe that it is essential to sedate the person in o rder to take him or her to the approved mental health service safely. The emergency registrar is also able to direct an authorised person to administer tranquilizing medications to the patient. In addition, they must specify the particulars necessary by the prescribed form and deal with this form according to the regulations (Mental Health Act, 1986, s.10). Question 5. (2 marks)A patient must be seen by a headhunter to confirm admission as an involuntary patient. Once a patient is received what time frame must be observed for the Psychiatric review?The authorised psychiatrist should examine the patient as soon as the involuntary treatment order is made by a medical practitioner employed by the approved mental health service or within 24 hours following the order (Mental Health Act, 1986, s.12AC). Therefore, the patient should be observed in that time frame until he or she being seen by the authorised psychiatrist. Question 6. (4 marks) (section 15 )If a person is dispatch from t he inpatient unit on a Community Treatment Order, what restrictions can be placed on the patient?If the authorised psychiatrist considers that it is appropriate and for the good and wellness of patient, the psychiatrist can discharge him or her from the approved mental health service on CTO. The person who had the community treatment order upon is influenced during the duration of the order which is not over 12 months. The person has to stay where it is specified by the order for the treatment. The order sets out the full term that a person must accept therapy and medication, conselling, management, rehabilitation and other related health services while living in the coummity. The person is provided compulsive care authorised by the CTO. In case of the person breaches the CTO by not complying with the conditions, the person may be taken to a mental health service and given appropriate treatment and care (New sec Wales Government, 2007, what is a community treatment order (CTO)? s ection).Question 7. (4 marks)How often must a Community Treatment Order be reviewed and what is the maximum space of time a Community Treatment Order can be imposed?At least once a month, the supervising psychiatrist or a medical practitioner such as public practitioner will visit you to decide whether the order should continue or not. If the psychiatrist, at the end of three months period, can extend the order for other three months (Government of Western Australia, 2005, what will choke while I am on the order? section).A CTO can be made for period of up to 12 months and ends on the date stated on the order and if no date is stated, it will expire 12 months after the order was made (New South Wales Government, 2007, when does a CTO come to an end?).Question 8. (5 marks)What is a Special strugglerant and what powers does this provide?Special Warrant apply where a member of the police force or any other person has reasonable ground to believe a person who appears mentally ill is unable to care for him or herself due to mental illness. In this case, the member of police force or that other person may give information oath to a magistrate (Mental Health Act, 1986, 11, para. 5) and seek a specific ensure.Under section 12 of The Mental Act (1986), a police forces member who accompanied by a registered medical practitioner is authorised and direct by the magistrate in the form of a special warrant in the prescribed form to visit and examine the person. Additionally, police personnel who act under special warrant with assistance as required have authority to legally enter any premise and use such force as necessary so that the registered medical practitioner can examine that person (Mental Heal Act, 1986, 12).Question 9. (5 marks) (No need to bring up references for these answers)True or False9.1. A patient can be detained in a Private Psychiatric Hospital bed as an involuntary patientFalse. A patient who is under involuntary treatment order can only be det ained in a public funded approved psychiatric hospital.9.2. The Victorian Mental Health Act makes supplying for voluntary patientsFalse. Admission of voluntary patients has been deleted by the amendment of 1995. As a result, they are treated as other voluntary patients and need consent to all treatments provided.9.3. Any patients can be given Electro Convulsive Therapy against their consent.False.Written consent take from the patients to perform electro convulsive therapy. 9.4. Any one who commits violent acts in the tinge Room can be restrainedTrue. A person doing scathe to him or herself ,patients, staffs other surrounding people in the emergency direction will be restrained for safety issue.9.5. An involuntary patient who refuses required surgical treatment can have this imposed upon them by the PsychiatristFalse. For study medical or surgical procedures, the psychiatrist needs consent from the Guardian and Administration Board.9.6. Lobotomy is legal in Victoria.True. In A ustralia, psychosurgery is performed by a select group of neurosurgeons. In Victoria, each individual operating theatre must receive the consent of a Review Board beforehand it may proceed.9.7. Patients who have difficulty with budgeting can have their accounts taken over by the Guardianship boardFalse. The Guardianship board appoint other person who is managing patients account.9.8. Patients can not be kept in solitude for more than than 15 minutesFalse. For the purpose of safety and treatment, the patient can be restrained until he or she settle down.9.9. The Psychiatrist must send a report of all seclusion that has occurred within a 12 month period to the Chief Psychiatrists Office.False.The psychiatrist has to send a report each month.9.10. Electroconvulsive therapy is to a course of not more than 6 treatments given over a period with not more than 7 days elapsing amongst any 2 treatmentsTrue. It is what described in electroconvulsive therapy.Question 10. (10 marks)List 10 of the reasons why a person is not to be considered to have a mental illness and write a apprise paragraph explaining why this is for each of these 10 reasonsAs stated in the Victorian Mental Health Act 1986 under section 8(2), a person is not considered to have mental illness due to the following reasonsThe person expresses or refuses or fails to express a particular semi policy-making opinion or belief (Section 8(2)).In Victoria, the law inhibits discrimination against people because of their actual or assumed political beliefs. (Victorian Equal Opportunity forgiving Rights Commission, 2007, para. 1)The person expresses or refuses or fails to express a particular spectral opinion or belief (Section 8(2)).Freedom of religion and belief is a basic human rights which is protected by a number of planetary treaties and declarations that include article 18(1) of the International Covenant on Civil and policy-making Rights (Australian Human Rights Comission, What is the freedom o f religion and belief? section, para. 1)The person expresses or refuses or fails to express a particular inner reference or sexual orientation (Section 8(2)).In 1973, because the influence of confirmable data and changes in friendly norms on with the development of a political active gay community in the United States, the Board of Directors of the American Psychiatric Association removed(p) homosexuality form the Diagnostic and Statistical Manual of Mental Disorders (DSM). The empirical evidence and professionals norm do not support that homosexuality is a form of mental illness. (Gregory, 2009, Removal from the DSM section, para. 1) The person engages in or refuses or fails to engage in a particular political activity (Section 8(2)). governmental activity refer to a whether a person participate or refuse to take part in a lawful political activity (Victorian Equal Opportunity Human Rights Commission, 2007, What does political beliefs and activities mean? section, para. 1). The person engages in or refuses or fails to engage in a particular religious activity (Section 8(2)).In a major look of Cruz et al. (2010), in the United States, many people use activity as a form of coping with life stresses. Over half of American universe of discourse ranked the religions importance very high in their lives, attent religious activities on a regular basis and pray daily. The person engages in immoral conduct (Section 8(2)).As an example, incest is defined as any sexuality between closely related people unremarkably within an immediate family, which is either illegal or social taboo (Incest, 2009, Definition section, para. 1)The person engages in illegal conduct (Section 8(2)). criminalism is specifically not a medical or psychiatric term, diagnosis, illness, or syndrome. The term refers to a pattern of human behavior or a specific act violating a law (Menaster, 2008, introduction section, para. 1).The person is intellectual disable (Section 8(2)).Intellectual d isability is a developmental disorder which affect almost one per cent of the population, where people have significantly more difficulty than others in understanding concepts and solving difficultys. It is not a mental illness (Government of South Australia, p.1)The person takes drugs or alcohol (Section 8(2)).Alcohol usually refers to drinks such as beer, wine, or spirits containing ethyl alcohol a substance that can cause drunkenness and changes in consciousness, mood, and emotions. Its effects leading to so many accidents, injuries, diseases, and disruptions in the family life of everyday Australians (Australia Government, para. 1). However, alcohol twist around should be consider mental illness.The person has an antisocial personality (Section 8(2)).The person expresses anti-social behaviour includes abusive or noisy neighbors, littering and graffiti (Directgov, para. 1) Question 11. (10 marks)An involuntary patient is found dead in a seclusion style by you? What is a repo rtable cobblers last and what are the responsibilities of the registered nurse?Coroners Act (2008) defined reportable finale is a particular category of death which is investigated by a coroner according to the Act and it is considered reportable if it meets one the following criteriaThe body, the death or the cause of death of the person is founded in Victoria.The person ordinarily stayed in Victoria when death occurs with unnatural, unexpected and resulted from a direct or indirect injury or accident.The death happen during or after following a medical procedure and this was not expected by the registered medical practitioner before the procedures operation.The identity of the death person is not known.The medical practitioner himself or herself has not signed or not likely to sign a death certificate. finale occurred outsite Victoria and the cause is not certified.The death of a person influenced under the Mental Health Act 1986 or under controlled, cared or clench of the Secr etary to the Deparment of Justice or a member of the police force. wipeout of person who is subject to non-custodial supervision order under section 26 of the Crimes (Mental Impairment and unfitness to be Tried) Act 1997 (Coroners Act, 2008).In the context of a patient found is death in a seclusion room, registered nurses division 1 or division 3 (Division 2 nurses are excluded) can verify death since the law do not inhibit them for taking this role. Verify death means competently undertake a clinical assessment of the death body to establish death has occurred (Victoria Government, 2009, p. 1). As guideline in Victoria Government (2004), the dead body should be fed up(p) as little as possible and the nurse is to inform the authorised psychiatrist and next of kin or carer of the death. The States Coroners Office is mean to be contacted for all reportable deaths occurred under the Coroner Act 1985. After copy the clinical record, the registered nurse is able to send the original or any other materials requested to the Coroner. The nursing staffs involved should provide appropriate and fitting support and debriefing to people affected by the death such as family, friends, staffs and those who have witnessed the death (Victoria Government, 2004, procedure to be followed in the event of a reportable death, para. 5). In case of patient died because of violence or suicide, chef psychiatrist needs to be notified on the day of the death and staff involve in the death should conduct a clinical review of the persons treatment and management (Victoria Government, 2004, procedure to be followed in the event of a reportable death, para. 6-9). Question 12. (10 marks)List the axis of rotation contained within the DSM-IV (TR) and provide lucubrate of the focus of each including an example of a diagnosis that might be found on each of the Axis. Axis I Clinical Disorders Other Conditions That May Be a Focus of clinical AttentionAmerican Psychiatric Association (APA) of 2000 stated that Axis I focus on all the conditions and various disorders included in the Classification except for mental retardation and personality disorders. An example of this is schizophrenia.Axis II Personality Disorders Mental RetardationIn a study by APA (2000), Axis II reports personality disorders and mental health retardation and also used for noting big(p) maladaptive personality features and defense mechanisms. Personality disorders and mental retardation are listed in separated axis to ensure consider given to the front end of these two that might otherwise be overlooked when attention is directed to the more usual axis. For instance, borderline personality disorder is included in axis II.Axis III General Medical ConditionsThis one describes general current medical conditions which are potentially related to the understanding or management of individuals mental disorders (American Psychiatric Association, 2000).Axis IV Psychological and environmental ProblemsIn a major study (APA, 2000), Axis IV is identify for reporting psychosocial and environmental problems that are likely to affect the diagnosis, treatment and prospect of mental disorders classified within Axis I and Axis II. A psychosocial and environmental problem is possibly a negative life event, a familiar or other interpersonal stress, lack or poor of social assistance pr personal resources or other problem related to the context where a persons difficulties have certain. In addition, psychosocial is possibly developed as a result of a persons psychopathology or may constitute problems that are considered in the overall management plan (APA, 2010). For instance, problems with indigenous support group.Axis V Global judging of FunctioningAPA (2010) suggested that Axis V is used for reporting the clinicians judgment regarding a persons overall function level. This is helpful for planning treatment and measuring its impacts, also predicting the outcomes. The Global Assessment of Functio ning (GAF) Scale is used as an appropriated choice in order to report the overall functioning of Axis V. In a re await by APA (2010), this scale is rated respectably among psychological, social, occupational functioning and is not use to impairment in functioning because of physical or environmental limitations. For example, GAF = 12 indicate some dangers of hurting self or others (e.g. frequently violent.) or occasional fails to maintain personal hygiene (e.g. smear faeces.) or rough-cut impairment in communication (e.g. largely incoherent or mute) (APA, 2010). Question 13. (30 marks)Search the world wide web for Hildergaurd Peplau and do a search for her publication. Write at least 4 pages about her life, her theoretical frameworks, her publications and her major contri aloneions to Mental Health treat. LifeHildergaurd Peplau was born in Reading, Pennsylvania , and in the course of 1909. She is the second child and middle daughter of immigrant parents who are an peremptory fat her and a dedicated but emotionally remote become preserving in a difficult marriage with the comfort of music and religion, and more acceptable in her time and place by immersing herself in cook and meticulous home making (Callaway, 2002). During childhood, Peplau was a child with intellectual curiosity, but stifled and physically abused by her domineering mother. The occur of ball War I made her family even more difficult along with persecution form their neighbous due to their German immigrant roots Cite.Her chosen nursing travel had little to do with the idea of providing care for sick people. In Reading, she had worked as a bookkeeper, store clerk and payroll clerk while polish courses at a business school and graduating as class valedictorian in 1928. Hildergard Peplau herself did not work in hospital or as private-nursing duty after successfully completing her nursing training. On the other hand, she found and a job as a staff nurse at Vermonts new elite but progressive ly to Bennington College. Callaway (2002) stated that because of her considerable impressive work, the college president decided to suspend admission requirement and admit Peplau for a degree course major in psychology. During World War II, Peplau enlisted into the U.S host Nurse Corps and was posted to a psychiatric hospital in England with the purpose of treating scarred the soldiers and those with battle-fatigue sent back from the front lines (Callaway, 2002). She was unendingly at the center of conflict and usually endured great personal hardship. She realize the nursing diploma, baccalaureate, masters and doctoral degrees and ultimately rose to the top of her profession. dispossessed y, she was disappointed by the lack of vision among co-workers and repeatedly betrayed by professional friends and sabotaged by the nursing leaders. Consequently, she decided to retired in 1974 from the faculty Rudgers University and sadden that all her years effort had seemingly come to naug ht. During the 25 years between the retirement from Rudgers University and her death in 1999, She was awarded no less than nine un get doctorates and was honored by the American Nurses Association with the establishment of the Peplau Hildegard Award, recognizing continuous parcel to the nursing profession (Callaway, 2002, p. 2). In addition, she received both the nursing highest honors that are the Christiane Reimann Prize and the only nurse so recognised within fifty Great Americans designated by Marquis Whos Who in 1997. Within her lifetime, she also earned the celebrity of being acknowledged by the American Academy of nurse as a Living Legend and an unofficial designation recognised by the University of California at Los Angeles as Psychiatric Nurse of the ampere-second. However, her lifes story is not well known in nursing professional.Hildegard Peplaus professional life included6 years of general and private-duty nursing, 7 years as a student and the nurse in charge at the health service at Bennington College, 3 years in the Army Nurse Corps, 5 years at Teachers College of Columbia University, 1 year as a practicing therapist, 20 years as a professor at Rudgers University, and 1 year as Execituve Director and 2 years as President of the American Nurses Association the only person ever to serve in both positions. (Callaway, 2004, p. 6)Theoretical FrameworksPeplau had shown her theoretical framework for psychodynamic nursing in a manuscripts entitled Interpersonal Relations in Nursing which is published in 1952. It defined elements that are person, environment, health and nursing, and discussed about phases of the interpersonal process between nurse and patient. She also revealed variety in nurses role during the course of contact (Landry, 2009).In a recent studies of Alice Landry (2009), phases of the interpersonal process according to Peplaus theory consist of four sequential phase that are orientation, identification, exploitation, and resolution. There are related factors influence the orientation component of the baffle such as personal values, cultures, beliefs, expectations and past related incidents.Role of nurses as described theatrically by Peplau are stranger, teacher, resourse person, counselor, surrogate and leader. Secondary roles come across included technical expert, mediatoe, safety agent, researcher, tutor, and manager of environment. Publicati